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Urinary > Urinary Tract Infection > Flashcards

Urinary Tract Infection Flashcards

1
Q

What is a UTI

A

A urinary tract infection (UTI) is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra.

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2
Q

What is infection in the bladder called

A

Cystitis

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3
Q

What is infection of the Kidney called

A

Pyelonephritis

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4
Q

What are 4 general predisposing factors to acquiring UTI

A

Immunosuppresion
Steroids
Malnutrition
Diabetes

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5
Q

What are more specific causes of UTI (x8)

A

Female sex (short urethra)

Sexual intercourse and poor voiding habits

Congenital abnormalities e.g. duplex kidney

Stasis of urine e.g. due to poor bladder emptying

Foreign bodies eg catheters, stones

Oestrogen deficiency in postmenopausal women creates a dry perineum (down below)

Neurological problems
- Multiple sclerosis

Fistula between bladder & bowel

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6
Q

What do you prescribe for Oestrogen deficiency in postmenopausal women

A

Oestrogen cream

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7
Q

What gram negative bacteria can cause UTI

A

E.coli - 70-95%
Proteus miribilis
Klebsiella species

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8
Q

What gram positive bacteria can cause UTI

A

Coagulase negative staphlycocci – 5-20%

-Enterococci

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9
Q

What the most common way bacteria get into the body

A

Transurethral route

Perurethral area contaminated

Recurrent UTIs, diaphragms,
- Urethra to bladder

Intercourse, catheterisation
- Bladder (and up ureters)

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10
Q

What other ways can bacteria get into the body

A

bloodstream

lymphatics

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11
Q

What are the presenting symtpoms of UTI in children

A 
Diarrhoea	
Excessive crying
Fever
Nausea and vomiting
Not eating
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12
Q

What are the presenting symtpoms of UTI in adults

A 
Flank pain
Dysuria (“like passing broken glass”)
Cloudy offensive urine
Urgency
Chills
Strangury
 pass
Confusion (very old people)
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13
Q

How would you describe the pain in UTI

A

Renal angle pain
NOT COLIC
Can be very painful and require opiate treatment

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14
Q

What is Stangury

A
  • Patient complains of little urine passing but still feels like they have lots to pass
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15
Q

What investigations should you carry out for UTI

A

Mid-stream sample of urine.
Urinalysis in ward.
Microbiology in laboratory
Culture and sensitivity

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16
Q

If a child or man has a UTI what further investigations should you do

A

Ultrasound or IVU may be helpful

Isotope studies to rule our reflux and scarring

17
Q

What are indicators of infection in a urine sample

A

Blood
Leucocytes
Protein
Nitrites

18
Q

What is treatment for a normal mild/moderate UTI

A 
Fluids
Antibiotics:
-	Amoxicillin (3-5 day course or 3g x 2), 	
-	Cephalosporin
-	Trimethoprim
19
Q

What is treatment for a severe UTI

A

Intravenous antibiotics

20
Q

What is a long term complication of repeated UTI in an abnormal urinary tract.

A

Chronic pyelonephritis

21
Q

What are the bacteriostatic properties of a normal urinary tract

A

Free flow of urine
Prostatic secretion are bacteriostatic
Anti-bacterial antibodies

22
Q

If you culture a normal MSSU what will you find

A

Urethral flora diminshed but always present

the flora will ALWAYS GROW in culture

23
Q

If a sample has 10^4 bacteria per ml what is the chance of infection

A

50% chance if not symptoms

24
Q

If a sample has 10^5 bacteria per ml what is the chance of infection

A

99/100 is infected

25
Q

If a sample has 10^3 bacteria per ml what is the chance of infection

A

Usually no infection

26
Q

What are causes of obstruction in the urinary system

A

BPH
Uterine prolapse (women)
Tumours
Calculi

27
Q

What is bilateral hydroureternephrosis

A

It involves the dilatation of the renal pelvis, calyces and ureter; it develops secondary to urinary tract obstruction and leads to a build-up of back pressure in the urinary tract, and it may lead to impairment of renal function and ultimately culminate in renal failure

28
Q

What is hydroureter

A

Hydroureter refers to dilation of the ureter(s) and is most often caused by obstruction of urine outflow due to blockage of the ureter(s) by calculi, chronic inflammation, luminal or intramural neoplasia, or accidental ligation during surgery.

Urinary (13 decks)

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