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Y4 Acute Care > Urinary Tract Infection > Flashcards

Urinary Tract Infection Flashcards

1
Q

What are the different UTI’s? (3 things)

A

Lower UTIs

  1. Cystitis = bladder infection
  2. Prostatits = prostate infection

Upper UTIs

  1. Pyelonephritis = kidney / renal pelvis infection
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2
Q

How are UTI’s classified?

A

Complicated vs Uncomplicated

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3
Q

What is an Uncomplicated UTI?

A

Normal renal structure + function

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4
Q

What is a Complicated UTI?

What are some examples of these complications? (4 things)

A

Structural / functional abn of Genitourinary tract

  1. Obstruction
  2. Stones
  3. Neurogenic bladder
  4. Renal transplant
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5
Q

What are the risk factors of UTIs? (11 things)

A

Bacteria introduction:

  1. Female (shorter urethra for bac to travel up)
  2. Sexual activity
  3. Urinary / faecal incontinence
  4. Constipation

Low urine flow:

  1. Dehydration
  2. Obst urinary tract

Bacteria growth:

  1. Stones
  2. Catheters
  3. Immunosuppression
  4. DM
  5. Pregnancy
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6
Q

What are the CF of Lower UTIs? (6 things)

A
  1. Confusion (elderly)
  2. Suprapubic pain / discomfort
  3. Urgency
  4. Frequency
  5. Dysuria
  6. Incontinence
  7. Swollen / tender prostate @ exam (if prostatitis)
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7
Q

What are the CF of Pyelonephritis (Upper UTI)? (6 things)

A
  1. Fever (more common in Upper UTI than Lower)
  2. Vomiting
  3. Loss of Appetite
  4. Renal angle tenderness @ exam
  5. Loin / Suprapubic / Back pain (bi or unilateral)
  6. Haematuria
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8
Q

What investigations should you do for sus UTIs? (4 things)

A
  1. Dipstick
  2. MSU culture
  3. Blood tests (if systemically unwell)
  4. Imaging
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9
Q

Which sus UTI patients do you treat straight away without doing investigations? (3 things)

A

A women who is:

  1. Not-pregnant
  2. NO vaginal discharge
  3. 3+ Lower UTI symptoms (or 1 severe)
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10
Q

What does a Urine dipstick show in UTI? (2 things)

A
  1. High nitrites
  2. High leukocytes
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11
Q

Why are nitrites high in UTI dipsticks?

A

Gram -ve bac causing UTI (e.g E coli) convert nitrates –> nitrites

(Nitrates = normal waste product of urine)

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12
Q

Why are leukocytes high in UTI dipsticks?

A

Leukocytes = WBC

obv jus high tryna fight da infection nigga

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13
Q

What should you do if you have a positive dipstick (high nitrites + leukocytes)?

A

Send urine to microbiology for confirmation

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14
Q

Which UTI patients should be considered for Imaging + urological assessment? (5 things)

What imaging + urological assessment should they get?

A
  1. Upper UTI
  2. Recurrent UTI (2+ / year)
  3. Persistent haematuria
  4. Unusual organism
  5. X respond to treatment
  • Imaging: US / CT
  • Urological assessments: Cystoscopy
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15
Q

What is the most common organism that causes UTIs?

A

E coli

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16
Q

What are the characteristics of E coli? (4 things)

A
  1. Gram -ve
  2. Anaerobic
  3. Rod-shaped
  4. Found in faeces so easily spreads to bladder
17
Q

What is the FIRST LINE treatment for Lower UTI’s in non-pregnant women?

A

Trimethoprim / Nitrofurantoin (3 day course)

18
Q

How do you manage non-pregnant women with Lower UTIs who don’t respond to Trimethoprim / Nitrofurantoin?

A

Culture urine + treat according to abx sensitivity

19
Q

What is the management of non-pregnant women with UPPER UTIs? (3 things)

A
  1. Take urine culture + start broad spec abx (e.g co-amoxiclav)
  2. Consider hospitalization bc abx resistance risk
  3. Avoid Nitrofurantoin bc doesn’t reach effective conc in blood
20
Q

Why should you get expert help for PREGNANT women with UTIs?

A

UTI in pregnancy assoc w preterm delivery + intrauterine growth restriction

21
Q

What is the FIRST LINE abx for UTIs in PREGANT women?

A

Nitrofurantoin

(but avoid in 3rd trimester bc assoc w haemolytic anaemia in newborn)

22
Q

What abx should be avoided when treating pregnant women w UTIs? (3 things)

A
  1. Ciprofloxacin
  2. Trimethoprim in 1st trimester
  3. Nitrofurantoin in 3rd trimester
23
Q

How do you treat MEN with LOWER UTIs?

A

Trimethoprim / Nitrofurantoin 7 day course (longer than women)

24
Q

What treatment should you consider for MEN with Prostatitis symptoms (pain in: pelvis / genitals / lower back / bum)?

Why?

A

Ciprofloxacin for 4 weeks course

Bc ability to penetrate prostate fluid

25
Q

How should you manage MEN with recurrent / UPPER UTIs?

A

Refer for urological investigation (US / CT / cystoscopy)

26
Q

What does NICE recommend for a patient diagnosed with a catheter related UTI?

A

Change catheter

Y4 Acute Care (31 decks)

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