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Year 3 > Urinary Tract infection > Flashcards

Urinary Tract infection Flashcards

1
Q

What is a lower UTI?

A

A urinary tract infection (UTI) is an infection of the kidneys, bladder, or urethra

Lower UTI= bladder and urethra

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2
Q

What is an upper UTI?

A

A urinary tract infection (UTI) is an infection of the kidneys, bladder, or urethra

Upper= Involvements of ureters and kidney

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3
Q

What are risk factors for UTIs?

A
  • Female Sex
  • Sexual activity
  • Immunosuppressant therapy
  • spermicide use
  • Family/ PMHX of UTI
  • post-menopause
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4
Q

What is classified as an uncomplicated UTI?

A

acute cystitis occurring in otherwise healthy, non-pregnant women without functional or anatomical urinary tract abnormalities.

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5
Q

What is a complicated UTI?

A

nfections in patients with functional or structural impairments that reduce the efficacy of antimicrobial therapy

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6
Q

What is the most common cause for UTIs in women?

A

Normally ascending UTI with eventual vaginal infection first

  • Most uncomplicated UTIs due to E-coli
  • Many others can cause complicated UTIs
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7
Q

What is the Epidemiology of UTIs in women?

A

50-60% of lifetime incidence

  • increases with age (over 65)
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8
Q

What is the epidemiology of UTIs in men?

A

About 13%

  • increases with Age
  • mostly complicated UTIs
  • 80% secondary to catheters
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9
Q

What are the causes of UTIs in men?

A

Also majority E-Coli

  • bur more prone to complicated UTIs
  • In men normally complicated: anatomical or function abnormalities
    • prostate disorders, immunosupressant etc.
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10
Q

What are presenting symptoms of an UTI in men and women?

A
  • fever (systemic involvement)
  • cloudy looking urine
  • dysuria
  • new nocturia + increased urine frequency
  • risk factors
  • urgency
  • haematuria
  • suprapubic pain/tenderness (Lower UTI)
  • flank and costo-vertebra angle tenderness (Upper UTI)
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11
Q

What are signs of a UTI?

A
  • Fever
  • Cloudy-looking urine/ smelly urine
    *
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12
Q

Which investigations would you do in a woman with an UTI (upper +. lower)

A

Both

  • urine dipstick
  • urine culture and sentsitivity

further to be considered

  • Renal ultrasound (to rule out urinary tract obstruction) (e.g. kidney stone; hydronephrosis; renal abscess; renal scarring)
  • * non-routine: urine micoscropy
  • post-void residual (if no full emptiing of bladder –> might cause recurrent UTI)
  • Abdo/Pelvic CT (rule out stones, renal abscess)
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13
Q

What could you find in a Urine Dipstic from a Patient with UTI?

A
  • Leukocytes
  • Nitrites (nitrates are converted to nitrites by bacteria)
  • Protein (if renal involvement)
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14
Q

What are the first line investigations for a UTI in men?

A
  1. Urine dipstick
  2. urinary micoscopy
  3. Urine culture
  4. Gram stain
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15
Q

How is a urine culture perfomed? What is being investigated?

A

Send a midstream, clean-catch urine specimen for culture (before giving antibiotics) if the patient:

(high risk of contamination in women)

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16
Q

What are possible differentials for a UTI?

A
  • over-active bladder
  • Carcinomas
  • non-infectious urethritis
  • Foreign body in bladder
17
Q

How is an UTI managed?

A
  1. Exclude Sepsis
  2. Consider ABX (send of urine culture before)
    1. Nitrofurantoin
    2. Trimethoprim if low risk of resistance (normally for 3 days)
  3. If not better within 48hrs
    1. Urine culture and ABX change
18
Q

What are possible complications from an UTI?

A

Generally in women low, in men higher

  • sepsis
  • renal and peri-renal abscesses
  • AKI

In Men

  • renal function impariment
  • prostatisis
  • polynephritis
19
Q

What is the prognosis for patients with UTIs?

A

Yound men

  • generally good prognosis

Oler men

  • higher likelyhood of complicated infections

Women

  • generally very good
20
Q

When would you consider referral for a UTI?

A

In women

  • if upper UTI with systemic symptoms –> consider referral for IV ABX
  • in men be more suspicious
21
Q

What is another name for an upper UTI?

A

Pyelonepthritis (if up the the pyleon of the kidney)

22
Q

What is the clinical presentation of someone with an pyleonephritis?

A

Back pain

  • fever
  • nausea
  • vomiting

Year 3 (52 decks)

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