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CP > Urinary tract infection > Flashcards

Urinary tract infection Flashcards

1
Q

What is classed as the UPPER urinary tract?

A

above the bladder - kidneys and ureters

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2
Q

What is classed as the LOWER urinary tract?

A

bladder and below - bladder, urethra, prostate (men)

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3
Q

What parts of the urinary tract are sterile?

A

kidneys
ureters
bladder

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4
Q

What part of the urinary tract normal contains flora and of what type?

A

urethra

perineal flora - skin/lower GI tract flora

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5
Q

What does skin flora predominantly contain?

A

coagulase negative staphylcocci

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6
Q

What does lower GI flora contain?

A

anaerobic bacteria
aerobic bacteria - enterobacteriaceae i.e. enteric gram negative nacilli, coliforms
gram positove cocci - enterococcus spp

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7
Q

What are the symptoms of cystitis?

A 
Dysuria - painful or difficult urination
urinary frequency
urgency
surpr-pubic pain/tenderness
polyuria
nocturia
haematuria - if severe
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8
Q

What infections are classed as LOWER urinary tract infections?

A

cystitis

urethral syndrome

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9
Q

What are the symptoms of pyelonephritis?

A 
symptoms of the lower UTI
loin/abdominal pain & tenderness
fever
rigors
nausea
vomiting
diarrhoea
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10
Q

What infections are classed as UPPER urinary tract infections?

A

Pyelonephritis

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11
Q

What is urethral syndrome?

A

abacterial cystitis
frequency-dysuria syndome
mostly affects 30-50 year old women
symptoms of lower UTI without infection e.g. allergy, hormones

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12
Q

What is classed as ‘significant’ bacteriuria?

A

10(5) cfu/mL

signifies infection

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13
Q

What are the limitations of ‘significant’ bacteria?

A

Bacterial count is on a normal curve (see next slide)
Many symptomatic females have bacterial counts of less than 10(5)
Males significant bacteria is around 10(3)
Not applicable in catheter urine/sterile aspiration

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14
Q

What is asymptomatic bacteriuria?

A

significant bacteria count but no symptoms of UTI

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15
Q

What is sterile pyuria and what can it signify?

A

pus cells in urine (high numbers of WBC) but no organisms grown in cultures
can signify: inflammation, trauma, polycystic kidney disease

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16
Q

What are the risk factors for acquiring a UTI?

A 
female
urinary stasis e.g. Pregnancy, prostatic hypertrophy, stones, strictures, neoplasia, residual urine
instrumentation e.g. cystoscopy 
sexual intercourse
fistulae
congenital abnormalities
17
Q

What are potential sources of infection?

A

perineum - movement of bacteria along the lumen
fistulae - bacteria from genital/GI to urinary tract
haematogenous - seeding of infection from the blood (rare)

18
Q

What is the main organism to cause a UTI?

A

E. coli

19
Q

What are the causes of sterile pyuria?

A

inhibition of bacterial growth i.e. unprescribed antibiotics
fastidious (hard to grow) organisms
urinary tract inflammation

20
Q

Explain how a catheter can cause a UTI

A

long term causes bacteria in the urine
need to distinguish between colonisation and infection
catheter removal can also cause bacteria in the urine
antibiotic prophylaxis may be used

21
Q

What investigations can be performed for a suspected UTI?

A

dipstick test
blood tests
microbiology
imaging

22
Q

What are the important things to look for on the dipstick for suspected UTI’s?

A

Blood
Protein
Nitrite
White blood cells

23
Q

In what circumstance does dipstick testing have no diagnostic value?

A

in patients with indwelling urinary catheters unless these have been placed very recently

24
Q

When should you do a blood test for a UTI?

A

Suspected pyelonephritis

25
Q

Describe what and how the urine sample should be taken for susupected UTI?

A

mid stream - transported in boric acid to preserve
clean catch
Otherwise: catheter urine, surpa-pubic aspirate

26
Q

What test should be performed for suspected urinary TB?

A

early morning urine
3 samples
whole content of the bladder

27
Q

What are the 2 main antibiotics given for UTI’s?

A

nitrofurantoin

Trimethoprim

28
Q

What antibiotics are used to treat pyleonephritis and what is its duration?

A

both given IV
cefuroxime
ciprofloxacin
7-14 days

29
Q

what groups of people do you treat that have asymptomatic bacteriuria?

A

pregnant
infant
prior to urological procedures

CP (50 decks)

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