Urinary Tract Infection Flashcards

1
Q

def in men

A

inflammatory reaction of urinary tract epithelium in response to pathogens (commonly bacteria)

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2
Q

how is UTI confirmed in men

A

symptomatic male demonstrates growth of a significant amount of organism

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3
Q

epi

A

very common in elderly

females>males

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4
Q

what is the most common cause of UTI in men and women

A

E.coli

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5
Q

aetiology in men

A

pathogens enter the urinary tract by ascending the urethra, indwelling catheters are often implicated
E.coli (most common)
Gram negative bacteria (klebsiella) + positive
enterococcus, staphylococcus, psuedomonas (hospital)

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6
Q

what disrupts the balance between host defence mechanisms and virulence of pathogens

A

immunodeficiency (HIV)

urine flow which normally washes out pathogens is disrupted (prostate disorders, renal stones)

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7
Q

who are complicated UTIs associated with

A

males

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8
Q

what are complicated UTIs

A

UTI with presence of factors which hinder efficacy

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9
Q

risk factors in men

A

benign prostatic hypertrophy
urinary tract stones
catheterisation
age

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10
Q

history in men

A

dysuria (difficult or painful urination)
increased urgency and frequency
suprapubic pain

hesitancy and nocturia is associated with BPH

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11
Q

examination in men

A

none

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12
Q

investigations in men

A
1 dipstick urinalysis
-positive leukocyte esterase +/ nitrate
2 urine microscopy + culture
-identifies leukocytes + bacteria
->10^2 colony-forming units indicates UTI in symptomatic men
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13
Q

a 59y/o man complains of urinary frequency, urgency and dysuria for several days/ NO haematuria or penile discharge but does have 3 episodes of nocturia most nights. PMH includes benign prostatic hyperplasia.

A

UTI

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14
Q

management of UTI in men

A

if asymptomatic or mild symptomatic
-oral antibiotic therapy with levofloxacin or ciprofloxacin
if symptomatic and severe
-IV antibiotics with levofloxacin or ciprofloxacin

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15
Q

complications in men

A

prostatitis

pyelonephritis

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16
Q

prognosis in men

A

prognosis decreases with age

17
Q

def in women

A

infection of the kidneys, bladder, urethra

18
Q

what is the most common type of UTI in women

A

infectious cystitis (bacterial infection of the bladder)

19
Q

aetiology in women

A

commonly uncomplicated cases
1 e.coli (most common)
2 staphylococcus saprophyticus

20
Q

what are uncomplicated UTIs

A

acute cystitis

21
Q

risk factors in women

A

sexual activity (strongest factor)
spermicide use
post-menopause
FHx

22
Q

history in women

A

dysuria, frequency, haematuria, back pain

patient may complain of urgency or supra-pubic pain and tenderness

23
Q

examination in women

A

costovertebral angle tenderness (pain on percussion of the area on the back)

24
Q

investigations in women

A

1 urine dipstick
-positive nitrate and leukocyte esterase
2 urine microscopy, culture + sensitivity
-bacteria, WBCs, possibly RBCs
-<10^5 colony-forming units per ml and pyuria is present (>20WBC/mm3) or symptomatic

25
what is the most specific and sensitive test for UTI in women
urine culture + sensitivity
26
A 27y/o healthy, sexually active woman presents with pain on urination and recent onset of urinary frequency and urgency
UTI
27
management of uncomplicated UTI in women (cystitis)
nitrofurantoin or trimethoprim if resistance ciprofloxacin or levofloxacin
28
management of complicated UTI in women (pylonephritis)
oral ciprofloxacin or levofloxacin
29
management for recurrent UTIs in women
post-coital antibiotics (nitrofurantoin) in pre-menopausal women plus intra-vaginal oestrogen therapy (eastradiol vaginal)
30
prognosis in women
good