Urinary Tract Infection Flashcards
What is the common presentation of UTI?
Dysuria
Increased frequency
Smelly urine
What is dysuria?
Pain when peeing
What does urine output change with?
Oral intake of fluids
Do the ureters store urine?
No
How do the ureters enter the bladder?
Enter at an angle
How do the ureters stop urine reflux?
Increasing pressure from the bladder as it fills closes off ureters and stops reflux of urine
Is the whole urinary tract sterile?
Yes
Except from the terminal urethra
Why are urinated specimens always contaminated?
Contaminated by terminal urethral flora
Describe the contamination of an initial urine specimen?
Always heavily contmainated
What type of urine sample do we want to collect for UTI testing?
MSSU
What is MSSU?
Mis stream specimen of urine
Patients void and stop mid-stream
Discarding urine then collecting next volume of urine
Is urethral flora present in MSSU?
Yes but it is always diminished
Is there such thing as a negative result for MSSU?
No
How do you tell a contaminated specimen from an infected specimen?
10 to power of 5
99% of time is infection
What is UTI probability of 10 to power of 3 or 4 in urine culture?
Probably infection if symptomatic
50% chance of infection if asymptomatic
What is the UTI probability of <10 to power of 3?
Usually no infection
Is viral infection common in UTI?
No rare
What are the main bacteria causatives of UTI?
Gut flora especially E.coli
Where does infection urually spread in TUI?
Usually ascending
Infection moves upwards
What is inflammation in the urethra?
Urethritis
What is cystitis?
Inflammation in the bladder
What is ureteritis?
Inflammation in the ureters
What is acute pyelonephritis?
Acute Kidney inflammation
What are the predisposing factors of a UTI?
Stasis of urine
Pushing bacteria up urethra from below
Generalised predisposition to infection
What are the common causes of urine stasis?
Obstruction
Loss of feeling of full bladder
What is the knock on effect of bilateral ureter obstruction?
Bilateral hydroureter
Bilateral hydronephrosis
Can lead to chronic renal failure
What is the effect of unilateral ureter obstruction?
Unilateral hydroureter
Unilateral hydronephrosis
What investigations are used to pin point ureter obstruction?
USS
CT
MRI
What is the triad that obstruction causes with UTI?
Obstruction
Infection
Increased calculous formation
More infections
What is the most important cause of obstruction in children?
Vesicoureteric reflux
What is vesicouretic reflux?
Decreased angulation of ureter at entering of the bladder
What is the management of children presenting with renal tract obstruction?
Always investigate and send to paediatric surgeons
What are the common causes of obstruction in men?
Benign prostatic hyperplasia
What are the common causes of obstruction in females?
Uterine prolapse
What are the common causes of obstruction in both sexes?
Tumours
Calculi
What is the effect of a loss of feeling of a full bladder?
Decreased sensation
No sense of when to micturate
Do not empty bladder completely
Stasis of urine
What is the most common cause of pushing bacteria up the urethra from below?
Sexual activity in females