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RENAL PATHOLOGY > Urinary Tract Infection > Flashcards

Urinary Tract Infection Flashcards

1
Q

What is the typical presentation of UTI?

A

Dysuria

Frequency

Smelly urine

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2
Q

What is the typical presentation of UTI in the very young?

A

Dysuria

Frequency

Smelly urine

Unwell

Failure to thrive

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3
Q

What is the typical presentation of UTI in the very old?

A

Dysuria

Frequency

Smelly urine

Incontinence

Off of feet

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4
Q

The renal blood flow received how much of the cardiac output?

A

20-25%

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5
Q

How does passage occur in the ureters?

A

Continuous flow - no storage

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6
Q

Where do ureters enter the bladder?

A

Angle of bladder

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7
Q

How does the ureteric entrance change as the bladder fills?

A

Increased bladder pressure closes off ureter and stops reflux

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8
Q

What are the bacteriostatic properties of urine?

A

Free flow of urine

Low pH

High osmolarity

High ammonia content

Bacteriostatic prostatic secretions

Anti-bacterial antibodies

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9
Q

What parts of the normal renal tract are not sterile?

A

Terminal urethra

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10
Q

What typical flora is found in the terminal urethra?

A

Skin and gut flora

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11
Q

How do you flush out terminal urethral floral bacteria?

A

Initial voiding before given specimen (mid stream specimen)

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12
Q

What urethral flora is found in MSSU?

A

Diminished but always present urethral flora

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13
Q

How is urethral flora differentiated from pathological flora?

A

Dip slide method >10^5 = infection

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14
Q

At what MSSU culture level is infection assumed?

A

>105

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15
Q

An MSSU culture of 103 → 104 suggests what?

A

Possible infection (50% without symptoms)

Probable with symptoms

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16
Q

An MSSU culture of <103 suggests what?

A

No infection

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17
Q

MSSU is difficult to collect in which patients?

A

Young and Elderly

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18
Q

What microorganisms cause UTI?

A

Gut flora esp E. coli

19
Q

What is the most common route of UTI?

A

Ascending from urethra

20
Q

What is acute pyelonephritis?

A

Acute kidney inflammation due to infection

21
Q

What factors predispose you to UTI?

A

a. Stasis of urine
b. Pushing bacteria up urethra
c. Generalised predisposition

22
Q

What factors can lead to urine stasis?

A

Obstruction

Spinal cord/brain injury (can’t feel bladder)

23
Q

What factors can cause bacteria to be pushed up urethra?

A

Sexual activity in females

Catheterisation

24
Q

Blockage at urethral level will lead to what structural changes?

A

Upper urethral & bladder dilation

Bilateral hydroureter

25
Q

Consistent bilateral hydroureter will lead to what?

A

Bilateral Hydronephrosis

26
Q

Bilateral hydronephrosis will lead to what?

A

Chronic renal failure

27
Q

Blockage of the pelvis on one side will lead to what?

A

Unilateral hydroureter

Unilateral hydronephrosis

28
Q

What are the consequences of obstruction?

A

Proximal dilation

Slowed urine flow → infection

Slowed urine flow → stone formation

29
Q

What is the triad of urinary obstruction?

A

Calculi leading do obstruction

Obstruction leads to infection

Infection leads to more calculi

30
Q

When urinary obstruction presents in children, how is it managed?

A

Always investigate first presentation

Send to surgeons

31
Q

What is the biggest cause of urinary obstruction in children?

A

Vesicoureteric reflux

32
Q

What is vesicoureteric reflux?

A

Biggest cause of obstruction in children

The insertion of the ureter into the bladder has decreased angulation

33
Q

Vesicoureteric reflux leads to what?

A

Vesicoureteric reflux with hydroureter

34
Q

What are the most common causes of obstruction in adults?

A

Men: Benign prostatic hyperplasia

Women: Uterine prolapse

Both: Tumours, calculi

35
Q

How do spinal cord/brain injuries lead to a predisposition towards UTI?

A

Decreased sensation → cant feel when to micturate → urine left in bladder → stasis of urine

36
Q

At what age do UTIs become more common in females?

A

Jump at 15+ (sexually active)

Again at >50

37
Q

How does sexual activity increase the risk of UTI in women?

A

Sexual activity moves lower urethral flora up the tract

38
Q

What factors increase womens’ predisposition to UTI?

A

Short urethra

Lack of prostatic bacteriostatic secretion

Urethra close to rectum

Sexual activity

Pregnancy

39
Q

How does pregnancy increase risk of UTI?

A

Pressure on ureters and bladder

40
Q

Why does Diabetes tend to increase risk of UTI?

A

Glucose in urine

Poor function of WBC

41
Q

Why is there an increase in UTIs in patients over 50?

A

Prostate problems

Uterine prolapse

Tumours

42
Q

What are the acute complications of UTI?

A

Sever sepsis

Septic shock

43
Q

What are the chronic complications of UTI?

A

Chronic damage -> hypertension -> chronic renal failure

Calculi -> Obstruction -> Hydronephrosis -> hypertension -> Chronic renal failure

RENAL PATHOLOGY (16 decks)

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