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Nephrology and Urology > Urinary Tract Infection > Flashcards

Urinary Tract Infection Flashcards

1
Q

What is bacteruria?

A

Bacteria in the urine

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2
Q

Bacteria is usually asymptomatic. T/F?

A

True

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3
Q

What is an uncomplicated UTI?

A

A lower UTI with normal structure and neurology

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4
Q

What is a complicated UTI?

A

Upper UTI with systemic signs and symptoms

or catheter associated UTI

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5
Q

What is urosepsis?

A

A complicated UTI where temperature >38 Celsius, heart rate >90, respiratory rate >20, WBC >15 or <4

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6
Q

In what patients does bacteria usually occur?

A 
Preschool age
Affects girls more than boys 
Hospitalised
Catheterised
Diabetic
Anatomical abnormalities
Pregnancy
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7
Q

When should asymptomatic bacteriuria be treated?

A

Preschool children
Pregnancy
Renal transplant
Immunocompromised

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8
Q

What are the clinical features of a UTI?

A 
Suprapubic discomfort
Dysuria
Urgency
Frequency
Cloudy, blood stained, smelly urine
Low grade fever
Sepsis
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9
Q

What are the signs/symptoms of UTI in neonates?

A

Failure to thrive and jaundice

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10
Q

What are the signs/symptoms of UTI in children?

A

Abdominal pain

Vomiting

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11
Q

What are the signs/symptoms of UTI in the elderly?

A

Nocturia
Incontinence
Confusion

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12
Q

What bacteria commonly cause UTI?

A 
E.coli
Klebsiella
Proteus
Pseudomonas
Streptococci
Staphylococci
Anaerobes
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13
Q

In non-pregnant women with suspected UTI should a urine culture be taken?

A

No

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14
Q

Should children and men with suspected UTI have a urine culture taken?

A

Yes

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15
Q

For how long should non-pregnant women with UTI be treated?

A

3-7 days

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16
Q

In pregnant women with suspected UTI should a urine culture be taken?

A

Yes

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17
Q

For how long should pregnant women with UTI be treated?

A

7-10 days

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18
Q

UTI in pregnancy can cause pyelonephritis. T/F?

A

True

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19
Q

How is recurrent UTI be defined?

A

> 2 episodes in 6 months

>3 episodes a year

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20
Q

How can recurrent UTI be avoided?

A

Encourage urge initiate and post-coital boiding
Intravaginal/oral oestrogen
Single post coital antibiotics
Prophylactic antibiotics if simple measures fail. (trimethoprim, nitrofurantoin)

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21
Q

How should suspected complicated UTIs be investigated?

A 
FBC
U&amp;Es
CRP
Urine sample
Blood sample
Renal ultrasound
CT
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22
Q

What complications can result from a catheter?

A 
UTI
Obstruction hydronephrosis
Chronic renal inflammation
Urinary tract stones 
Long term risk of bladder cancer
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23
Q

How can catheter infections be prevented?

A

Catheterise only when necessary
Remove catheters when no longer needed
Removing/replacing catheters if they were causing infection, catheter care and hand hygiene

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24
Q

How should catheter associated UTI be treated?

A

Empirical antibiotics

Catheter removed if not needed or replaced under antibiotic cover

25
What causes acute pyelonephritis?
Upper UTI
26
How can community acquired infections causing acute pyelonephritis be treated?
Co-ampxiclav, ciprofloxacin and trimethoprim
27
How can hospital acquired infections causing acute pyelonephritis be treated?
Broad spectrum antibiotics for 7-14 days +/- radiological/surgical intervention
28
There is positive urine and blood cultures in renal abscess. T/F?
True
29
How can renal abscess become life threatening?
Emphysematous | Pyelonephritis
30
What are the risk factors for perinephritic abscess?
``` Lower tract UTI Anatomical abnormalities Renal calculi Bacteraemia Haematogenous spread ```
31
What are the common causative organisms which can cause perinephritic abscess?
``` e.coli proteus s.aureus streptococci candida ```
32
There are usually positive blood cultures in perinephritic abscess. T/F?
True
33
Perinephritic abscess may require surgical management. T/F?
True
34
Acute bacterial prostatitis is usually spontaneously. T/F?
True
35
What are the symptoms of acute bacterial prostatitis?
``` Fever Perineal/back pain UTI Urinary retention Diffuse oedema Micro abscesses ```
36
What are the likely causative organisms or acute bacterial prostatitis?
E.coli proteus s.aureus N.gonorrhoea
37
What are the possible complications of acute bacterial prostatitis?
``` Prostatic abscess Spontaneous rupture Epidiymitis Pyelonephritis Systemic sepsis ```
38
What investigations should be conducted in acute bacterial prostatitis?
``` Urine culture Blood culture Transcranial ultrasound CT MRI ```
39
What antibiotics should be given for acute bacterial prostatitis?
Ciprofloxacin | Olfoxacin
40
What are the symptoms of chronic prostatitis?
Perineal discomfort Back pain Low grade fever UTI symptoms
41
What are the common causative organisms of chronic prostatitis?
E.coli Proteus Enterococcus S.aureus
42
Chronic prostatitis may follow chlamydia urethritis. T/F?
True
43
Chronic prostatitis is usually asymptomatic. T/F?
True
44
What is epididymitis?
Inflammatory reaction of the epididymis
45
What can cause epididymitis?
Ascending infection from the urethra | Urethral instrumentation
46
What are the symptoms of epididymitis?
``` Pain Fever Swelling Penile discharge Symptoms of UTI/urethritis ```
47
What are the common causative organisms of epididymitis?
``` GBN Enterococci Staphylococci TB Chalmydia N.gonorrhoea ```
48
What is orchitis?
Inflammation of one or both testicles
49
What are the symptoms of orchitis?
Testicular pain and swelling Dysuria Fever Penile discharge
50
What is the common cause of orchitis?
Mumps
51
What are the complications of orchitis?
Testicular infarction | Abscess formation
52
Sexual transmitted bacteria should be ruled out in orchitis. T/F?
True
53
What is Fournier's gangrene?
A form of necrotising fasciitis
54
What are the risk factors for Fournier's gangrene?
UTI Complications of IBD Trauma Recent surgery
55
Fournier's gangrene is usually a mixed infection. T/F?
True
56
How is Fournier's gangrene investigated?
Blood cultures Urine Tissue/pus
57
How is Fournier's gangrene treated?
1st line management alongside broad spectrum antibiotics (pip-tazobactam, gentamicin, metronidazole, clindamycin)
58
What can pyuria with no bacteria indicate?
``` Previous/recent antibiotics Tumour Calculi Urethritis Tuberculosis ```
59
For uncomplicated UTI what antibiotics can be given?
``` Amoxicillin Trimethoprim Nitrofuratoin Pivmecillinam Fosfomycin ```

Nephrology and Urology (13 decks)

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