Urinary tract infection

Question 1

What’s cystitis & its symptoms?

Answer 1

Inflammation in the bladder
= Dysuria (pain in urination)
= constant feeling of Urgency to urinate
= Frequently urinating
= Suprapubic (lower ab) pain

Question 2

What’s pyelonephritis & its symptoms?

Answer 2

Inflammation in kidneys
= DUFS in cystitis
= Flank (kidney area) pain
= back ache
= Fever = Rigors (shaking, chills)

Question 3

What does a large no. (++ or +++) of epithelial cells in urine specimen indicate?

Answer 3

indicates badly collected specimen bc vaginal/urethral contamination

Question 4

List 4 types of organisms would you expect to be in a first void urine. (4-6)

Answer 4

distal urethra NF

• Coag. neg. staph.: S. epidermis, S. sarophiticus
• Enterococcus faecalis
• a haemolytic streptococci
• enteric bacteria
• corynebacteria

Question 5

Using calibrated loop method, How many colonies equate to > 10^8 cfu/L?

Answer 5

> 200 colonies

Question 6

List 2 methods in lab to determine urine colony count

Answer 6

1. Filter paper foot

2. Calibrated loop

Question 7

List 2 parasites (Genus specie) that may be detected in urine (3) and briefly what they/eggs look like

Answer 7

• Trichomonas vaginalis: looks like an egg w/ multiple flagella @ one end
• Schistosoma haematobium: egg w/ spine
• Enterobius vermicularis: eggs look like a drawing of a mitochondrion

Question 8

What does uric acid crystals in urine indicate?

Answer 8

• diet: consumption of Hi/moderate [ ] of purines (metabolised => uric acid)
• gout
• person have leukaemia or lymphoma & be on chemotherapy

Question 9

What does yeast in urine indicate?

Answer 9

• poorly collected specimen

- genital infection

Question 10

What does calcium oxalate crystals in urine indicate?

Answer 10

diet: consumption oxalate-rich food

Question 11

What is anatomical ease (in terms of UTI)?

Answer 11

hospital problem in females : introducing rectal flora in genital area as a result of wiping from butt ->up after a patient urinates lying down

Question 12

What white cell count (WCC) would normally be associated with UTI?

Answer 12

> 100 x 10^6 WBC/L

Question 13

What does Nitrite in urine indicate?

Answer 13

presence of Enterobacteriaceae - reduces nitrate -> nitrite

Question 14

List 4-5 female risk factors for UTI

Answer 14

• shorter urehtra = easy access from distal urethra
• Proximity of anus to urethra
• During pregnancy: foetus may put pressure on ureters = blocks/stops flow of urine in bladder = decrease frequency of urinatio- In pregnancy
• pregnancy= increases [glucose in urine] = nutrients for bacteria to grow in urethra
• anatomical ease

Question 15

What is a peadiatric bag? and list 3 potential problems of it

Answer 15

a bag w/ a sticky surface on the opening used to collect urine from children (stick bag to genital area & wait)

• (long) delays in processing = overgrowth = hard to detect initial no.
• difficult to avoid NF contamination e.g. NF of skin washes into urine bc child is moving
• prone to faecal contamination

Question 16

A patient suspected of UTI is asked to provide mid-stream urine, a) why? and b) name 2 possible pathogens responsible (Genus species)

Answer 16

a) bc to avoid the NF in the distal urethra (in the 1st void)
b) Escherichia coil & Enterobacteriaceae

Question 17

Which bacteria are responsible for UTI?

Answer 17

• E. coli
• K. pneumonia
• Proteus vulgaris, P. mirabilis
• Pseudomonas aeruginosa
• S. saprophiticus
• Enterococcus faecialis