Urinary Tract Infection Flashcards
1
Q
Define UTI
A
Infection of the kidney (pyelonephritis), bladder (cystitis), urethra (urethritis) or prostate
gland (prostatitis)
2
Q
What are the causes/risk factors of UTIs?
A
Transurethral ascent of normal colonic organisms • E. coli • Proteus mirabilis • Klebsiella • Enterococci
Risk factors • Female • Sexual activity • Family history • Instrumentation e.g. indwelling catheter • Stones • Strictures
3
Q
What are the symptoms of UTIs?
A
Cystitis • Frequency • Urgency • Dysuria • Haematuria • Suprapubic pain • Smelly cloudy urine
Pyelonephritis • Back/flank pain • Fever • Rigors/chills • Malaise
Prostatitis • Fever • Lower back/perineal pain • Urgency • Hesitancy • Intermittency • Post-micturition dribbling • Poor Stream
Elderly • Malaise • Nocturia • Incontinence • Confusion
4
Q
What are the signs of UTIs?
A
Cystitis
• Fever
• Suprapubic tenderness
• Bladder distension
Pyelonephritis
• Fever
• Loin/flank tenderness
Prostatitis
• Tender, swollen prostate
5
Q
What investigations are carried out for UTIs?
A
• Urine dipstick – blood, protein, leucocytes, nitrites
• Urine MC&S – bacteria, WBC, RBC, growth of >105 colonies/ml (>102 if
symptomatic)
• Renal USS – exclude structural abnormalities in women with recurrent UTIs,
children, men
6
Q
What is the management for UTIs?
A
Antibiotics – 3 day course • Co-trimoxazole • Trimethoprim • Nitrofurantoin • Amoxicillin • Ciprofloxacin • IV gentamicin, cefuroxime or ciprofloxacin in pyelonephritis plus paracetamol
Prevention • High fluid intake • Regular micturition (esp. after sex) • Cranberry juice • Low dose antibiotic therapy in recurrent UTI
7
Q
What are the complications of UTIs?
A
- Renal papillary necrosis
- Renal/perinephric abscess
- Pyonephrosis
- Gram negative septicaemia
