urinary tract infection

Question 1

define a UTI?

Answer 1

: the presence of a pure growth of > 105 organisms per mL of fresh MSU

Question 2

what are the subclassifications of a UTI?

Answer 2

o Lower UTI - affecting the urethra (urethritis), bladder (cystitis) or prostate (prostatitis)
o Upper UTI - pyelonephritis
o Uncomplicated UTI
o Complicated UTI

Question 3

what organism most commonly causes UTIs?

Answer 3

Escherichia coli

Question 4

what are the risk factors of getting a UTI?

Answer 4

o	FEMALE  
o	Sexual intercourse  
o	Exposure to spermicide  
o	Pregnancy  
o	Menopause  
o	Immunosuppression 
o	Catheterisation  
o	Urinary tract obstruction  
o	Urinary tract malformation

Question 5

epidemiology of UTIs?

Answer 5

much more common in men

Question 6

symptoms of an uncomplicated UTI?

Answer 6

o	Frequency  
o	Urgency 
o	Dysuria 
o	Offensive smelling urine 
o	Low grade fever 
o	Haematuria 
o	Suprapubic pain

Question 7

symptoms of prostatic?

Answer 7

o Flu-like symptoms
o Low backache
o Swollen or tender prostate on PR

Question 8

symptoms of acute pyelonephritis?

Answer 8

o High fever
o Rigors
o Vomiting
o Loin pain and tenderness

Question 9

best initial investigation?

Answer 9

• Urine Dipstick

o Positive leucocyte and nitrites

Question 10

when should urine culture be sent?

Answer 10

o To be sent if
o Age>65
o Visible or non-visible haematuria

Question 11

how to manage an uncomplicated UTI?

Answer 11

• Empirical treatment of TRIMETHOPRIN or NITROFURANTOIN for 3-6 days

Question 12

alternative antibiotics?

Answer 12

Co-amoxiclav or Cefalexin

Question 13

how to treat pyelonephritis?

Answer 13

• Hospital admission should be considered

* cephalosporin or quinolone for 10-14 days

Question 14

complications of UTI?

Answer 14

•	Ascending infection can lead to: 
o	Pyelonephritis  
o	Perinephric and intrarenal abscess  
o	Hydronephrosis or pyonephrosis  
o	AKI 
o	Sepsis