Urinary Tract Infection (UTI)

Question 1

What are the causes of UTIs?

Answer 1

Proximity to anus
E. Coli
Pregnancy
Catheters
Kidney stones
Enlarged prostate
Constipation (kids)
Familial link
Urinary tract abnormality
Weakened immune system

Question 2

Why may enlarged prostate cause UTI?

Answer 2

Blockage of urinary flow = bacteria stuck

Question 3

Why may constipation cause UTI?

Answer 3

Faecal loading puts pressure on bladder = urinary flow impaired

Question 4

What are symptoms of infection?

Answer 4

Increased urgency
Increased frequency
Cloudy urine
Dysuria
New nocturia
Systemically unwell = fever
Suprapubic pain

Question 5

How do you do a test?

Answer 5

Dipstick
OR mid stream culture

Question 6

What does it mean if leucocytes are present?

Answer 6

Bacteria

Question 7

What does it mean if nitrites are present?

Answer 7

Bacteria

Question 8

What does it mean if bilirubin is present?

Answer 8

Liver disease

Question 9

What does it mean if proteins are present?

Answer 9

Damage to glomerulus

Question 10

What does it mean if blood is present?

Answer 10

Infection
Tumour
Trauma

Question 11

What does it mean if glucose is present?

Answer 11

Diabetes

Question 12

What can be used as self-care?

Answer 12

Water
Paracetamol
Ibuprofen

Question 13

What is the 1st line empirical antibiotic?

Answer 13

Nitrofurantoin 100mg BD 3 days
OR
Trimethoprim 200mg BD 3 days

Question 14

What is different for men for 1st line treatment?

Answer 14

Take for 7 days
= indicates something

Question 15

When must you come back after treatment?
Symptoms

Answer 15

Shivering, chills + muscle pain
Confused
Smelly urine
N+V
Visible blood
Temperature above 38 OR below 36
Kidney pain in back
Symptoms worsen
Symptoms don’t improve after 48hrs

Question 16

How do you prevent UTIs?

Answer 16

Wipe from front to back
Don’t wait to pass urine
Urinate after sex
Drink enough fluids
Avoid occlusive underwear

Question 17

What happens with recurrent UTIs?
(2 episodes over 6 months or >3 infections/year)

Answer 17

Patient initiated self-treatment
Post-coital prophylaxis
Continuous prophylaxis

Question 18

What happens in patient initiated self-treatment ?

Answer 18

Give antibiotics in advance
= have symptoms = take

Question 19

What happens in post-coital prophylaxis ?

Answer 19

Antibiotics/weeing after sex

Question 20

What happens in continuous prophylaxis?

Answer 20

Long term antibiotics
BUT antibiotic resistance

Question 21

What is the first choice for prophylaxis?

Answer 21

Trimethoprim
OR Nitrofurantoin

Question 22

What is the 2nd choice for prophylaxis?

Answer 22

Amoxicillin
OR Cefalexin

Question 23

What are the treatment group considerations?

Answer 23

Pregnant
Male
Obese
Elderly
Children

Question 24

What happens in pregnancy if present of bacteria but no symptoms?

Answer 24

Still treat

Question 25

What is 1st line for UTI in pregnancy?

Answer 25

Nitrofurantoin 100mg BD for 7 days

Question 26

What is the 2nd line for pregnancy UTI?

Answer 26

Amoxicillin 500mg TDS 7 days
OR Cefalexin 500mg BD 7 days

Question 27

What do you do with people with catheters?

Answer 27

Check for blockages
Remove or change
Need 7 day course

Question 28

What is the treatment of acute pyelonephritis or upper UTI children older than 3 months?

Answer 28

Cefalexin
OR Co-amoxiclav

Question 29

What is the treatment of lower UTI in children older than 3 month?

Answer 29

Trimethoprim
OR Nitrofurantoin, Amoxicillin or Cefalexin

Question 30

What are indicators of severe illness from UTI in children?

Answer 30

Temperature
RR
HR
Capillary refill time
Effort breathing
Colour of skin, lips + tongue
Appearance of mucous membranes