Urinary tract infections Flashcards
What group experience confusion in a UTI
Elderly
Presentation of lower UTI
- dysuria
- polyuria
- urgency
- cloudy smelly urine
- haematuria
Pain location in lower UTI
Suprapubic
Pain location & radiation in upper UTI
- loin, suprapubic (uni/bilateral)
- radiates to back
Renal angle tenderness is seen in what UTI
Upper
Presentation of upper UTI
- fever (more important than in LUTI)
- vomiting
- loss of appetite
- haematuria
What type of infection increases the risk of pyelonephritis
Haematogenous
Failure of what orifice increases the risk of pyelonephritis
Vesicouretral
Commonest 2 bac that cause UTI
- E Coli
- enterobacteria
In a UTI why is there nitrites present in a dipstick
Gram -ve (E. coli) breaks down nitrates
Why are leukocytes raised in UTI
Inflammation
Microscopy culture is sourced from
MSU
HCG is taken to check for
Ectopic pregnancy
Nitrites vs leukocytes for UTI diagnosis
Nitrites better —> more specific
RFs
- females
- urinary catheters
- stones/stasis
- pregnancy
1st line med for UTI that is also preferred in pregnancy
Oral nitrofurantoin
Contraindications for oral nitrofurantoin
- giving birth
- G6PD deficiency
- elderly + CKD
1st line med for UTI that is contraindicated in pregnancy
Oral trimethoprim
Why is oral trimethoprim avoided in 1st trimester
Anti-folate effect
Creatinine rise can be seen in what Abx
Oral trimethoprim
2nd line meds for UTI
- pivmecillinam
- amoxicillin
- cefalexin
Duration of Abx in simple LUTI women
3 days
Duration of Abx in women who are immunocompromised/abnormal kidney function
5-10 days
Duration of Abs in men, preggo, CRUTI
7 days
4 Abx options for pyelonephritis
- cefalexin
- co-amoxiclav
- trimethoprim
- ciprofloxacin
