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8. Urology (Medical Knowledge) > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

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USMLE® Step 1 flashcards
1
Q

What are different types of urinary tract infections?

A
  • Kidney
    • Acute pyelonephritis
    • Chronic pyelonephritis
  • Bladder
    • Cystitis
  • Urethra
    • Urethritis
  • Prostate
    • Prostatitis
  • Epididymis/testis
    • Epididymo-orchitis
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2
Q

What is a kidney infection called?

A
  • Acute pyelonephritis
  • Chronic pyelonephritis
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3
Q

What is a bladder infection called?

A
  • Cystitis
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4
Q

What is a urethral infection called?

A
  • Urethritis
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5
Q

What is a prostate infection called?

A
  • Prostatitis
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6
Q

What is a epididymis/testis infection called?

A
  • Epididymo-orchitis
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7
Q

What is the M:F ratio of urinary tract infections?

A

1:3

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8
Q

What is the most common hospital acquired infection?

A

Urinary tract infection

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9
Q

What are some predisposing factors for a urinary tract infection?

A
  • Immunosuppression
  • Steroids
  • Malnutrition
  • Diabetes

Specific to urinary tract:

  • Female sex (short urethra)
  • Sexual intercourse and poor voiding habits
  • Congenital abnormalities
    • Such as duplex kidney
  • Stasis of urine
    • Such as due to poor bladder emptying
  • Foreign bodies
    • Such as catheters, stones
  • Oestrogen deficiency in postmenopausal woman
  • Fistula between bladder and bowel
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10
Q

What bacteria commonly causes urinary tract infections?

A
  • E coli
  • Proteus
  • Klebsiella
  • Enterococcus
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11
Q

What form of transfer occurs for urinary tract infections?

A
  • Transurethral route
    • Periurethral area contaminated
    • Urethra to bladder
    • Bladder (and up ureter)
  • Bloodstream
  • Lymphatics
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12
Q

Describe the natural history of urinary tract infections?

A
  • Single episode 90% of time
  • Complicated vs uncomplicated
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13
Q

What is the clinical presentation of urinary tract infections in children?

A
  • Diarrhoea
  • Excessive crying
  • Fever
  • Nausea and vomiting
  • Not eating
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14
Q

What is the clinical presentation of urinary tract infections in adults?

A
  • Flank pain
  • Dysuria (like passing broken glass)
  • Cloudy offensive urine
  • Urgency
  • Chills
  • Strangury
  • Confusion (very old people)
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15
Q

What are the clinical features of acute pyelonephritis?

A
  • Pyrexia
  • Poor localisation
  • Loin tenderness (renal angle)
  • Signs of dehydration
  • Turbid urine
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16
Q

What investigations are done for acute pyelonephritis?

A
  • Mid-stream sample of urine
  • Urinalysis in ward
    • Blood
    • Leucocytes
    • Protein
    • Nitrates
  • Microbiology in laboratory
    • Microscopy and gram staining
    • Bacteriuria > 105 CFU/ml
    • Culture and sensitivity
17
Q

What additional investigations are done for acute pyelonephritis in children, men or when UTIs are frequent?

A
  • USS or IVU may be helpful
  • Isotope studies to rule out reflux and scarring
18
Q

What are the principles for management of urinary tract infections?

A
  • Identify the infecting organism and institute appropriate treatment
  • Identify predisposing factors and treat if possible
19
Q

What is the treatment of urinary tract infections?

A
  • Fluids
  • Antibiotics
    • Amoxicillin
    • Cephalosporin
    • Trimethoprim
    • IV antibiotics for severe infections
20
Q

What are examples of abnormal urinary tracts?

A

Includes:

  • Anatomical/neurological abnormalities
  • Stones
  • Diabetes

All may cause infections and sometimes lead to renal impairment

21
Q

Do repeated UTIs result in renal damage?

A

Even repeated/persistent UTIs rarely result in renal damage

22
Q

How do UTIs in children lead to renal damage?

A

UTIs in children, damage is caused by reflux and infection

23
Q

What investigations are done for UTIs in children?

A
  • Micturating cystogram
  • Assess progression by USS and biochemistry
24
Q

What is the treatment for UTIs in children?

A

Surgery

25
Q

What advice is given to avoid recurrent UTIs?

A
  • Fluid intake 2L/day
  • Void every 2-3 hours by day
  • Void before bedtime and before and after intercourse
26
Q

What is indwelling urinary catheter?

A

Is a catheter that is left in your bladder

27
Q

What is inevitable with an indwelling urinary catheter?

A

Aseptic technique but colonisation is inevitable

Antibiotics only if patient is symptomatic:

  • Replace catheter
28
Q

When does bacteriuria occur?

A

When >= 105

But depends on clinical symptoms

29
Q

How is chronic pyelonephritis diagnosed?

A

Radiological diagnosis

30
Q

What is the clinical presentation of chronic pyelonephritis?

A
  • Scarring and clubbing
  • Hypertension/CRF
  • Reflex
31
Q

What percentage of chronic pyelonephritis leads to renal failure?

A

15%

8. Urology (Medical Knowledge) (17 decks)

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