Urinary Tract Infections

Question 1

Bacteruria definition

Answer 1

Bacteria in urine. Present in all Urinary Tract Infections

Question 2

Pyuria

Answer 2

White blood cells in urine

Question 3

Significant bacteruria

Answer 3

10^5 bacteria in urine

Question 4

Dysuria

Answer 4

Burning on urination

Question 5

Lower Urinary Tract Infection

Answer 5

self explanatory

Question 6

Urethritis

Answer 6

Inflammation of the urethra

Question 7

pyelonephritis

Answer 7

renal pelvis/ kidney infection

Question 8

Acute Urethral syndrome

Answer 8

frequent urination

Question 9

Classic cystitis ( bacteria count over 10^5) accounts for what percentage of cases of dysuria

Answer 9

50%

Question 10

UTIs are the most common bacterial infection

Answer 10

true

Question 11

most common causative organism?

Answer 11

E.Coli

Question 12

UTI’s are more prevalent in which sex during infancy?

Answer 12

Males

Question 13

UTI’s are more prevalent in which sex from ages 3-50?

Answer 13

Females greatly outnumber males

Question 14

Lower UTI symptoms

Answer 14

• frequency of urination
• dysuria
• turbid urine
• suprapubic discomfort
• hematuria

Question 15

Upper UTI

Answer 15

• flank pain or CVA tenderness

- fever, chills

Question 16

Birth control usage corresponds strongly to the presence of Urinary tract infections in sexually active individuals

Answer 16

truth

Question 17

Spermicidal foam changes the microflora of the vagina

Answer 17

truth

Question 18

Diaphragms change the angle of the urethra

Answer 18

truth

Question 19

Antibiotics for pyelonephritis

Answer 19

Aminoglycosides like topamycin concentrate in high amounts in the infected kidney

Question 20

Pathogenesis of UTI

Answer 20

95% are from an ascending route.

• Urethral Trauma
• Intercourse
• Instrumentation
• Diaphragm use

Question 21

5% of UTI’s are from hematogenous spread

Answer 21

ok

Question 22

Uropathogenic E. Coli

Answer 22

Cause most UTI’s. Express a number of virulence factors

Type 1 Fimbriae- mannose-sensitive fimbrae, blocked by manos sugar

P- Fimbriae- “pyelo-fimbrae” cause pyelonephritis if the bacteria expresses them

Question 23

Type 1 Fimbrae

Answer 23

attach to mannose in the lower urinary tract

Question 24

P- fimbrae

Answer 24

Attch to p- blood group in upper urinary tract. Will cause pyelonephritis

Question 25

First step in diagnosis of UTI?

Answer 25

microscopic urinalysis

Question 26

Pathogenesis of UTI

Answer 26

Adhesion, Colonization, Invasion, Phase Variation

ACIP

Question 27

What is the rate limiting step for bacterial growth?

What do bacteria such as E. Coli do to overcome this?

Answer 27

Iron availability

They release exotoxins such as alpha hemolysin which lyse red blood cells to remove iron

Question 28

What is the name of the capsule that prevents uropathogenic E coli from being killed due to WBC invasion

Answer 28

K- antigen

Question 29

Important to remember that the poly’s coming in as an immune response have receptors for mannose which helps them find and bind the bacteria. How do the bacteria respond to this?

Answer 29

PHASE VARIATION. They quit making type 1 fimbriae and start making P- fimbriae.

Question 30

Host defense mechanism

Answer 30

• Bacterial growth inhibition
• urine flow
• epithelial cell turnover
• antibodies

Question 31

Things that can predispose to UTI

Answer 31

• urine flow obstruction
• abnormal flow
• trauma
• reflux
• intrumentation
• general health

Question 32

When the ureter dialates it is called?

Answer 32

Hydroureter. occurs when flow out is blocked

Question 33

How long are males treated for a lower urinary tract infection?

Answer 33

1 week

Question 34

How long are females treated for lower UTIs

Answer 34

1-3 days

Question 35

Upper tract infection

Answer 35

1-6 weeks of treatment…IV then oral

Question 36

Asymptomatic bacteriuria?

Answer 36

NOT TREATED… Especially in the elderly…KNOW