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Urinary Pathophysiology > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

what causes most urinary tract infections?

A

bacteria

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2
Q

what are the requirements for a urinary tract infection?

A

uropathogenic bacteria in sufficient numbers
epithelial receptors
flagella
iron scavenging system
breakdown in normal host defense mechanisms

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3
Q

what in the urethra protects against urinary tract infections?

A

length, width, location
high-pressure zone
peristalsis

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4
Q

what are some anatomic structures that help to protect against upper urinary tract infections?

A

vesicoureteral valves
ureteral peristalsis
length of ureters

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5
Q

true/false: there is a normal flora/microbiome in the urinary tract that helps to protect against urinary tract infections

A

true

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6
Q

what are some antimicrobial properties of urine?

A

highly acidic and alkaline environment
high urine osmolality- especially cats
high concentration of urea and weak organic acids
Tamm-Horsfall mucoprotein
prostatic secretions

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7
Q

what does Tamm-Horsfall mucoprotein do?

A

impairs adhesion to uropathogenic E. coli to epithelial cells
bacteriostatic

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8
Q

what does activation of toll-like receptors on luminal surface of bladder epithelium produce?

A

IL-8
neutrophil chemoattractant

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9
Q

what are some contributing factors to urinary tract infections?

A

abnormal micturition
urinary catheters

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10
Q

what are some anatomic defects that can make an animal predisposed to urinary tract infections?

A

vesicoureteral reflux
ectopic ureters
ureterocele
urachal diverticulum/remnant
excessive perivulvar skin folds
damage to uroepithelium

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11
Q

what are some things that can cause immunosuppression or change in urine that can predispose to urinary tract infections?

A

renal failure
diabetes mellitus
hyperadrenocorticism
FeLV/FIV
chemotherapy

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12
Q

in cats, who is more likely to have a UTI?

A

older cats due to concurrent disease

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13
Q

what are some organisms that can cause urinary tract infections?

A

E. coli
Staphylococcus pseudointermidus
Enterococcus
Proteus
Steptococcus
Pseudomonus
Klebsiella

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14
Q

how prevalent are urinary tract infections in horses?

A

uncommon

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15
Q

what organisms are known to cause urinary tract infections in cattle?

A

Corynebacterium renale
E. coli
Trueperella

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16
Q

when should you avoid a cystocentesis?

A

if there is a risk of a transitional cell carcinoma

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17
Q

how should you confirm if you think you see cocci?

A

gram stain or wright stain

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18
Q

when is it difficult to identify a urinary tract infection?

A

small bacteria
low numbers of bacteria
can have contamination if got feces in urine sample

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19
Q

what are some fungi that can cause a urinary tract infection?

A

candida
cryptococcus
aspergillus

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20
Q

_____________ may be used to demonstrate the characteristic capsule of Cryptococcus?

A

india ink prep

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21
Q

what is cystitis?

A

inflammation of the bladder

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22
Q

what is urethritis?

A

inflammation of the urethra

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23
Q

what are the signs of upper urinary tract disease?

A

depression, anorexia
fever
vomiting
other signs of uremia
lumbar or abdominal pain
diary cattle: decreased milk
weight loss, pu/pd
azotemia
neutrophilia

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24
Q

what are the classifications for urinary tract infections?

A

sporadic
recurrent
subclinical bacteriuria

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25
Q

how do you diagnose sporadic bacterial cystitis?

A

lower urinary tract signs
concurrent urinalysis abnormalities
urinalysis to detect comorbidities
aerobic culture, especially in cats

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26
Q

what can cause relapsing urinary tract infection?

A

wrong antibiotic or dose or duration of therapy
lack of owner compliance
concurrent GI disease or decreased renal concentrating ability
failure to eliminate predisposing factors

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27
Q

what are some acute pathologic changes with lower urinary tract infection?

A

bladder thickened
focal hemorrhages, erosions, ulcerations
+/- emphysema
exudate or blood clots

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28
Q

subclinical bacteriuria is reported in _________ of healthy dogs and _________ of healthy cats

A

2-12%
1-13%

29
Q

if an animal has bacteriuria, but no clinical signs of urinary tract infection, should you treat it?

A

no

30
Q

when should you treat subclinical bacteriuria?

A

evidence of upper urinary tract infection
patients have urease-producing infections
patients have plaque-forming bacteria
patients have signs of emphysematous cystitis

31
Q

what part of the kidney is more susceptible to infection?

A

medulla

32
Q

what are some signs of chronic pyelonephritis?

A

poor doer
weight loss
pu/pd
may be asymptomatic
cattle: poor weight gain, diarrhea

33
Q

how does leptosporosis do in the environment?

A

survives weeks to months

34
Q

what is the most common manifestation of leptosporosis?

A

acute kidney injury
often hepatic involvement

35
Q

in dogs, _______________ is the most common cause of a hematogenous bacterial infection

A

leptosporosis

36
Q

when should you consider leptosporosis?

A

fever and unspecified illness
signs of renal disease
especially if renal disease is accompanied by signs of liver disease

37
Q

what do calves and lambs get with leptosporosis?

A

severe, acute illness
fever
intravascular hemolysis, anemia, icterus
acute kidney injury (uncommon)

38
Q

what do adult cattle get with leptosporosis?

A

mastitis
decreased milk production
abortion
acute kidney injury and hemolysis (uncommon)

39
Q

what species of leptsporosis is most common in swine?

A

L. bratislava

40
Q

what does leptosporosis cause in swine?

A

abortions
stillbirths or neonatal deaths
decreased fertility in sows

41
Q

what does leptosporosis cause in equine?

A

recurrent uveitis
abortion
kidney failure in foals

42
Q

what are the routes of infection for UTIs?

A

usually ascending infection from perineum
catheterization
hematogenous: uncommon
direct extension from infected site near urinary tract: uncommon

43
Q

how do vesicoureteral valves prevent infection?

A

pressure of urination closes opening
prevents reflux and permits removal of all urine

44
Q

how do bacteria in the host interfere with pathogenic bacteria?

A

occupy receptors for bacterial P-fimbriae
bacteriocidins

45
Q

what are the mucosal defense barriers?

A

distal urethra has normal flora
proximal urethra: microplicae entrap bacteria
exfoliation of urothelial cells
production of antimicrobial molecules
antibody production

46
Q

what does lipocalin and lactoferrin do as defense?

A

sequester iron from bacteria
produced by renal tubular epithelial cells

47
Q

what cells produce antimicrobial proteins?

A

macrophages and epithelial cells

48
Q

what antimicrobial protein does the bladder produce?

A

cathelecidins

49
Q

what antimicrobial protein do the kidneys produce?

A

beta-defensins

50
Q

what does activation of toll-like receptors on the luminal surface of bladder epithelium lead to?

A

production of IL-8

51
Q

neutrophils help clear bacteria, in acute UTI, but ____________________

A

cause tissue damage

52
Q

what is a vesicoureteral reflux?

A

valve remains open: puppies or acquired

53
Q

what bacteria are most common in hematogenous infections of foals?

A

gram negatives

54
Q

when do cattle get UTIs?

A

pyelonephritis after parturition

55
Q

who is pyelonephritis most common in in swine?

A

farrowing sows

56
Q

what are some parasites that infect the urinary tract?

A

Capillaria plica
Dioctophyme renale
Stephanurus dentatus

57
Q

what makes a UTI recurrent?

A

three or more episodes of clinical cystitis within preceding 12 months
two or more within 6 months

58
Q

what can cause recurrent bacterial cystitis?

A

alterations in host defenses
development of resistant bacteria

59
Q

what are some chronic changes with lower urinary tract infection?

A

thickened bladder wall
can lead to polyploid cystitis

60
Q

who has higher rates of subclinical bacteriuria?

A

diabetes mellitus, obesity, parvovirus, acute disc herniation, paralyzed dogs, dogs treated with cyclosporine or glucocorticoids

61
Q

what bacteria causes plaques?

A

Corynebacterium urealyticum

62
Q

what are some urease-producing bacteria?

A

Proteus spp
Klebsiella
Staphylococcus aureus
Staphylococcus pseudintermedius

63
Q

how can you diagnose pyelonephritis?

A

isosthenuric urine
white blood cell casts confirm
radiographs and sonograms

64
Q

why is the medulla more susceptible to infection?

A

poor inflammatory response
decreased blood flow
hyperosmolarity inhibits immune
low pH
hypoxic environment

65
Q

what should you evaluate a patient with acute pyelonephritis for?

A

leptospirosis

66
Q

what cells does leptospirosis have an affinity for?

A

renal proximal tubules, biliary tract, and vascular endothelium

67
Q

what are the abnormalities on a chemistry profile associated with leptospirosis?

A

elevated BUN and creatinine
elevated ALT
elevated alkaline phosphatase
elevated bilirubin

68
Q

what is leptospirosis like in cats?

A

inherently resistant
develop antibodies

Urinary Pathophysiology (11 decks)

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