Urinary Tract Infections Flashcards
What is a urinary tract infection (UTI)?
A urinary tract infection (UTI) is a common bacterial infection that affects the urinary system, which includes the kidneys, ureters, bladder, and urethra. UTIs can range from mild to severe and may lead to serious complications, especially in high-risk populations.
What are the symptoms of a lower urinary tract infection (cystitis)?
Symptoms of a bladder infection (cystitis) include:
- Dysuria: Painful or burning sensation during urination.
- Increased Frequency: The need to urinate more often than usual, often with little urine output.
- Urgency: A strong, persistent urge to urinate.
- Hematuria: Presence of blood in the urine, making it appear pink, red, or cloudy.
- Suprapubic Pain: Discomfort or pressure in the lower abdomen.
- Nocturia: Frequent urination at night, disrupting sleep.
Why is it important to understand the symptoms and complications of UTIs?
Understanding the symptoms and complications of UTIs is crucial for effective care and to prevent recurrence, especially in high-risk populations where UTIs can lead to serious complications.
What are the symptoms of an upper urinary tract infection (pyelonephritis)?
Symptoms of pyelonephritis (kidney infection) include:
- Fever and chills: Common signs of systemic infection.
- Flank Pain: Pain or tenderness in the back or side, often below the ribs.
- Nausea and vomiting: Associated with more severe infection or systemic response.
- Costovertebral Angle Tenderness: Tenderness over the lower ribs on the back, indicating kidney inflammation.
- Fatigue and malaise: General feelings of being unwell or fatigued.
What is urethritis and what are its symptoms?
Urethritis is an infection of the urethra, and its symptoms include:
Dysuria: Pain or a burning sensation during urination.
Purulent Urethral Discharge: Particularly common in sexually transmitted infections like gonorrhea or chlamydia.
What is asymptomatic bacteriuria, and when does it require treatment?
Asymptomatic bacteriuria is the presence of bacteria in the urine without symptoms. It typically does not require treatment unless the individual is pregnant, undergoing surgery, or has other risk factors for complications.
What are some anatomical and structural abnormalities that can complicate UTIs?
Anatomical and structural abnormalities that can increase the risk of recurrent or complicated UTIs include:
Obstructions: Such as kidney stones or an enlarged prostate, which can block normal urine flow.
Urinary Tract Abnormalities: Conditions like vesicoureteral reflux (backflow of urine into the kidneys) or congenital anomalies that predispose individuals to recurrent infections.
How does diabetes mellitus complicate UTIs?
Diabetes can impair the immune response, making individuals more susceptible to infections. Additionally, high blood sugar levels promote bacterial growth in the urinary tract, increasing the frequency of infections.
Why are pregnant women more susceptible to UTIs?
Pregnancy alters the urinary tract due to hormonal changes, an enlarged uterus pressing on the bladder, and slowed urine flow. Untreated UTIs during pregnancy can lead to complications like preterm labor and low birth weight.
How do immunocompromised states affect UTI risk?
Individuals with weakened immune systems, such as those on immunosuppressive medications or with conditions like HIV/AIDS, are at higher risk for developing complicated UTIs due to their reduced ability to fight infections.
How do urinary catheters increase the risk of UTIs?
Indwelling urinary catheters increase the risk of urinary tract infections, particularly in hospitalized or long-term care patients. These are called catheter-associated urinary tract infections (CAUTIs), one of the most common healthcare-associated infections.
How does menopause contribute to UTI risk?
After menopause, hormonal changes can cause thinning of the vaginal and urethral mucosa, making postmenopausal women more prone to developing UTIs.
How does older age increase the risk of UTIs?
Older adults may experience changes in bladder function, a weakened immune response, and may have other comorbidities, making them more susceptible to UTIs.
How does a previous UTI history affect future UTI risk?
Having a previous UTI is a significant risk factor for recurrent infections. Some individuals may experience repeated infections, sometimes caused by resistant organisms, which can make treatment more challenging.
What is the primary treatment for UTIs?
The primary treatment for UTIs is antibiotic therapy, with the choice of antibiotic depending on the site of infection, the patient’s risk factors, and local resistance patterns.
What antibiotics are used for uncomplicated lower UTIs (cystitis)?
For uncomplicated cystitis, first-line antibiotics include:
Nitrofurantoin (100 mg twice daily for 5 days)
Trimethoprim-sulfamethoxazole (TMP-SMX)
Fosfomycin (single-dose treatment)
What antibiotics are used for complicated UTIs?
For complicated UTIs, broader-spectrum antibiotics may be needed, such as:
Ciprofloxacin or Levofloxacin (fluoroquinolones)
Ceftriaxone or Piperacillin-tazobactam (for severe infections or pyelonephritis)
How are upper UTIs (pyelonephritis) treated?
Patients with pyelonephritis may require hospitalization for intravenous (IV) antibiotics, particularly if they are febrile, severely ill, or unable to tolerate oral medications.
What supportive care measures are recommended for UTIs?
Supportive care for UTIs includes:
Pain Relief: Over-the-counter analgesics like acetaminophen or ibuprofen, and Phenazopyridine for symptom relief.
Hydration: Adequate fluid intake to help flush out bacteria from the urinary tract.
How should catheter-related UTIs be managed?
For catheter-related UTIs, the catheter should be replaced with sterile technique, and appropriate antibiotics should be initiated based on culture results.
How are recurrent UTIs managed?
For recurrent UTIs, prophylactic antibiotics may be prescribed, or additional strategies like cranberry supplementation or vaginal estrogen (for postmenopausal women) may be considered.
How is obstructive uropathy treated in UTIs?
If a UTI is related to an obstruction (e.g., kidney stones, enlarged prostate), treatment of the underlying cause, such as surgery or urological intervention, may be necessary.
How does diabetes management affect UTI treatment?
In diabetic patients, tight glycemic control is essential to prevent recurrent infections and promote overall immune function.
How does diabetes management affect UTI treatment?
In diabetic patients, tight glycemic control is essential to prevent recurrent infections and promote overall immune function.
