Urinary Tract Infections

Question 1

What is the difference between Venereal and non-venereal UTI’s?

Answer 1

• Venereal: STD w/out UTI (bacterial, viral, parasitic)

- Non-venereal: nosocomial, community-acquired UTI

Question 2

What consists of Lower UTI infections? Upper UTI?

Answer 2

• Lower: cystitis, urethritis, prostatitis

- Upper: pyelonephritis, intra-renal abscess, perinephric abscess

Question 3

What is the difference between Uncomplicated and Complicated UTI?

Answer 3

• Uncomplicated: infection w/ normal urinary tract; usually have a single organism
• Complicated: infection w/ abnormal urinary tract; more than 1 organism

Question 4

What are the characteristics of the Ascending route of UTIs?

Answer 4

• Most common route for all UTIs

- Females>males due to shorter urethra

Question 5

What is the Hematogenous route of UTI’s most commonly seen with?

Answer 5

-seen with Staphylococcus aureus, gram negative bacilli = rare

Question 6

What is the characteristic of the Lymphatic route?

Answer 6

-increased bladder pressure can cause lymphatic flow to be directed towards kidney

Question 7

What are the antimicrobial properties of urine?

Answer 7

• extremes of osmolarity
• high urea concentration
• high organic acid concentration
• low pH

Question 8

What kind of rods are most prevalent in community-acquired UTIs? Most common pathogen?

Answer 8

• aerobic gram negative rods

- Community-acquired: E.coli

Question 9

What is the most common pathogen in nosocomial UTIs? pathogen for yeasts?

Answer 9

• Nosocomial: E.coli

- Yeasts: Candida albicans

Question 10

What is the most common urologic anomaly in children and what does it do?

Answer 10

-Vesicoureteral reflex = retrograde passage of urine from bladder to upper urinary tract

Question 11

What are the symptoms for Lower UTIs?

Answer 11

• inflammation of urethral and bladder mucosa
• dysuria
• suprapubic pain

Question 12

What are the symptoms of Upper UTI’s?

Answer 12

• Fever and flank pain

- Lower UTI symptoms as well

Question 13

What are the signs and symptoms of acute uncomplicated cystitis? What bacteria causes it? Treatment?

Answer 13

-sudden onset, multiple urinary symptoms
-pyuria
-sometimes hematuria
Bacteria: E.coli; may have more than 1 infection due to reinfection of a different E.coli strain.
Treatment: antibiotics (3 days)

Question 14

What are the signs and symptoms of Acute Uncomplicated pyelonephritis? What bacteria causes it? How to diagnose?

Answer 14

-pyuria
Bacteria: E.coli w/ unique markers of carbohydrate receptors on uroepithelial cells
Diagnosis: WBC casts

Question 15

What trimester in pregnancy does bacteriuria usually occur?

Answer 15

-1st trimester, great chance of becoming pyelonephritis

Question 16

What is the most common Urease-producing microorganism?

Answer 16

-Proteus mirabilis

Question 17

What is prostatitis? Symptoms?

Answer 17

-relapsing acute lower UTI of same microorganism
Symptoms: -pelvic "heaviness"
-rectal/perineal pain
-urinary hesitancy
-dribbling/burning