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BVetMed4 - Urinary > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

What is the most common cause of UTIs?

A

Bacterial

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2
Q

What is pyuria?

A

Increased WBCs in urine

Inflammation which may or may not be associated with infection

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3
Q

What is the most common route of infection?

A

Ascending

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4
Q

What are most uropathogens derived from?

A

Faecal flora - coliforms

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5
Q

What is the most common bacterial isolate in dogs and cats with UTIs?

A

E. Coli

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6
Q

What is the most common bacterial isolate in cows and horses?

A

Corynebacterium sp

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7
Q

What is the most important bacterial isolate in UTIs in pigs?

A

Uropathogenic MDR E. coli

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8
Q

How can uropathogenic bacteria exist in the urinary tract?

A

Planktonic - free in urine

Biofilm - polysaccaride and water matrix

Intracellular communities - can invade cells

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9
Q

What are some risk factors for UTI development?

A 
Female 
Older
Anatomical/physiological LUT abnormality 
Incontinence 
Urolithiasis 
CKD 
Iatrogenic 
Immunosuppression 
Antibiotics
Inflammation
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10
Q

What clinical signs are associated with LUTI?

A 
Pollakiuria 
Stanguria/dysuria 
Haematuria
Inappropriate urination
Overgrooming genitalia esp. cats
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11
Q

What clinical signs are associated with UUTI?

A

Renal/lumbar pain
PU/PD
Haematuria
Fever/sepsis

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12
Q

How can you definitively diagnose a UTI ?

A

Urinalysis

Quantitative culture of urine

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13
Q

How should you collect urine for bacteriology?

A

CYSTO

No antibiotics 5-7 days before sampling

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14
Q

What are the facets of urinalysis?

A

Sediment examination
SG
Dipstick

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15
Q

What information can be obtained from quantitative culture?

A

Number of colony forming units determined

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16
Q

What is the fastest way of determining bacterial load in urine?

A

Point of care tests

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17
Q

What do you determine from antimicrobial susceptibility testing?

A

Minimum inhibitory concentration of antimicrobial

Clinical breakpoint

18
Q

How can you classify the different types of bacterial UTI?

A 
Sporadic bacterial cystitis 
Recurrent bacterial cystitis 
Upper UTIs
Bacterial prostatitis 
Subclinical bacteriuria
19
Q

Compare the incidence of sporadic bacterial cystitis in dogs and cats.

A

Common in dogs, rarer in cats

20
Q

What clinical presentation is associated with sporadic bacterial cystitis?

A

No more than 3 episodes per year
Patient otherwise healthy
(NOT entire male dog)

21
Q

How would you treat sporadic bacterial cystitis?

A

NSAIDs to reduce inflammation
Empirical - Amoxy clavulante
Change post sensitivity
— if results available within 24h, wait until sens to treat

3-5d antibiotics based on sensitivity

22
Q

What is the difference between sporadic and recurrent bacterial cystitis?

A

Recurrent - more than three episodes per year or more than two in 6 months

23
Q

How would you approach work up for recurrent Bacterial cystitis?

A

Find underlying cause

Further diagnostics
- urine c+s
US, Rads, cystoscopy
Review previous Abs

24
Q

How should you treat recurrent bacterial cystitis?

A

As for sporadic
Address causal factors
FOLLOW UP CULTURE 5-7d post Abs

25
Q

What comorbidities are associated with recurrent bacterial cystitis?

A 
Endocrinopathies
Renal disease 
Obesity 
Abnormal vulvar conformation 
Congenital UT abnormalities 
Urinary retention
Urinary incontinence 
Prostatic dz
Polyploid cystitis 
Urolithiasis 
Immunosuppressive therapy 
Rectal fistula
26
Q

What would you consider in an entire male with a UTI?

A

Bacterial prostatitis

27
Q

What drug can penetrate the drug prostate barrier?

A

Fluoroquinolones

28
Q

Is antibiotic therapy indicated in subclinical bacteriuria

A

NO

29
Q

How do most diuretics act?

A

Inhibit sodium chloride reabsorption to increase salt and water excretion

30
Q

Name a loop diuretic

A

FUROSEMIDE

31
Q

Why might IV Furosemide be good for acute pulmonary oedema?

A

Has a pulmonary venodilator action when given IV

32
Q

How does Furosemide reach the loop of Henle?

A

PCT secretion

33
Q

Where do thiazides diuretics act?

A

Early DCT

34
Q

Name a potassium sparing diuretic

A

Spironolactone

  • competitive antagonist of aldosterone
  • prevents potassium excretion
35
Q

What is a potential adverse effect associated with spironolactone?

A

Hyperkalaemia

Less of a risk because competitive with aldoserone

Hyponatraemia

36
Q

What is and adverse effect associated with Furosemide ?

A

Hypokalaemia

Hypochloraemic metabolic acidosis

Hyponatraemia

37
Q

What adverse effect is associated with thiazides?

A

Hypomagnesaemia

Hypochloraemic metabolic acidosis

Hyponatraemia

38
Q

What drugs are diuretics synergistic with?

A

Vasodilators

— need to reduce dose once congestion resolves

39
Q

What is the effect of NSAIDs on salts?

A

Exacerbate salt and water retention as PGs are natriuretic (salt losing)

40
Q

Describe the course of action of loop diuretics

A

Most effective but short acting

BVetMed4 - Urinary (15 decks)

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