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Pathology 3001 > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

What is micturition?

A

Urination

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2
Q

What is cystitis?

A

Infection confined to the bladder

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3
Q

What is pyelonephritis?

A

Kidney infection

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4
Q

What is urethritis?

A

Inflammation of the urethra

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5
Q

What is prostatitis?

A

Inflammation of the prostate

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6
Q

What percentage of women have more than 1 UTI in their lifetime?

A

20 - 30%

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7
Q

What age are men who usually get UTIs?

A

> 50 years

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8
Q

How often are UTIs single or isolated attacks?

A

90%

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9
Q

What can recurrent attacks (10%) be due to?

A
  • Relapse (20%)
    Being infected with another pathogen
  • Reinfection (80%)
    Being reinfected with the same infection
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10
Q

What are the signs/symptoms of a lower UTI infection?

A
  • Frequency of micturition
  • Urgency to urinate
  • Dysuria
  • Suprapubic pain + tenderness
  • Smelly/cloudy urine
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11
Q

What are the signs/symptoms of an infection of pelvis and kidney (acute pyelonephritis)?

A
  • Loin pain and kenderness
  • High fever
  • Systemic upset
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12
Q

What investigation should you perform if their are complications with a UTI?

A

Excretion urography

CT urogram

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13
Q

What can result in an abnormal Excretion urogram CT urogram?

A
  • Stones
  • Obstruction
  • Polycystic kidneys
  • Vesicoureteric reflux
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14
Q

What associated diseases can cause complications with UTIs?

A
  • Diabetes Melitus
  • Sickle cell disease
  • Analgesic abuse
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15
Q

What is the Vesicoureteric reflux?

A

Condition in which urine flows retrograde, or backward, from the bladder into the ureters/kidneys.

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16
Q

How do E.coli adhere to the bladder?

A

P. fimbriae adhere to the uroepithelium

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17
Q

What is the most common cause of UTIs?

A

E. coli (80% of community acquired)

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18
Q

What are the 2 different serotypes of UPEC E. coli?

A
  • O (somatic)

- K (capsular)

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19
Q

What are the virulence factors of E. coli?

A
  • Fimbriae (adhesion)
  • K antigen
  • Haemolysin
20
Q

What are the 2 different types of fimbriae (pili) on E. coli?

A
  • Type 1

- Type P

21
Q

What is iron acquisition machinary on E. coli activated via?

A

Siderophores

22
Q

What is the response of E.coli to adhesion?

A
  • Iron acquisition machinery activated via siderphores
  • Stimulates growth and reproduction
  • Once a monolayer has formed a biofilm may develop
  • Bacteria with type 1 fimbriae may become internalised in phagocytes and epithelial cells
23
Q

What are the features of the E. coli K antigen?

A
  • Polysaccharide
  • Forms a micro-capsule
  • Confers resistance to phagocytosis
24
Q

What are the features of the E. coli Haemolysin?

A
  • Cytolytic exo-protein
  • Damages tissue membranes in vivo
  • Causes kidney damage
25
Q

What are some of the main features of Proteus Mirabilis?

A
  • Gram negative
  • Faculative anaerobe
  • Bacillus
  • Peritrichous flagellae
  • Produces urease
  • Swarming ability (produce surfactant)
26
Q

What does urease produced by proteus mirabilis do?

A
  • Breaks down urea into ammonia making urine less acidic and more alkali
  • Can creat crystals of calcium carbonate which build up and creat kidney stones
27
Q

What are the gram negative bacteria which can cause UTIs?

A
  • Escherichia coli
  • Proteus mirabilis
  • Klebsiella sp.
  • Enterobacter sp.
  • Serratia sp.
28
Q

What are some of the gram positive bacteria which can cause UTIs?

A
  • Staphylococcus saprophyticus
  • Staphylococcus epidermidis
  • Enterococcus sp.
  • Corynebacteria
  • Lactobacillus
29
Q

Where can staphylococcus saprophyticus be found normally?

A

Female perineum and vagina

30
Q

WHat can increase the risk of staphylococcus saprophyticus?

A

Sexual activity

31
Q

What are the features of staphylococcus saprophyticus?

A
  • Gram positive

- Coagulase negative

32
Q

What can be the non-bacterial causes of UTIs?

A
  • Candida albicans
  • Trichomonas vaginalis
  • Schistosoma haematobium
  • Mycobacterium fortuitum
  • Histoplasma capsulatam
  • Polyomaviruses
  • CMV
  • Rubella
33
Q

When can a candida infection become serious?

A
  • Opportunistic infection in immunocompromised individuals (can be deadly in HIV)
  • Usually commensal
  • Often associated with antibiotic use
34
Q

What is Trichomonas vaginalis?

A
  • Protozoa which can cause UTIs
  • Pear-shaped flagellate
  • Causes trichomoniasis
35
Q

What is the pH at which trichomonas vaginalis prefers?

A

~6

36
Q

What kind of worm is Schistosoma haematobium?

A

Trematode worm

37
Q

What is schistosomiasis treated with?

A

Praziquantal

38
Q

Where can the entry points be for bacteria entering a catheter?

A
  • Urethral meatus and aroun catheter
  • Junction between catheter and collection tube
  • Connetion to drainage bag and reflux from bag to tubing
39
Q

What is the bacteria content which deems urine to have significant bacteriuria?

A
  • Mid stream specimen with >10^5 per ml

- Catheter specimen of urine will have lower number than MSU

40
Q

When is a suprapubic aspiration of bladder urine taken?

A
  • Very rare occasions

- Can be for schistosoma haematobium

41
Q

What can bacteria cause nitrates to become?

A

Reduce to nitrites

42
Q

What can leukocytes produce which appear on a dipstick?

A

Leukocyte esterase

43
Q

What are the Urinary Tract host defenses?

A
  • Urine - osmolality, pH
  • Sloughing of epithelial cells
  • Urine flow and micturition
  • Mucosal inhibitors of bacterial adherence
  • Complement activation
  • Inflmmatory response
  • Immune responses
  • Commensals
44
Q

What can cranberry/blueberry juice contain which can prevent UTIs?

A

Proanthrocyanidins

- Prevent E. coli from adhereing to the uroepithelium

45
Q

What oral antibiotics can be used to treat UTIs?

A
  • Co-trimoxazole
  • Nitrofurantoin
  • Nalidixic acid
  • Co-amoxiclav
  • Trimethoprim
  • Ciprofloxacin

Pathology 3001 (15 decks)

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