urinary tract infections (UTI)

Question 1

when is asymptomatic bacteria considered normal ?

Answer 1

considered normal in the >65 year old age group

Question 2

what is the function of bacterial biofilms ?

Answer 2

urogenital cells are covered by dense bacterial biofilms which lactobacilli predominate, preventing pathogens from attaching and forming adhesions onto epithelial cells

Question 3

what factors affect and influence the composition of the biofilms ?

Answer 3

estrogen levels 
oral contraception 
glycogen content and vaginal pH 
steroid therapy 
Diseases (e.g DM)

Question 4

are UTIs more common in makes or females and why ?

Answer 4

more common in women because of the shorter urethra

Question 5

what are the factors that increase the incidence of UTIs?

Answer 5

sexual intercourse 
use of spermicides 
increased incidence in postmenopausal women 
abnormal renal tracts (anatomically)
urinary catheters in situ

Question 6

what are the routes of infection for UTIs?

Answer 6

ascending in females ( colonized bacteria)

haematogenous routes

Question 7

what are the factors influencing UTI in npathogenesis ?

Answer 7

virulence of the bacteria

host defense system

Question 8

what are organisms that are commonly associated with UTI’s?

Answer 8

E.coli
enterococci
Group b streptococcus
Candida albicans

Question 9

what is the clinical presentation of the UTI if the kidneys are affected ?

Answer 9

acute pyelonephritis is associated with upper back and side pain
high fever
shaking and chills
nausea and vomiting

Question 10

what is the clinical presentation if the bladder is affected in UTIs?

Answer 10

with cystitis there is -
pelvic pressure 
lower abdomen pressure 
frequent and painful urination 
blood in urine

Question 11

what is the clinical presentation if the urethra is affected ?

Answer 11

with urethritis -
burning with urination
discharge

Question 12

when do we consider an uncomplicated UTI ?

Answer 12

cystitis or pyelonephritis that occurs in premenopausal women with no functional or structural abnormalities of the urinary tract , who are not pregnant and no
significant comorbidities

Question 13

when do we consider a complicated UTI ?

Answer 13

when the patient is :
-a child or is pregnant
-if the patient has any of the following:
.structural or functional abnormality
.comorbidity increasing the risk of acquired infection
.recent instrumentation

Question 14

what are the diseases of renal interstitial tissue broadly divided into ?

Answer 14

1. non specific suppurative inflammation

2. specific infectionss

Question 15

what are the non specific suppurative inflammation

Answer 15

pyelonephritis
pyonephrosis
pyemic abscess

Question 16

what are the routes of infections of pyelonephritis ?

Answer 16

hematogenous

ascending infection

Question 17

what is the most common causative organism causing heamtogenous pyelonephritis ?

Answer 17

E coli

Question 18

how can heamtogenous pyelonephritis spread

Answer 18

from septicemia

infective endocarditiss

Question 19

how can ascending infection pyelonephritis be caused ?

Answer 19

intra renal reflux
incompetence of the vesico ureter valve
colonization of the distal urethra

Question 20

what is the morphology of acute pyelonephritis ?

Answer 20

tubular necrosis

patchy interstitial suppurative inflammation

Question 21

what are the complications of acute pyelonephritis ?

Answer 21

pyelonephrosis
papillary necrosis
perinephric abscess
chronic pyelonephritis

Question 22

what is the clinical course of acute pyelonephritis ?

Answer 22

1. pain at renal angle
2. systemic evidence of inflammation
3. pyuria and bacteriuria
4. dysuria

Question 23

what is chronic pyelonephritis grossly characterized by ?

Answer 23

grossly: visible scarring and deformity of the pelvicalcyeal systemm

Question 24

what is chronic pyelonephritis morphologically characterised by ?

Answer 24

interstitial inflammation and parenchymal scars

Question 25

what are the types of chromic pyelonephritis ?

Answer 25

chronic obstructivee

chronic reflux

Question 26

what are the nature of the scars in chronic reflux associated pyelonephritis ?

Answer 26

the scars are polar

Question 27

what os the arbitrary cut off value for significant bacteruria ?

Answer 27

> 105 colony forming

Question 28

what bacteria are more commonly spread hematogenoulsy causing a UTI ?

Answer 28

s. aureus

TB

Question 29

what is the pathway in which UTIs cann cause AKI ?

Answer 29

colonizationn 
uroepithelium penetration 
ascension 
pyelonephritis 
acute kidney injury

Question 30

what is an example of a specific infection of the renal interstitial tissues ?

Answer 30

TB

Question 31

what are the presence of colloid casts evidence of ?

Answer 31

tubular damage