Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgery block (Y3) > Urology (3) (infection) > Flashcards

Urology (3) (infection) Flashcards

1
Q

lower urinary tract infection

A

involve infection in the bladder, causing cystitis (inflammation of the bladder). They can spread up to the kidneys and cause pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RF for uti

A
  • Women (urethra is shorter)
  • Sexual activity- bacteria spread around the perineum from the anus)
  • Incontinence
  • Poor hygiene
  • Urinary catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

causes of bacterial UTI

A

Causes

  • Bacteria- E.coli most common
    • Klebsiella pneumonia
    • Pseudomonas aeruginosa
  • Primary sources faeces
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

presentation of lower urinary tract infection

A
  • Dysuria (pain, stinging or burning when passing urine)
  • Suprapubic pain or discomfort
  • Frequency
  • Urgency
  • Incontinence
  • Haematuria
  • Cloudy or foul smelling urine
  • Confusion is commonly the only symptom in older and frail patients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

investigations for UTI

A
  • dipstick
  • MSU
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Dipstick and UTI

A
  • Nitrites (gram neg bacteria break down nitrates, a normal waste product in urines, into nitrites)
  • Leukocytes
  • RBC
    • Presence of leukocytes +RBC indicates likelihood of UTI
    • If only leukocytes present do not treat
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MSU

A

mid stream urine

  • Microscopy, culture and sensitivity testing
  • Asymptomatic bacteriuria- positive urine cultures without symptoms of UTI (common in elderly)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

uncomplicated UTI

A

Uncomplicated UTIs are most common in young, sexually active women.

occurs in patients who have a normal, unobstructed genitourinary tract, who have no history of recent instrumentation, and whose symptoms are confined to the lower urinary tract.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complicated UTI

A

A complicated urinary tract infection (UTI) is a term to describe a UTI that doesn’t respond to traditional treatments. This may be due to underlying medical conditions or other risk factors, such as age and anatomical differences

  • Pregnant patients
  • Patients with recurrent UTIs
  • Atypical symptoms
  • When symptoms do not improve with antibiotics
  • Men with UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

management of uncomplicated UTI

A
  • Trimethoprim for 3 days
  • Nitrofurantoin for 3 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

side effects of trimethoprim and nitrofurantoin

A
  • Side effects same for both:
  • Itching
  • D and V
  • Stomach upset
  • Loss of appetite
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

management of asymptomatic bacteriuria

A
  • Offer antibiotics to pregnant women
  • Usually doesn’t need to be treated in nonpregnant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

management of UTI in pregnant patients

A
  • Avoid nitrofurantoin in third trimester- risk of neonatal haemolysis
  • Avoid trimethoprim in first trimester- works as a folate antagonist
    • Congenital malformation e.g. neural tube defects such as spina bifida
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

duration of antibiotics of complicated UTI

A
  • 5-10 days of antibiotics for immunosuppressed women, abnormal anatomy or impaired kidney function
  • 7 days of antibiotics for men, pregnant women or catheter-related UTIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

‘Multi-Drug Resistant Gran Negative Organism (MGNO)’

A
  • Gram negative bacteria that are resistant to antibiotics that they have been sensitive to in the past
  • MSU – to test for susceptibility
  • Fosfomycin has been shown to retain some activity against MDR bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Asymptomatic bacteriuria

A

is the presence of bacteria in the properly collected urine of a patient that has no signs or symptoms of a urinary tract infection. Asymptomatic bacteriuria is very common in clinical practice

17
Q

pyelonephritis presentation

A
  • Fever
  • Vomiting
  • Unilateral loin to groin pain
  • N and V
  • Co-existing lower UTI
  • On examination
    • Unilateral or bilateral costovertebral angle tenderness with or without suprapubic tenderness
    • Assess for AAA as DD
18
Q

pyelonephritis invesitgations

A
  • Urinalysis and culture
  • Routine bloods (FBC, CRP, U&Es)
  • Renal US for evidence of obstruction
    • If suspected- non-contrast CT imaging (KUB)
19
Q

management of pyelonephritis

A
  • Empirical antibiotics
  • IV fluid is appropriate
  • Analgesia
  • Anti-emetics
  • Non-responding cases- catherization and high dependency unit monitoring
20
Q

complications of pyelnophritis

A
  • Severe sepsis
  • Multi-organ failure
  • Renal scarring (CKD)
  • Pynonephrosis
  • Preterm labour
21
Q

Epididymo-orchitis

A

Inflammation of the epididymis (orchitis is inflammation of the testicle). Usually result of infection.

22
Q

risk factors for epididymitis or orchitis

A
  • <35 usually
  • sexually active
  • UTI
23
Q

causes of epididymo-orchitis

A
  • 20-40/50- STI e.g. chlamydia, Neisseria gonorrhoea
  • 40/50+ - UTI esp E.coli
  • Often recent history of
    • UTI
    • Unprotected sex
    • Catheter
    • Check for mumps history (usually bilateral symptoms)- may present like this before glands in neck
24
Q

presentation of Epididymo-orchitis

A
  • Gradual onset
  • Unilateral
    • Testicular pain
    • Dragging
    • Swelling of testicle and epididymis
    • Tenderness on palpation, particularly over epididymis
    • Urethral discharge (more likely to be STI than E.coli)
    • Fever and potentially sepsis
25
Q

investigaitons for epidiymo-orchitis

A
  • Bloods- FBC, UandEs, cultures
  • Urine microscopy, culture and sensitivity (MC&S)
  • Chlamydia and gonorrhoea NAAT testing on a first pass urine
  • Charcoal swab of purulent urethral discharge for gonorrhoea culture and sensitivities
  • Saliva swap for PCR testing for mumps, if suspected
  • Serum antibodies for mumps, if suspected (IgM – acute infection, IgG – previous infection or vaccination)
  • Ultrasound may be used to assess for torsion or tumours
26
Q

management of epidiymo orchitis

A
  • If very unwell or septic admit for IV antibiotics
  • If risk of STI- refer to GUM
  • If low risk of STI- ofloxacin for 14 days
  • Analgesia, supportive underwear, reduce PA, abstain from intercourse
27
Q

complications of Epididymo-orchitis

A

chronic pain, chronic epididymitis, testicular atrophy, sub-fertility, abscess

28
Q

Epididymo- orchitis sometime confused with

A

testicular torsion

29
Q

Epididymo- orchitis vs testicular torsion

A
  • Testicular torsion
    • Reactive hydrocele
    • Scrotal wall erythema
    • Decreased blood flow
  • Epididymo-orchitis
    • Epididymis is located posterolateral to the testis
    • Tender, swollen and indurated
    • Increased blood flow

Surgery block (Y3) (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions