UTI Flashcards
presentation of UTI
dysuria
frequency
smelly urine
very young - FTT
very old - incontinence
why do ureters enter bladder at an angle
with increasing pressure from bladder as it fills it closes off ureter and prevents urine reflux
why are females predisposed
short urethra lack prostatic bacteriosatic secretion urethra close to rectum sex pregnancy - pressure on ureters + bladder
general predisposing factors
immunosuppresion
steroids
malnutrition
diabetes
predisposing factors specific to urinary tract
female sex - short urethra
sex and poor voiding habits
congenital abnormalities e.g. duplex kidney
stasis of urine e.g. poor bladder emptying
foreign bodies e.g. catheter, stones
oestrogen deficiency in post-meno woman
UTI clinical features: children
diarrhoea excessive crying fever N&V not eating
UTI presentation: adults
flank pain dysuria cloudy, offensive urine urgency chills strangury confusion - elderly
clinical features of acute pyelonephritis
pyrexia poor localisation loin tenderness signs dehydration turbid urine
Ix
MSSU
urinalysis
microbiolgy
Ix in kids, men, frequent UTI
USS, IVU
isotope studies
treatment
fluid
antibiotics - amoxicillin, cephalosporin, trimethorpim
reflux nephropathy
UTIs in kids
damaged caused by relfux and infection
recurrent infection Mx
fluid intake 2L per day
void every 2-3hrs
void before bedtime and after sex
avoid bubble bath and constipation
baceriuria
> 10^5
chronic pyelonephritis
scarring
htn
15% progress to renal failure
