UTI

Question 1

What is important about the urethra?

Answer 1

It is not sterile - makes it hard to diagnose

Question 2

What is asymptomatic bacteria

Answer 2

When there is bacteria in the urine but there is no infection.

Question 3

When are we worried about bacteria in the urine?

Answer 3

• In children
• In pregnant women

Question 4

Define

• Bacteuriria
• Cystitis

Answer 4

Question 5

Define uncomplicated UTI.

Answer 5

Question 6

Define uncomplicated UTIs

Answer 6

Question 7

In who do we always consider a complicated UTI?

Answer 7

Question 8

What is the prevalence of bacteriuria in young non pregnant women?

Answer 8

1% to 3%

Question 9

What percentage of those with bacteriuria are symptomatic?

Answer 9

40-50%

Question 10

What is the most frequent organism causes UTIs?

Answer 10

Question 11

What E.coli serogroups cause infection?

Answer 11

Question 12

How does virulence vary between types of organisms?

Answer 12

Question 13

What are the other organisms that cause UTIs?

Answer 13

Question 14

What is proteus mirabilis associated with?

Answer 14

Stones

Question 15

What is Klebsiella aerogenes associated with?

Answer 15

Catheters

Question 16

What is second to e.coli infection in young women?

Answer 16

Staphylococcus saprophyticus

Question 17

What happens in recurrent UTIs?

Answer 17

Question 18

What are the antibacterial host defences in the urinary tract?

Answer 18

Question 19

How does an ascending UTI develop in women?

Answer 19

Once within bladder, bacteria ,multiply then pass up the ureters, especially if vesicoureteral reflux present, to the renal pelvis and parenchyma

Question 20

How do renal tract abnormalities affect UTIs?

Answer 20

Question 21

What are the causes of obstruction?

Answer 21

Question 22

What are the neurogenic causes of obstruction

Answer 22

•Neurogenic malfunction

• poliomyelitis,
• tabes dorsalis,
• diabetic neuropathy,
• spinal cord injuries

Question 23

How does reflux affect UTis?

Answer 23

•Vesicoureteral reflux tends to perpetuate infection by maintaining a residual pool of infected urine in the bladder after voiding

Question 24

Describe the haematogenous route to UTIs?

Answer 24

Staph aureus doesn’t usually ascend the kidney

Not a UTI

Question 25

What are the symptoms of UTIs in children \<2 yrs and neonates?

Answer 25

* Failure to thrive * vomiting * fever

Question 26

What are the symptoms of UTIs in children \>2yrs

Answer 26

* frequency * dysuria * abdominal or flank pain

Question 27

What are symptoms of lower UTIs?

Answer 27

Question 28

What are the symptoms of upper UTIs?

Answer 28

Question 29

What symptoms do older patients with UTIs have?

Answer 29

Question 30

How do we investigate UTIs?

Answer 30

Question 31

What are the further ix of UTIs?

Answer 31

Question 32

What are the NICE guideline to treating UTIs in under 65yr olds?

Answer 32

Question 33

What do we need to consider in men under 65yrs?

Answer 33

Question 34

What are the NICE guidelines to treating UTIs in over 65yr olds?

Answer 34

Question 35

How should we interpret results in adults for UTIs? What should we consider?

Answer 35

Question 36

How do you interpret a urine culture in a suspected UTI?

Answer 36

Question 37

What are white cells and epithelial cells indicative of?

Answer 37

Question 38

Why would you get sterile pyuria?

Answer 38

Question 39

Why do we culture organisms?

Answer 39

It is likely that a significant proportion of its wirtth both symptomatic and asymptomatic infection will have less than 105 * does not rule out uti

Question 40

What is the treatment of UTIs

Answer 40

Question 41

What is the significance of fungal infections in UTIs?

Answer 41

* no tx recommended expect if immunocompromised or going for surgery

Question 42

Define pyelonephritis

Answer 42

* Infection of the Kidney * The greater the number of organisms delivered to the kidneys, the greater is the chance of producing infection. * The kidney itself is not uniformly susceptible to infection—very few organisms are needed to infect the medulla, whereas 10,000 times as many are needed to infect the cortex

Question 43

What is pyelonephritis associated with? How do you treat? What do you image

Answer 43

Question 44

What are the complications of UTIs?

Answer 44

Question 45

Explain the use of prophylaxis in UTIs.

Question 46

Answer 46

Squamous epithelial cells

Question 47

Answer 47

Squamous cell epithelial

Question 48

Answer 48

Nitrite