UTI

Question 1

why are women more prone

Answer 1

Shorter + Wider Urethra closer proximity to the anus

Question 2

threshold for bacteria

Answer 2

> X105 C

Question 3

examples of aysymptomatic bacteriuria

Answer 3

Asymptomtamic bacteriuria: Significant bacteriuria in 2 consecutive mid-stream samples
in women or 1 in men WITHOUT any symptoms of UTI - Common in pregnancy

Question 4

lower uTI

Answer 4

Predominantly bladder infection, can also involve urethra and prostate
Posthitis, balanitis, balanoposthitis, cavernitis, orchitis, epididymitis,
epididimorchitis, urethritis, prostatitis, cystitis

Question 5

balantititis

Answer 5

Balanitis is pain and inflammation (swelling and irritation) of the glans (head) of the penis that happens most often in uncircumcised males.

Question 6

balanoposthitis

Answer 6

an inflammation that affects both the glans penis and prepuce

Question 7

complicated uTI

Answer 7

males 
pregnancy 
congenital anomalies 
resistant to AB'S
obstruciton 
immunodeficiency

Question 8

recurrent UTI

Answer 8

> 2 infections within 6 months or 3 infections within 1yr

Question 9

isolated UTI

Answer 9

Interval of at least 6 months between infections

Question 10

RF

Answer 10

women
sexual activity - multiple sexual partners
SPERMICIDES
not drinking enough water
menopause - alterations in vaginal flora, including replacement of lactobacilli by potential uropathogens.

diabetes 
catheters - non social infection 
bad Hygiene 
POLYCTSTIC KIDNEY DISEASE 
colovesical fistula 
spinal cord injury causing a neurogenic bladder 
VUR

Question 11

organisms

Answer 11

gy
Gram (-Ve): E.coli (80%), Klebsiella
S.epidermidis: Common in women?

s. saprophyticus, a coagulase-negative staphylococcal species, is an organism virtually unique to acute cystitis.(lecture)
P.miribilis: Suspect if staghorn calculi present also
Fungal & Staph spp: Associated with hematogenous spread
Viral infections: Adenovirus (rare)

Question 12

pathogenies

Answer 12

1. Ascending mode of entry of infection into upper urinary tract (95%)- usually GRAM NEGATIVE
   2.hematogenous - gram + staphylococcal
2. Direct extension of infection from adjacent organs - surgical point of view
   Fistulas - vesicointestinal/recta
   4 .lymph- but little evidence

Question 13

why are elderly more at risk

Answer 13

prolapsed organs which impaired bladder emptying , more states of urine in general

Question 14

charactersisc of pyelonpehriits

Answer 14

FEVER !!!!!
postive succucio renalis
general intoxicated state, nausea, vomiitn

Question 15

complications

Answer 15

May develop peritonitis Peri-renal Abscess formation

Rupture Peritonitis

Question 16

urine findings

Answer 16

k: Elevated Leukocyte esterase (detect a substance that suggests there are white blood cells in the urine) + Nitrite (bacteria reduce nitrate to nitrite) +
RBC’s and Proteinuria (1g10 WBC/mL

Question 17

pyuria

Answer 17

Pyuria >10 WBC/mL

Question 18

false negative

Answer 18

Antibiotics, soap, fastidious organism (don’t grow on

agar), TB

Question 19

indications for urine culture

Answer 19

pregnancy
sepsis
children

Question 20

what should you always do when you suspect UTI in patient

Answer 20

always give ab’s!

always do imaging to look for a stone!

Question 21

dx of pyelonephritis

Answer 21

Acute cholecystitis, Appendicitis, Renal colic, Pelvic inflammatory disease, lower lobe pneumonia

Question 22

most common uti in men without any anomalies

Answer 22

proasttits

Question 23

REINFECTION VS RELAPSE

Answer 23

reinfection : usually a diff organism

relapse: sme organismi persist despite microbial therapy

Question 24

host protective factors

Answer 24

The normal flora of the distal urethra plays an important role in host defense by preventing colonization at this site by potential uropathogens.
Urine is a good nutrient source for most bacterial species, and common uropathogens grow well in urine.
The most important host defense that maintains sterility of the urine is normal, unobstructed voiding.

Tamm-Horsfall protein prevents attachment of Escherichia coli to uroepithelial cell receptors and also removes other uropathogens such as Klebsiella pneumoniae and Staphylococcus saprophyticus

secretory ig a too, urine iG G

Question 25

rf in men

Answer 25

Acute uncomplicated urinary tract infection in men is uncommon, but reported risk factors have included intercourse with a female partner with recurrent urinary tract infection, not being circumcised, and anal intercourse.

Question 26

where are you most likely to see gross hematuria

Answer 26

acute cystitis