UTI Flashcards
UTIs
• More common in (boys or girls?) than (boys or girls?)
• (Men or Women?)- greater risk than (men or women?) - 40 5-0% vs 0.04%
Girls; boys
Women; men
Aetiology of acute uncomplicated UTI
Most commonly by _________
E.coli
Aetiology of Complicated UTIs
Organisms:
Viruses:
Fungi:
Protozoa:
Pseudomonas, enterobacter, serratia
Rubella, mumps, HIV
Candida, histoplasma
T.vaginalis, S.hematobium
Factors that suggests complicated UTI
• __________ or ________ of urinary tract
•_____ gender
•________
•_______ Or ______ patient (age)
• Diabetes
• Immunosuppression
Functional or anatomic abnormality
Male; Pregnancy
Elderly; Childhood
Factors that suggests complicated UTI
•Recent __________ use
• Indwelling ________
•Urinary tract instrumentation
•_________-acquired infection
• Symptoms at presentation
antimicrobial agent
urinary catheter
Hospital
Risks that could predispose one to UTI
REDUCED _________
PROMOTE ————-
FACILITATE __________
URINE FLOW
COLONIZATION
ASCENT
Risks that could predispose one to UTI
REDUCED URINE FLOW
•prostatic _________ ,Outflow ________, prostatic _________
• urethral _______, foreign body
(_________ )
•_________ bladder
• Inadequate _______________
carcinoma; obstruction; hyperplasia
stricture; calculus
Neurogenic
fluid uptake (dehydration)
Risks that could predispose one to UTI
PROMOTE COLONIZATION
•____________-increased inoculation
• __________- increased binding
•_________ depletion-increased binding
•______________ - decreased indigenous flora
Sexual activity
Spermicide
Estrogen
Antimicrobial agents
Risks that could predispose one to UTI
FACILITATE ASCENT
• _____________
• Urinary _________
• Fecal _________
• Residual urine with ___________
Catheterization
incontinence
incontinence
ischemia of bladder wall
Pathogenesis of UTIs - 4 Routes Of Entry
•________ infection - most common, _________
• __________ spread
• __________ spread
•___________ from other organs - PID, GU Fistula
Ascending; intrarenal reflux
Blood-borne
Lymphatogeneous
Direct extension
Risk factors of UTIs
Females- ________,________,________,_________
Males: _______,_______,_______
Shorter urethra ; sexual intercourse; contraceptives; incomplete bladder emptying
BPH; bacterial prostatitis; age
Clinical manifestations of UTIs
• Depends on the site of the infection
• Urethritis -________,________,________
• Cystitis - _____,_____,______, pelvic ______,________ pain ,________,_______
• Pyelonephritis:_______,______,_______,______,_________
dysuria; urgency; frequency
dysuria; urgency; frequency ; discomfort, suprapubic pain, haematuria,pyuria
fever, sepsis, shock;chills; rigor
INVESTIGATIONS to confirm UTIs
• URINE: _______,_______,________
• Imaging - ______,______,______
Microscopic examination, Urinalysis, Urine culture
USS, CT Scan, MRI
URINE SAMPLES
• Uncontaminated ___________ urine sample
• Methods OF Collection.
-stick on bags
- _________
-_________________ - gold standard
mid-stream
catheterization
suprapubic aspirations
Abnormal urine MCS finding
Bacteria > ___/mL
10^5
Treatment of UTI
• Asymptomatic
- _________ treatment is required except in special situations
- Non-specific therapy
- adequate ________
- Maintaining _______ of urine by taking fluids like __________
No
water intake
acidity; cranberry juice
_______ and ———— are the drug of choice in renal failures
Penicillin
Cephalosporin
Blood level of drugs are important in ___________
Pyelonephritis
Treatment Duration
•______ dose therapy
• _____-day therapy
• _____-day course
• ______ day course
Single
3
7
10-14
Advantage of 3-day therapy over 7-day
Same efficacy but less side effects
___ day therapy is useful in pregnancy
7
_____ day therapy is useful for complicated UTI
14
How to handle bacteruria in pregnancy
Aim is to prevent _______
__ day therapy is done
Therapy continues _________________
Pyelonephritis
7
At regular interval during pregnancy
