UTI Flashcards
Which UTI is in the kidneys?
Acute/chronic pyelonephritis
Which UTI is in the bladder?
Cystitis
Which UTI is in the urethra?
Urethritis
Which UTI is in the prostate?
Prostatitis
Which UTI is in the epididymis/teste?
Epudidymo-orchitis
Is incidence of UTI’s higher in males or females?
Females
What is one of the most common hospital acquired infections?
UTI
funny that
What are some general predisposing factors for a UTI?
Immunosuppression
Steroids
Malnutrition
Diabetes
What are some predisposing factors for a UTI that are specific to the urinary tract?
Female sex
Sexual intercourse and poor voiding habits (not peeing after sex)
Congenital abnormalities
Stasis of urine
Foreign bodies e.g. catheters
Oestrogen deficiency in postmenopausal women
Fistula between bladder and bowel
Why is female sex a predisposing factor to a UTI?
Females have shorter urethras
What is the most common causative organism of a UTI?
E.coli
Is E.Coli gram positive or negative?
Gram negative
Where do the organisms causing a UTI usually come from?>
The bowel
How else can organisms be transferred and cause UTI’s?
Transurethral route
Bloodstream
Lymphatics
In terms of using the toilet, what can cause a UTI?
Wiping from back to front after bowel movements as could force bowel bacteria into the urethra.
What are some of the features of a UTI in a child?
Diarrhoea
Excess crying
Fever
Nausea and vomiting
Not eating
What are some of the features of a UTI in an adult?
Flank pain
Dysuria (“like passing broken glass”)
Cloudy offensive urine
Uregncy
Chills
What is a classic symptom of a UTI in very old people?
Confusion
->Bankfoot x
What does it suggest if dysuria is at the initiation of urination?
Pathology is located within the urethra
What does it suggest if dysuria is at the end of urination?
Bladder pathology
What are some of the clinical signs of acute pyleonephritis?
Pyrexia
Poor localisation
Loin tenderness at renal angle
Signs of dehydration
Turbid urine
What are the investigations used for UTIs?
Mid-stream sample of urine
Urinalysis in ward e.g. blood, leucocytes, protein, nitrates
Microbiology in a lab using staining etc.
UTI’s aren’t usually anything to worry about in adult females.
However, in a man, child or someone with frequent UTI’s, what might be some follow-up procedures to do?
Ultrasound
Isotope studies to rule out reflux and scarring
What are the principles of management for a UTI?
Identify the infecting organism and institute appropriate treatment
Identify predisposing factors and treat if possible
What is the treatment for a UTI usually?
Fluids
Antibiotics- amoxicillin, cephalosporin, trimethoprim
What is the treatment for a severe UTI?
IV antibiotics
What can cause repeated UTI’s in chilren?
Reflux nephropathy
If a patient requires a long-term catheter, how often does it need to removed to reduce risks of UTI?
Replaced every 12 weeks
What happens as a consequence of recurrent UTI’s?
Chronic pyelonephritis
What happens in chronic pyelonephritis?
Scarring and clubbing of the kidneys over a period of time
What is important to note about acute pyelonephritis pain?
It’s constant
How does pyelonephritis affect the size of the kidney?
Causes enlargement of the kidney
RECAP- what are the four signs of inflammation?
Calor; heat
Rubor; redness
Dolor; pain
Tumour; swelling
Name three gram-negative organisms which can cause a UTI.
i’m just trying to think of potential exam questions and they might have five choices and say which of the following gram - or + is most likely to cause a UTI dik
E.Coli- most common
Proteus mirabilis
Klebsiella species
Name three gram-positive organisms which can cause a UTI.
i’m just trying to think of potential exam questions and they might have five choices and say which of the following gram - or + is most likely to cause a UTI dik
Coagulase- negative staphylococci
Enterococci
Group B streptococci
What advice would you give for recurrent UTI in young women?
-Void after intercourse
-More fluids
-More frequent urination
According to urinary examination today, what are the two drugs most often used to treat UTI’s?
->MSSU samples take a couple of days to come back so often one of these two drugs are given in the mean time as usually cover most bacteria
Trimethoprim
Nitrofurantoin
