UTI

Question 0

Describe the appropriate clinical and laboratory investigations used to diagnose UTI

Answer 0

Clinical - visual (colour), urine dipstick (leucocyte esterase, nitrate, proteinuria), turbidity
Laboratory - culture, urology

Question 1

Describe some host and bacterial factors in UTI

Answer 1

Host factors:
Shorter urethra (female)
Obstruction
Neurological (incomplete emptying)
Ureteric reflux (ascending infection)
Bacterial factors:
Fimbrae allow for attachment to host epithelium
Haemolysins damage host membrane
Urease breaks down urea creating a favourable environment for growth
K antigen permits production of polysaccharide capsule

Question 2

Describe appropriate treatments and prophylaxis of UTI

Answer 2

Increase fluid intake
Uncomplicated UTI - 3 day course trimethoprim/nitrofurantoin
Complicated UTI - 5 day course cephalexin

Question 3

Describe appropriate treatment and prophylaxis of pyelonephritis

Answer 3

14 day course co-amoxiclav

Question 4

Describe some clinical syndromes and symptoms of UTI

Answer 4

Cystitis (LUTI) - low grade fever, dysuria, frequency 
Acute pyelonephritis - loin pain, fever 
Chronic nephritis (UUTI)
Asymtommatic bacteruria
Septicaemia +/- shock

Question 5

Explain the difference between uncomplicated and complicated UTI

Answer 5

Uncomplicated - healthy female of child bearing age

Complicated - paediatric, elderly, pregnant, male, recurrent infections

Question 6

Describe some common sites and causes of UTI

Answer 6

Sites - pelvic ureteric junction, ureter, bladder neck, prostate, urethra
Causes - calculi, increased calcium, strictures