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Nephrology > UTI > Flashcards

UTI Flashcards

1
Q

Define bacturia

A

bacteria in urine, symptomatic or asymptomatic

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2
Q

Define UTI

A

symptomatic ̄c +ve culture or dipstick

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3
Q

Define urethral syndrome

A

symptomatic but no bacteriuria

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4
Q

Classification of UTI - uncomplicated, complicated, recurrent, relapse?

A

Uncomplicated: normal GU tract and function
Complicated: abnormal GU tract, outflow obstruction, ↓
renal function, impaired host defence, virulent organism
Recurrent: further infection ̄c new organism
Relapse: further infection ̄c same organism

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5
Q

Presentation of pyelonephritis

A

Fever, rigors
Loin pain and tenderness
Vomiting
Oliguria if ARF

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6
Q

Presentation of cystitis

A 
Frequency and urgency
  Polyuria
  Haematuria
  Dysuria
  Suprapubic tenderness
  Foul smelling urine
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7
Q

Presentation of prostatitis

A

Flu-like symptoms
Low backache
Dysuria
Tender swollen prostate on PR

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8
Q

Causes of sterile pyuria

A 
TB
  Treated UTI
  Appendicitis
  Calculi
  TIN
  Papillary necrosis
  Polycystic Kidney
  Chemical cystitis (e.g. cyclophosphamide)
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9
Q

Risk factors for UTI

A 
Female
  Sex
  Pregnancy
  Menopause
  DM
  Abnormal tract: stone, obstruction, catheter,
malformation
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10
Q

Organisms causing UTI

A

E. coli
Staphylococcus saprophyticus
Proteus (alkaline urine → struvite renal stones) Klebsiella

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11
Q

Investigations for UTI

A

Dipstick
MSU for MCS
Bloods: FBC, U+E, blood cultures (if systemic signs) US: children, men, recurrence, pyelonephritis

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12
Q

Positive culture =

A

> 10^4 CFU/ml pure growth

>10^3 CFU/ml pure growth of E. coli or S. saprophyticus >10^5 CFU/ml mixed growth ̄c one predominant organism

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13
Q

General treatment and advice

A

Drink plenty, urinate often, cranberry juice

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14
Q

Prevention

A

Drink more
Abx prophylaxis
? cranberry juice

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15
Q

Uncomplicated definition and treatment

A

Young-middle aged non-pregnant females with symptoms of lower urinary tract infections
1st line therapy: Trimethoprim PO 200 mg BD for 3 days
Alternative: Nitrofurantoin PO 50mg QDS for 3 days

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16
Q

Complicated definition and treatment

A

Males, older women, catheterised patients, abnormal renal tract, immunocompromised patients, or history of recurrent UTI’s
1st line: Trimethoprim PO 200 mg BD for 5 days
Alternative: Nitrofurantoin PO 50mg QDS for 5 days

17
Q

LUTS with systemic sepsis treatment

A

1st Line: Co-amoxiclav IV 1.2g tds

18
Q

Pyelonephritis treatment plus alternative due to pen allergy

A

1st Line: Co-amoxiclav orally 625mg tds for 14 days
Penicillin allergy: Ciprofloxacin orally 500mg bd for 7 days

19
Q

Catheterised patients treatment

MRSA evidence

A

Antibiotics are only required if patient is systemically unwell. Treat as for complicated UTI if needed.
Trimethoprim and nitrofurantoin are usually active against MRSA - a cause of catheter-related UTI in hospital.

Nephrology (17 decks)

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