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Y2 Renal > UTI > Flashcards

UTI Flashcards

1
Q

Cystitis is often referred to as…

A

a lower UTI

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2
Q

Pyelonephritis is…

A

a upper UTI

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3
Q

The kidneys, ureters, bladder and urethra are normally sterile - TRUE/FALSE

A

FALSE - the lower urethra is normally colonised by coliforms and enterococci

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4
Q

What is meant by a complicated UTI?

A

a UTI complicated by systemic symptoms or urinary tract structural abnormalities

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5
Q

Bacturia does not always mean a UTI - TRUE/FALSE

A

TRUE - bacteria in the urine may not mean infection in the elderly or catheterised patients; ask about symptoms

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6
Q

All cystitis is infection - TRUE/FALSE

A

FALSE - cystitis simply refers to inflammation in the bladder

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7
Q

Risk factors for a UTI (7)

A

Female sex, sexual contact, pregnancy, immunosuppression/compromise, obstruction, malformation, familial

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8
Q

You should treat a positive urine dipstick without symptoms in pregnancy - TRUE/FALSE

A

TRUE - many women who are positive may be asymptomatic until they develop pyelonephritis or fetal death occurs

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9
Q

You should treat a positive urine dipstick without symptoms in the elderly - TRUE/FALSE

A

FALSE - only treat if symptomatic

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10
Q

You should treat a positive urine dipstick without symptoms in patients with a catheter - TRUE/FALSE

A

FALSE - the longer a catheter is in place, the more likely it is to be colonised

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11
Q

Symptoms of a UTI

A

Dysuria, frequency of urination, nocturia, haematuria, fever, loin pain, rigors

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12
Q

Which symptoms of a UTI suggest pyelonephritis?

A

fever, loin pain, rigors

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13
Q

What are some risk factors for developing pyelonephritis?

A

diabetes, HIV/AIDs, immunosuppression, UT abnormalities

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14
Q

Whhat form of specimen should be collected for urinary culture and why?

A

Mid-stream urine - the initial urine passed will be contaminated with colonisers of the urethra

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15
Q

What features of a urine dipstick suggest infection?

A

Leukocytes (WBCs), Nitrites - coliforms convert nitrates to nitrites

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16
Q

Why are protein and blood not necessarily suggestive of infection?

A

protein should not be positive, blood may suggest infection or may be a sign of other things

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17
Q

What are the ideal features of an antibiotic used to treat an uncomplicated lower UTI?

A

excreted in the urine, oral, inexpensive and few side effects

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18
Q

What is abacterial cystitis/urethral syndrome?

A

when a patient has symptoms of a UTI but no growth in culture

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19
Q

What may cause abacterial cystitis/urethral syndrome?

A

early phase UTI, urethral trauma (honeymoon cystitis), urethritis (chlamydia/gonorrhoea)

20
Q

Do you treat asymptomtomatic bacturia?

A

Only in pregnant women, not in the elderly

21
Q

When should a catheterised patient with significant bacteruria be given antibiotics?

A

Only when there is supporting evidence of UTI - unneccessary antibiotics may only result in resistance

22
Q

Treatment for lower UTI - women

A

trimethoprim or nitrofurantoin - 3 days/PO

23
Q

What organisms does trimethoprim treat?

A

coliforms

24
Q

Treatment for lower UTI - men

A

trimethoprim or nitrofurantoin - 7 days/PO + get cultures

25
Q

Treatment for complicated UTI/pyelonephritis - GP

A

Co-amoxiclav or co-trimoxazole - 14 days

26
Q

What organism does co-trimoxazole treat?

A

enterococci

27
Q

Treatment for complicated UTI/Pyelonephritis - Hosp

A

Amoxicillin and gentamicin - 3 days/IV; co-trimoxazole if penicillin allergic

28
Q

What organisms does amoxicillin treat?

A

enterococci

29
Q

What organisms does gentamicin treat?

A

coliforms

30
Q

4 Cs of C.difficile

A

Cephalosporins, co-amoxiclav, clindamycin, ciprofloxacin

31
Q

Extended spectrum beta lactamases are resistant to…

A

all cephalosporins and almost all penicillins

32
Q

Extended spectrum beta lactamases in UTIs may respond to…

A

Nitrofurantoin

33
Q

Which antibiotic should be avoided in first trimester of pregnancy?

A

trimethoprim

34
Q

Which organisms does trimethoprim not treat?

A

pseudomonas

35
Q

Trimethoprim may also be found in which antibiotic?

A

co-trimoxazole - trimethoprim + sulphamethoxazole

36
Q

What condition is associated with co-trimoxazole?

A

Steven Johnson Syndrome

37
Q

Which antibiotic should be avoided in late pregnancy, breast feeding and babies under 3 months?

A

nitrofurantoin

38
Q

Which organisms does nirtofurantoin not treat?

A

pseudomonas

39
Q

Common causative organisms of UTIs?

A

e.coli, proteus, pseudomonas, enterococcus faecalis, staph saphrophyticus

40
Q

E.coli is a…

A

gram neg. coliform; endotoxin causes fever

41
Q

Proteus produces…

A

urease –> ammonia and a foul smelling urine (burnt chocolate); produces swarming cultures

42
Q

Pseudomonas is a…

A

gram neg. bacillus

43
Q

What is pseudomonas associated with?

A

catheters and equipment

44
Q

Which antibiotic best treats pseudomonas?

A

cipfrofloxacin - not to be used in pregnant women/young kids

45
Q

Which organism is most commonly associated with hospital acquired infections?

A

enterococcus faecalis

Y2 Renal (3 decks)

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