UTI

Question 1

UTI?

Answer 1

The presence of a pure growth of >105 organisms per ml of fresh MSU. Lower UTI (rethra, bladder, prostate), upper UTI (renal pelvis).

Question 2

UTI aetiology?

Answer 2

most caused by Echerishia coli

Question 3

UTI risk factors (7)?

Answer 3

female, sexual intercourse, exposure to spermicide, pregnancy, menopause, immunosuppression, catherterisation.

Question 4

UTI epidemiology?

Answer 4

very common, 3% of GP consultations, much more common in females

Question 5

UTI symptoms of cystitis?

Answer 5

frequency, urgency, dysuria, haematuria, suprapubic pain.

Question 6

UTI symptoms of prostatitis?

Answer 6

flu-like symptoms, low backache, few urinary symptoms, swollen or tender prostate on PR.

Question 7

UTI symptoms of pyelonephritis?

Answer 7

high fever, rigors, vomiting, loin pain and tenderness

Question 8

UTI signs?

Answer 8

fever, abdo or loin tenderness, foul-smelling urine, distended bladder, enlarged prostate

Question 9

UTI investigations?

Answer 9

urine dipstick will be positive for leucocyte esterase and nitrates, USS to rule out obstruction, U&Es to check renal function, blood culture if systemically unwell and risk of urosepsis.

Question 10

UTI management?

Answer 10

empirical treatment of uncomplicated UTIs; trimethoprim or nitrofurantoin for 3-6 days.

Question 11

UTI complications?

Answer 11

Ascending infection can lead to pyelonephritis, perinephric and intrarenal abscess, AKI, sepsis.