UTI Flashcards
How would a UTI present?
- Dysuria (pain on micturation)
- Frequency/urgency
- Smelly cloudy urine
- Chills
- Flank Pain
- Strangury (Wanting to void but can’t)
- Confusion (elderly)
What microorganisms cause UTI?
Mostly bowel organisms
- E. Coli
- Proteus Spp.
- Klebsiella Spp.
- Pseudomonas Aeruginosa
- Enterococci
What do we call infalmmation of the urethra, bladder, ureter or kidney?
Urethritis
Cystitis
Ureteritis
Acute Pyeonephritis (chronic if recurrent or prolonged)
What are the main tests for UTI?
Dipstick Urinalysis
Mid Stream specimen of Urine - MSSU for urine culture & Microscopy
Suprapubic aspiration (mainly for people who cant give an MSSU e.g. young kids or elderly)
How do you tell if bacteria in a urine culture are pathogenic or contaminating commensals?
They grow in log scales in the culture. 10^5 is almost certainly infectious even if asymptomatic.
What are the complications of a UTI?
- Sepsis and septic shock
- Chronic pyelonephritis
- Calculi –> Obstruction –> Hydronephrosis –> Hypertension & chronic renal failure
What are the categories of UTI aetiology?
1) Stasis of Urine (either obstruction or loss of full bladder feeling)
2) Pushing bacteria up urethra (sex in women or urological procedures)
3) Generalised predisposition to infections (e.g. diabetes)
What can cause you to lose the feeling of a full bladder?
A spinal cord or brain injury
Whats the main cause of obstruction in children?
Vesicouretic reflux
Its a loss of the angle of entry of ureter to bladder
What are the main causes of obstruction in adults?
- Benign Prostatic Hyperplasia (men)
- Uterine Prolapse (Women)
- Tumours & Calculi (both)
What are the consequences of an obstruction?
back up of urine causing hydroureter and hydronephrosis and eventually chronic renal failure.
Slowed flow –> Infection & sediment formation (calculi)
Why are women more at risk of UTIs?
- Short urethra
- No prostatic bacteriostatic secretion
- Close urethral orifice to rectum
- Sexual activity (vagina just behind urethra so pushes bacteria up)
- Pregnancy pressures the ureter & bladder
Why does diabetse predispose you to UTIs?
1) Glc in urine
2) Poorly functioning WBCs
How would a UTI present in a small child?
Non-specific symptoms
- Diarrhoea
- Crying & not eating
- N&V
- Fever
How would pyelonephritis appear?
~dehydration Fever Loin/flank pain ~systemic unwellness/bacteraemia Cloudy Urine
