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Renal & Urology > UTI > Flashcards

UTI Flashcards

1
Q

Define Urinary Tract Infection (UTI)?

A

The presence of a pure growth oif > 10^5 organisms per mL of fresh MSU

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2
Q

What is the sub-classification of UTI?

A

Lower UTI

Upper UTI

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3
Q

What does the Lower UTI affect?

A

Urethra (urethritis)
Bladder (cystitis)
Prostate (prostatitis)

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4
Q

What does the Upper UTI affect?

A

Renal Pelvis (pyelonephritis)

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5
Q

What’s important to remember about the lab classification of UTI?

A

1/3 of women with symptoms of UTI will have a negative MSU

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6
Q

What is the other classification of UTIs?

A

Uncomplicated UTI

Complicated UTI

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7
Q

What are the characteristics of Uncomplicated UTI?

A

Normal renal tract and funxtion

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8
Q

What are the characteristics of Complicated UTI?

A

Abnormal renal/genitourinary tract, voiding difficulty/obstruction, reduced renal function, impaired host defences, virulent organism (e.g. S. aureus)

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9
Q

What are more UTIs caused by?

A

Escherichia coli

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10
Q

What are the other causative organisms of UTIs?

A

Staphylococcus saprophyticus
Proteus mirabilis
Enterococci

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11
Q

What are the atypical organisms that can cause UTI?

A

(usually in immunocompromised individuals)
Klebsiella
Candida albicans
Pseudomonas aeruginosa

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12
Q

What are the risk factors for UTIs?

A 
Female 
Sexual intercourse 
Exposure to spermicide 
Pregnancy
Menopause 
Immunosuppression
Catheterisation
Urinary tract obstruction
Urinary tract malformation
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13
Q

What is the epidemiology of UTIs?

A

Very common
1-3% of GP consultations
The majority of women will have a UTI in their lifetime
Much more common in FEMALES

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14
Q

What are the presenting symptoms of Cystitis?

A 
Frequency
Urgency 
Dysuria 
Haematuria 
Suprapubic pain
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15
Q

What are the presenting symptoms of Prostatitis?

A

Flu-like symptoms
Low backache
Few urinary symptoms
Swollen or tender prostate on PR

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16
Q

What are the presenting symptoms of Acute Pyelonephritis?

A 
High fever 
Rigors 
Vomiting 
Loin pain and tenderness 
Oliguria (if AKI)
17
Q

What are the signs of UTI on physical examination?

A 
Fever 
Abdominal or loin tenderness 
Foul-smelling urine 
Distended bladder (occasionally)
Enlarged prostate (if prostatitis)
18
Q

What investigations do we do for UTIs?

A 
Urine Dipstick 
Urine Microscopy
Urine Culture 
Ultrasound 
Bloods
19
Q

What do we see on a Urine Dipstick for UTIs?

A

Positive leucocyte esterase and nitrites

20
Q

What do we see in Urine Microscopy for UTIs?

A

Presence of leucocytes indicates infection

21
Q

Why do we do Urine Culture for UTIs?

A

To exclude diagnosis of it the patient failed to respond to empirical antibiotics

22
Q

Why do we do US for UTIs?

A

Rule out obstruction

23
Q

What bloods do we do for UTIs?

A

FBC
U&Es - check renal function
CRP
Blood cultures - if systemically unwell and risk of urosepsis

24
Q

What is the Empirical treatment of uncomplicated UTI?

A

Trimethoprin or Nitrofurantoin
Treat for 3-6 days
Men with UTI may need a longer course of antibiotics

25
Q

What are some alternative treatments of UTIs?

A

Co-amoxiclav

Cefalexin

26
Q

What is the other treatment of UTIs?

A

Prophylactic antibiotics may be used in certain circumstances (e.g. recurrent cystitis associated with sexual intercourse)

27
Q

What can ascending infection lead to in UTIs?

A 
Pyelonephritis 
Perinephric and intrarenal abscess 
Hydronephrosis or pyonephrosis 
AKI
Sepsis
28
Q

What complication is common in men with UTIs?

A

Prostatic involement (e.g. prostatitis)

29
Q

What is the prognosis for UTIs?

A

GOOD prognosis with appropriate treatment

Renal & Urology (18 decks)

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