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renal system > UTI > Flashcards

UTI Flashcards

1
Q

Give examples of UTIs.

A
  • Pyelonephritis
  • Renal abscess
  • Cystitis
  • Urethritis
  • Prostatitis
  • Epididymo-orchitis
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2
Q

What is the incidence of UTI?

A
  • Common

- Accounts for around 6% of GP consultations

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3
Q

Who is usually affected by UTI?

A
  • F:M 3:1

- Affects 30% of women at some time

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4
Q

What is UTI an important cause of in children?

A

CRF

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5
Q

What is the incidence of pyelonephritis in women?

A

3 per 1,000 women per year

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6
Q

What is the incidence of symptomatic UTI in men?

A

5 per 10,000 men per year

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7
Q

How prevalent is UTI as an HAI?

A

Accounts for around 38% of HAI (the largest contributor)

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8
Q

General factors which make an individual
more susceptible to UTI (or other infection)
include:

A
  • Immunosuppression
  • Steroids
  • Malnutrition
  • Diabetes
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9
Q

What factors may predispose someone to UTI?

A
  • Female sex (short urethra)
  • Sexual intercourse and poor voiding habits
  • Congenital abnormalities e.g. duplex kidney
  • Stasis of urine e.g. due to poor bladder emptying
  • Foreign bodies eg catheters, stones
  • Oestrogen deficiency in postmenopausal women
  • Fistula between bladder & bowel
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10
Q

Why can wiping from front to back after a bowel movement cause UTI?

A

It may force germs into the urethra

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11
Q

What organisms usually cause UTI?

A

Bowel Organisms

  • E. coli
  • Proteus
  • Klebsiella
  • Entercoccus
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12
Q

How can bowel bacteria be transferred to cause UTI?

A
  • Transurethral route
  • Bloodstream
  • Lymphatics
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13
Q

How may bacteria be transferred from the urethra to the bladder?

A
  • Intercourse

- Catheterisation

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14
Q

What events usually occur to result in UTI caused AKI?

A
  • Colonisation
  • Uroepithelium penetration
  • Ascension
  • Pyelonephritis
  • AKI
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15
Q

How can UTI be classified?

A
  • Single episode (90%) vs recurrent

- Complicated vs uncomplicated

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16
Q

What are the clinical features (signs and symptoms) of UTI in children?

A
  • Diarrhoea
  • Excessive crying
  • Fever
  • Nausea and vomiting
  • Not eating
17
Q

What are the clinical features (signs and symptoms) of UTI in adults?

A
  • Flank pain
  • Dysuria (“like passing broken glass”)
  • Cloudy offensive urine
  • Urgency
  • Chills
  • Strangury (desperate to pee but only small/nothing comes out)
  • Confusion (very old people)
18
Q

What are the clinical features of acute pyelonephritis?

A
  • Pyrexia
  • Poor localisation
  • Loin tenderness (renal angle)
  • Signs of dehydration
  • Turbid urine
19
Q

How should UTI be investigated?

A
  • MSSU
  • Urinalysis in ward
  • Microbiology in lab (microscopy and gram staining)
20
Q

What are you looking for in the urinalysis carried out on the ward?

A
  • Blood
  • Leucocytes
  • Protein
  • Nitrites
21
Q

When should culture and sensitivity be carried out on urine samples?

A

Bacteruria >10^5 CFU/ml

22
Q

What should be carried out on children, males or recurrent UTI patients?

A
  • US or IVU may be helpful

- Isotope studies to rule out reflux and scarring

23
Q

What are the principles of UTI management?

A
  • Identify the infecting organism & institute appropriate treatment
  • Identify predisposing factors and treat if possible
24
Q

What is the treatment for UTI?

A
  • Fluids
  • Antibiotics
  • IV antibiotics (for severe infections)
25
Q

What antibiotics can be used in the treatment of UTI?

A
  • Amoxicillin
  • Cephalosporin
  • Trimethoprim
26
Q

What can abnormal urinary tracts causes?

A

Infections and sometimes lead to renal impairment

27
Q

What can cause an abnormal urinary tract?

A
  • Anatomical / neurological abnormalities
  • Stones
  • Diabetes
28
Q

How can reflux nephropathy present?

A

As UTIs in children

29
Q

What causes damage in reflux nephropathy?

A

Damage is caused by reflux and infection

30
Q

How can reflux nephropathy be investigated?

A
  • Micturating cystogram (radionuclide 99Tc techniques)

- Assess progression by ultrasound scan & biochemistry

31
Q

How is reflux nephropathy treated?

A

Surgery

32
Q

What advice should be given to those with recurrent infections?

A
  • Fluid intake 2l / day
  • Void every 2-3 hours by day
  • Void before bedtime & before and after intercourse
33
Q

When should someone with an indwelling catheter be given antibiotics?

A

Only is the patient is symptomatic and the catheter should be replaced

34
Q

What is inevitable with indwelling catheters?

A

Colonisation

35
Q

What type of technique must be carried out with indwelling catheters?

A

Aseptic

36
Q

What is important to note with bacteruria?

A

30% will progress to symptomatic illness

37
Q

How can chronic pyelonephritis present?

A
  • Scarring and clubbing
  • Hypertension/CRF
  • ?Reflux
38
Q

What can chronic pyelonephritis progress to?

A

15% progress to renal failure

39
Q

How is chronic pyelonephritis diagnosed?

A

Radiological diagnosis

renal system (26 decks)

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