UTI

Question 1

What is a urinary tract infection (UTI)?

Answer 1

A UTI is an infection in any part of the urinary system, including kidneys, ureters, bladder, and urethra. Most infections affect the lower urinary tract (bladder & urethra).

Question 2

Who is at higher risk for UTIs?

Answer 2

Women are at greater risk, with UTIs being 50 times more common in women aged 20–50 than in men.

Question 3

What are the classifications of UTI by location?

Answer 3

• Upper UTI: Pyelonephritis (acute, chronic)
• Lower UTI: Cystitis (bladder), Urethritis (urethra), Prostatitis (prostate), Epididymitis (epididymis)

Question 4

What are the classifications of UTI by complexity?

Answer 4

• Uncomplicated UTI: Infections in non-pregnant women with no structural abnormalities, responsive to antibiotics.
• Complicated UTI: Occurs in children, men, pregnant women, or those with structural abnormalities.

Question 5

What are some iatrogenic risk factors for UTI?

Answer 5

Indwelling catheters, antibiotic use, spermicides.

Question 6

What are some behavioral risk factors for UTI?

Answer 6

Frequent sexual intercourse, voiding dysfunction.

Question 7

What are some anatomic/physiologic risk factors for UTI?

Answer 7

Short urethra in females, pregnancy, vesicoureteral reflux (VUR).

Question 8

What are genetic risk factors for UTI?

Answer 8

Familial tendency, uroepithelial susceptibility.

Question 9

What are the most common bacteria causing UTIs?

Answer 9

Gram-negative bacteria (most common):
- Escherichia coli (75–95%)
- Klebsiella, Proteus mirabilis, Pseudomonas aeruginosa
Gram-positive bacteria (less common):
- Staphylococcus saprophyticus (5–10%)
- Enterococcus faecalis, Streptococcus agalactiae

Question 10

What are the routes of UTI infection?

Answer 10

• Ascending (most common)
• Iatrogenic
• Hematogenous
• Lymphogenous
• Extension from neighboring organs

Question 11

Describe the steps in UTI pathophysiology.

Answer 11

1. Bacterial colonization of urethra → Migration to bladder
2. Inflammatory response in bladder
3. Bacterial invasion → Neutrophil infiltration
4. Biofilm formation → Tissue damage
5. Bacteria ascend to kidneys

Question 12

How does the body naturally prevent UTIs?

Answer 12

• Urine: Acidic pH, high osmolality, bacterial adherence inhibitors, flushing effect.
• Mucosal Immunity: Cytokine secretion, mucopolysaccharides, IgA, bactericidal prostatic secretions in men.

Question 13

What are common symptoms of UTI?

Answer 13

Dysuria, urgency, frequency, burning urination, suprapubic pain, fever, hematuria, abdominal pain.

Question 14

What are key symptoms of different UTI types?

Answer 14

• Urethritis: Urethral discharge
• Cystitis: Bladder irritation, painful urination
• Pyelonephritis: Fever, flank pain, costovertebral tenderness
• Prostatitis: Tender prostate on DRE

Question 15

What lab tests are used to diagnose UTI?

Answer 15

• Urinalysis: Leukocyte esterase, nitrites, WBCs, RBCs, pus cells
• Urine culture: Bacteria count >10⁵ CFU/ml
• Blood tests: WBC count, CRP, ESR
• Renal function tests: Creatinine, urea, electrolytes
• Imaging: KUB ultrasound, IVU, MRI, CT scan

Question 16

What are the primary treatments for UTI?

Answer 16

• Antibiotics: Based on causative organism & resistance pattern
• Supportive care: Analgesics, antipyretics, hydration
• Lifestyle modifications: Avoid irritant drinks, drink water, use heating pads

Question 17

When should a patient with UTI be hospitalized?

Answer 17

• Severe illness or sepsis
• Presence of complications
• Non-responsiveness to outpatient treatment
• Inability to maintain oral hydration

Question 18

What are potential complications of untreated UTI?

Answer 18

• Recurrent infections
• Kidney damage (pyelonephritis)
• Increased risk of premature birth in pregnant women
• Urethral strictures (in men)
• Sepsis (life-threatening bloodstream infection)