UTI Pathology

Question 1

What are four bacteriostatic properties of a normal urinary tract?

Answer 1

Free flow of urine through normal anatomy flushes bacteria out– assumes drinking enough fluids
Low pH, high osmolality, and high ammonia (NH3) content of normal urine
prostatic secretions are bacteriostatic
anti-bacterial antibodies

Question 2

What part of the urinary tract isn’t sterile?

Answer 2

Urethra

Question 3

What is an MSSU?

Answer 3

Mid stream specimen urine (patient starts peeing then stops and collects the rest of the sample so as much bacteria is flushed as possible) Cant get a negative MSSU as will always be able to culture something from the urethra

Question 4

What do the log degree of MSSU indicate about infection

Answer 4

<10(3) means probably no infection
10(3)-10(4) possible infection
10(5) is an infection
Pathology report will indicate if there are pathogenic bacteria at low levels

Question 5

What is the usual causative organism of UTI?

Answer 5

E. Coli

Very rarely viral

Question 6

What is inflammation of the urethra, ureter, bladder and kidney called?

Answer 6

Urethra – urethritis 
Bladder – cystitis
Ureter – ureteritis
Kidney – acute pyelonephritis 
Kidney – if recurrent/prolonged infection chronic pyelonephritis

Question 7

What are three predisposing factors of UTI?

Answer 7

Stasis of urine (congenital abnormality or obstruction or spinal problem)
Pushing bacteria up urethra from below (sexual intercourse or catheterisation)
Generalised predisposition to infection (diabetes or immunocompromised)

Question 8

What does an obstruction at the level of the urethra cause?

Answer 8

Upper urethral and bladder dilatation
Bilateral hydroureter
Bladder dilatation, bilateral hydroureter and bilateral hydronephrosis and eventual chronic renal failure

Question 9

What does an obstruction at the level of one of the ureters cause?

Answer 9

Unilateral hydroureter

unilateral hydronephrosis but still got one working kidney

Question 10

What is vesicoureteric reflux?

Answer 10

A congenital abnormality of the ureters that means they do not enter the bladder at an angle. This means get reflux with hydroureter which might be picked up on scan.

Question 11

What are common causes of obstruction in adults?

Answer 11

Men – Benign Prostatic Hyperplasia (not a tumour) of prostate – functional and anatomical obstruction
Women – uterine prolapse
Both sexes – tumours and calculi

Question 12

Why are females more disposed to UTI than males?

Answer 12

Short urethra
Lack of prostatic bacteriostatic secretion
Closeness of urethral orifice to rectum
Sexual activity – (helps if void after intercourse)
Pregnancy – pressure on ureters and bladder