UTI Pathology

Question 1

How does a UTI commonly present?

Answer 1

Dysuria, frequency, smelly urine

Question 2

What occurs in increased fluid intake?

Answer 2

Decreased resorption of fluid, increased urine output

Question 3

Why is the ureter tapered?

Answer 3

To stop influx of urine on increased pressure

Question 4

What are features of normal urine ?

Answer 4

Low pH, High osmolality, high ammonia content

Question 5

What site of the Urinary Tract is not sterile?

Answer 5

Terminal Urethra

Question 6

What is not wanted in a urine sample?

Answer 6

The initial void

Question 7

What is the best method of obtaining a urine sample?

Answer 7

Mid Stream Specimen of Urine

MSSU

Question 8

What is indicative of a UTI in an MSSU?

Answer 8

Growth level of 10^5

Question 9

If MSSU culture shows a 10^3/10^4 result, what else must be present to indicate UTI?

Answer 9

UTI symptoms

Question 10

When are MSSU’s difficult to obtain?

Answer 10

When patients are elderly or young children

Question 11

What is the most likely causative organism of a UTI?

Answer 11

e. coli

Question 12

What is the route of infection seen in a UTI/

Answer 12

Usually ascending

Question 13

Define urethritis?

Answer 13

Inflammation of urethra

Question 14

Define cystitis ?

Answer 14

Inflammation and infection of bladder

Question 15

Define ureteritis?

Answer 15

Inflammation and infection of ureter

Question 16

Define acute pyelonephritis?

Answer 16

Inflammation of the kidneys

Question 17

What are the three predisposing features of UTI’s?

Answer 17

Stasis of urine, pushing up of bacteria from below, generalised predisposition to infection

Question 18

What causes stasis of urine?

Answer 18

Obstruction or loss of “feeling” of full bladder due to spinal cord/brain damage

Question 19

What causes bacteria to be pushed up the urethra?

Answer 19

Sexual activity in females or catheterisation

Question 20

Why does stasis of urine cause a UTI??

Answer 20

Urine cannot be flushed out

Question 21

What are the consequences of obstruction?

Answer 21

Proximal dilation, slowed urine flow, cannot flush out bacteria = INFECTION

Slowed flow = sediment formation = OBSTRUCTION

Question 22

What is vesicoureteric reflux?

Answer 22

Decreased angulation of ureter = Increased reflux

Question 23

What are the most common causes of obstruction?

Answer 23

Men - benign prostate hyperplasia

Women - Uterine Prolapse

Both sexes - tumours and calculi

Question 24

How does spinal cord/brain injury cause UTI?

Answer 24

Decreased sensation = no sense of when to urinate or empty bladder = urine left in bladder = stasis of urine

Question 25

Why are females more prone to UTI's after sex?

Answer 25

Short urethra with lack of prostatic bacteriostatic secretion

Question 26

Why does pregnancy increase UTI chances?

Answer 26

there is pressure on ureters and bladder

Question 27

What is hydroenephrosis?

Answer 27

Water in kidneys

Question 28

Why are those with poorly controlled diabetes prone to UTI'S?

Answer 28

Glucose secreted in urine = ideal environment for bacterial growth

Question 29

Why does catheterisation cause UTI's?

Answer 29

Any instrumentation of UTI pushes flora up UT