UTI - Pathoma Flashcards
What three regions can you get a UTI in?
- Urethra
- Bladder
- Kidney
What direction do most UTI’s progress?
Most commonly ASCENDING infection
What are three common risk factors for UTI?
- Sexual intercourse
- Urinary stasis
- Catheters
What symptoms are absent in cystitis?
Systemic signs (e.g. fevers, chills)
What are the typical laboratory findings in cystitis?
- UA: cloudy urine with > 10 WBC’s/hpf
- Dipstick: positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites)
- Culture: GOLD STANDARD, >100,000 colony forming units
What is the most common pathogen causing cystitis?
E.coli (80%)
What pathogen causing cystitis has an increased incidence in young, sexually active women?
Staphylococcus saprophyticus
What interesting finding results when cystitis is caused by Proteus mirabilis?
alkaline urine with ammonia scent
What does sterile pyuria (>10 WBCs/hpf and leukocyte esterase) with a negative urine culture suggest?
Urethritis due to Chlamydia trachomatis or Neisseria gonorrhoeae.
(dominant presenting sign = dysuria)
What causes an increased risk for pyelonephritis?
Vesicoureteral reflux (from bladder up the ureters)
How can you tell the difference between symptoms of pyelonephritis vs. cystitis?
Pyelo: SYSTEMIC Symptoms
- fever
- flank pain
- WBC casts
- leukocytosis
- also symptoms of cystitis
How are WBC casts formed?
Infection “walks” up tubule => inflammatory cells get into tubule => model themselves into shape of tubule => urinated out
What are the three most common pathogens of pyelonephritis?
- E. coli (90%)
- Enterococcus faecalis
- Klebsiella species
What happens in Chronic Pyelonephritis?
Interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis
What are the most commonly seen cases of Chronic Pyelonephritis?
- Children with vesicoureteral reflux (VUR)
2. Pt with BPH or cervical carcinoma
