Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal > UTI's > Flashcards

UTI's Flashcards

1
Q

What is a UTI

A

Presence of microorganisms in the urinary tract causing inflammation such as cystitis, urethritis and prostatitis and upper causing pyelonephritis .

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Why are UTI’S more common in women

A

Women have a shorter urethra thus bacteria has a shorter distance to travel to.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Methods of transmission

A

Faeces- when wiping
Sex
Incontinence
Poor hygiene
Urinary catheters

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common microorganisms to cause a UTI

A

KEEPS

Klebsiella
E coli
Enterococci
Proteus
Staphylcoccus coagulase negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

key diagnostic factors of UTI

A

Dysuria (pain, stinging or burning when passing urine
New nocturia
Cloudy or foul smelling urine
risk factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is FUNDS

A

Frequency
Urgency
Nocturia
Dysuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Other diagnostic factors for UTI

A

-Urgency
-Visible haematuria
- frequency
- suprapubic pain or tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What symptoms would a patient have that would make you suspect pyelonephritis

A

Fever
Loin/back pain
Nausea/vomiting
Renal angle tenderness on examination
headache
Triad - loin pain, fever, pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Presence of nitrates on urine dipstick would indicate

A

UTI- with gram -ve bacteria such as ecoli

E coli breaks down nitrates a normal waste product

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Leukocytes in urine dipstick test would indicate

A

Infection or inflammation
presence of leukocyte esterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is microscopic haematuria

A

blood on dipstick but not seen looking at the sample

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is macrscopic haematuria

A

blood is visible in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Most common cause of UTI

A

E. Coli
gram neg-ve anerobic rod shaped bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Duration of antibiotics

A

3 days - for simple UTI
5-10 days for immunosuppressed women, abnormal anatomy or impaired kidney function
7 days of antibiotics for men, pregnant women or catheter related UTI’S

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

UTI during pregnancy increases the risk of ..

A

pyelonephritis, premature rupture of membranes and pre-term labour.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

antibiotic options for pregnancy ..?

A

Nitrofurantoin (avoid in the third trimester)
Amoxicillin (only after sensitivities are known)
Cefalexin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Nitrofuratoin needs to be avoided in the third trimester why ?

A

risk of neonatal haemolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

describe sympathetic and parasympathetic neural control of the LUT

A

Parasympathetic - Detrusor contraction
Smooth muscle sphincter relaxation

Sympathetic- smooth muscle sphincter contraction
- inhibit detrusor contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is pyelonephritis

A

Severe infectious inflammation of the parenchyma ( functional tissue )

ascend from the lower urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

most common bacteria that causes pyelonephritis

A

E COLI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

KEY DIAGNOSTIC FACTORS OF pyelonephritis

A

triad of loin pain, fever and pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

1st investigations to order for pyelonephritis

A

urinalysis
urine culture and sensitivity
fbc
ESR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

GS investigation for pyelenephritis

A

Mid stream Urine and culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Tx for pyelonephritis

A

IV Antibiotics- broad spectrum, cefalexin for 7-10 days, co-amoxiclav or gentimiacin
Trimethorpim or amoxicillin if sensitive
Analgesia- paracetamol
Fluid replacement
Drain obstructed kidney
Catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is cystitis
inflammation of the urinary bladder, most common in sexually active women
26
Rx for cystitis
- sexually active - DM - History of UTI - Pregnancy
27
Presentation of cystitis
Suprapubic tenderness and discomfort Dysuria- discomfort , pain burning on urination Frequency Cloudy smelly urine haematuria
28
Investigations for cystitis
1st line Urine dipstick- nitrates or WBC'S then uti mid stream urine sample -GS
29
Management of cystitis
Antibiotics- 3 days trimethoprim BUT AVOID IF PREGNANT
30
What is prostatitis
Inflammation and swelling of the prostate due to E coli
31
Presentation of Prostatitis
- VERY tender prostate FEVER, CHILLS, MALAISE
32
Management of prostatitis
ciprofloxacin or levofloxacin for 14 days
33
What is urethritis
Urethritis is inflammation of the urethra commonly caused by neisseria gonorrhoeae and chlamydia trachomatis
34
presentation of urethritis
Dysuria Urethral discharge pruritus at the end of the urethra skin lesion
35
two main categories of urethritis
Gonococcal if neisseria is isolated non gonococcal if neisseria is not isolated
36
key diagnostic factors of urethritis
presence of risk factors urethral discharge urethral irritation or itching dysuria
37
risk factors of urethritis
age 15 to 24 years female sex Gay men low socio-economic status
38
1st line investigation for urethritis
Urine dipstick GS = Mid stream MC+S
39
gs for urethritis
mid stream urine sample
39
Management of urethritis
NG - IM ceftriaxone and azithromyocin
40
what is epidydo- orchitis
inflammation of the epididymis causing scrotal pain and swelling that develops over the course of a few days and lasts <6 weeks. It is usually unilateral. The pain is relieved by elevating testes Cremaster reflex intact
41
Investigations for Epididymo-orchitis
1st line = urine dipstick + leukocytes/blood/nitrates GS - Mid stream MC+S NAAT - detect STI type for treatment if necessary
42
key diagnostic factors of epidymo orchitis
age >19 years unilateral scrotal pain Gradual onset swelling symptoms <6 weeks' duration
43
Rx for epidymo orchitis
- unprotected sexual intercourse - bladder outflow obstruction - immunosuppression
44
Difference between complicated and uncomplicated UTI
An uncomplicated UTI is an infection in the lower urinary tract, the bladder and urethra. A complicated UTI is when the infection extends beyond the bladder to the kidneys and is more serious Also deemed complicated in pregnancy
45
Lower tract infections
UTI Cystitis
46
Upper tract infections
Pyelonephritis
47
Classifications of UTIs
Asymptomatic bacteriuria Uncomplicated Complicated
48
What is Bacteriuria
The presence of bacteria in the urine -Symptomatic -Asymptomatic
49
What is pyuria?
Presence of leucocytes in the urine Associated with infection Sterile pyuria – 10 or more white blood cells per cubic mm
50
Causes of Pyuria
infections (chamydia, gonorrhoea, HSV, trichomonas) Pyelonephritis Papillary necrosis Diabetes Renal TB Renal stones Cancer
51
Who does uncomplicated affect?
Non pregnant women
52
Who does complicated effect?
Pregnant Men Catheterised Children Recurrent/persistent infection Immuncompromised Noscomial infection Structural abnormality Urosepsis Associated urinary tract disease
53
Which pathogen is associated with renal stones that causes UTI?
Proteus
54
Which pathogen is assosciated with Hospital/catheter assosciated UTIs?
Klebsiella
55
Which pathogen affects young women the most for UTIs?
Staph.saprophyticus
56
What is the average bladder capacity?
500ml Significant reduction in capacity accompanies acute inflammation and leads to increased frequency.
57
Symptoms of UTI
UTI: Pain in peeing, needing to pee LUT: Fever, haematuria
58
Urinalysis for UTI
Blood Protein pH Ketones Nitrates Leucocytes Glucose
59
What do we need for urine samples?
MSU CSU Bag urine Early morning urine SPA aspirate Clean catch
60
Why do we use early morning urine?
TB 3 x early morning urine. Highest concentration of bacilli so more likely to see
61
What do we see on the microscopy for UTIs?
White blood cells Red blood cells Casts Bacteria Epithelial cells
62
What are casts?
- Cylindrical protein mouldings formed in the renal tubules - give clues to renal pathology - Can be indicative of infection - Damage to kidney epithelium (glomerulonephritis)
63
What do RBC casts indicate?
- glomerulonephritis - renal ischaemia and infarction
64
Acute tubular necrosis is associated with what types of casts
- granular - epithelial
65
Asymptomatic bacteriuria treatment
If >65 then do not treat Other groups that get asymptomatic bateriuria – pregnant patients, diabetics, transplant patients – all should be treated
66
What is first-line treatment for uncomplicated UTIs?
Nitrofurantoin:
67
Side effects of antibiotics
Not given in thrid trimester –risk of neonatal jaundice/Neonatal haemolysis Can’t be used in G6PD deficiency Nausea and vomiting headaches dizziness liver problems neuropathy acute and chronic pulmonary reactions Antimicrobial resistance
68
How does Fosfomyocin (New antibiotic) work
Prevents formation of N-acetyl muramic acid – component of bacterial cell wall
69
Pivmecillinam (new antibiotic)
Interferes with bacterial cell wall. Bactericidal.
70
How to prevent infections of catheter samples
Do not dipstick Change or remove catheter when starting treatment Send a fresh sample (not from bag)
71
Catheter associated UTI - pathogenesis
Insertion may carry organisms into the bladder At risk of infection up to 24 hours post removal Hospitable environment in the catheter Formation of biofilms (protected from flow of urine, host defences and antibiotics) Incomplete voiding
72
What can short term catheters cause?
Monomicrobial infections
73
Long term catheter issues
Polymicrobial infections Complications: UTI/Pyelonephritis Stones Obstruction Chronic inflammation
74
How to prevent catheterisation of UTI?
Intermittent catheterisation Suprapubic catheterisation
75
How to prevent bacteriuria
Keep catheter closed Remove as soon as possible
76
How to prevent complications
Don’t treat if asymptomatic Catheter replacement
77
How does the prevalence of UTI increase in pregnant women?
Age Parity Sexual activity Diabetes Previous UTI
78
How to investigate UTI in pregnancy
Culture rather than dipstick Positive cultures should be confirmed with a second sample Asymptomatic bacteriuria should be treated(unlike elderly) -20-40% untreated bacteriuria develop acute symptomatic pyelonephritis Test of cure should be sent 1 week after treatment
79
Ascending route of infection for pyelonephritis
Urethra colonised with bacteria. Massage of the urethra during intercourse can force bacteria into the female bladder
80
Haematogenous route of infection of pyeloephritis
S.aureus/Candida Lymphatic spread is very rare
81
Complications of pyelonephritis
Renal abscess Slow/no response to Antibiotics Imaging More common in diabetics Emphysematous pyelonephritis Rare, gas accumulation in the tissues Life threatening May need nephrectomy
82
Mrs A Vrige (23 years old) has been complaining of dysuria, urgency and frequency passing urine. Similar urinary symptoms over the last few months were treated with 3 days of Cephalexin by another GP. She is in a stable relationship with her husband and takes the oral contraceptive pill. Using the BIA urinalysis algorithm to help you, you decide to treat empirically for UTI Which antibiotic do you use while awaiting results? A. Ciprofloxacin B. Trimethoprim C. Nitrofurantoin D. Tazocin E. No antibiotic needed
D. Tazocin
83
Mr C Docalot is a 65 year old man with benign prostatic hyperplasia for which he has been prescribed tamsulosin for several years. He presents with 3 days of increased urinary frequency and lower back pain. On examination he is unwell and agitated: T 390C and BP 90/50 and there is right renal angle tenderness. What key samples should be taken: MSU and Blood culture Sputum and MSU CSU Blood culture All of the above
A - MSU and blood culture
84
Mr C Docalot is a 65 year old man with benign prostatic hyperplasia for which he has been prescribed tamsulosin for several years. He presents with 3 days of increased urinary frequency and lower back pain. On examination he is unwell and agitated: T 390C and BP 90/50 and there is right renal angle tenderness. What would you treat with first line and for how long? A. Trimethoprim 7 days B. Nitrofurantoin 14 days C. Co-amoxiclav 14 days D. Co-amoxiclav 7 days E. Ciprofloxacin 7 days
C
85
Mr E.Home is an 84 year-old man who has become confused and agitated. He has been sent to the frailty unit and you assess him. Other than the confusion, the only significant finding from history and examination is that he has a long-term urinary catheter. The nurse uses a dipstick to assess the urine. This will give her an indication if an infection is present or not: A. True B. False
B. false
86
Mr E.Home is an 84 year-old man who has become confused and agitated. He has been sent to the frailty unit and you assess him. Other than the confusion, the only significant finding from history and examination is that he has a long-term urinary catheter. The nurse completes the form and sends the urine sample to the Microbiology lab who inoculate some culture plates and dispose of the sample. Should Microscopy be performed on the sample? A. Yes B. No
B. No
87
Mrs B.gravid is a 37 year old, 28 weeks pregnant women in the antenatal clinic who has brought a urine sample with her. She is otherwise well. Urinalysis shows leukocytes and protein. This indicates: A. Nothing - this is expected in pregnancy B. Pre-eclampsia C. UTI D. Possibility of pre-eclampsia and UTI E. Obstetric cholestasis
D
88
Mrs B.gravid is a 37 year old, 28 weeks pregnant women in the antenatal clinic who has brought a urine sample with her. She is otherwise well. The microscopy shows epithelial cells but no pus cells, this suggests: A. Definite infection B. Pyelonephritis C. Pre-eclampsia D. Sample contamination E. None of the above
D
89
Mrs B.gravid is a 37 year old, 28 weeks pregnant women in the antenatal clinic who has brought a urine sample with her. She is otherwise well. Based on this sample, the patient should be treated as a UTI. A. True B. False
B. False
90
The risk of pyelonephritis in untreated asymptomatic bacteriuria in pregnancy is: A. 5-10% B. 20-40% C. 50-60% D. 60% E. 70-75%
B
91
What antibiotic should be avioided in pregnant women
Trimethoprim

Renal (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions