UTI's

Question 1

do UTIs always have symptoms

Answer 1

no

Question 2

symptoms of UTIs

Answer 2

pain on urinating
bacteria
sepsis

Question 3

define a complicated UTI. give examples

Answer 3

a structural or functional abnormality e.g. catheter
urinary obstruction 
neurological disease
immunosuppression 
renal failure 
pregnancy

Question 4

how to diagnose asymptomatic bacteriuria

Answer 4

bacteria isolated from urine but not systemic symptoms

Question 5

when does asymptomatic bacteriuria require treatment

Answer 5

in risk groups usually

Question 6

TF: UTI is the most common bacterial infection

Answer 6

TRUE

Question 7

Serious consequences of UTIs?

Answer 7

sepsis

renal damage

Question 8

is pyelonephritis uncomplicated?

Answer 8

yes as long as there’s no structural and neurological symptoms

Question 9

what is pyelonephritis

Answer 9

kidneys, more serious nephritis means inflammation or infection of the kidney nephrons

Question 10

what is cystitis

Answer 10

lower UTI

Question 11

complicated UTIs are associated with?

Answer 11

factors which compromise the UT

Question 12

risk factors for cystitis

Answer 12

female 
prior uTI 
sexual activity 
vaginal infections 
diabetes 
obesity 
genetic susceptibility

Question 13

can incontinence increase risk of UTI

Answer 13

yes bladder isn’t emptied efficiently or often enough

Question 14

can hormones increase UTI risk?

Answer 14

yes oestrogen deficiency can put women at risk

Question 15

how do we detect a UTI in a pregnant woman

Answer 15

get a urine sample every few weeks when you see midwife

Question 16

what is a UTI in pregnancy associated with?

Answer 16

premature delivery

low birth weight

Question 17

people at risk of UTI

Answer 17

infants 
pregnancy 
elderly 
catheterised 
diabetes 
AIDS/ immunocompromised

Question 18

why are infants high risk?

Answer 18

cant always tell us

hard to get a urine sample

Question 19

does diabetes increase UTI risk in men?

Answer 19

no

Question 20

what bacteria are most UTIs caused by

Answer 20

UPEC: uropathogenic E.coli

Question 21

TF: bacteria are the only things that cause a UTI

Answer 21

no fungus also

Question 22

features of organisms causing a UTI? what characteristics must they have?

Answer 22

flagella and be highly mobile
be able to withstand flow
proteus: form a community to ‘swarm’ up

Question 23

does cloudy urine mean there’s an infection?

Answer 23

not always- could a protein

can also be clear despite having bacteria in

Question 24

what is a major problem in UTI treatment?

Answer 24

resistance

Question 25

E.coli gram stain and shape?

Answer 25

gram negative rod

Question 26

how can e.coli get to the urinary tract

Answer 26

must be present in the gut- fecal contamination- hygiene advice

Question 27

what aids sticking of the bacteria to the urethra

Answer 27

pilli

Question 28

once E.coli has colonised what will the body do? how does the bacteria respond?

Answer 28

WBC will come to attack the bacteria will then form a biofilm to resist, then will start to produce toxins and proteases which further damage host tissue

Question 29

how does E.coli damage host tissue?

Answer 29

by releasing more toxins and proteases

Question 30

virulence factors to get up the urinary tract?

Answer 30

swarming flagella motility

Question 31

what happens re the inflammatory response when there's a catheter?

Answer 31

the catheter is abiotic so: | fibrinogen from the plasma starts to accumulate on the catheter- this is nutritious for the bacteria

Question 32

what will eventually happen to the catheter once bacteria colonise

Answer 32

will eventually block and need to be removed

Question 33

TF: when there's catheter the bacteria don't reach the kidneys

Answer 33

true

Question 34

what do recurrent episodes suggest about the strain of the bacteria?

Answer 34

the same bacterial strain

Question 35

how do the bacteria colonise in the bladder in recurrent UTIS?

Answer 35

reservoir in the bladder not previously eliminated by antimicrobials

Question 36

explain the establishment and recurrence of UTIs? think big here xx

Answer 36

luminal replication- not on the inside of cells attach and invade using pills some get eliminated by immune system and some form quiescent reservoirs (hibernating) hence not sensitive to Ams these then replicate inside cells

Question 37

what are quiescent reservoirs? why are they not sensitive Ito Ams?

Answer 37

pools of bacteria in cells which are asleep- hibernation so not sensitive

Question 38

what happens if the epithelial cells with the reservoirs in are lost?

Answer 38

the bacteria is released where they start the cycle again

Question 39

advantages for the bacteria of going into quiescent reservoirs

Answer 39

can survive nutrient limitation or bad conditions

Question 40

management of UTIs is based on

Answer 40

patient history and symptoms

Question 41

3 antibacterials for recurrent UTIs

Answer 41

cephalexin nitrofurantoin trimethoprim

Question 42

what can we use to treat ab resistant UPEC

Answer 42

Carbapenem

Question 43

novel UTI therapies aim to block what?

Answer 43

adhesion of bacteria to the urethra and prevent reservoir formation

Question 44

what are policies

Answer 44

interfere with pills assembly and block adhesion

Question 45

what are mannosides

Answer 45

anti-adhesives and prevent binding

Question 46

what is another treatment option for UTIs

Answer 46

vaccines