UTI-TIDK Flashcards
UTI mostly confined where?
if UTI involves upper GU tract
lower GU tract (cystitis)
pyelonephritis, calculi
chronic pyelonephritis assoc with …
1) obstruction
2) VU-reflux
3) Chronic renal failure
4) HTN
highest percentage of bacteriuria in which age group
elderly
what is most common route of UTI?
most common bacteria?
Ascending infection
E coli
Causes of hematogenous spread? patient groups?
assoc with which diseases?
1) debilitated patients
2) kidney injury
3) staph aureus, group A strep
1) septicemia
2) endocarditis
virulence factors of UTI
1) bacterial adhesion (pili = P)
2) “O” Antigens = certain strains more resistant
3) endotoxin (decr ureteric peristalsis)
host defenses against UTI
1) hydrokinetic
2) chemical = urine
3) immunological
4) cellular
mechanical host defenses
chemical host defenses
bladder emptying/urine flow
ureteric peristalsis
mucus
prostatic secretions = antibacterial
urine osmolality, pH, ammonia
P1 blood group antigens
immunological host defense
cellular host defense
IgA, complement
PMN’s, shedding urothelial cells
predisposing factors to UTI
1) females = shorter urethra, bacterial colonization, urethral trauma
2) instrumentation
3) decr urine flow
4) calculi, vesicoureteral reflux
5) immune compromise
6) kidney/UT disease, pregnancy
Clinical manifestations of symptomatic UTI
recurrent infection in males usu = urinary tract disease
clinical manifestations of ealry childhood
nonspecific sx
irritability, convulsions
complications of UTI
1) recurrence
2) acute pyelo
3) renal/perinephric abscess
4) chronic pyelo/renal scarring
complications of UTI with diabetes
papillary necrosis
complications of UTI with proteus
staghorn calculi
causes of chronic pyelonephritis
1) urinary tract obstruction
2) vesicoureteral reflux (VUR)
Obstruction predisposes to ___
Obstruction interferes with ____
Obstruction + infection =
1) infection and recurrence
2) eradication
incr pressure, inflamm, ischemia, direct injury
causes of urinary tract obstruction
1) intrinsic = tumors, calculi, clot
2) stricture
3) extrinsic = tumor, hemorrhage, retroperitoneal fibrosis
4) diabetes/neuro
most common cause of kidney stone
calcium oxalate = phosphate
consequences of urinary tract obstruction
1) hydronephrosis
2) infection = acute/recurrent
3) chronic obstructive pyelonephritis
4) renal failure
5) HTN
primary vesicoureteral reflux
1) common in…
2) how does timing change
1) infants
2) decr freq/severity during childhood
mild
secondary vesicoureteral reflux
1) causes
2) patient population
1) congenital, neurogenic bladder, obstruction
2) older children, adults
reflux nephropathy = chronic non-obstructive pyelo
more extensive where?
often…
severe, persistent reflux + infection = organisms access renal parenchyma
poles (compound vs. simple)
unilateral or unequal bilateral
scars of chronic pyelo are usu… assoc with…
polar
assoc with blunted calyces
