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Renal System > UTIs > Flashcards

UTIs Flashcards

1
Q

What is lower UTI?

A

Bladder (cystitis)
Prostate (prostatitis)

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2
Q

What is Upper UTI?

A

Kidneys (pyelonephritis)

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3
Q

What are the predisposing factors to UTI?

A

Short urethra in females
Sexual activity
Urinary incontinence
Oestrogen deficiency in menopause
Dehydration
Obstruction e.g. kidney stones
Diabetes
Immunosuppression
Pregnancy
Catheterisation
Renal tract malformation

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4
Q

What are the most common bacteria in UTI?

A

E.coli (75-95%)
Staphylococcus saprophyticus (5-10%)
Klebsiella pneumoniae
Proteus mirabilis

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5
Q

What are the symptoms of cystitis?

A

Frequency
Dysuria
Urgency
Suprapubic pain
Polyuria
Haematuria
Cloudy or foul smelling urine

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6
Q

What are the symptoms of prostatitis?

A

Pelvic pain
Urinary symptoms- dysuria, hesitancy, frequency, retention
Swollen or tender prostate
Sexual dysfunction
Pain with bowel movements
Systemic- fever, myalgia, nausea, fatigue

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7
Q

What are the symptoms of pyelonephritis?

A

Fever
Rigor
Vomiting
Loin/back pain
Sepsis

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8
Q

What is the pathology of pyelonephritis?

A

Affects tubules, interstitium and renal pelvis
Interstitial abscesses filled with pus
Tubules damaged, contain neutrophil casts

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9
Q

What is chronic pyelonephritis?

A

Repeated episodes of acute
Leads to fibrosis, renal interstitium scarring and renal tubules atrophy

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10
Q

What investigations are done for UTI?

A

Urine dipstick- non pregnant women
MSU culture- pregnant women, men, children
Blood tests- systemically unwell
Imaging, men with upper UTI, a recurrent UTI, failure to respond to treatment, pyelonephritis

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11
Q

What is present on urine dipstick in UTI?

A

Nitrites
Leukocytes
RBCs

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12
Q

What is the management of a non pregnant woman with 3+ symptoms of cystitis and no vaginal discharge?

A

3 day course of trimethoprim or nitrofurantoin (if eGFR>30)

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13
Q

What is the management of a non pregnant immunosuppressed woman with UTI?

A

5-10 days of antibiotics

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14
Q

What is the management of a non pregnant with upper UTI?

A

Urine culture and treat with broad spectrum antibiotic e.g. co-amoxiclav

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15
Q

What is the management of a UTI in a pregnant woman?

A

Get expert help
Treat with antibiotic for 7 days- nitrofurantoin, amoxicillin
Confirm eradication

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16
Q

What are the risks of UTI in pregnancy?

A

Pyelonephritis
Premature rupture of membranes
Pre-term labour

17
Q

What antibiotics are avoided in pregnancy?

A

Trimethoprim in 1st trimester (folate antagonist)
Ciprofloxacin
Nitrofurantoin in 3rd trimester (risk of neonatal haemolysis)

18
Q

What is the management of a lower UTI in a man?

A

7 day course of trimethoprim or nitrofurantoin (if eGFR>30)

19
Q

What is the management of prostatitis in a man?

A

Hospital admission if systemically unwell
4 week course of ciprofloxacin
Analgesia and laxatives

20
Q

What is the management of upper UTI in a man?

A

Refer for urological investigation

21
Q

What are the complications of UTI?

A

Pyelonephritis
Urosepsis
sEPTIC SHOCK

Renal System (12 decks)

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