UTIs Flashcards
where can UTIs be located?
upper ( kidney)
lower
give one upper UTI?
Pyelonephritis
( there is only one )
give four lower UTIs?
- cystitis
- prostatitis
- urethritis
-epidydmo- orchitis
what organisms cause UTIs?
KEEPS
Klebsiella
E-coli
Enterobacter
Proteus
Saprophyticus
in 80% of cases what is the causative organism for UTI?
UPEC
- uropathogenic E coli
who is most likely to be affected by UTIs? why?
females more likely to be affected
- due to a shorter urethra therefore closer to anus an easier for bacteria to colonise
what is the fist line of diagnosis for UTIs?
- urine dipstick
- +ve leukocytes
- +ve nitrates
- +/- haematuria
what is the gold standard test for diagnosis for UTIs?
midstream mcs
- confirms UTI + identifies pathogen
what is pyelonephritis?
- infection of renal parenchyma and upper ureter
how is pyelonephritis spread?
- via ascending transurethral spread ( mc
- also via blood or lymphatics
-usually caused by UPEC but can be other KEEPS
What are the risk factors for pyelonephritis?
- urine stasis ( stones)
- renal structural abnormalities
- catheters
- females < 35
what are the symptoms for pyelonephritis?
triad of:
1. loin pain
2. fever
3. pyuria
others: back pain, headache, nausea and vomiting, cystitis symptoms
how is pyelonephrtitis diagnosed?
- urine dipstick
- mc + s
- USS
how is pyelonephritis treated?
- analgesia
- paracetamol
- antibiotics - ciprofloxacin or co-amoxiclav
define cystitis
infection of the bladder
what are the risk factors of Cystitis?
- children
- females
- pregnancy
- catheters
- urines stasis
- bladder lining damage
what are the cause of cystitis?
- UPEC
- other KEEPS
what are the symptoms of cystitis?
- suprapubic tenderness and pain
- hematuria
- polyuria
- dysuria
- increased frequency and increased urgency
- confusion in elderly
how is cystitis diagnosed?
- urine dipstick
- mc + s
how is cystitis treated?
- antibiotics- trimethoprim/ nitrofurantoin
- ( if pregnant- amoxicillin)
what Is urethritis?
urethral inflammation due to infectious or non infectious causes
what are the types of causes of urethritis?
infective
non infective
what are the infective causes of urethritis?
- gonococcal —> gonorrhoea
- non gonococcal—-> chlamidya ( mc)
what are the non infective causes of urethritis?
- trauma
- urethral structure
- irritation
what are the risk factors for urethritis?
- msm
- unprotected sex
what are the symptoms for urethritis?
- skin lessons
- dysuria +/- discharge
- urethral pain
- penile discomfort/ pruritus
- reactive arthiritis
what is the treatment for UTIs?
- NG- IM Ceftriaxone + azithromycin
- CT- azithromycin + doxycycline
how are UTIs diagnosed?
- urine dipstick
- mc + s - gram -ve diplococcus= gonorrhoea
- NAAT ( nucleic acid amplification test)- detect STIs
a way to remember active arthritis symptoms
can’t see
can’t pee- urethritis
can’t climb a tree
what is epididymo- orchitis?
inflammation of epididymis extending to testes
what are the causes of epididymo- orchitis?
- urethritis (STI) <35 yrs
- cystitis extension > 35yrs
- catheters ( elderly)
what are the symptoms for epididymo- orchitis?
- unilateral scrotal pain and swelling - pain relieved with elevating testes ( positive prehns sign)
- cremaster reflex intact
what is a Ddx for epididymo- orchitis?
testicular torsion
( important to therefore rule out)
how is epididymo- orchitis diagnosed?
- NAAT
- urine dip stick
- mc + s
how is epididymo- orchitis treated?
depends on cause
what are uncomplicated UTIs?
- female
- healthy
- pre-menopausal
- not pregnant
- anatomically and functionally normal urinary tract
what are complicated UTIs?
- post menopausal
- pregnant
- anatomically or functionally abnormal urinary tract
- foreign body in urinary tract
- one or more comorbidities
what is prostatisis?
inflammation of the prostate gland usually due to bacteria
describe acute prostatisis
- pain
- frequent peeing
- if can’t pee- acute urinary retention
- lower back pain
describe chronic prostatisis
- pain
- enlarged prostate
- erectile dysfunction
how is prostatitis treated?
- antibiotics
