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Renal + Urology > UTIs > Flashcards

UTIs Flashcards

1
Q

What are the main causes of obstruction to complete bladder emptying?

A

pregnancy
prostatic hypertrophy
renal calculi
tumours
strictures

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2
Q

What is the most common UTI pathogen?

A

Ecoli

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3
Q

What is the most common cause of someone developing a UTI?

A

ascending route from urethra to bladder

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4
Q

What is the difference between uncomplicated and complicated UTI?

A

uncomplicated = normal (anatomical and function) urinary tract

complicated = functional or anatomical abnormality (including catheters) - lower antibiotic threshold

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5
Q

What is an isolated UTI?

A

no previous UTI for 6mo

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6
Q

What is a recurrent UTI?

A

> 2 infections in 6mo or >3 in 12mo

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7
Q

What is relapsing UTI?

A

inadequate therapy
reinfection normally within same month (same organism)

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8
Q

Acute lower UTI symptoms

A

dysuria
urgency
frequency

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9
Q

Cystitis symptoms and signs

A

symptoms:
- frequency
- urgency
- suprapubic pain on postponing
- dysuria
- foul smelling, discoloured urine
- mild systemic upset

signs:
- temperature
- suprapubic tenderness

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10
Q

Cystitis investigations

A

urine dipstick
MSU for culture

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11
Q

Cystitis treatment

A

non-pharmacological (mild):
- fluids
- alkalinisation of urine (potassium citrate)

antibiotics:
- trimethoprim
- nitrofurantoin
- fosfomycin
- cefalexin

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12
Q

Uncomplicated UTI pathogens

A

Ecoli
other enterobacteriacae:
- proteus mirabilis
- K.pneumoniae

S.saprophyticus

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13
Q

What is the significance of S.saprophyticus infection?

A

only occur in urinary system
risk in pregnancy

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14
Q

Complicated UTI pathogens

A

Ecoli
other enterobacteriacae:
- proteus spp
- klebsiella spp
- citrobacter spp
- enterobacter spp

pseudomonas aeruginosa
enterococcus spp
Group B strep (if pregnant, need abx in labour)
candida spp

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15
Q

Where can UTIs come from?

A

ascending from perineum, vagina, large bowel
haematogenous: TB, Staph aureus

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16
Q

What antibiotics can be used for cystitis?

A

nitrofurantoin
trimethoprim
cephalexin
fosfomycin

17
Q

What antibiotics are used for pyelonephritis/UTI sepsis?

A

IV gentamicin
b lactam/inhibitor

18
Q

What antibiotics can be used for pseudomonas UTI?

A

IV gentamicin
IV piperacillin/tazobactam
IV aztreonam
IV meropenem
IV ceftazidime
IV/PO ciprofloxacin

19
Q

Who should urine dipstick not be done on?

A

> 65y
catheterised

20
Q

What would be positive on dipstick if UTI present?

A

leucocytes
nitrites

21
Q

How are antibiotic sensitivities tested?

A

pellets of antibiotic placed on culture plate
bigger ring around pellet = infection sensitive to antibiotic

22
Q

Symptoms of UTI in patient with a catheter

A

temperature
bladder pain
cloudy, smelly urine
single species on culture

23
Q

How should catheter UTIs be treated?

A

replace catheter
treat as complicated UTI

24
Q

Risk factors for recurrent UTI?

A

post menopausal
increased post void residual
urinary incontinence
vesical prolapse

25
Q

Conservative management options for recurrent UTI

A

good hygiene - wipe back to front, clean with water only
drink plenty
voiding after sex
timed voiding

26
Q

Medical management options for recurrent UTI

A

cranberry capsules
D-mannose
topical oestrogen
Hiprex with vitamin C
intravesical GAG replacement

27
Q

Pyelonephritis presentation

A

pyrexia
loin pain
rigors
urinary symptoms - dysuria, frequency, offensive smelling urine, haematuria

28
Q

What investigations should be done in suspected pyelonephritis?

A

bloods - FBC, UE, CRP
urine dip/MSU/blood cultures
US KUB

29
Q

Pyelonephritis initial management

A

IV gentamicin (5mg/kg)
IV fluids

30
Q

Infected obstructed kidney causes

A

stone
tumour
stricture
external compression

31
Q

Infected obstructed kidney management

A

urological emergency
needs urgent decompression - ureteric stent or nephrostomy

32
Q

Complication of epididymoorchitis

A

scrotal abscess

33
Q

What needs to be ruled out in suspected epididymoorchitis?

A

testicular torsion
STIs

34
Q

Signs/symptoms of prostatitis

A

pelvic pain
mixed urinary and sexual symptoms
DRE - tender prostate

35
Q

Fournier’s gangrene risk factors

A

DM
hypertension
immunosuppression
poor nutrition

36
Q

Causative organisms of Fournier’s gangrene

A

staphylococcus
streptococcus
clostridium perfringens

37
Q

How is urinary TB diagnosed?

A

dipstick - blood, WBC, no nitrites
EMU - AAFB
CXR + sputum
imaging (US, CT cystoscopy)
skin test

38
Q
A

Renal + Urology (37 decks)

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