UTIs

Question 1

Asymptomatic UTI

Answer 1

have bacteria level. 10 ^5 but no symptoms

Question 2

Cystitis

Answer 2

inflammation of the bladder

Question 3

Pyelonephritis

Answer 3

inflammation of upper respiratory tract (kidney and renal pelvis)

Question 4

when does the frequency of UTIs increase in men

Answer 4

65

Question 5

Lower UTIS

Answer 5

bladder, urethra (cystitis)

Question 6

Upper UTIs

Answer 6

pyleonrephritis (kidney, ureters, renal pelvis)

Question 7

uncomplicated UTIs

Answer 7

UTI in healthy person (no structural abnormalities)

• includes premenopausal women

Question 8

Complicated UTIs

Answer 8

something predisposing them to UTI
- postmeno
- structural abnormalities
- catheter that impacts urine flow
- immunocompromised

Question 9

Ascending vs descending route of infection

Answer 9

Ascending: self infection with fecal B
- more common in F

Descending: blood borne origin

Question 10

What can increase risk of UTI

Answer 10

DM
anything that impacts urine flow
F
catheter
ABX use
pregnancy
hospitalization

Question 11

What host factors inhibit bacterial growth

Answer 11

pH of urine, antimicrobial peptides

Question 12

What factors stop bacterial from sticking

Answer 12

mucin in bladder
urine flow

Question 13

Estrogen impact on UTI

Answer 13

protective

Question 14

What are the normal microflora of urethra

Answer 14

coagulase - staph, lactobacc, diphtheriods

Question 15

T or F: all the areas above the urethra are sterile in healthy people

Answer 15

T

Question 16

T or F: most CA uncomp UTIs are form multiple pathogens

Answer 16

F - normally single pathogen cause

— comp (catheters, abnormalities): multiple pathogens causing at once

Question 17

What bacteria is the main cause of CA uncomp UTI

Answer 17

E. coli

Question 18

What are the more common causes of hosp comp UTIS

Answer 18

Enterobacteria
Pseudomonas
gram +

Question 19

What bacteria is a common cause of UTIS in sexually active F

Answer 19

Staph saprophyticus + Enterococci

Question 20

When would you find Candida causing UTIs

Answer 20

catheter on ABX therapy
DM
hospital

Question 21

SS of Lower UTI

Answer 21

pee a lot, pain with peeing, urgency

Question 22

SS of Upper UTI

Answer 22

systemic : fever, malaise, pain on flank

Question 23

T or F: clinical SS correlate well with presence + extent of infection

Answer 23

F

Question 24

Acute Urethral Syndrome

Answer 24

when you have SS but bacteria level is low
- < 10 ^5 or even sterile
- may has pyuria

Question 25

Methods to Collect Urine

Answer 25

1) Midstream collection: wash area + pee into cup 2) Catherization 3) Suprapubic bladder aspiration: done in babies, stick needle in to collect pee

Question 26

Why is it important to transport sample right away/measure right away

Answer 26

To avoid bacteria replication — diagnosis is done quantitatively

Question 27

Types of microscopic exams

Answer 27

1) Gram stain : easy + cheap, tell us if yeast or B 2) Pyuria: >/= 8 WBC/mL in urine when look under microscope — if present + person has SS: significant B — but can be associated with other diseases

Question 28

Indirect Indices

Answer 28

1) Leukocyte Esterase Test: activated leukocytes produce LE when infection occurring - measure this (detect) 2) Nitrate Reductase Test: some of the pathogens causing UTIS reduce nitrate to nitrite - screen for levels in urine - can be negative if B doesn’t reduce nitrate ( Staph sapp, Entero faecalis )

Question 29

What is detected on urine test strips

Answer 29

protein, ketones, bilirubin, WBCs, RBCs, nitrite, sugar

Question 30

Limit of gram stain

Answer 30

slower than other tests, can’t detect fastidious organisms

Question 31

Limit of Pyuria

Answer 31

Can have WBCs with no infection - infection might be elsewhere in the body

Question 32

Limit of LET

Answer 32

false -: if a lot of protein in urine false +: contamination

Question 33

Limit of NRT

Answer 33

false -: non nitrate reducing bacteria causing UTI

Question 34

Interpretation of Culture Results

Answer 34

quantitatively ; have UTI diagnosis if: -is symptomatic + >/= 10^5 CFU/mL symptomatic + F: >/= 10^2 CFU/mL - asymptomatic + >/=10^5 in 2 consecutive tests - any growth from suprapubic bladder aspiration

Question 35

Who may have true UTI but CFU less than 10 ^5

Answer 35

- those who had ABX recently - urinary obstruction - acute urethral syndrome

Question 36

Sterile pyuria

Answer 36

pyuria but no UTI may occur - surgery - blood in urine - systemic condition -meds

Question 37

Treatment: drugs

Answer 37

sulfamethazole, nitrofuranion, cephalexin

Question 38

Duration for uncomp

Answer 38

2-3 days

Question 39

comp duration

Answer 39

7-14 days

Question 40

recurrent UTI therapy

Answer 40

ABX daily for at least 6 mths - ABX after sex - take daily ABX again for 2-3 days if SS