UTIs Flashcards
what does the timing of blood in urine suggest about the orygin:
Urethral: blood seen at the start of the voiding
Bladder/above: blood diffusely present
Prostate/bladder base: blood at the end of micturition
who should not be investigated further if blood is found on urin dipstick
menstruating females
what is a normal excretion of protein in urine
up to 30mg/24h
what is Microalbuminuria
albumin excretion between 30-300 mg/24h
what paramiters are checked on urine dipstick
blood, glucose, proetin, nitrate, leukocyte esterase
What worents a referal of UTI for USS
male, child, non-responsive to treatment/recurrent >2/year, pyelonephritis or unusual organisms, persistent haematuria
what are the risk factors for UTI
- Female
- Sexual intercourse
- Exposure to spermicide (diaphragm or condom)
- Pregnancy (can be asymptomatic until pyelonephritis)
- Menopause
- Immunosuppression/DM
- Urinary tract: obstruction, stones, catheter, malformation
what is the difference between UTI and bacteruria
Bacteruria: bacteria in the urine
UTI: The presence of a pure growth of >105 organisms per mL of fresh MSU
What are the common organisms that cause UTIs
E.coli: most common i.e. 75-95% community case/41% hospital
Proteus mirabilis
Staphylococcus saprophyticus.
what are the symptoms of pyelonephritis
Acute pyelonephritis:
• High fever, rigors, vomiting, loin pain and tenderness, oliguria (if AKI).
what are the symptoms of UTI
Cystitis:
• Frequency, dysuria, urgency, haematuria, suprapubic pain.
what are the signs of UTI
- Fever
- Abdominal/loin tenderness
- Foul-smelling urine
- May have distended bladder and enlarged prostate
What is the difference between complicated and uncomplicated UTI
- Uncomplicated: normal renal tract and function i.e. usually women
- Complicated: abnormal renal/GU tract, obstruction, ↓ renal function
what are the first line investigations for UTI
Urine dipstick: +ve nitrates and leukocytes
Whata are the laboratory investigations for UTI and who should be investigated
male, pregnant, child, immunosuppressed
o Check for bacterial presence
o Check sensitivity to antibiotics
o Sterile pyuria (↑WCC + no infection): consider other causes
What sort of preventive mthods can be used to avoid UTIs
good hydration, prophylactic antibiotics or antibiotic immidiet with start of symptoms, cranberry juice
what is the managment for uncomplicated UTI
trimethoprim 200mg/12h PO 3d/7d in male
what is the managment for pyalonephritis
co-amoxiclav 1.2g/8h IV 7d
How is managment of UTI different in pregnant women
antibiotics with bacteuria regardless of symptoms
what are the causes of sterile pyuria
o UTI treatment
