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Urinary System > UTIs > Flashcards

UTIs Flashcards

1
Q

What are the peaks of UTIs for women?

A

Young child
Age of sexual activity
Child bearing
Elderly

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2
Q

When do men have peaks of UTIs?

A

Infancy

Elderly

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3
Q

UTIs are most commonly caused by what in the elderly?

A

Urinary tract obstruction

Eg. Enlarged uterus or prostate

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4
Q

What patient factors increase the risk of UTIs?

A

Shorter urethra
Obstruction - BPH, pregnancy, stones, tumours
Lack of flushing
Neurological problems - residual urine, likely to fester
Ureteric reflux - ascending infection from bladder

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5
Q

What bacterial factors increase likelihood of causing UTI?

A

Fimbriae
K antigen - polysaccharide capsule to resist host defences
Urease
Haemolysins

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6
Q

What are the most likely pathogens to cause UTIs?

A

Coliforms eg. E-coli

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7
Q

Apart from E-coli, what pathogens can cause UTIs?

A 
Proteus
Enterococcus
Coagulase negative staph 
Pseudomonas
Staph aureus
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8
Q

What is the most common UTI?

A

Cystitis

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9
Q

Describe the presentation of cystitis

A

Urgency and frequency of urination
Pain (burning)
Sometimes a low grade fever

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10
Q

Asymptomatic bacteriuria is generally not a problem unless in …

A

Pregnant women

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11
Q

Describe the presentation of pyelonephritis

A

Fever
Loin pain
Dysuria
Frequency of urination

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12
Q

Describe an uncomplicated UTI

A

Infection by a usual organism in a patient with a normal urinary tract and normal urinary function

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13
Q

Describe a the most common uncomplicated UTI

A

Females
Child bearing age
Common cystitis presentation

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14
Q

Describe a complicated UTI

A

When one or more factors are present that predispose the person to persistent infection, recurrent infection or treatment failure

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15
Q

What factors make the UTI complicated?

A 
Abnormal urinary tract 
Virulent organisms 
Impaired host defences
Impaired renal function 
(Most cases in children, men and pregnant women)
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16
Q

What investigations do we do for uncomplicated UTI?

A

Urine dipstick

17
Q

What investigations do we do for complicated UTIs?

A

Culture urine
Turbidity
Dipstick testing

18
Q

What are the ways of collecting urine for culture?

A

Mid stream urine
Collection bag
Catheter sample
Suprapubic aspiration

19
Q

How isn’t nitrite a reliable test?

A

Not all bacteria produce the enzyme to make nitrite

20
Q

What are urine dipsticks useful for in UTIs?

A

Good at telling us how likely they are NOT to have an infection

21
Q

What are urine dipsticks not useful for?

A

Uncomplicated UTIs in women
Men with typical/severe symptoms
Catheterised patients (usually positive)
Older patients without features of infection

22
Q

What is the role of culture in UTIs?

A

Guidance for treatment
Collect data - epidemiology
See if urine collection is good quality
Test sensitivity to Abx

23
Q

What do we call the area of clearance when testing Abx sensitivity?

A

Zone of inhibition

24
Q

How do we treat most cases of cystitis?

A

Self-limiting

No Abx necessary for most

25
Q

When would we image the tract in UTIs?

A

All children

Septic patients

26
Q

What is sterile pyuria?

A

Presence of increased WBCs in urine without a positive culture

27
Q

What are some causes of sterile pyuria?

A 
Already on Abx
Urethritis 
Vaginal infection/inflammation
Chemical inflammation
TB
Appendicitis
28
Q

Describe the treatment for UTI

A

Increase fluid intake
Address underlying disorder
3 day course Abx - uncomplicated
5-7 day course - complicated

29
Q

Describe Abx for simple cystitis

A

Trimethoprim or nitrofurantoin

3 day course

30
Q

Describe Abx for complicated UTI

A

Trimethoprim, nitrofurantoin or cephalexin

5 - 7 days

31
Q

Why is amoxicillin not an appropriate treatment for UTIs?

A

Many organisms causing UTIs are resistant to amoxicillin

32
Q

Who do we do follow up UTI cultures for?

A

Children

Pregnant women

33
Q

How do we treat pyelonephritis?

A 
14 day course 
Agent with systemic activity 
Possibly IV
Co-amoxiclav 
Ciprofloxacin 
Gentamicin
34
Q

How and why do we give prophylaxis for UTIs?

A

3 or more episodes per year
No treatable underlying condition
Trimethoprim or nitrofurantoin
Single nightly dose

Urinary System (14 decks)

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