UTIs Flashcards
CyWhat is cystitis and what branch of medicine is it commonly seen in?
Cystitis is infection of the bladder
Commonly seen in family practice
What other structures might also be infected with an infection of the bladder?
What is infection of the bladder known as if it infects these areas?
Uretes
Calyces (urine collecting system of the kidney)
In this case known as an ascending infection
What are the classical symptoms of cystitis?
Which one of these symptoms is an unreliable feature?
Frequency Urgency Dysuria Suprapubic discomfort Urine colour Fever
Fever is an unreliable feature
What does repeated episodes of cystitis increase the risk of?
Renal damage
What is pyelonephritis?
When the kidney parenchyma becomes infected
What is the renal angle?
The angle between the spine and the lowest ribs of the back
What is a key sign that distinguishes between cystitis and pyelonephritis?
Pyelonephritis leads to raised WBC (neutrophilia)
Cystitis does not raise WBC
If pyelonephritis is left untreated, what can it result in?
Abscess
Bacteraemia
Septic shock
Which two groups of individuals do not present with the classical symptoms of pyelonephritis?
Give an example of the symptom these groups respectively may only present with?
Young children and the elderly
Young children may only present with fever
Elderly may only become confused
What is honeymoon cystitis?
Cystitis which follows frequent sexual intercourse
What is urethritis associated with?
STIs
Genital self infections
Why should Chlamydia and Gonoorhoea always be included in a differential diagnosis of urethritis?
As the infection are:
1) Infection may be symptomatic in females
2) If left untreated can lead to fertility
According to SIGN guidelines, what are cranberry based products beneficial at preventing?
Urinary recurrent infections in adult women
Give 3 causes of excess leucocytes in urine?
Infected urine
After exercise
Urine has been contaminated by vaginal discharge
What type of urine samples are used for urinalysis and why is this?
Mid-stream urine samples are used because both the first and last parts of urine can be contaminated
Which group of individuals should not receive treatment for asymptomatic bacteriuria?
Over 65 year olds
Those with a catheter in situ
When should you send or not send a MSU when investigating a lower UTI in a non-pregnant woman?
Do not send a pretreatment MSU on 1st presentation
Send a MSU for all treatment failures
When should you prescribe antibiotics for a lower UTI in a non-pregnant female?
If severe or 3 or more symptoms = treat
If mild or 2 or less symptoms = dipstick guidance
What antibiotics should be given to those suffering from a lower UTI if they are adults?
Trimethoprim
or
Nitrofurantoin
How does the duration of antibiotics treat a lower UTI differ for men a women?
Women - 3 days
Men - 7 days
What antibiotics are used to treat pyelonephritis and for how long it is prescribed?
Ciprofloxacin for 7 days
or
Co-amoxiclav for 14 days
What is not recommended to be used for diagnosis catheter related UTIs?
Dipsticks
What antibiotic should people receive if they are being treated for a symptomatic UTI following catheterisation?
The same treatment as for a lower UTI
i.e. Trimethoprim or Nitrofurantoin
