UTIs

Question 1

what is meany by polyuria

Answer 1

presence of white blood cells in the urine

Question 2

What is meant by noscomial

Answer 2

Caused by more anti-microbial resistant strains

Question 3

How does E coli cause a UTI

Answer 3

P fimbriae attach to the urological epithelium

ascends the renal tract to cause pyelonephritis

Question 4

What group does e coli belong to?

Answer 4

Enterobacteriacae gram -ve

Question 5

when do UTIs occur?

Answer 5

pathogen virulence increases

host defence mechanism decreases

Question 6

What are factors that affect a pathogen?

Answer 6

Motility mediator- flagella powers directional movement
Adhesions- fimbria allow attachment to host epithelium
Toxins - destroy host tissue and cause system instability
Invasins- protease breakdown host epithelial barrier
Immune escape mediators- disguise bacteria from immune recognition
Biofilm production- shield bacteria from immune attack

Question 7

what alters the periurethral area?

Answer 7

Systemic antibiotics 
prolonged hospitalisation 
oestrogen deficiency 
low vaginal pH
low cervical IgA
spermicides

Question 8

what is the role of urethra

Answer 8

extra protective factors in males

urethra lining secretes antibacterial peptides

Question 9

What are symptoms of urethritis?

Answer 9

Infection of urethra
irritation and dysuria
occasional discharge

Question 10

treatment for STIs caused by chalydia tochamatis

Answer 10

arithromycin or doxycycline

Question 11

treatment for neisseria gonorrhoea

Answer 11

certftriaxone and/or azithrymycin

Question 12

What investigations for urethritis

Answer 12

urine- microbiological culture + swab for PCR

Question 13

what can cause prostatitis?

Answer 13

e coli
entercoccus faecalis
proteus species
GI pathogens

Question 14

treatment for prostatitis

Answer 14

ciprofloracin or co-trimoxazole `

Question 15

define lower UTI

Answer 15

Infection between the urethra and the uretrovesical junction

Question 16

define upper UTI

Answer 16

infection above the ureterovesical junction

Question 17

cystitis risk factors

Answer 17

ineffective voiding
smoking
diabetes mellitus
sexual intercourse

Question 18

What is cystitis?

Answer 18

inflammation of the bladder

Question 19

How does ineffective voiding contribute to cystitis

Answer 19

bladder outflow obstruction
memory impairment
neurological deficit

Question 20

How does smoking contribute to cystitis

Answer 20

causes a chemical intersitial cystitis

Question 21

How does diabetes mellitus contribute to cystitis

Answer 21

raised urinary glucose feeds bacterial growth

Question 22

How doe sexual inercourse contribute to cystitis

Answer 22

delivers pathogens to urethral entry

Question 23

Presntation of cystitis

Answer 23

Urinating is painful, frequent, urgent 
Urine that is bloody, turbid, foul- smelling 
Fever
confusion 
abdominal pain

Question 24

What investigations are rewuired for cystitis?

Answer 24

Urinalysis - urine dipstic
urine microscopy - pyuria/ bacteruria
imaging

Question 25

Why might nitrates be false -ve?

Answer 25

due to diuretic use or low dietry intake of nitrate

Question 26

What imaging is required for cystitis?

Answer 26

CT / ultrasound of renal tracts looking for - anatomical abnormality renal stones tumour

Question 27

management of cystitis

Answer 27

hydration glycaemia control in diabetes antibiotic therapy

Question 28

examples of antibiotic therapy for cystitis

Answer 28

nitrofuranatoin trimethoprim privmecillinam cephalaxin

Question 29

prophylaixs of cysitis

Answer 29

genitial hygeine post coital voiding avoidance of diaphragm estrial vaginal cream for post menopausal

Question 30

What is pyelonephritis also known as?

Answer 30

kidney infection

Question 31

What are risk factors of pyelonephritis

Answer 31

cystitis | interference with ureter peristalsis

Question 32

classic presentation of pyelonephritis

Answer 32

fevers/rigors flank pain nausea and vomiting

Question 33

investigation for pyelonephritis

Answer 33

same measures as cystitis blood cultures imaging- USS/ CT of renal tract

Question 34

Managment of pyelonephritis

Answer 34

ressucitation empirical antimicrobial therapy targeted antimicrobial therapy

Question 35

treatment for pyelonephritis

Answer 35

IV pipercillin- tazobactam IV/PO- ciprofloxacin IV- gentamicin

Question 36

what is a complicated UTI

Answer 36

factors that will increase the chance of acquiring bacteria and decrease the efficacy of therapy

Question 37

problems with complicated UTIs

Answer 37

structural/functional abnormality of the urinary tract immunocompromised host hypervirulent or resistant bacteria

Question 38

how to diagnose asymptomatic bacteruria

Answer 38

clean catch urine with >100,000 CFU/ml of the same organism

Question 39

who gets treatment for asymptomatic bacteruria

Answer 39

pregnant women | and patients awaiting urological surgery/procedure

Question 40

when do you not use a dipstick to diagnose a UTI

Answer 40

when a catheter is present