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UroNephro > W3L1 UTI > Flashcards

W3L1 UTI Flashcards

1
Q

Host defense mechanisms?

A

A- Preventing bacteria from colonizing vagina
B- Eliminating bacteria that enter the bladder
C- Urine

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2
Q

Definition UTI?

A
  • Presence >105 CFU/ml urine with/out symptoms

- Inflammatory response of urothelium to organism invasion leading to symptoms

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3
Q

Classification Bacteriuria & Pyuria?

A
  1. Bacteriuria
    - Symptomatic
    - Asymp
  2. Pyuria
    - Sterile
    - Infection
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4
Q

Etiology?

A
  1. Causative organism
    - Bacterial: E coli (80%)
    - fungal: candida alb
    - Protozoal: T vaginalis
    - parasitic: Bilharziasis Oxyuris
  2. Route of inf
    - Asc-bl-lymph-others
3. Predis Factor
A.General:
- DM
- Immune compromized patients 
- Chronic debilitating diseases 
B. Local:
- Stones
- Indwelling catheters
- VUR
- Obstruction
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5
Q

Classification UTI

A
  1. Uncomplicated UTI:
    - Episode UTI in otherwise healthy individual
    - No predisposing factors
    - No functional/structural abnormalities
    - Occasional lower UTI in women
  2. Complicated UTI:
    - All other UTIs.
    - Factors predicting :
    • RF, DM, Tx
    • Obstructive uropathy
    • Perioperative
    • Radiation/chemical injury
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6
Q

Nonspecific UTI?

A
  1. Urethritis
  2. Cystitis
  3. Pyelonephritis
  4. Epididymitis
  5. Epididymoorchitis
  6. Prostatitis
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7
Q

ACUTE PYELONEPHRITIS Incidence?

A
  • > females
  • Childhood
  • Puberty
  • Soon after marriage
  • pregnancy
  • menopausal
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8
Q

Clinical Features AP?

A
  • Prodromal symptoms: Anorexia, headache, malaise
  • Pain
  • Fever
  • Cystitis
  • Tender loin
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9
Q

Investigations AP?

A
  • Pyuria

- Leukocytosis

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10
Q

Management AP?

A
  1. Broad spectrum ab until
  2. Not very unwell:
    - No need for hospitalization
    - Ab: fluoroquinolone oral(10-14d)
    - Symptomatic
  3. Very ill patient
    - Hospitalization.
    - IV antibiotic:3rd gen cephalosporin IV/IM(10-14d)
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11
Q

Causes CHRONIC PYELONEPHRITIS?

A
  • Recurrent attacks of acute pyelonephritis
  • VUR
  • Stone disease
  • Previous surger
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12
Q

Pathology CP?

A
  1. Interstial inflammation & scarring renal parenchyma.
  2. Tubules atrophy
  3. THEN glomeruli (fibrosis & hyaline change)
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13
Q

Clinical Features CP?

A 
- Constitutional symptoms: Anorexia,
headache, malaise
- Pain: Dull aching
- Fever: Low grade in attacks
- Cystitis
- HTN
- Anemia
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14
Q

Management CP?

A
  • Ttt causes (stones)
  • Chronic suppresive therapy
  • Nephrectomy
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15
Q

CP/Inv PERINEPHRIC ABSCESS?

A
  • Loin pain & tenderness
  • Attacks high grade fever
  • Oblitrated posas shadow(KUB)
  • US & CT(diagnostic)
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16
Q

Management PA?

A
  • Unilocular: PCTD

- Multilocular: open drainage

17
Q

Incidence/ PF/ Organism CYSTITIS?

A 
- >females (25%)
PF:
- Incomplete empty bladder(BPH, stricture)
- Foregin body(stone, tumor)
- Colonization perineal skin(E.coli)
- Estrogen deficiency
18
Q

CP/Inv Cyst?

A
  • Urinary frequency (earliest symptom) - Painful micturition
  • Pyuria
  • Hematuria
  • Suprapubic tenderness
  • Urine analysis / C&S
19
Q

DD Cy

A
  • Acute urethritis

- Acute vaginitis

20
Q

Management Cy

A
  • General & symptomatic: Increase fluid intake
  • Simple urinary antiseptics/Antimicrob
  • If persistent symptoms: investigate for predisposing factors
21
Q

Classification PROSTATITIS?

A
  1. Acute bacterial prostatitis (ABP)
  2. Chronic bacterial prostatitis (CBP)
  3. Chronic pelvic pain syndrome (CPPS)
    A: inflammatory B: non inflammatory
  4. Asymptomatic inflammatory prostatitis (histological prostatitis)
22
Q

CP/Inv ABP?

A
  • Fever & rigors
  • LUTS
  • Pain (SP, perineal, genital)
  • DRE: Tender prostate boggy swelling if abcess is present
  • Culture organism(diagnostic)
23
Q

Management ABP?

A
  • General & symptomatic: Increase fluid intake/ Antipyretic/ Bed rest
  • Specific: Ab >=1m(IV till acute phase subside)
  • Drainage of the abscess if present
24
Q

CP/Inv CBP?

A
  • Recurrent UTI.
  • Asymptomatic between episode
  • Intermittent low grade fever
  • DRE: normal/slightly enlarged
    tender prostate/not indurate, nodular
  • Prostatic massage: pus cells & bacteria in prostatic fluid
25
Q

Management CBP?

A
  • Specific: Ab >= 3m according to C&S
  • Fluoroquinolones(choice)
  • Consider prophylaxis
26
Q

CHRONIC NON BACTERIAL PROSTATITIS

A 
▪AE unknown.
▪Symptoms (pain and LUTS)
▪>3 months
▪Wax and wane with time
▪No bacterial infection.
27
Q

ASYMPTOMATIC INFLAMMATORY PROSTATITIS

A

▪Asymptomatic
▪Detected only in histology
▪No treatment except surgical procedure is needed

28
Q

Etiology, Route of infection and predisposing factors Acute Epidiymo-
orchitis?

A 
▪Ascending infection( most common)
▪Hematogenous ( mumps)
▪UTI
▪Instrumentation.
▪Prostate or bladder surgery.
▪ST
29
Q

CP/Inv AEO

A 
▪General: FHMA
▪Pain
▪LUTS
▪Tender scrotal swelling
▪Urine analysis/ C&S
▪Scrotal US & doppler
30
Q

Management AEO?

A
  1. General:
    - Bed rest
    - Local: lead subacetate fomentations testicular elevation
    - Systemic: analgesic & antipyretic
  2. Specific:
    - STD: ( Gono&Non Gono-Coccal)
    • Ceftriaxone IM
    • Doxycycline(100mgx2 daily)
    • Azathioprine(14d)
      - Non STD:
    • well: oral quinolone
    • un well: IV ab(1m)

UroNephro (18 decks)

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