Week 3 - Urinary tract infections Flashcards

1
Q

Most common infecting organism when it comes to UTI

A

Uropathogenic E. coli

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2
Q

Damage which UTI is related to

A

Vesicoureteral reflux

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3
Q

UTI are more common in men than in females

A

False, they are much more common in women

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4
Q

Is there any point in life when boys and girls have the same risk for developing a UTI

A

Yes, during infancy

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5
Q

Renal-Focused history and physical examination

A
  • Age of toilet training
  • Characteristics of frequency
  • Family history of renal disease
  • Color and odor
  • Unexplained episodes of fever
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6
Q

3 ways to get a UTI

A
  • Ascension to the kidneys
  • Hematological way
  • Damage caused by trauma con un fierro contaminado
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7
Q

2 types of UTI

A
  • Cystitis
  • Pyelonephritis
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8
Q

Cystitis characteristics

A
  • Dysuria
  • Frequency
  • Tenesmus
  • Suprapubic pain
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9
Q

Acute pyelonephritis characteristics

A
  • Pain in renal fossa
  • Fever with dysuria
  • Tenesmus
  • Frequency
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10
Q

Main characteristic to differentiate cystitis of pyelonephritis

A

Fever

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11
Q

When can you say its a complicated UTI

A
  • Presence of foreign bodies
  • Obstruction
  • Immunosuppression
  • Renal insufficiency
  • Renal transplant
  • Urinary retention
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12
Q

E. coli divides by binary fusion every…

A

15 to 20 minutes

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13
Q

Patient has E. coli UTI, you give them treatment and then it comes back bc it never went away (same E. coli)

A

Recurrence

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14
Q

Patient has E. coli UTI, you give them treatment and they feel better, 6 months later they get another UTI caused by the same E. coli

A

Relapse

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15
Q

Patient has E. coli UTI, you give them treatment and they’re now A-OK… 4 months later they get another UTI from a different pathogen

A

Reinfection

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16
Q

Sepsis related to UTI is known as

A

Urosepsis

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17
Q

When some bacteria UTI persists for months/ years with relapses, even after treatment it is called…

A

Chronic UTI

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18
Q

Pathological changes in the kidney bc of a UTI

A

Chronic pyelonephritis: augmented size, decreased size, renal scars

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19
Q

Host defenses mechanism can be divided into

A
  • Nonimmune mechanisms (highly effective)
  • Adaptive immunity
  • Innate immunity
  • Inflammatory response
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20
Q

Virulence factors for UPEC

A
  • Pilli type 1 (F1C)
  • P pilli
  • S pilli
  • Dr. adhesins
21
Q

UPEC can form biofilms to be easier to identify

A

False, they produce biofilms to sorta “hide”

22
Q

Proteus mirabilis characteristic

A

Produces urease and changes pH to alkaline

23
Q

Diagnosis for UTI

A
  • Urine dipsticks for pyuria and bacteriuria
  • Gold standard: urocultivo
24
Q

Important results of urianalisis

A
  • Leukocytes
  • Nitrates (only produced by bacteria)
  • Leukocyte esterase (produced by active leukocytes)
  • Microscopic bacteria presence
25
Q

Types of agar used for urine culture

A
  • Blood agar
  • Agar MacConkey
26
Q

Method of collection for urine culture

A
  • Clean catch
  • Chorro medio
27
Q

Classification of UTI

A
  • Altas/ upper
  • Bajas/ lower
28
Q

Treatment for uncomplicated cystitis in non pregnant women

A

Nitrofurantoin

29
Q

Treatment for complicated cystitis in men or women

A

Fluroquinoloness or nitrofurantoin

30
Q

Treatment for complicated cystitis in pregnant women

A

Cephalexin

31
Q

Treatment for complicated pyelonephritis in non pregnant women and men

A

Cephalosporin or quinolones

32
Q

When would you do an image study in regards to a UTI

A
  • In any acute episode of pyelonephritis
  • In a boys first UTI
  • In a recurrent UTI infection in girls
33
Q

The worst complication of pyelonephritis

A
  • Perirrenal abcess with pus and air
  • Intrarrenal abcess
34
Q

Bacterias that LOVE to colonize catheters

A

Gram + cocci Streptococcus pneumoniae or Staphylococcus aureus

35
Q

UTIs are most commonly caused by an ______ mechanism

A

Ascending

36
Q

Bacteria that has fimbriae and bind themselves to the urinary tract cells

A

E. coli (UPEC)

37
Q

Other bacteria that can cause UTI

A
  • Staphylococcus saprophyticus
  • Klebsiella pneumoniae
  • Proteus mirabilis
38
Q

Risk factors for cystitis

A
  • Female
  • Frequent sexual intercourse
  • DM
  • Indwellin catheter
  • Impaired bladder emptying
39
Q

Bacteria related to honeymoon cystitis

A

Staphylococcus saprophyticus

40
Q

Gold standard to diagnose a UTI

A

Urine culture

41
Q

CBC results when diagnosing cystitis

A
  • @ CBC: WBC normal
  • Dipstick test: + leukocyte esterase (pyuria) & + nitrites
  • Microscopy: > 10 WBC/ high power field
42
Q

Urethritis is the inflammation of the urethra and can be caused by

A
  • Neisseria gonorrhoeae
  • Chlamydia trachomatis
43
Q

Risk factors for acute pyelonephritis

A
  • Indwelling catheters
  • Diabetes mellitus
  • Pregnancy
  • Obstruction @ UT
44
Q

Ppl with acute pyelonephritis present: dysuria, urinary frequency and urgency, flank pain and systemic symptoms that distinguish them from cystitis, which systemic symptoms?

A
  • Fever
  • Chills
  • Nausea
  • Vomiting
45
Q

Clinical examination @ patient with pyelonephritis is positive for

A
  • Giordano’s sign
  • Costovertebral tenderness
46
Q

Results of diagnostic tests done to diagnose pyelonephritis

A
  • CBC: WBC is high
  • Urianalysis: leukocyte esterase and nitrates +
47
Q

Renal interstitial has fibrosis and scaring that may lead to renal atrophy

A

Chronic pyelonephritis

48
Q

Microorganism that alkalinize urine + give it ammonia smell

A

Proteus

49
Q

Chronic proteus infection may lead to

A

Xanthogranulomatous pyelonephritis