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Urinary > Week 7 - UTI > Flashcards

Week 7 - UTI Flashcards

1
Q

What can cause obstruction of the urethra and lead to UTIs?

A
  • Prostate enlargement
  • Pregnancy
  • Tumour
  • Stones
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2
Q

What neurological problems increase the risk of UTIs?

A

-Incomplete emptying/ residual urine

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3
Q

List some virulence factors of UTI pathogens which aid infection

A
  • Fimbrae/pili for attachment
  • Haemolysins to damage host membranes and cause renal damage
  • K antigen for production of polysaccharide capsule
  • Urease to break down urea and create a favourable environment
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4
Q

What is the most likely causative organisms of UTIs in the community?

A

-Coliforms

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5
Q

What is the most likely causative organisms of UTIs in hospital?

A

-Staph aureus

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6
Q

What are possible causative organisms of UTIs?

A
  • Coliforms
  • Proteus spp.
  • Enterococci
  • Staphylococci
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7
Q

Give examples of clinical conditions caused by UTIs

A
  • Lower UTI (cystitis)
  • Acute pyelonephritis
  • Chronic nephritis
  • Septicaemia
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8
Q

Describe the symptoms of lower UTI

A
  • Dysuria
  • Frequency
  • Urgency
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9
Q

Describe the symptoms of upper UTI

A
  • Loin to groin pain
  • Fever
  • May have dysuria and frequency
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10
Q

When is a UTI classified as uncomplicated?

A

-In a healthy women with no risk factors

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11
Q

When is a UTI classified as complicated?

A

-Pregnancy, treatment failure, suspected pyelonephritis, males, paediactric

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12
Q

When does a urine culture need to be done in UTI?

A

-In a complicated UTI

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13
Q

How is an uncomplicted UTI diagnosed?

A

-Turbidity and Urine dipstick positive for nitrites and leukocyte esterase

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14
Q

What turns urine cloudy in UTI?

A

-Presence of WBCs

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15
Q

Explain the specificity and sensitivity of nitrites on a dipstick

A
  • Poorly sensitive as can only detect a limited number of bacteria so a ned result does not rule out infection
  • Highly specific as if it is positive it is most likely UTI
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16
Q

Explain the specificity and sensitivity of leucocyte esterase on a dipstick

A

-High sensitivity with good specificity

17
Q

When is microscopy indicated in UTIs?

A
  • Kidney disease -> nephritis, renal colic,
  • Suspected endocarditis
  • Children under 6
  • Schistosomiasis
18
Q

What is the purpose of urine culture?

A
  • Investigation of complicated UTI
  • Epidemiology of isolates
  • Abx susceptibility
19
Q

What are some differential diagnoses to UTI?

A
  • STI
  • mechanical/physical causes
  • vaginal infection (thrush)
  • Renal TB
20
Q

Why may someones urine be sterile upon presenting with infection?

A
  • Already on Abx
  • STI
  • Thrush
  • TB
21
Q

Outline the treatment of a UTI

A
  • Increase fluid intake
  • Address underlying disorders
  • 3 day course trimethoprim for uncomplicated and 7 days for complicated
22
Q

What are the two main drugs for UTI treatment?

A
  • Trimethoprim

- Nitrofurantoin

23
Q

Why is amoxicillin not appropriate for UTIs?

A

-50% strains are resistant

24
Q

How do you treat pyelonephritis?

A
  • 14 day course

- ciprofloxin or IV gentamycin

25
Q

When is prophylaxis considered for UTIs?

A

-When more than 3 or more episodes in one year and there is no treatable underlying condition

26
Q

NAme the defences of the urinary tract to bacteria

A
  • Regular flushing

- Antibacterial secretion into urine and urethra

27
Q

What is sterile pyuria?

A

-White blood cells in urine without bacterial growth

28
Q

Why is there more incidence of UTIs in females?

A

-Shorter urethra

29
Q

When is it necessary to do 3 urinary specimens?

A

-When TB is suspected

30
Q

When should UTIs have a follow up?

A

-Children and pregnancy

31
Q

When is Abx treatment indicated in a catheter sample?

A

-When pt is systemically unwell

Urinary (21 decks)

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