Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Micro Exam 2 > Withey: Urinary Tract Infections > Flashcards

Withey: Urinary Tract Infections Flashcards

1
Q

DEFINITION OF UTI BY LOCATION

Kidney:

A

Kidney: pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DEFINITION OF UTI BY LOCATION

Ureter:

A

Ureter: ureteritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DEFINITION OF UTI BY LOCATION

Bladder:

A

Bladder: cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

DEFINITION OF UTI BY LOCATION

Prostate:

A

Prostate: prostatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

DEFINITION OF UTI BY LOCATION

Urethra:

A

Urethra: urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lower UTI Definition: (3)

A

cystitis, prostatitis, urethritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Presentation of Cystitis:

A

Cystitis: dysuria, urinary urgency and frequency, bladder fullness/discomfort; may also have hematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Presentation of Prostatitis:

A

Prostatitis: pain in lower back, perirectal area and testicles (as well as the above symptoms)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Upper UTI Definition: (3)

A

Upper UTI: pyelonephritis, intra-renal abscess, perinepheric abscess (late complication of pyelonephritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do women get UTIs?

A

A shorter urethra in women permits ascending infections of the bladder (cystitis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why do men get UTIs?

A

Physical abnormalities (such as enlarged prostate) may prevent voiding and enhance bacterial growth in the bladder.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Presentation of Pyelonephritis:

A

Pyelonephritis: cystitis symptoms as well as the following
o Fever/sweating
o N/V/D
o Flank pain
o Signs/symptoms of dehydration or hypotension
o Can show signs of speticemic shock

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Uncomplicated UTI Definition:
Effect on long term renal function:
Duration:

A

Infection in a structurally and neurologically normal urinary tract

  • Little to no effect on long term renal function
  • Simple cystitis of short duration that is easily cleared with antibiotics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Complicated UTI Definition:
Duration:
Males:
Antibiotic resistant bacteria:

A

Infection in a urinary tract with functional or structural abnormalities (indwelling catheters, renal stones, enlarged prostate)

  • Causes cystitis of long duration or hemorrhagic cystitis
  • UTIs in males always considered complicated
  • Antibiotic resistant bacteria also fall into this category
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the leading cause of both complicated and uncomplicated UTIs?

A

E.coli

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the leading cause of uncomplicated UTIs? (2)

A

E.coli, S.saprophyticus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the leading cause of complicated UTIs? (5)

- Two leading causes?

A

*E.coli, *Enterococcus, P.aeruginosa, Klebsiella, Proteus (an many others)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

General pathogenesis
Entry

What determines how far it ascends?
What is it often due to?

A

Entry: ascent from urethra (how far it ascends depends on virulence factors)

Often due to poor hygiene (inoculation from host flora) or sexual contact

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the most important factor in pathogenesis?

A

Adherence to host epithelium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

General pathogenesis
Adherence to host epithelium

Why do the organisms need organelles?

A

Negative charge on both bacteria and epithelial surfaces, and therefore, the bacteria need organelles to reach out and attach host cells, effectively overcoming repulsive forces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

General pathogenesis
Adherence to host epithelium

Maximum repulsion zone:
Ideal distance:

A

10um is the maximum repulsion zone

15um is where they want to be

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

General pathogenesis
Adherence to host epithelium

Examples:
G-
G+

A

Adhesions, pili/fimbriae (Gram negatives) and polysaccharides (G positives)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Uropathogenic E.coli (UPEC)

Virulence Factors: (7)

A
  1. Pili/Fimbriae-Associated Adhesins
  2. Type 1 pili
  3. Type S Fimbriae (SfaI and SfaII):
  4. Afrimbrial Adhesins
  5. Toxins
  6. LPS (Endotoxin)
  7. K Antigen (Polysaccharide Capsule)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Uropathogenic E.coli (UPEC)
P Pili Associated with Pyelonephritis (PAP)

Binds to:
How can individuals be predisposed?
Blocking by mannose:

A

Binds to digalatoside receptor (glycosphingolipids/globobiose)
- Individuals can be predisposed to infection due to high density of these receptors

Mannose insensitive (binding not blocked by mannose)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Uropathogenic E.coli (UPEC)
P Pili Associated with Pyelonephritis (PAP)

Causes what in labs? Binds what on RBCs?
Helps resist what?
Induces what for inflammation?

A

Causes hemagglutination in lab (binds P Ags on RBCs)

Help resist phagocytosis

Proflammatory (induce IL-6, IL-8 and PMN infiltration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Uropathogenic E.coli (UPEC)
Type 1 Pili

Mannose:
Does what to RBCs?
What does the invertible promoter element allow it to do?

A

Binds to mannose (therefore mannose sensitive) in order to mediate binding to uroepithelium

Agglutinates RBCs

Invertible promoter element allows it to be turned on in the bladder and off in the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Uropathogenic E.coli (UPEC)
Type S Fimbriae (SfaI and SfaII)

Binds to what on glycoproteins?
Mannose:
Does what to RBCs?

A

Binds to sialic acids on glycoproteins (therefore, mannose insensitive)

Agglutinates RBCs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Uropathogenic E.coli (UPEC)
Type S Fimbriae (SfaI and SfaII)

Effect on kidney and bladder:
Often associated with: (2)

A

Causes both cystitis and pyelonephritis

Often associated with neonatal meningitis and bacteremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Uropathogenic E.coli (UPEC)
Afrimbrial Adhesins

Recognizes:
What aids in adhesion to uroepithelium? What else do they aid in?

A

Recognize Dr blood group Ags

AfaD and AfaE aid in adhesion to uroepithelium and internalization (recurrent UTIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Uropathogenic E.coli (UPEC)
Afrimbrial Adhesins

What does Dr adhesion recognize? What does it aid in?

A

Dr adhesion recognizes basolateral surface integrins to aid in internalization (recurrent UTIs)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Uropathogenic E.coli (UPEC)

Toxins: (2)

A

Alpha hemolysin

Cytotoxic necrotizing factor type 1 (CNF-1)

32
Q

Uropathogenic E.coli (UPEC)
Alpha hemolysin

Effect on RBCs:
Effect on renal tubular cells:
Effect in pyelonephritis:

A

Lyses RBCs (iron for growth) and renal tubular cells

Mediates kidney damage in pyelonephritis

33
Q

Uropathogenic E.coli (UPEC)
Cytotoxic necrotizing factor type 1 (CNF-1)

What % of EPEC strains?
Kills what tissue?
What are not as virulent?

A

~40% of EPEC strains

Kills human bladder epithelium by apoptosis

Mutants in CNF-1 are not as virulent

34
Q

Uropathogenic E.coli (UPEC)
LPS (Endotoxin)

What type of cytokine release?
Synergistic effect with:

A

Proinflammatory cytokine release (i.e. IL-8)

Synergistic effect with P fimbrae

35
Q 
Uropathogenic E.coli (UPEC)
K Antigen (Polysaccharide Capsule)

Composed of:
Resistance to:

A

Composed of polysaccharides

Anti-phagocytic/serum resistance

36
Q

What causes causes 80-90% of CA-UTIs?

What is the source?

A

Uropathogenic E.coli (UPEC)

Host’s own intestinal flora or sexual partner’s flora

37
Q

Uropathogenic E.coli (UPEC)
Ascending Infection of Urethra

What do E.coli bind to the urethra with?

A

E.coli bind to urethra using Type 1 fimbriae (not washed out)

38
Q

Uropathogenic E.coli (UPEC)
Ascending Infection of Urethra

What do E.coli bind to the Bladder with?

A

Ascend further to bladder where they again bind using Type 1 fimbriae with FimH tip

39
Q

Uropathogenic E.coli (UPEC)
Ascending Infection of Urethra

How do E.coli move up the ureter?

A

Move up ureter using flagellar motility

40
Q

Uropathogenic E.coli (UPEC)
Ascending Infection of Urethra

What mediates binding in the kidney? How does it evade immune response?

A

Reach the kidney where P fimbriae with PagG tip mediate binding (antigen switch to evade immune response as well)

41
Q

Uropathogenic E.coli (UPEC)

What contributes to cell damage?

A

Inflammatory response and toxins contribute to cell damage

42
Q

Uropathogenic E.coli (UPEC)
Examination of urine

Gram stain:
Shape:
Look for what type of cell?
What are the G+ rods adhering to epithelial cells?

A

Gram stain: look for Gram negative rods, RBC and WBC

- Note: Gram + rods adhering to epithelial cells are lactobacilli (normal flora)

43
Q

Uropathogenic E.coli (UPEC)
Examination of urine

Blood agar plate:
MacConkey:
Cysteine-lactose-electrolyte deficient agar (CLED):

A

Blood agar plate: beta hemolysis and quantitation

Selective Media:

  • MacConkey: lactose positive colonies (red/pink)
  • Cysteine-lactose-electrolyte deficient agar (CLED): yellow colones
44
Q

Uropathogenic E.coli (UPEC)
Examination of urine

Indole Test:
Oxidase test:

A

Indole Test: pink/purple

Oxidase test: negative

45
Q

Uropathogenic E.coli (UPEC)
Identification

Need to differentiate between:

BAP
Contaminants/Normal Flora:
Questionable/Repeat:
Bacterial Infection:

A

Need to differentiate between infection and contamination:

BAP: streaked with calibrated loop so that 1 colony= 100 CFU/ml

  • Contaminants/Normal Flora: less than 10,000 organisms per mL
  • Questionable/Repeat: 10,000-100,000 organisms per mL
  • Bacterial Infection: greater than 100,000 organisms per mL
46
Q

Staphylococcus saprophyticus
Virulence Factors: (4)
Ubiquity of homolysin:

A
  1. S.saprophyticus surface associated protein
  2. Hemagglutinin/fibronectin-binding protein
  3. Hemolysin: not in all uropathogenic strains
  4. Urease
47
Q

Staphylococcus saprophyticus

G +/-?
Causes inflammation of what?
Rarely causes:
M vs F?

A

Gram + cocci

Urethritis and cystitis

Rarely causes pyelonephritis

More common in females than males

48
Q

Staphylococcus saprophyticus
Urease

Hydrolyzes urea to give:
Toxic to:

A

Hydrolyzes urea to give ammonium ions

Toxic to bladder tissue

49
Q

Staphylococcus saprophyticus
Urease

Effect on urine pH:
What forms with chronic UTIs?

A

Raises pH of urine (promotes formation of kidney stones that can obstruct urinary tract)

Struvite stones with chronic UTIs (magnesium ammonium phosphate)

50
Q

Staphylococcus saprophyticus

Causes:
Rarely associated with:
F vs M:
Possible risk factors: (4)

A

Causes: urethritis and cystitis (rarely associated with pyelonephritis)

More common in females

Possible Risk Factors:
o	Auto-infection (colon)
o	Sexual activity 
o	Hormone flux at menstruation
o	Spermicide nonoxynol-9
51
Q

Staphylococcus saprophyticus
Laboratory Identification

G+/-?
Shape:
Grows on what type of plate?
Doesn’t grow on:

A

Shape: Gram positive cocci in clusters

Growth: CNA agar (none of MAC, EMB or CLED)

52
Q

Staphylococcus saprophyticus
Laboratory Identification

Cat +/-?
Coag +/-?
Novobiacin sensitive?

A

Biochemical: catalase positive, coagulase negative, novobiacin resistant

53
Q

Klebsiella pneumoniae

Virulence Factors: (5)

A

Type 1 Fimbriae

Type 3 Fimbriae

Polysaccharide Capsule

LPS

Urease

54
Q

Klebsiella pneumoniae
Type 1 and 3 Fimbriae

Mannose sensitivity:

A

Type 1 Fimbriae: mannose sensitive hemagglutinin

Type 3 Fimbriae: mannose-resistant hemagglutinin

55
Q

Klebsiella pneumoniae
Polysaccharide Capsule

Layers:
Phagocytic?

A

Polysaccharide Capsule: bilayered and anti-phagocytic

56
Q

Klebsiella pneumoniae
LPS

What type of resistance?
Mediated by what?

A

LPS: serum resistance (mediated by O antigen)

57
Q

Klebsiella pneumoniae
Urease

What does it convert urea into?
What does it form?
What % of isolates produce urease?

A

Hydrolyzes urea to give ammonium ions (stone formation; almost 100% produce)

58
Q

Klebsiella pneumoniae
Laboratory Identification

G +/-?
Shape
Appearance
Lac +/-?
Hemolytic?
A

Shape: Gram negative rod

Appearance: mucoid colonies (due to capsule)

Growth: lactose positive on MAC, EMB and CLED; non-hemolytic on BAP

59
Q

Proteus mirabilis

Virulence Factors: (4)

A

Adhesins:

Flagella

Urease

HpmA Hemolysin

60
Q

Proteus mirabilis
Adhesins

MR/P
Hemagglutinin?
Contributes to colonization of:
Increases risk of:

A

MR/P (Mannose Resistant Proteus-like):

  • Hemagglutinin
  • Contributes to colonization of urinary tract
  • Increases risk of acute pyelonephritis
61
Q

Proteus mirabilis
Flagella

Motility contributes to:

A

Highly motile (swarming motility; contributes to ascending infection from ureters to kidney)

62
Q

Proteus mirabilis

Urease production causes:

A

Urease: STRONG producer of urease (rapidly causes stone formation)

63
Q

Proteus mirabilis

What virulence factor is potent and cytotoxic for a variety of cells?

A

HpmA Hemolysin: potent and cytotoxic for a variety of cells

64
Q

Proteus mirabilis
Adhesins

PMF
Hemagglutinin?
Contributes to colonization of:

A

PMF (Proteus miribalis fimbria):

  • Not a hemagglutinin
  • Contributes to colonization of the bladder (not the kidney)
65
Q

Proteus mirabilis

Site of colonization:
Infection:

A

Site of colonization: colon

Infection: most often seen in patients with underlying disease

66
Q

Proteus mirabilis
Laboratory Identification

G +/-?
Shape
Lac +/-?
Hemolytic?
Smell:
A

Shape: Gram negative rods

Growth: lactose negative on MAC, EMB and CLED; hemolytic with swarming phenomenon on BAP

Smell: highly urease positive and culture reeks of ammonia

67
Q

Enterococcus spp

Virulence Factors: (3)

A

Aggregation Substance (Asa1)

Cytolysin

Sex Pheromones

68
Q 
Enterococcus spp
Aggregation Substance (Asa1)

Facilitates:
Adhesion to what type of eukaryotic cells?

A

Facilitates conjugal plasmid exchange between cells

Adhesion to eukaryotic cells expressing integrins

69
Q

Enterococcus spp
Cytolysin

Lysis what?

A

Lyses RBCs (iron for growth)

70
Q

Enterococcus spp
Sex Pheromones

Normally function where?
What type of chemoattractant?

A

Normally function in plasmid acquisition

Triggers immune response as neutrophil chemoattractant

71
Q

Enterococcus spp

Site of colonization:
More common in what population?

A

Site of colonization: colon

Infection: more often seen in hospitalized patients with indwelling catheters

72
Q

Enterococcus spp

G +/-?
Shape
Tolerant to:
Bile esculin +/-?
Cat +/-?
A

Shape: Gram positive cocci
Growth: salt tolerant (will grown in 6.5% NaCl)
Biochemical: bile esculin positive; catalase negative

73
Q

Host Protective Mechanisms For UTIs: (5)

A

Normal flora: but urinary tract is normally sterile (only in the anterior urethra)

Flushing action of urine

Sloughing of the epithelium

High osmolality, low pH: hard for bacteria to survive
- Insignificant immune defense

74
Q

Host Factors In Infection

What receptors do uroepithelial cells have that bacteria recognize?

What do women with recurrent UTIs have more of?

A

Uroepithelial receptors that bacteria recognize (mannose R)

Women with recurrent UTIs tend to have more mannose receptors

75
Q

Host Factors In Infection

What blood groups are more prone to developing recurrent UTIs?

What allows bacteria to migrate against the flow of urine?

A

Pk and P1 blood groups more prone to developing recurrent UTIs

Blockage or other physiological malfunction (neurological disorder, pregnancy, diabetes etc.) in urinary tract allows bacteria to migrate against the flow of urine

76
Q

E. coli example

1) Penis/urethra:
2) Bladder:
3) Ureter:
4) Kidney:

A

1) Penis/urethra: Type 1 fimbriae
2) Bladder: Type 1 fimbriae, FimH tip
3) Ureter: Flagellar motility is important
4) Kidney: P fimbriae, PapG tip, antigen switching to evade immune response

Micro Exam 2 (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions