UTI Flashcards Preview

Yr 2 - Renal System > UTI > Flashcards

Flashcards in UTI Deck (22)
Loading flashcards...
1
Q

How would a UTI present?

A
  • Dysuria (pain on micturation)
  • Frequency/urgency
  • Smelly cloudy urine
  • Chills
  • Flank Pain
  • Strangury (Wanting to void but can’t)
  • Confusion (elderly)
2
Q

What microorganisms cause UTI?

A

Mostly bowel organisms

  • E. Coli
  • Proteus Spp.
  • Klebsiella Spp.
  • Pseudomonas Aeruginosa
  • Enterococci
3
Q

What do we call infalmmation of the urethra, bladder, ureter or kidney?

A

Urethritis
Cystitis
Ureteritis
Acute Pyeonephritis (chronic if recurrent or prolonged)

4
Q

What are the main tests for UTI?

A

Dipstick Urinalysis

Mid Stream specimen of Urine - MSSU for urine culture & Microscopy

Suprapubic aspiration (mainly for people who cant give an MSSU e.g. young kids or elderly)

5
Q

How do you tell if bacteria in a urine culture are pathogenic or contaminating commensals?

A

They grow in log scales in the culture. 10^5 is almost certainly infectious even if asymptomatic.

6
Q

What are the complications of a UTI?

A
  • Sepsis and septic shock
  • Chronic pyelonephritis
  • Calculi –> Obstruction –> Hydronephrosis –> Hypertension & chronic renal failure
7
Q

What are the categories of UTI aetiology?

A

1) Stasis of Urine (either obstruction or loss of full bladder feeling)
2) Pushing bacteria up urethra (sex in women or urological procedures)
3) Generalised predisposition to infections (e.g. diabetes)

8
Q

What can cause you to lose the feeling of a full bladder?

A

A spinal cord or brain injury

9
Q

Whats the main cause of obstruction in children?

A

Vesicouretic reflux

Its a loss of the angle of entry of ureter to bladder

10
Q

What are the main causes of obstruction in adults?

A
  • Benign Prostatic Hyperplasia (men)
  • Uterine Prolapse (Women)
  • Tumours & Calculi (both)
11
Q

What are the consequences of an obstruction?

A

back up of urine causing hydroureter and hydronephrosis and eventually chronic renal failure.

Slowed flow –> Infection & sediment formation (calculi)

12
Q

Why are women more at risk of UTIs?

A
  • Short urethra
  • No prostatic bacteriostatic secretion
  • Close urethral orifice to rectum
  • Sexual activity (vagina just behind urethra so pushes bacteria up)
  • Pregnancy pressures the ureter & bladder
13
Q

Why does diabetse predispose you to UTIs?

A

1) Glc in urine

2) Poorly functioning WBCs

14
Q

How would a UTI present in a small child?

A

Non-specific symptoms

  • Diarrhoea
  • Crying & not eating
  • N&V
  • Fever
15
Q

How would pyelonephritis appear?

A
~dehydration
Fever
Loin/flank pain
~systemic unwellness/bacteraemia
Cloudy Urine
16
Q

Risk factors for a UTI?

A
  • Sex
  • Stones
  • Immunosuppression (Long term CCS, DM or transplant meds)
  • Anatomical Abnormalities e.g. horseshoe kidney or duplex collecting system
  • Foreign Body e.g. catheter or stent
  • Static urine due to Poor bladder emptying e.g. retention
  • Malnutrition
  • Pre-existing parenchymal disease
  • Fistula between bladder/bowel

Female specific:

  • Female
  • Oestrogen Deficiency
  • Pregnancy
  • Childbirth
17
Q

How do you test for a UTI?

A

Dipstick Urinalysis looking for nitrites/protein/leucocytes and blood.

MSSU - Culture & Microscopy

18
Q

What other tests would we do in kids with UTIs?

A

A micturating Cystogram to check for vesico-ureteric reflux

19
Q

How do we treat most UTIs?

A

3-5 days of amoxicilin, trimethoprim or nitrofurantoin

20
Q

How would we advise women with recurrent UTIs?

A

Drink plenty of fluids

Urinate frequently, particularly bbed and before/after sex.

21
Q

How do we handle UTIs due to indwelling catheters.

A

Only treat if the patients symptomatic.

If you do treat you have to change the catheter before starting treatment

22
Q

What radiological signs (CT) may indicate pyelonephritis?

A
  • Scarring
  • Clubbing of Calyces
  • Abscess
  • Emphysematous (gaseous) pyelonephritis. Lots of gas pockets within the kidney due to gas-forming bacteria.