11:9: UTI Flashcards Preview

MHD V: Renal > 11:9: UTI > Flashcards

Flashcards in 11:9: UTI Deck (38):
1

What is bacteriuria?

- Bacteria in the urine
- Significant if over 10 to the fifth

2

What is cystitis?

- Infection of bladder characterized by dysuria, frequency, urgency and suprapubic pain

3

What is dysuria?

Painful or difficult urination

4

What is urethritis?

- Infection confined to urethra characterized by dysuria, and mucoid or purulent discharge from urethral meatus

5

What is acute pyelonephritis?

- Infection of kidney characterized by flank pain / tenderness and fever
- Often associated with dysuria, urgency, frequency

6

What is an uncomplicated UTI?

- Dysuria, frequency, and urgency with bacteriuria and pyuria
- Often seen in women
- On renal or urologic dysfunction or obstruction

7

What is a complicated UTI?

- Pyuria and document microbial pathogen
- Shows local and systemic signs: fever, chills, malaise, pain
- Occurs in presence of urinary tract abnormality

8

Most common route of UTI infection and how is it caused?

ASCENDING
1. Gut flora reach bladder through urethra
2. Perineal colonization in women
3. Intercourse
4. Catheterization

9

What is hematogenous route?

- Bacteria reach tract through blood

10

What is hemolysin?

- Enzyme produced by UTI bacteria forming pore in epithelial wall allowing bacteria to colonize

11

What does urease do?

Elevate urinary PH by breaking down urea making more hospitable environment for organisms

12

What is Type I (MS)?

- Mannose sensitive fimbriae that attaches to D mannose on many cells of bladder and lower tract

13

What are P fimbriae?

Attaches to P blood group antigens on RBC and urothelium of renal pelvis and kidney

14

What does iron scavenging allow?

- The UTI organism to grow and multiply

15

What causes most UTIs?

1. E Coli 80%
2. Staph saprophyticus 15%

16

Risk factors for UTIs?

1. Sexual intercourse
2. Spermicide
3, PH
4. Voiding of urine empties bacteria
5. Pregnancy
6. Obstruction
7. Catheterization

17

What is vesicoureteral reflux?

- Congenital condition carrying bacteria to renal pelvis
- Returns infected urine to bladder after voiding

18

Risk of UTI with catheterization?

3% - 10% per day under catheterization

19

Impact of age and sex on UTI?

- Females more at risk than males
- Equal risk in both genders in elderly

20

Why do elderly get UTIs?

1. Bladder prolapse
2. Prostate hypertrophy
3. Incontinence

21

Clinical features of cystitis?

1. Acute dysuria, urgency, frequency
2. Suprapubic pain and tenderness
3. Hematuria
4. Pyuria
5. Positive culture even at low levels

22

Risk factors for cystitis?

- Young sexually active women
- Anal sex in men
- Lack of circumcision

23

Differential diagnosis in women with dysuria?

1. Cystitis
2. Urethritis
3. Vaginitis

24

What is special about dysuria in vaginitis?

Pain is external and not in urethra

25

What is external pain and not in urethra indicative of?

Vaginitis

26

Where is hematuria seen in women with dysuria?

Cystitis

27

When do we not see pyuria in women with dysuria?

Vaginitis

28

Clinical features of pyelonephritis?

1. Acute flank pain, fever, and lower tract symptoms
2. Costovertebral tenderness
3. Bacteremia / septic shock
4. Papillary necrosis
5. WBC casts

29

What does WBC cast in urine tell you?

- Upper urinary tract infection
- Likely pyelonephritis

30

Clinical features of prostatitis?

1, Perineal and lower back pain
2. Fever chills, dysuria
3. Boggy tender prostate

31

How to get clean specimen in urine sample?

"Clean voided midstream urine"
- Want sample from midstream flow so it is not contaminated by organisms outside tract in genital tissue
- Want urine from bladder

32

Diagnostic definition of pyuria?

- 10 WBCs per microliter
- Mainstay diagnosis for UTI

33

What is leukocyte esterase?

- Noted in dipstick urine test indicating pyuria

34

What does nitire on dipstick test mean?

- Activity of bacterial nitrate reductase which is indicative of UTI
- May not work on some bacteria or small colony count

35

How to treat UTI?

1. Treat all with symptoms regardless of age
2. Bacteriostatic agents work just fine

36

Treatment for acute cystitis?

- Culture or urinalysis not necessary
- Antibiotic for 3 - 5 days

37

Treatment for pyelonephritis?

- Urinalysis and culture indicated
- Antibiotics 5 - 14 days

38

Most significant risk factor for catheter associated UTI?

Duration of use