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Renal > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

What is acute cystitis?

A

infection of the bladder

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2
Q

What is pyelonephritis?

A

infection of the kidney and renal pelvis

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3
Q

What is sterile pyruria?

A

puss in urine without bacterial growth

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4
Q

At what point does the urinary tract become sterile?

A

the bladder sphincter

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5
Q

What is the most common aetiological agent of UTIs?

A

E. coli

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6
Q

What is the most common gram positive cause of UTIs?

A

staph saprophyticus

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7
Q

What bacteria in the same family as E. coli is a cause of UTIs?

A

proteus species

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8
Q

What other bacteria cause UTIs (usually in hospitals)?

A

klebsiella, enterobacter, serratia, pseudomonas, enterococcus, staphylococcus

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9
Q

Do viral pathogens cause classical UTIs?

A

no

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10
Q

Which viruses shed asymptomatically in the urine?

A

CMV, rubella, polyomavirus (in immunocompromised patients)

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11
Q

Which virus causes haemorrhagic cystitis?

A

adenovirus

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12
Q

Which virus causes renal disease?

A

hantavirus

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13
Q

How do bacteria usually access the urinary tract?

A

ascending from the urethra via contamination from the anus

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14
Q

Which bacteria can infect the urinary tract from the blood?

A

staph aureus, salmonella typhi, TB

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15
Q

What are the features that give the urinary tract innate immunity?

A

epithelium is resistant, some bacteria dont like growing in urine, constant flushing effect or regular bladder emptying

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16
Q

Why do women get more UTIs than men?

A

because the urethra is shorter and straighter and closer to the anus

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17
Q

What will increase the risk of UTIs in infant males?

A

no circumcision

18
Q

What else will increase the risk of UTIs?

A

heavily colonised distal urethra

19
Q

What abnormalities will cause an increase risk of UTIs?

A

structural abnormalities and functional abnormalities which prevent bladder emptying e.g. horse shoe kidney, tumour, stones, enlarged prostate, neurological, vesico-ureteric reflux

20
Q

What common foreign body will cause an increased risk of UTIs?

A

catheter

21
Q

What feature do most E. coli have that helps them adhere and cause UTIs?

A

type 1 fimbria

22
Q

What feature do some E. coli have that is specific for UTIs?

A

pylonephritis associated pili (PAP pili)

23
Q

Is there one specific virulence factor that all uropathogenic E. coli share?

A

no

24
Q

What enzyme does proteus have?

A

urease - to get energy from urea - ammonia as an end product

25
Q

What features helps E. coli swim up ureters?

A

flagella

26
Q

What are the symptoms of a UTI?

A

increase frequency of micturition with burning, possible fever, possible tenderness over bladder or kidneys

27
Q

If you found the pathogen of a UTI in the blood what would it indicate?

A

pylonephritis

28
Q

Why do you need to take a midstream urine sample?

A

the first part of the urine may have normal microbiota and the last part may have prostatic secretions

29
Q

What is the significance of a pathogen in a bag sample of urine?

A

no significance- may be from the urine or may be from the skin or the gut - only significant if it is sterile

30
Q

What is the significance of a pathogen in a supra pubic aspirate?

A

definitely the cause of the UTI

31
Q

Why dont you collect from the bag of the catheter?

A

because the bacteria will have replicated

32
Q

What number of white blood cells in the urine indicates infection?

A

> 10^5

33
Q

Does a raised white cell count always mean infection?

A

no - could mean stones or tumours or other things - sterile pyuria

34
Q

What does the presence of squamous epithelial cells indicate?

A

a poorly collected sample

35
Q

What number of bacteria in a midstream sample indicates infection?

A

> 10^5 CFU

36
Q

What does nitrites in the urine indicate?

A

there are bacteria - but not all bacteria will produced nitrites so if negative it is not definitive

37
Q

Why should you check the pH of urine before giving treatment to alkalinise urine?

A

because if the urine is alkaline there are ammonia forming bacteria (proteus) and there is a risk of forming struvite stones

38
Q

What antibiotic treatment is given for UTIs?

A

cephalexin or co-amoxyclav or trimethoprim

39
Q

What antibiotic treatment is given for sepsis caused by pyelonephritis?

A

amoxycillin and gentamicin

40
Q

When is asymptomatic bacteriuria significant?

A

in pregnancy - can be associated with premature

41
Q

What defines recurrent UTIs?

A

more than 2 in 6 months

Renal (12 decks)

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