Urinary tract infection/pyelonephritis Flashcards
1
Q
What is the defintion of a UTI?
A
Infection at any point during the urinary tract from the kidneys → the urethras
105 colony-forming units per millilitre (cfu/ml)
Cystitis = infection of the bladder/lower UTI
Pylonephritis = infection of urethers and renal parenchyma/upper UTI
Recurrent UTI – due to relapse and reinfection
2
Q
How common is a UTI?
A
Very common in woman, less so in men and children
3
Q
What is the pathology of a UTI?
A
- E.coli is the most common causative organism – transfers from bowel organisms to the bladder
- Staphylococcus is also a cause
- Acute pyelonephritis:
- Neutrophil infiltration of the renal parenchyma
- Small cortical abscesses
- Pus in the renal medulla
4
Q
What are the risk factors/aetiology of a UTI?
A
- Woman
- Pregnancy – early detection and treatment necessary
- Sexual intercourse – frequent or new sexual partners
- Urethral catheterisation
- Urinary obstruction/stasis
- Previous damage to the bladder epithelium
- Bladder stones
- Poor bladder emptying
- Diabetes
5
Q
What are the signs/symptoms of a UTI?
A
- Lower UTI
- Micturition
- Dysuria
- Suprapubic pain and tenderness
- Haematuria
- Smelly urine
- Cloudy urine
- Acute pyelonephritis
- Loin pain and tenderness
- Nausea/vomiting
- Fever
6
Q
What diseases present similarly to UTI’s?
A
- Urethral syndrome
- Atrophic vaginitis
- Urethritis
- Sexually transmitted diseases e.g. chlamydia, herpes etc.
- Enlarged/inflamed prostate
- TB
7
Q
What investigations are conducted for a suspected UTI?
A
- Mid stream urinary dipstick
- Nitrates
- Leucocytes
- Blood
- Urine microscopy and culture – if complicated/high risk
- US
- Contrast enhanced CT
8
Q
What are the pharmacological treatments for UTI’s?
A
- Trimethoprim/nitrofurantoin/amoxicillin – course will be longer/IV for pyelonephritis
- Analgesia
9
Q
What are the non pharmacological treatments for UTI’s?
A
- ↑ fluid intake
- Cranberry juice
- Avoid caffeine/alcohol/acids
- Urinate before bed and after intercourse
- Avoid spermicidal jellies and constipation
