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Medicine Phase 2a GU > Infection > Flashcards

Infection Flashcards

(51 cards)

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1
Q

Examples of GU infections

A 
Pyelonephritis
Cystitis
Prostatitis
Urethritis
Epididymo-orchitis
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2
Q

What is pyelonephritis

A

Infection within the renal pelvis

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3
Q

What is cystitis

A

Infection causing inflammation of the bladder

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4
Q

What is prostatitis

A

Bacterial infection of the prostate gland

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5
Q

What is urethritis

A

Urethral inflammation

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6
Q

What is epididymis-orchitis

A

Pain, swelling and inflammation of the epididymis

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7
Q

Types of pyelonephritis

A

Acute

Chronic

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8
Q

Pathophysiology of acute pyelonephritis

A

Often, infection will rise from the bladder to the renal pelvis.
Haematogenous spread also possible.
Local infection will cause inflammation and damage.

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9
Q

Aetiology of acute or chronic pyelonephritis (and risk factors)

A

Infection by UTI organisms (Escherischia coli, Klebsiella, Proteus, Enterococcus)
RF: Calculi, catheterisation, pregnancy, diabetes

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10
Q

Clinical presentation of acute pyelonephritis

A

Rapid, loin, suprapubic or back pain.
Fever, malaise, nausea, anorexia.
Possibly lower UTI, with frequent dysuria, haematuria or hesitancy.

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11
Q

Epidemiology of acute pyelonephritis

A

Can occur at any age

Generally more frequent in females, except in neonates

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12
Q

Diagnosis of acute pyelonephritis

A

Urine dipstick
Urine is cloudy with an offensive smell
Midstream culture

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13
Q

Treatment of acute pyelonephritis

A

Support
Antibiotics, empirically
*Ciproflaxcin / Co-amoxiclav first line (at PEEK bacteria)

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14
Q

Complications of acute pyelonephritis

A

Septicaemia

Renal abscess

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15
Q

Pathophysiology of chronic pyelonephritis

A

Chronic infection can cause characteristic scarring of the kidney

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16
Q

Clinical presentation of chronic pyelonephritis

A 
Failure to thrive
Possibly hypertension
Rapid, loin, suprapubic or back pain. 
Fever, malaise, nausea, anorexia. 
Possibly lower UTI, with frequent dysuria, haematuria or hesitancy.
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17
Q

Epidemiology of chronic pyelonephritis

A

4/100,000 asymptomatic adults

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18
Q

Diagnostic tests of chronic pyelonephritis

A

Urine dipstick

Midstream culture

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19
Q

Treatment of chronic pyelonephritis

A

Blood pressure control to slow progression of renal failure

Antibiotics (empirically) -> probs ciprofloxacin/co-amoxiclav

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20
Q

Complications of chronic pyelonephritis

A

Septicaemia
Progressive renal scarring
Secondary hypertension

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21
Q

Pathophysiology of cystitis (inflamed bladder from infection)

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A

Infection of urine stored in the bladder.

Can be ‘washed out’ with frequent fluids.

22
Q

Aetiology of cystitis

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A

Can be caused from incomplete emptying

23
Q

Clinical presentation of cystitis

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A 
Frequent urination
Urgency
Dysuria
Abdominal tenderness
Swollen bladder
Confusion (elderly)
24
Q

Epidemiology of cystitis

25
Diagnosis of cystitis
History | Midstream urine
26
Treatment of cystitis
Often resolves without treatment | Fluids and possibly antibiotics
27
Clinical presentation of Prostatitis (bacterial infection of prostate gland)
``` Macroscopic haematuria Fever Dysuria Pyrexia Sharp pelvic/penile/anal pain ```
28
Aetiology of prostatitis (name specific organisms)
Usually gram negative organisms; Escherichia coli, Enterobacter, Serratia. Sometimes STI: Neisseria gonorrhoeae and Chlamydia trachomatis
29
What sexually transmitted gram negative organisms can cause prostatitis
Neisseria gonorrhoeae | Chlamydia trachomatis
30
Epidemiology of prostatitis
15% of men experience symptoms at some point in their life
31
Diagnosis of prostatitis
DRE (digital rectal examination): Gland can feel nodular, 'boggy', tender and hot
32
Treatment of prostatitis (what is 1st line)
Antibiotics (empirically) | Quinolones (1st line!) e.g. Ciprofloxacin (A Quinalone)
33
Types of urethritis
Gonococcal | Non-gonococcal
34
Clinical presentation of gonococcal urethritis
May be asymptomatic. Usually is asymptomatic in women. Urethral discharge, more noticeable after holding urine overnight. Dysuria
35
What is the difference in presentation of non-gonococcal urethritis (compared to gonococcal)
Same except NO DISCHARGE in Non-gonococcal
36
Aetiology of Gonococcal Urethritis
Neisseria gonorrhoeae | As a result of STI
37
Aetiology of Non-gonococcal urethritis (2 most common causes)
Number of organisms can cause this. | *Chlamydia trachomatis, Mycoplasma genitalium most commonly
38
Epidemiology of urethritis
Non-gonococcal urethritis is most common condition diagnosed and treated in men in genitourinary
39
Diagnosis of urethritis
Urethral smear | Screen for STIs
40
Treatment of Gonococcal urethritis
Antibiotics (empirically) | Quinolones (1st line!) e.g. Ciprofloxacin (A Quinalone)
41
Treatment of Non-Gonococcal urethritis
``` Antibiotics Specifically Ceftriaxone (A Quinolone) ```
42
Complications of prostatitis
Chronic infection
43
Complications of urethritis
``` Non-Gonococcal = Epididymitis, Prostatitis Gonococcal = same but also risk of gonococcal arthritis; can remit spontaneously if untreated ```
44
Most common routes of infection leading to epididymo-orchitis infection
Most common route of infection is infection spreading from the urethra. Second is from the bladder.
45
Clinical presentation of epididymo-orchitis
Unilateral scrotal pain and swelling. | In STI: urethral discharge also. Tenderness to palpation on affected side. Palpable swelling
46
Aetiology of epididymo-orchitis
Men <35 = most commonly STI >35 = generally gram negative enteric organisms Can also be viral
47
Epidemiology of epididymo-orchitis
25/10,000 (may have dropped)
48
Diagnosis of epididymo-orchitis
Culture urethral smear
49
Treatment of epididymo-orchitis
Check for torsion STI advice Empirical antibiotics if appropriate: Doxycycine and Cefixime or Ciprofloxazin (Quinolone)
50
Complications of epididymo-orchitis
Reactive hydrocele | Abscess formation
51
``` Which 2 of these would you not treat with Ciprofloxacin: Pyelonephritis Cystitis Prostatitis Gonococcal urethritis Non-gonococcal urethritis Epididymo-orchitis ```
Cystitis = Trimethoprin | Non-gonococcal urethritis = Ceftriaxone

Medicine Phase 2a GU (18 decks)

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