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REGUB > L9: Urinary Tract Infections > Flashcards

L9: Urinary Tract Infections Flashcards

(40 cards)

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1
Q

How do oral contraceptives and spermicides increase a woman’s risk of a UTI?

A

they decrease the amount of protective lactobacilli present in the vaginal flora

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2
Q

List 2 reasons why the incidence of UTI in males increases with age

A
  1. prostatic enlargement

2. loss of bactericidal activity of prostatic secretions

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3
Q

List the 3 “routes of infection”/possible ways a UTI may be acquired

A
  1. Ascending (from anal area)
  2. Haematogenous (from BSI)
  3. Direct (typically from fistula – vesico-colic fistula)
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4
Q

What is the most common “route of infection”/way to acquire a UTI?

A

ascending route - infected by bacteria from anal area

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5
Q

List some of the localizing symptoms that are associated with an acute UTI

A
  • suprapubic pain (cystitis)
  • flank pain (pyelonephritis)
  • dysuria
  • frequency
  • urgency
  • nocturia
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6
Q

What is dysuria?

A

painful or difficult urination

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7
Q

List some of the systemic symptoms that are associated with an acute UTI

A
  • fever
  • rigors
  • acute confusional state/delirium in elderly
  • nausea
  • anorexia
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8
Q

If a patient has both localizing and systemic symptoms associated with their UTI what is this called?

A

complicated infection

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9
Q

List ALL of the causative pathogens of community-acquired UTI

A

A. GRAM NEGATIVE BACILLI
i) Enterobacterales: E. coli, P. mirabilis, K. pneumoniae, Enterobacter spp., Citrobacter spp.

ii) Pseudomonas aeruginosa

B. GRAM POSITIVE COCCI

    • Staph. saprophyticus*
    • Strep. agalactiae
    • Enterococcus faecalis*
    • Enterococcus faecium*
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10
Q

List some of the MOST COMMON causative pathogens of community-acquired UTI? [5]

A
  • E. coli
  • P. mirabilis
  • Staph. saprophyticus
  • Enterococcus faecalis
  • Enterococcus faecium
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11
Q

What is the MOST common pathogen causing UTI? Which serotypes of E. coli are more successful uropathogens?

A

E. coli

- serotypes 01, 02, 04

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12
Q

Staph. saprophyticus cause UTIs. Which population does Staph. saprophyticus usually affect?

A

young women - causes uncomplicated cystitis

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13
Q

Enterococci can cause a UTI. Which population does enterococci affect?

A
  • critically ill

- immunoscompromised pts

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14
Q

Pseudomonas aeruginosa is a gram negative bacillus that causes which type of UTI? Which population does it normally affect?

A

complicated infection in…

    • critically ill
    • immunocompromised
    • structural urinary tract abnormalities
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15
Q

Which uropathogen is associated with a sweet odour?

A

Pseudomonas aeruginosa

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16
Q

Which uropathogen produces a pigment?

A

Pseudomonas aeruginosa

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17
Q

List some of the causative pathogens of healthcare associated UTI

Study These Flashcards
A
  • enterobacterales
  • pseudomonas aeruginosa
  • enterococcus faecalis/faecium
18
Q

What are the predisposing factors for health-care associated UTIs?

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A
  • presence of urinary catheters
  • pts who had manipulation of the urinary tract
  • urinary stasis
  • dehydration
  • debility (physical weakness)
19
Q

To confirm a UTI, you need 2 things which are:

Study These Flashcards
A
  1. Presence of Clinical Symptoms

2. Supporting Evidence for UTI

20
Q

What is an asymptomatic bacteriuria?

Study These Flashcards
A

bacteria in the urine without the symptoms of a UTI

21
Q

Asymptomatic bacteriuria usually does not needed to be treated. In which cases does an asymptomatic bacteriuria need to be treated? [2]

Study These Flashcards
A
  1. pregnancy

2. pts who had a manipulation of the urinary tract

22
Q

What samples can be taken to diagnose a UTI?

Study These Flashcards
A
  • mid stream urine (MSU)
  • catheter specimen urine (CSU)
  • blood cultures (if systemically unwell)
23
Q

What are some things that may be found in the urine of a patient with a UTI?

Study These Flashcards
A
  • bacteria
  • leukocytes
  • nitrites
24
Q

If there is a mixed growth present on the colony culture of a UTI patient’s urine - what does this mean?

Study These Flashcards
A

specimen likely contaminated

25
When treating a UTI in a female with cystitis, what will the duration of treatment be? How will this be administered
3 days | PO (oral route)
26
When treating UTIs in males or patients with urinary catheters in situ, what will the duration of treatment be? How will this be administered?
7 days | PO (oral route) typically
27
When treating complicated UTIs, UTI w/ pyelonephritis and UTI w/ BSI, what will the duration of treatment be? How will this be administered?
7-14 days | IV
28
Why do asymptomatic bacteriuria need to be treated in pregnancy? What are the possible complications?
- risk that it will progress to UTI and pyelonephritis | - more likely to suffer miscarriage or premature labour
29
List some of the risk factors of UTIs in children
- poor urine flow - previous UTIs - vesicoureteric reflux (VUR) - dysfunctional voiding - abdominal mass (external compression)
30
List some of the clinical symptoms of UTI in children
- fever - irritability - increased frequency - dysuria - foul smelling urine - haematuria
31
List the 3 investigations/tests that can be done to investigate UTI in children
1. Ultrasound 2. Dimercaptosuccinic Acid (DMSA) Scan 3. Micturating Cystourethrogram (MCUG)
32
What does a DMSA scan show?
- used to detect UTI in children | - determine residual renal parenchymal defects
33
What does a MCUG test show?
- used to detect UTI in children | - used to determine if vesicoureteral reflux
34
Why do patients with diabetes mellitus have an increased risk of UTIs?
- bladder dysfunction (due to neuropathy) - vascular disease - glucose in urine (supports bacterial growth)
35
What is the clinical presentation of acute pyelonephritis?
- pain in flank, renal angle - systemic symptoms (fever, rigors, nausea, vomiting, BSI...) - may not have symptoms of cystitis (dysuria, urgency)
36
What is the treatment for acute pyelonephritis?
- empiric cefuroxime + gentamicin | - drainage, if pus or abscess present
37
What is sterile pyuria?
WBC or pus cells present in the urine, but there is a sterile urine culture (nothing growing in culture)
38
List the causes of sterile pyuria?
- antimicrobial therapy - tumour - urinary stones - chlamydia urethritis or other STI - TB (less common) - brucellosis (less common)
39
What are the symptoms of renal tuberculosis?
- sterile pyuria - increased frequency - painless haematuria - malaise - fever - weight loss - persistent symptoms for weeks or months
40
How can a renal tuberculosis be diagnosed? (specimen + test)
early morning urine (on 3 consecutive days) | -- mycobacterial culture for up to 8 weeks

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