Lower Urinary Tract Infection (UTI)

Question 1

lower UTI

Answer 1

infection in urethra & bladder

Question 2

patho

Answer 2

• result of bacterial infection (usually E.coli)
• normal flora in genitalia migrates to urethra
• can arise from normal flora in gut migrating to urinary tract
• urethral entry –> ascending infect into bladder
• microbes may enter from circulation (septicemia)

Question 3

defense mechanisms to UTI

Answer 3

• Washout
• Local IR
• Mucin layer on surface of transitional epithelium
• prostatic fluid (men)
• periurethral normal flora in vagina (women)

Question 4

washout

Answer 4

urine flow forces microbes & bacteria to flush out urethra

Question 5

Mucin layer on surface of transitional epithelium

Answer 5

• Secreted by cells that line bladder
• Composed of glycoproteins
• Provides barrier b/w epith lining & any bact that makes it into bladder

Question 6

prostatic fluid (men)

Answer 6

Antibacterial properties

Question 7

Periurethral normal flora in vagina (women only)

Answer 7

Microbial antagonism:

Normal flora uses resources & prevents establishment of invasive microbes

Question 8

risks of UTI

Answer 8

• catheterization (iatrogenic)

- obstruction of urethra

Question 9

why is obstruction of urethra a risk

Answer 9

Urine stasis in bladder & reflux of urine back into bladder carrying microbes back in (seen in BPH)

Question 10

mnfts

Answer 10

• acute onset
• lower back pain
• abd pain
• frequency
• dysuria (pain upon urination)
• fever

Question 11

Dx

Answer 11

• Hx, clinical presentation
• urinalysis
• microscopic urinalysis
• urine C&S

Question 12

urine C&S purpose

Answer 12

Identify bacteria & guide what Abx to use

Question 13

Tx

Answer 13

• start broad-spectrum Abx
• adequate fluid intake
• address underlying cause

Question 14

when are broad spectrum Abx stopped

Answer 14

• once C&S specimen analyzed

- usually about 1wk of Abx

Question 15

adequate fluid intake purpose

Answer 15

Helps void urine, flush bacteria out of urinary tract