Session 7 - UTI Flashcards Preview

Semester 3 - Urinary > Session 7 - UTI > Flashcards

Flashcards in Session 7 - UTI Deck (59)
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1

Outline the three main defences against UTI

• Regular flushing during voiding
• Length of urethra
• Antibacterial secretions into urine

2

What does regular flushing during voiding do to help avoid UTIs?

• Removes organisms in distal urethra

3

Outline four host factors which predispose to UTI

• Short urethra - More infections in female
• Obstruction
• Neurological - Incomplete emptying, residual urine
• Ureteric reflex - Ascending infection from bladder, especially in children

4

Give four ways obstructions occur in the urethra

• Enlarged prostate
• Pregnancy
• Stones
• Tumours

5

Outline five bacterial factors which predispose micro-organisms to urinary tract infection

• Fimbriae allow attachment to host epithelium
• Faecal flora migrate across periurtheral area
• K antigen permits production of polysaccharide capsule
• Haemolysins damage host membranes and cause renal damage

Urease breaks down urea creating a favourable environment for bacterial growth

6

What bacteria types commonly cause UTI's?

• Gram -'ve bacteria

7

What is the commonest type of UTI?

• An infection of the lower tract - Cystitis

8

What is the most common cause of UTIs?

• Migration of e.coli from faecal flora across peri-urethral area

9

What can cause upper UTI's?

• Haematogeneous (blood borne) or ascending routes of infection
• Upper UTI (pyelonephritis)

10

Give three types of lower UTI

• Bacterial cystitis
• Abacterial cystitis
• Prostatitis

11

Give main symptoms of bacterial cystitis

• Frequency and dysuria, often with pyuria and haematuria

12

Give main symptoms of abacterial cystitis

• Frequency and dysuria, often with pyuria and haematuria

13

How could you tell the difference between bacterial and abacterial cystitis?

• Bacterial cystitis will be coupled with a bacteraemia

14

Give main symptoms of prostatitis

Fever, dysuria, frequency with perineal and lower back pain

15

Give two types of upper UTI's

Acute pyelonephritis
Chronic interstitial nephritis

16

What are symptoms of acute pyelonephritis

• Symptoms of cystitis
• Fever and loin pain

17

What are symptoms of chronic interstitial nephritis

Renal impairment following chronic inflammation - infection one of many causes

18

What is an asymptomatic UTI?

• Covert Bacteriuria
• Detected only by culture

19

Give two examples of when an asymtpomatic UTI would be important?

Pregnancy
Childhood

20

What is the main organism responsible for UTI's?

• Coliforms - e.coli - GRAM NEGATIVE SO STAINS PINK

21


What bacteria cause young women and hospitalised patients to develop UTI's?

Staph Saprophyticus

22

Why is there a difference between the bacteria types which cause UTI in hospital and the community?

• Hospital provides extra risk factors, such as catherterisation which can provide a biofilm surface

23

What are two types of UTI?

• Complicated
• Uncomplicated

24

What is an uncomplicated UTI?

• Vast majority of UTI's

Found in healthy women

25

What is a complicated UTI?

• Anything which isn't in a healthy woman (Pregnancy, treatment failure, suspected pyelonephritis, males, pediatric)

26

How is an uncomplicated UTI investigated?

• No need for urine culture

Infection indicated by Nitirite/Leukocyte esterase dipstick testing

27

What is leukocyte esterase?

• An enzyme produced by WBCs which can be detected in the urine in the event of infection

28

What does a positive nitrite test usually indicate?

• That the cause of the UTI is a gram negative organism (usually e.coli)

Gram -'ves

29

What investigations need to occur in a complicated UTI?

• A urine sample must be take, from which a culture will be drawn so bacteria can be identified

30

Give four methods of collecting a urine sample

• Mid stream specimen
• Adhesive bag over genitalia
• Catheter sample from special tube in catheter
• Suprapubic aspiration