Session 7 - UTI Flashcards Preview

Semester 3 - Urinary > Session 7 - UTI > Flashcards

Flashcards in Session 7 - UTI Deck (59)
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31

How are urine samples collected?

• Mid stream, as urethera's normal flora should not be collected

32

How can samples be collected from small children?

• Adhesive bag places over genitals

33

What is the issue with using an adhesive bag to collect urine from children?

• False positive rate of 20%

34

Where are catheter samples collected from?

• Needle placed up catheter tube
• Not from the bag

35

What is suprapubic aspiration of urine?

• Needle placed through suprapubic region of pelvis into bladder and urine aspirated up

36

How are collected samples stored between collection and culture?

• Transported at 4*C with a small amount of boric acid in collection tube
• Prevents bacterial division

37

• Prevents bacterial division
What investigations can be performed on cloudy urine?

• Turbidity test
• Dipstick testing

38

What is turbidity?

• Whether the urine looks cloudy - If so, indicative of UTI

39

What are four dipstick tests which can be performed on urine?

• Leukocyte esterase - Indicates presence of WBCs
• Nitrite - Indicates presence of nitrate reducing bacteria
• Haematuria - Present in UTI and many other conditions
• Proteinuria - Present in UTI and many other conditions

40

In what 6 situations is microscopy used on urine culture?

• Kidney disease
• Suspected endocarditis
• Children under 6
• Schistosomiasis
• Suprapubic aspirate
• When requested

41

What is urine culture and what needs to occur before infection can be confirmed?

• A number of colony forming units must occur - >100,00 per ml (10^5 cfu/ml) distinguished bacteriuria/contamination

42

What are the five main advantages of urine culture?

• To investigate complicated UTIs
• Gives epidemiology of isolates
• Sensitivity testing
• Specificity testing
• Control of specimen quality
○ Can differentiate between properly collected and contaminated samples (poorly collected samples may contain epithelial cells)

43

What 5 details are needed to correctly interpret a urine culture?

• Clinical details
○ Symptoms
○ Previous antibiotics
• Quality of specimen
• Delays in culture
• Microscopy
• Organsims location

44

What is sterile pyuria?

Pus in urine

45

What does sterile pyuria indicate?

• A UTI is present but unable to be cultured

46

Give three situations where sterile pyuria would be present?

• Patient already treated with antibiotics
• OR infected with bacteria that are difficult isolate or culture

OR can be due to tuberculosis or appendicitis (appendix stuck on bladder

47

What are three other causes of UTI symptoms

• Vaginal infection/inflammation
• Sexually transmitted pathogens
• Mechanical/physical/chemical causes

48

What are general treatments for UTI?

• Increase fluid intake
• Address underlying disorders

49

How is an uncomplicated UTI treated?

• 3 day course of antibiotics
• 3 day course reduces the selection pressure for resistance

50

What is given for complicated UTI treatment?

5 day course antibiotics

51

Should amoxicillin be used to treat complicated UTI's?

• No

50% of isolates (bacteria) resistance

52

How should pyelonephritis/septicaemia be treated?

• 14 day course of antibiotics
• Use more potent agent with systemic activity

53

When is antibiotic prophylaxis indicated?

• Three or more episodes of UTI in one year

No treatable underlying condition

54

What is antibiotic prophylaxis

• Single, low, nightly dose of antibiotics to prevent bacteria build up in static urine
• All breakthrough infections documented

55

What is pyelonephritis?

• Infection in kidney

56

What is the worst case scenario in a UTI?

• Bacteria manage to invade blood stream from urinary tract
• Gram negative septicaemia will occur

57

What are you likely to see in a culture of contaminated urine?

• Simple Squamous Epithelial cells

58

What is sensitivity of a test?

The rate of true positives

59

What is specificity of a test?

Rate of true negatives