Urinary 8 - UTIs Flashcards Preview

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Flashcards in Urinary 8 - UTIs Deck (30):
1

Name the normal defence mechanisms of the body against UTIs:

- Antimicrobial secretions
- Regular flushing during micturition

2

What factors may predispose someone to UTIs?

- Shorter urethra (women)
- Obstruction (enlarged prostate, pregnancy, stones, tumours)
- Neurological (incomplete emptying = residual urine)
- Vesicoureteric reflux

3

Name 4 factors which may obstruct the urinary tract:

- Enlarged prostate
- Pregnancy
- Stones
- Tumours

4

Which antigens allow some E coli to produce a polysaccharide capsule, to protect it against host defences?

K antigen

5

What is the importance of K antigens to E coli survival in the urinary tract?

Allows E coli to produce a polysaccharide coat, to resist host defences ie antibacterial secretions.

6

Name 3 types of UTI associated with the lower urinary tract:

- Bacterial cystitis
- Abacterial cystitis
- Prostatitis

7

Name 2 types of UTI associated with the upper urinary tract:

- Acute pyelonephritis
- Chronic interstitial nephritis

8

List the symptoms associated with cystitis:

- Increased freq. of urination
- Dysuria (pain or burning sensation on urination)
- Low grade fever

9

How can you tell bacterial and abacterial cystitis apart?

Bacteriuria test

10

List the symptoms associated with Prostatitis:

- Fever
- Dysuria (pain or burning sensation on urination)
- Increased freq. of urination
- Perineal and low back pain

11

List the symptoms associated with Acute Pyelonephritis:

- Increased freq. of urination
- Dysuria (pain or burning sensation on urination)
- Fever
- Loin pain

12

List the symptoms associated with Acute Interstitial Nephritis:

- Fever
- Haematuria
- Drowsiness
- Confusion
- Nausea
- Fluid retention
- Change in urine output

13

Define uncomplicated infection:

Infection with a typical organism in a patient with normal urinary tract, and normal urinary function.
May occur in men and women of any age, however men, children and pregnant women are usually treated as complicated.

14

Define complicated infection:

When 1+ factors present which predispose a patient to persistent/recurrent infection, or treatment failure:
- Atypical virulent organism (S aureus)
- Abnormal urinary tract (catheter, vesicoureteric reflux)
- Impaired host defences
- Impaired renal function

15

What are the most common pathogens causing UTIs?

Gram negative rod bacteria
- Enterobacteriaceae: E coli, Klebsiella, Salmonella, Shigella

16

Which 2 types of bacteria are more likely to cause UTIs in a hospitalised patient?

- Staph. aureus
- Pseudomonas

17

Describe the investigation of a UTI:

MSU:
- Turbidity
- Dipstick testing (Leukocyte esterase, Nitrite, Haemat-/Protein-uria)
- Microscopy
- Culture

18

What are the 3 main factors a dipstick tests urine for to exclude a UTI?

1) Leukocyte esterase
2) Nitrite
3) Haemat-/Protein-uria

19

Explain 'sterile pyuria':

Presence of WBCs in urine, but no bacteria present

20

List some causes of Sterile Pyuria:

- Recent course of Antibiotics
- Urethritis (chlamydia/gonorrhoea)
- Neoplasm
- Vaginal infection/inflammation
- Urinary TB
- Chemicals

21

How should uncomplicated cystitis be treated?

- Increased water intake
- Address underlying disorders
- 3 day course of oral antibiotic (Trimethoprim or Nitrofurantoin)

22

How should complicated cystitis be treated?

- Increased water intake
- Address underlying disorders
- 5-7 day course or oral antibiotic (Trimethoprim or Nitrofurantoin, or Cephalexin)
- Post-treatment cultures for children/pregnant women

23

Name 2 antibiotics used to treat cystitis:

- Trimethoprim
- Nitrofurantoin
- Cephalexin

24

What class of antibiotic is Nitrofurantoin?

Aminoglycoside

25

What class of antibiotic is Trimethoprim, and how do they work?

Dihydrofolate Reductase Inhibitors
- Inhibit synthesis of Thymidine, Purines and amino acids (inhibit folate acid synthesis)

26

What class of antibiotic is Cephalexin, and how do they work?

Beta-lactam (Cephalosporins)
- Inhibit cell wall synthesis by expressing beta-lactamase genes

27

Describe acute sepsis management:

Sepsis 6:
- Give high flow O2
- Take blood sample (ABG)
- Start fluid challenge
- Give IV antibiotics (Meropenem)
- Measure urine output
- Measure lactate

28

How should acute pyelonephritis be treated?

- Increased water intake
- Address underlying disorders
- 10-14 day course of oral/IV antibiotic (Co-Amoxiclav, Gentamicin, Ciprofloxacin)

29

At what point should treatment be started if a catheterised patient has a UTI?

If systemic symptoms are present

30

What prophylaxis is available for people prone to UTIs, with no treatable underlying condition?

Single nightly dose of Trimethoprim or Nitroofurantoin