Urinary Tract Infection Flashcards Preview

Pathoma - Kidney and Urinary Tract Pathology > Urinary Tract Infection > Flashcards

Flashcards in Urinary Tract Infection Deck (35):
1

What is a Urinary Tract Infection (UTI)?

Infection of urethra, bladder or kidney

2

How does UTI most commonly occur?

Most commonly arises due to ascending infection

3

What population has a higher incidence of UTIs?

Females

4

What are the most common risk factors for UTIs?

Sexual intercourse, Urinary stasis (inc. risk for bacteria to grow in urine) and catheters.

5

What is Cystitis?

Infection of the bladder

6

What does Cystitis present with?

Dysuria (pain when urinating), urinary frequency, urgency and suprapubic pain

7

What symptoms are usually absent with Cystitis?

Systemic signs (e.g. fever) are usually absent

8

What are three important laboratory tests for UTI?

1. Urinalysis
2. Dipstick
3. Culture

9

What does a Urinalysis show with UTI?

Cloudy urine with > 10 WBCs/high power field (hpf)

10

What does a Dipstick test show with UTI?

Positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites)

11

What does a Culture show with UTI?

Greater than 100,000 colony forming units (gold standard)

12

What is the most common cause of UTIs? What percentage of UTIs does it represent?

E. coli, 80%

13

What is the second most common cause of UTIs?

Staphylococcus saprophyticus

14

In what age/group is Staphylococcus saprophyticus most common?

Increased incidence in young, sexually active women (but E. coli is still more common in this population)

15

What is the third most common cause of UTIs?

Klebsiella pneumoniae

16

What is the fourth most common cause of UTIs?

Proteus mirabilis

17

What do you find in UTIs caused by proteus mirabilis?

Alkaline urine with ammonia scent

18

What is the fifth most common cause of UTIs?

Enterococcus faecalis

19

What is Sterile Pyuria?

Presence of pyuria (>10 WBCs/hpf and leukocyte esterase) with a negative urine culture.

20

What is pyuria?

Presence of pus in the urine

21

What does the finding of Sterile Pyuria suggest?

Urethritis due to Chlamydia trachomatis or Neisseria gonorrhoeae

22

What is the dominant presenting sign of urethritis?

Dysuria

23

What is Pyelonephritis?

Infection of the kidney

24

What usually causes Pyelonephritis?

Usually due to ascending infection

25

When is there an increased risk for Pyelonephritis?

With vesicoureteral reflux

26

What does pyelonephritis present with?

Fever, flank pain, WBC casts, and leukocytosis in addition to symptoms of cystitis.

27

What is the most common pathogen associated with Pyelonephritis?

E. coli (90%)

28

What are the second and third most common pathogens associated with Pyelonephritis?

2. Enterococcus faecalis
3. Klebsiella species

29

What is Chronic Pyelonephritis?

Interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis.

30

What causes Chronic Pyelonephritis?

Due to vesicoureteral reflux (children) or obstruction (e.g. BPH (benign prostatic hyperplasia) or cervical carcinoma)

31

What is vesicoureteral reflux?

-Angle between bladder and ureter is malformed -->
-Inc. risk of reflux to kidney -->
-Inc. scarring

32

What does Chronic Pyelonephritis lead to?

Cortical scarring with blunted calyces

33

What type of scarring is characteristic of vesicoureteral reflux?

Scarring at the upper and lower poles is characteristic of vesicoureteral reflux

34

What is seen in a histological slide of Chronic Pyelonephritis?

Atrophic tubules containing eosinophilic proteinaceous material --> they resemble thyroid follicles ('thyroidization' of the kidney)

35

What can be seen in the urine of Chronic Pyelonephritis?

Waxy casts