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Flashcards in Urinary Tract Infection Deck (19):
1

What is infection of the epididymis/testis called?

Epididymo-orchitis

2

What is the most common type of hospital acquired infection?

UTI

3

What are the general predisposing factors which make an individual more susceptible to UTI?

Immunosuppression

Steroids

Malnutrition

Diabetes

Female sex  (short urethra)

Sexual intercourse and poor voiding habits

Congenital abnormalities e.g. duplex kidney

Stasis of urine e.g. due to poor bladder emptying

Foreign bodies eg catheters, stones

Oestrogen deficiency in postmenopausal women

Fistula between bladder & bowel

 

4

Name three organisms capable of causing a UTI

E.Coli

Klebsiella species

Enterococci

Proteus mirabilis

 

5

What is the possible consequence of ascension of UTI?

Pyelonephritis and acute kidney injury

6

What are the clinical features of UTI in children?

–Diarrhoea 

–Excessive crying

–Fever

–Nausea and vomiting

–Not eating

7

What are the clinical features of UTI in adults?

–Flank pain

–Dysuria (“like passing broken glass”)

–Cloudy offensive urine

–Urgency

–Chills

–Strangury - feeling if having not voided even though they have

–Confusion (very old people)

8

What are the clinical features of acute pyelonephritis?

Pyrexia

•Poor localisation

•Loin tenderness (renal angle)

•Signs of dehydration

Turbid urine

9

What are the investigations for UTI?

MSSU

•Urinalysis In ward

–Blood,

–leucocytes,

–protein and

–nitrites

 

•Microbiology In laboratory

–Microscopy and Gram staining

–Bacteruria >105 CFU /ml

  Culture and sensitivity

 

 

10

What are the relevant investigations for children, men or when UTIs are frequent?

Ultrasound or IVU may be helpful

Isotope studies to rule our reflux and scarring

11

What are the principles of management of UTI?

1  Identify the infecting organism & institute appropriate treatment

2  Identify predisposing factors and treat if possible

12

What is the treatment of UTI?

•Fluids

•Antibiotics

  Amoxicillin (3-5   day  course or   3g x 2),   cephalosporin

  Trimethoprim

Severe infections

  Intravenous   antibiotics

13

When is renal impairment likely to occur after a urinary tract infection?

If the urinary tract is functionally normal (on imaging) - repeated / persistent UTI's seldom result in renal damage

 

If there is anotomical / neurological abnormalities / stones /  diabetes - may cause infections and sometimes lead to renal impairment

14

What is a congenital cause of UTI's in children?

Reflux and infection

15

What is the relevant investigation for reflux nephropathy?

Micturating cystogram (radionuclide 99 Tc techniques)

 

Assessment of pregression by ultrasound scan and biochemistry

 

16

What is the treatment for reflux nephropathy?

Surgery

17

What are the recommended drinking habits and voiding habits for recurrent infections?

•Fluid intake 2l / day

 

•Void every  2-3 hours by day

 

•Void before bedtime & before and after intercourse

18

What are the radiological findings of chronic pyelonephritis?

Scarring and clubbing

19