Urinary Tract Infection (UTI) Flashcards Preview

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Flashcards in Urinary Tract Infection (UTI) Deck (16):
1

What is infection of the epididymis/ testes called?

Epididymo-orchitis

2

What are the most common causes of HAI?

Urinary tract 38%
Surgical wound 22%
Lower Respiratory tract 15%
Bloodstream 5%
Others 20%

3

What general predisposing factors make an individual more susceptible to infection?

Immunosuppression
Steroids
Malnutrition
Diabetes

4

What specific predisposing factors make an individual more susceptible to UTI?

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 e.g. catheters, stones

Oestrogen deficiency in postmenopausal women

Fistula between bladder and bowel

5

What are the most common bacterial aetiologies of UTI?

Gram negative:
-E. COLI
-PROTEUS mirabilis
-KLEBSIELLA species

Gram positive:
-S. saprophyticus
-ENTEROCOCCI
-Group B strep
-Staph aureus

6

What is strangury?

Characterized by painful, frequent urination of small volumes that are expelled slowly only by straining and despite a severe sense of urgency, usually with the residual feeling of incomplete emptying

7

What are the clinical features of UTI in children?

-Diarrhoea
-Excessive crying
-Fever
-Nausea and vomiting
-Not eating

8

What are the clinical features of UTI in adults?

-Flank pain
-Dysuria
-Cloudy offensive urine
-Urgency
-Chills
-Strangury
-Confusion (very old people)

9

What are the clinical features of acute pyelonephritis?

Pyrexia

Poor localisation

Loin tenderness (renal angle)

Signs of dehydration

Turbid urine

10

Give a differential diagnosis for acute pyelonephritis

Renal/ ureteric calculi

11

What are the investigations in UTI?

MSSU

Urinalysis in ward
-Blood
-Leucocytes
-Protein
-Nitrites

Microbiology
-Microscopy and gram staining
-Bacteruria >10^5 CFU/ml
-Culture and sensitivity

12

What further investigations will you want to consider in children, men or when UTIs are frequent?

Ultrasound or IVU

Isotope studies to rule out reflux and scarring

13

What are the principles of UTI management?

Identify the infecting organism and institute appropriate treatment

Identify predisposing factors and treat if possible

14

How do you treat UTI?

Fluids

Antibiotics
-Amoxicillin (3-5 day course or 3g x 2)
-Cephalosporin
-Trimethoprim

Severe infections -> IV antibiotics

15

How do you diagnose reflux nephropathy?

Micturating cystogram (radionuclide 99Tc techniques)

Assess progression by ultrasound scan and biochemistry

16

What advice can you give to women with recurrent UTIs?

Fluid intake 2L / day

Void every 2-3 hours by day

Void before bedtime and after intercourse

Avoid constipation