Flashcards in Urinary Tract Infections Deck (46)
What are two examples of factors which make a UTI 'complicated'?
Systemic symptoms or a renal tract structural abnormality
What are some risk factors for the development of a UTI?
Diabetes, catheterisation, sexual activity/pregnancy in women
What organism is the most common cause of a UTI?
Which organism causing UTI produces a 'burnt chocolate' smell on culture, and shows a 'swarming' pattern?
Which organism causing UTI can result in the formation of struvite (triple phosphate) stones?
S. saprophyticus is an organism which can cause UTI- it is most common in who?
Women of child-bearing age
Symptoms of dysuria, haematuria, frequency/urgency and suprapubic pain are characteristic of which UTI?
Other than the characteristic features of cystitis, what are some additional features of acute pyelonephritis?
Fever/rigors, nausea/vomiting, loin pain
What are some presenting symptoms of prostatitis?
Flu-like symptoms, lower backache, haematospermia
A swollen/tender/boggy prostate on examination suggests what possible diagnosis?
If an MSSU cannot be taken for any reason, what are some other methods of obtaining an uncontaminated urine sample for microscopy, culture and sensitivity?
Suprapubic aspiration or straight catheter
Which two elements of urinalysis testing are most specific for a UTI?
Nitrites and leukocytes
What investigation is used as a first line investigation for UTI in hospital, or to confirm a diagnosis suspected on urinalysis in primary care?
What investigation should be performed on every uncatheterised male who presents with a UTI?
If patients with a UTI are systemically unwell, what blood tests should be taken?
FBC, U&E, CRP, blood cultures
What is the first line investigation if imaging is necessary for someone with a UTI?
If nothing is detected on renal ultrasound, what is the second line imaging test for UTI?
Which antibiotic commonly used to treat UTIs must be avoided in the first trimester of pregnancy?
Which antibiotic commonly used to treat UTIs must be avoided in late pregnancy, breastfeeding and children aged < 3 months?
What is the risk of using nitrofurantoin in late pregnancy, breastfeeding and children aged < 3 months?
Which antibiotic commonly used to treat UTIs comes with a risk of severe pulmonary reactions and should be avoided in those with pre-existing interstitial lung disease?
If a patient has an eGFR < 20ml/min, what antibiotic should be used instead of gentamicin?
What lifestyle advice should be given to all patients with a UTI?
Drink lots of fluids and urinate often
What is meant by the term abacterial cystitis?
The patient has symptoms of a UTI but no significant growth on culture
Symptomatic relief is the treatment advised for abacterial cystitis or urethral syndrome. What can be used to alkalinise the urine for this purpose?
What is meant by the term asymptomatic bacteriuria?
The patient has bacteria in the urine but remains asymptomatic
When is antibiotic treatment required for asymptomatic bacteriuria and why?
In pregnant women- if untreated, this risks progressing to pyelonephritis or causing IUGR/premature delivery
How should pregnant women with asymptomatic bacteriuria be treated?
Antibiotics for 7 days and a test of cure
What is the antibiotic of choice for the treatment of asymptomatic bacteriuria or UTI in the first two trimesters of pregnancy?