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Systems 2nd Year Renal > UTI > Flashcards

UTI Flashcards

1
Q

Kidney Infections called

A

Pyelonephritis

Renal Abscess

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2
Q

Bladder Infection called

A

Cystitis

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3
Q

Highest rate of hospital acquired infection

A

Urinary Tract

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4
Q

Name 7 Factors which are Predisposing Factors Specific to

A 
Female Sex
Sex and Poor Voiding
Congenital Abnormalities
Stasis of Urine
Foreign Bodies
Oestrogen Deficiency in Postmenopausal Women
Fistula between Bladder and Bowel
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5
Q

Why is female sex a predisposing factor specific to urinary tract

A

Short urethra

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6
Q

Which bacteria is most common Gram Neg UTI Organism

A

E Coli

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7
Q

Which bacteria is most common Gram Pos UTI Organism

A

Coagulase Neg Stayphylocci

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8
Q

Which organisms usually in UTI (4)

A

E Coli
Proteus
Klebsiella
Enteroccocus

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9
Q

Clinical Features of UTI in Children

A 
Diarrhoea
Excessive Crying
Fever
Nausea and Vomit
Not Eating
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10
Q

Clinical Features of UTI in Adult

A 
Flank Pain
Dysuria
Cloudy offensive Urine
Urgency
Chill
Strangury
Confusion
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11
Q

Clinical Features of Acute Pyelonephritis (5)

A 
Pyrexia
Poor Localisation
Loin tenderness (Renal Angle)
Signs of Dehydration
Turbid Urine
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12
Q

Investigations for UTI

A

Mid Stream Urine
Urinalysis
Bacteruria >10.5
Culture and Sensitivity

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13
Q

What investigations may be useful for UTI in children or men or frequent UTI’s

A

Ultrasound

IVU

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14
Q

What study may rule out reflux and scarring in UTI

A

Isotope Study

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15
Q

Antibiotics for UTI

A

Amoxicillin, Cephalosporin, Trimethroprim

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16
Q

What is Reflux Nephropathy

A

UTI in Children

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17
Q

Tests for Reflux Nephropathy

A

Micturating Cystogram
Ultrasound
Biochemistry

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18
Q

Treat Reflux Nephropathy

A

Surgery

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19
Q

How much fluid should be taken in to prevent UTI

A

2/L a Day

Void every 2-3 Hours

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20
Q

What is inevitable with Indwelling Urinary Catheter

A

Colonisation

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21
Q

What does Bacteriuria need to be with UTI

A

> 10.5

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22
Q

Chronic Pylonephritis is what type of diagnosis

A

Radiological

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23
Q

which conditions associated with chronic pyelonephritis

A

Hypertension and CRF

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24
Q

what percentage of chronic pyelonephritis can progress to renal failure

A

15%

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25
Q

Schistosomiasis can cause which UTI

A

Cysitits

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26
Q

What percentage of Renal Blood Flow is Cardiac Output

A

20-25%

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27
Q

Resorption of fluid is diminished if what happens to fluid intake

A

increase then increase urine output

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28
Q

Which renal organ does not store urine

A

Ureters

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29
Q

As bladder increases pressure as it fills what happens to ureters

A

the ureters close off and stops reflux of urine

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30
Q

Normal Bacteriostatic properties of normal urinary tract

A

Low pH, High Osmolarity and High Ammonia (NH3) content of normal urine

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31
Q

Prostatic secretions are said to be

A

bacteriostatic

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32
Q

Urinary tract except for where is sterile

A

Terminal Urethra

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33
Q

Suprapubic aspirated of urine. is

A

sterile

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34
Q

Urine specimen is always

A

Contaminated

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35
Q

In Mid Stream Specimen Urine what happens to urethral flora

A

diminished but always present

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36
Q

Urethral Flora will always do what in culture

A

Grow

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37
Q

In Mid Stream Specimen Sample there is no such thing as

A

negative result

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38
Q

If MSSU Culture is 10.3-10.4 then what is the percentage chance of infection if no symptoms

A

50%

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39
Q

Route of UTI infection is almost always

A

ascending

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40
Q

Upper Urethral and Bladder Dilatation can lead to

A

Bilateral Hydroureter and eventually Chronic Renal Failure

41
Q

Unilateral Hydroureter is at what level

A

of renal pelvis on 1 side only

42
Q

Consequences of Obstruction

A

Proximal Dilatation
Infection
Increased Calculous Formation

43
Q

What triad make up Obstruction in UTI

A

Infection
Calculi
Obstruction

44
Q

Obstruction in Children always investigate when

A

1st presentation

45
Q

Most important type of Obstruction in children

A

Vesicoureteric Reflux

46
Q

What happens in Vesicoureteric Reflux

A

Decreased Angulation of Ureter into Bladder

47
Q

Common cause of obstruction in men

A

Benign Prostatic hyperplasia

48
Q

Common cause of obstruction in women

A

Uterine Prolapse

49
Q

Spinal Cord/Brain Injury can lead to what happening regarding volume in bladder

A

High Residual Volume = Stasis

50
Q

In females sex tends to move what up the urinary tract

A

Lower Urethral Flora

51
Q

Why is diabetes a predisposition to UTI

A

Glucose in Urine

Poor Function of WBC

52
Q

Acute Complication of UTI

A

Sepsis/Septic Shock

53
Q

Calculi in UTI can lead to

A

Obstruction Hydronephrosis

54
Q

Chronic Pyelonephritis can lead to

A

Hypertension and Chronic Renal Failure

55
Q

A diagnosis of Urinary Tract infection needs

A

Microbiological evidence and symptoms/signs

56
Q

Microbiological evidence needed for UTI

A

Bacterial count of 10.4 from MSSU with no more than two species of micro organisms

57
Q

Orchitits is what

A

UTI of Testis

58
Q

Pyelonephritis especially can lead to what complication

A

Sepsis

59
Q

UTI can lead to what malignancy as complication

A

Squamous Cell Caricinoma

60
Q

How to investigate Lower tract UTI

A

MSSU/CSU
Flow Study
Residual Bladder Scan
cystoscopy

61
Q

how to investigate upper tract UTI

A

USS Kidneys
IVU/CT-KUB
MAG-3 Renogram
DMSA Scan

62
Q

Is renal colic an emergency

A

Yes

63
Q

is acute retention an emergency

A

yes

64
Q

is chronic high pressure retention an emergency

A

yes

65
Q

is testicular torsion an emergency

A

yes

66
Q

is paraphimosis an emergency

A

yes

67
Q

is priapism an emergency

A

yes

68
Q

Essential Features of Acute Retention

A

Painful
Palpable Bladder
Inability to pee
Percussible Bladder

69
Q

Which organisms are commonly associated with UTI (4)

A

E Coli
Klebsiella
proteus
Pseudomonas

70
Q

UTI accounts for approx how much GP Consults

A

6%

71
Q

Bacteruria in UTI is

A

The presence of bacteria in urine. Note that the anterior urethra is not sterile and the presence of urethral organisms in urine washed out during micturition is not bacteriuria.

72
Q

Pyuria in UTI is

A

The presence of pus cells (actually neutrophil polymorphs) in significant quantities in urine. This represents an inflammatory response and is supportive evidence of the presence of
a UTI.

73
Q

When to treat women with UTI

A

3 or more symptoms

74
Q

MSU Sample is collected after first

A

10-20ml of stream has passed

75
Q

What usually causes UTI in younger men

A

STI’s eg Chlamydia or Gonnorhoea

76
Q

For Kidney UTI antibiotics should be given for

A

7 Days

77
Q

Culture and Antibiotics should only be given with Catheter related infection when

A

Patient symptomatic

78
Q

When to treat asymptomatic bacteriuria

A

Pregnant

Surgery

79
Q

Evidence that asymptomatic bacteriuria in pregnancy associated with

A

Increased risk pyelonephritis and premature delivery

80
Q

Textbook cause of Sterile Pyuria

A

Renal Tuberculosis but could be STI

81
Q

How to test for Renal Tuberculosis

A

Three early morning urines for ZN Stain and TB

82
Q

Patients with Chronic pyelonephritis may show what on radiology

A

Clubbing of Calyces with Scarring or Cortical Parenchyma

83
Q

If ureters appear dilated on radiograph then what test should be done

A

micturating cystogram to detect VUR

84
Q

When should urine cultures be taken

A

Dipstick Inconclusive for Women with Mild or limited symptoms

Suspected UTI in Men

Suspected Acute Pyelonephritis

Pregnant Women

After failed antibiotic

Recurrent UTI

Children with Suspected UTI

85
Q

What is recurrent UTI defined as

A

> 2 UTI’s within 6 months or >3 UTIs in a year

86
Q

Where should catheter specimens be obtained from in catheter related urinary infection

A

catheter sampling port

87
Q

for children with UTI sampling do not use

A

Cotton Wool balls
Gauze
sanitary towels

88
Q

for children with UTI sampling

A

Suprapubic Aspiration useful as no contamination

89
Q

E coli UTI is linked to

A

p fimbriae

90
Q

Staph Saprophyticus is a coagulase neg staph recognised as cause of UTI in

A

Sexually active women

91
Q

Proteus in UTI produces which enzyme

A

Urease which splits urea to release ammonia

92
Q

Urease and Urea do what to urine

A

Make it alkaline and encourage stone formation

93
Q

Which organisms are more common in UTI in Hospital patients

A

Proteus
Klebsiella
Pseudomonas Spp

94
Q

Presence of how many white blood cells in Microscopy of UTI is determined significant pyuria and thus significant inflammation

A

> 10 White Blood Cells

95
Q

Trimethroprim or nitrofurantoin in UTI should not be used when

A

Pregnancy

96
Q

Treatment for Lower UTI in Men

A

14 Days of Quinolone eg Ciprofloxacin

97
Q

Acute Pyelonephritis Treatment

A

Ciprofloxacin for 7 Days

98
Q

Treatment for pregnant UTI

A

Cephalexin

99
Q

Nitrofurantoin could cause what in pregnant UTI at term

A

Neonatal Haemolysis

Systems 2nd Year Renal (30 decks)

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