UTI Flashcards

1
Q

how many people are affected by UTI yearly?

A

Epidemiology: affect 150 million people a year

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2
Q

who is most at risk of UTI? is

A
  • Peak is young, sexually active women aged 18 to 24
  • Sexual activity, pregnancy, incontinence
  • Post-menopause (absence of oestrogen – vaginla atrophy)
  • Presence of cystocele
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3
Q

what is pyelonephritis?

A

upper or complicated UTI  bacterial ascent
kidney infection

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4
Q

what defines a recurrent bacterial cystitis?

A

two or more UTIs in 6mths or three in 12months

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5
Q

what are the most common pathogens causing UTI?

A

most common e.coli, klebsiella, pneumonia and enterococcus faecalis

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6
Q

why are females more at risk of UTI?

A

females are 30x more likely to get UTI than males due to shorter urethra. Greater chance of bacteria reaching bladder before being expelled in urine

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7
Q

what is cystocele?

A

where supportive tissues around bladder and vaginal wall weaken and stretch – bladder and vaginal wall fall into vaginal canal

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8
Q

in males what can increase risk of UTI?

A

BPH, urethral strictures

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9
Q

what can increase risk of UTI in both sexes?

A

histories of UTI, diabetes

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10
Q

what symptoms are seen within incomplicated UTIs?

A
  • Dysuria, urgency, frequency, hesitancy, suprapubic pain
  • New onset nocturia, new onset incontinence, haematuria (can be non visible)
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11
Q

what systemic features may be seen in neonates with a UTI?

A
  • Neonates/ infants: irritability, poor feeding, fever
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12
Q

what symptoms may be seen within complicated UTIs?

A
  • Flank pain, suprapubic pain, cloudy urine, pelvic pain
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13
Q

what is important within history taking of UTI?

A

hydration, diet, prior UTIs, sexual history, medication history

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14
Q

what can be seen within clinical exam indicating UTIs?

A

suprapubic tenderness, costovertebral tenderness (if kidneys)

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15
Q

what should be included to diagnose a UTI?

A

clinical features
history
MC&S
urine dip

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16
Q

when is MC&S needed?

A

always need in complicated or recurrent UTI

17
Q

why would nitrities be positive within urine dip?

A

nitrates are broke n down into nitrites only in presence of bacteria

18
Q

why would leucocytes be present on urine dip

A

enzyme leukocytes produce in response to bacteria to urine

19
Q

what is pyuria?

A

WBC in urine

20
Q

what is sterile pyruia?

A

WBC in urine without infection - renal malignancy, GU TB

21
Q

who should be medically management if diagnostic tests of UTI are positive but they are asymptomatic

A

pregnant women only

22
Q

what conservative management is there within UTI?

A

increased hydration
- Personal hygiene
- vitC as urinary acidifier
- consumption of D-mannose and cranberry products

23
Q

how can you manage cystitis - uncomplicated UTI?

A
  • simple analgesia
  • 3 day nitrofurantoin or trimethoprim are 1st line on lower/ uncomplicated women
  • 7-14 days in men or pregnant – complicated
24
Q

what medication may be used in complicated UTIs?

A
  • Fluoroquinolone may need IV if urosepsis
  • Urosepsis/ severe pyelonephritis  co-amox or ceftriaxone
25
Q
A