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Flashcards in UTI Deck (30):
1

What are common causative organisms of UTIs?

E. coli – most common
Staph. saprophyticus

**95% from GI tract

2

In infants, (M, F) more commonly have UTI's.
In 3-50 y/o, (M, F) more commonly have UTI's.

M
F

3

What age group has the highest rate of bacteriuria?

>65

4

What are contributing factors that increase # UTI's in younger ages?

sex
pregnancy

5

What contraceptives have increased incidence of UTI?

diaphragm/spermicide > spermicidal foam/condoms > oral contraceptives

6

What is the most common route of infection?

95%: Ascending route (Urethral trauma, Intercourse, Instrumentation, Diaphragm use)

<5%: Hematogenous route

7

Mechanisms for pathogenesis of UTIs?

Adhesion
Colonization
Invasion
Phase variation

8

What bacterial factors contribute to UTI's?

1. Uropathogenic E. coli = Virulence factors
2. Structural = adhesions on fimbriae (type 1 and p-)

9

**ADD INFO ON PATHOGEN!

**

10

Host Defense Mechanisms?

Bacterial growth inhibition
Urine flow
Epithelial cell turnover
Antibodies

11

Predisposing host factors?

Urine flow obstruction
Female factors
Abnormal urine flow
Urethral trauma
Vesiculo-ureteral reflux
Instrumentation

12

Clinical Manifestations of UTI of lower tract?

Frequency of urination
Dysuria - painful urination
Turbid urine
Suprapubic discomfort
Hematuria
Asymptomatic cystitis

13

Clinical Manifestations of UTI of upper tract?

Fever
Chills
Flank pain and “CVAT”
Asymptomatic pyelonephritis

14

Dx of UTI?

Microscopic urinalysis
Gram stain of urine
Urine culture
Blood cultures (PRN)
Screening tests

15

Complications of UTI:

Gram negative sepsis
Intrarenal or extrarenal abscess
Chronic renal insufficiency
Struvite renal calculi
Recurrent infection

16

Prevention of UTI:

Proper use of urinary catheterization

Correction of anatomic abnormalities

Prophylactic antibiotics - RARELY

17

Abx treatment for asymptomatic bacteriuria in elderly?

none!

18

Abx treatment of upper tract UTI?

1-6 weeks (IV vs oral therapy)

19

Abx treatment of upper tract UTIs for M vs F?

Males: 1 week

Females: 1-3 days (but longer if complicated UTI)

20

pus in urine (inflammation or infxn)

Pyuria

21

inflamm. of renal pelvis (upper UTI)

Pyelonephritis

22

symptoms of UTI (frequency, urgency, dysuria), but no apparent source of infxn


Acute urethral syndrome

23

How do birth control methods increase UTI risk?

spermicide changes flora of vagina

diaphragm changes angle of urethra, may ↑ reflux

24

Abx which are best at concentrating more in inflamed kidney than uninflamed

Aminoglycosides (tobramycin, gentamicin)

25

Abx which concentrate about the same in inflamed vs uninflamed

Sulfonamides and trimethoprim

26

Abx which concentrate LESS in inflamed kidney than uninflamed

Ampicillin/cephalothin

27

Abx which can treat prostatitis

Cipro

28

impairs phagocytosis

Capsular polysaccharide [K antigen]

29

Proteins at the end of type 1 fimbrae can bind:
Why is this important?

mannose in host tissues (=attachment)

Mannose present in lower UT → lower UTI

30

P antigen present in:
Why is this important?

in renal pelvis

expression of P-fimbriae → pyelonephritis