UTI

Question 1

Which UTI is in the kidneys?

Answer 1

Acute/chronic pyelonephritis

Question 2

Which UTI is in the bladder?

Answer 2

Cystitis

Question 3

Which UTI is in the urethra?

Answer 3

Urethritis

Question 4

Which UTI is in the prostate?

Answer 4

Prostatitis

Question 5

Which UTI is in the epididymis/teste?

Answer 5

Epudidymo-orchitis

Question 6

Is incidence of UTI’s higher in males or females?

Answer 6

Females

Question 7

What is one of the most common hospital acquired infections?

Answer 7

UTI

funny that

Question 8

What are some general predisposing factors for a UTI?

Answer 8

Immunosuppression
Steroids
Malnutrition
Diabetes

Question 9

What are some predisposing factors for a UTI that are specific to the urinary tract?

Answer 9

Female sex
Sexual intercourse and poor voiding habits (not peeing after sex)
Congenital abnormalities
Stasis of urine
Foreign bodies e.g. catheters
Oestrogen deficiency in postmenopausal women
Fistula between bladder and bowel

Question 10

Why is female sex a predisposing factor to a UTI?

Answer 10

Females have shorter urethras

Question 11

What is the most common causative organism of a UTI?

Answer 11

E.coli

Question 12

Is E.Coli gram positive or negative?

Answer 12

Gram negative

Question 13

Where do the organisms causing a UTI usually come from?>

Answer 13

The bowel

Question 14

How else can organisms be transferred and cause UTI’s?

Answer 14

Transurethral route
Bloodstream
Lymphatics

Question 15

In terms of using the toilet, what can cause a UTI?

Answer 15

Wiping from back to front after bowel movements as could force bowel bacteria into the urethra.

Question 16

What are some of the features of a UTI in a child?

Answer 16

Diarrhoea
Excess crying
Fever
Nausea and vomiting
Not eating

Question 17

What are some of the features of a UTI in an adult?

Answer 17

Flank pain
Dysuria (“like passing broken glass”)
Cloudy offensive urine
Uregncy
Chills

Question 18

What is a classic symptom of a UTI in very old people?

Answer 18

Confusion

->Bankfoot x

Question 19

What does it suggest if dysuria is at the initiation of urination?

Answer 19

Pathology is located within the urethra

Question 20

What does it suggest if dysuria is at the end of urination?

Answer 20

Bladder pathology

Question 21

What are some of the clinical signs of acute pyleonephritis?

Answer 21

Pyrexia
Poor localisation
Loin tenderness at renal angle
Signs of dehydration
Turbid urine

Question 22

What are the investigations used for UTIs?

Answer 22

Mid-stream sample of urine
Urinalysis in ward e.g. blood, leucocytes, protein, nitrates
Microbiology in a lab using staining etc.

Question 23

UTI’s aren’t usually anything to worry about in adult females.
However, in a man, child or someone with frequent UTI’s, what might be some follow-up procedures to do?

Answer 23

Ultrasound
Isotope studies to rule out reflux and scarring

Question 24

What are the principles of management for a UTI?

Answer 24

Identify the infecting organism and institute appropriate treatment
Identify predisposing factors and treat if possible

Question 25

What is the treatment for a UTI usually?

Answer 25

Fluids Antibiotics- amoxicillin, cephalosporin, trimethoprim

Question 26

What is the treatment for a severe UTI?

Answer 26

IV antibiotics

Question 27

What can cause repeated UTI's in chilren?

Answer 27

Reflux nephropathy

Question 28

If a patient requires a long-term catheter, how often does it need to removed to reduce risks of UTI?

Answer 28

Replaced every 12 weeks

Question 29

What happens as a consequence of recurrent UTI's?

Answer 29

Chronic pyelonephritis

Question 30

What happens in chronic pyelonephritis?

Answer 30

Scarring and clubbing of the kidneys over a period of time

Question 31

What is important to note about acute pyelonephritis pain?

Answer 31

It's constant

Question 32

How does pyelonephritis affect the size of the kidney?

Answer 32

Causes enlargement of the kidney

Question 33

RECAP- what are the four signs of inflammation?

Answer 33

Calor; heat Rubor; redness Dolor; pain Tumour; swelling

Question 34

Name three gram-negative organisms which can cause a UTI. i'm just trying to think of potential exam questions and they might have five choices and say which of the following gram - or + is most likely to cause a UTI dik

Answer 34

E.Coli- most common Proteus mirabilis Klebsiella species

Question 35

Name three gram-positive organisms which can cause a UTI. i'm just trying to think of potential exam questions and they might have five choices and say which of the following gram - or + is most likely to cause a UTI dik

Answer 35

Coagulase- negative staphylococci Enterococci Group B streptococci

Question 36

What advice would you give for recurrent UTI in young women?

Answer 36

-Void after intercourse -More fluids -More frequent urination

Question 37

According to urinary examination today, what are the two drugs most often used to treat UTI's? ->MSSU samples take a couple of days to come back so often one of these two drugs are given in the mean time as usually cover most bacteria

Answer 37

Trimethoprim Nitrofurantoin