Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Renal > UTI > Flashcards

UTI Flashcards

(55 cards)

Start Studying
1
Q

Definition of bacteruria

A
  • Bacteria in MSU
  • Single organism>105 CFU/ml
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Pyuria definition

A

WBC or pus on urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Predisposing factors

AGE, SEX

A

AGE

  • Incidence increases with age

SEX

  • Short female urethra→UTI by ascending route
  • Symptomatic infection in females till age 50
  • Significant male infections after 50
    • Prostatic hypertrophy
    • UT abnormalities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Predisposing Factors

Structural/meurological abnormalities of UT

A
  • Vesico-uretric reflux
  • Urethral valves or strictures
  • Calculus formation
  • Postatic hypertrophy
  • Bladder diverticulum
  • Neurogenic bladder

NOTE: these are associated with residual urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Most frequent predisposing factor in hospital

A

Indwelling urinary cathetr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Host factors that predispose to UTI

A
  • DM→risk of severe bacterial pyelonephritis
  • Immunosupression, steroids, cytotoxic drugs→ recurrent UTI and with unusual bacteria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How do fecal flora reach urinary tract

A

Ascending route

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Micturition, females and UTIs

A

During micturtion, organisims may reach neck of bladder esp after instrumentation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What causes majority of UTIs

A

E.coli setorypes O2, O4, O6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

E. coli with K1 antigen

A

Capsular Ag

associated with pyelonephritis more than cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Most common cause of hematogenous infecion of kidney

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

E. coli

Characteristics

A

Causes

  • cystitis
  • pyleonephritis
  • Community and hospital inections
  • M and F
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Staphy saprophyticus

A
  • Honeymoon cystitis
  • NOVOBIOCIN RESISTANT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Proteus Species

A

P. mirabilis

  • Indole negative
  • most frequent cause of proteus UTI

P. vulgaris

  • Indole positive
  • AMPICILLIN RESISTANT

BOTH

  • Associated with alkaline urine that encourages calculi formation (staghorn)
  • Pyelonephritis
  • Septecemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Klebsiella, Enterobacter, Serratia

A
  • recurrent or HCA UTI
  • Assoicated with hospital outbreak
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Psuedomonas

A
  • Resistant to many antiobiotics
  • Recurrent or HCA UTI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is associated with renal or perinephric abcess

A

S. aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Adenovirus

A
  • Acute hemorrhagic cystitis in children
  • Allogenic BM transplant recipients
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Candida common in

A
  • Indwelling catheter
  • On antibiotics
  • DM
  • Immunocompromised
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Parisitic cause of UTI

A

Schistiosoma haematobium

  • Free swimming
  • Infective larval cercaria
  • Burrows into human skin in contaminated waters
  • Common in ME and Africa (EGYPT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Midstream urnie use

A

To decrease number of urethral organisms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Catheter specimen urine

A

NOT bag

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Suprapubic Aspiration of Bladder indicated in

24
Q

Which is difficult to interpret

25
Getting uretric urine
Cystoscopy
26
Getting urine from kidney
Nephrostomy
27
Timing for MSUs
First sample of day ie early morning since bacteria grow overnight in bladder
28
Timing of specimen collection in Renal TB
**3** early morning urine
29
Timing of Specimen Collection in Schistosoma haematobium
Terminal portion of urine
30
What should you do if specimen not reach lab within 2 hrs
* Fridge at **4°C** for 24hrs * Contain **1.8% boric acid** * **​**Inhibits bacteria * Dip slide or dip inoculum technique * Suitabl for general practice * Costly * NO cell count or quantification
31
Lab UTI diagnosis involves
1. Microscopy 2. Semi-quantitative culture 3. Succeptibility testing
32
Microscopy for centrifuged and uncentrifuged urine
**Uncentrifuged** * For WBC * RBC * Bacteria * Epithelial cells **Centrifuged** * CASTS→imp for **glomerulonephritis**
33
Microscope result interpretation WBC
WBC\<10/mm3→NORMAL WBC\>10/mm3 * UTI * UT tumor * UT calculi * Urinary catheter * Chlamydia * TB of UTI * Partially treated UTI
34
Microscope Interpretation RBC
* UTI * Calculi * Tumor * **Vasculitis** * **GN** * **Renal TB**
35
Proteinurea and UTI
Common but \<2g/day
36
Overall, what suggests UTi in microscope
\>10 WBC, protein, bacteria and or RBC
37
What suggests upper UTI
Presence of casts
38
When should specimen be repeated
Presence of epithelial cells ie contaminated
39
Rapid screening methods
**A. Leukocytes estrase test** * High sensnitivity for wbc including lysed * FALSE NEGATIVES * Vit C * High protein * Glucose * Cephalosporins * Nitrofurantoin **Nitrate Reductase Test** * Nitrate→Nit**RITE** * Detect 40-80% of positive cultures * False Negatives * Diuretics * Low nitrate in diet * **Pseudomonas, group b strep, enterococcus do not prodce nitrate**
40
Semi quantitative culture methods of MSU
**Calibrated loop technique** * MSU: use standard bacteriological loop at 2µl size * SPA, uretric urine, urine from kidney: loop size at 100µl **Poor plate method** * Time consuming
41
What qualifies as significant bacteriuria in MSU
Pure growth of **one** organism **_AND_** \>105bacteria CFU/ml of urine if present in one urine sample: 80% confident its UTI Confidence inreases with pyuria and symptoms
42
What qualifies as no evidence of UTi in pt not on antibiotics
Bacteria count less than 103 CFU/ml
43
What does bacteria coun of 104-5CFU/ml indicate
Equivocal results OR Infection with fungi or S aureus and pus cells
44
What indicates probable contamination
* Mixed growth in MSU * Count _\<_ 103 CFU/ml * Epithelial cells in microscopy
45
Interpreting SPA or uretric samles
* Significant bacteruria doesnt apply * Single colony may be significant * \<103 CFU/ml is significant * Even if mixed, can use it to identify bacteria, report and significance?
46
Interpreting Urine catheter
* \>105 CFU/Ml is evidence of infection * 2 organisms common in indwelling catheter * Less than 104-5 may still be significant
47
Interpreting blood culture
* If systemic infection is possible as in Upper UTIs
48
Management involves
* Hydration * Samples for urinalysis, culture and sensitivity * Antibiotics * Manage underlying disease * Investigate and manage obstruction or structural abnormality
49
Treatment of symptomatic patients
* Empirical treatment according to local resistance data
50
Treatment for uncomplicated lower UTI (f)
Antibiotics for 3-5 days Nitrofurantoin or trimeohoprim sulfamethoxazole
51
When are antibiotics indicated fro 7-10 days
* Lower UTI * MEN * children * females with previous uti
52
Managment of relapse
* Consider structural abnormalities * calculi * obstruction * chronic prostatis * urological investigations * Urine cultures * RFT * Imaging * Prophylaxis * Low dose TMP/SMZ or NItrofurantoin for _\>_6months * Cranberry juice
53
Management of re infection
* If related to sex * Post coital voiding * Single dose antibiotic * No precepitating event * Long term prophylaxis esp f child at risk for renal damage * Pregnancy * B latams eg **cefotaxime**
54
Managemennt of Acute Pyelonephritis
* Admit * Hydration and antipyretics * Antibiotics * IV for 14 days * **Ceftriaxone or amoxicillin-clavulanic acid with amikacin** * Surgery * predisposing condition * NOt respond to tehraoy * Complicated by renal abscess
55
Follow up of Acute Pyelonephritis
* Repeat culture * IVP * Nuclear scan * US * Cystoscoy * MCUG * Surgery

Renal (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions