UTI's Flashcards
(61 cards)
what is the term for pus cells in the urine and what does this represent?
pyuria
neutrophil polymorphs in the urine - inflammatory process usually UTI
what is the term for inflammation / infection of the bladder?
cystitis
what are the symptoms of a UTI?
dysuria polyruia frequency of urination / strangury suprapubic tenderness flank pain haematuria pyrexia / chills cloudy offensive urine confusion
what is dysuria?
painful or difficult urination
what are the guidelines wit regards to tretament/investigation women presenting with a suspected UTI?
women presenting with 3 or more symptoms should be started on antibiotic treatment (3 day course)
2 symptoms or fever = mid-stream urine sample
what 2 tests can be carried out to investigate a UTI?
urine dip stick
mid-stream urine samlple
what does can a dipstick test detect that can suggest a UTI?
nitrite (metabolic by product of some bacteria)
protein (sign of inflammation)
leucocyte (inflammatory marker)
in dipstick testing: if there is positive leucocyte but protein and nitrite are negative, does this indicate a UTI ?
it doesn’t exclude or diagnose UTI alone
a urine culture would be required for further investigation
on urine dip stick, if there is protein but negative leucocyte and nitrite, does this indicate UTI and why?
the protein can be due to other causes so should be further investigated with urine culture
what is the cause of increasing rates of men with UTI as they age?
secondary to obstruction caused by prostatic hypertrophy
what organisms may be responsible for UTI in younger men?
STI’s;
- chlamydia
- gonorrhoea
what may be recurrent UTI in older men the sign of?
prostatitis
at what percent does someone with a catheter have of a UTI?
5% per day
should asymptomatic bacteriuria patients be treated and why/
no as treatment shows no benefit
however there is exception with pregnancy, people undergoing urological surgery or surgery involving artificial prosthesis
what is acute pyelonephritis?
infection of the upper urinary tract
what are the presentations of acute pyelonephritis?
loin pain & fever (most common)
sterile pyuria
urinary symptoms i.e. frequency, dysuria
may be systemically unwell = signs of sepsis; rigors, nausea/vomiting,
in a patient with suspected pyelonephritis, what is the initial management?
urine culture
start antibiotic treatment immediately
(blood cultures if the patient is systemically unwell)
what is the difference in antibiotic treatment for cystitis vs acute pyelonephritis?
cystitis = 3 days pyelonephritis = 7 days
what is asymptomatic bacteriuria in pregnancy associated with and what is done to reduce this?
increased risk of pyelonephritis
premature delivery
screening pregnancy women by urine (MSU) culture
what are the causes of sterile pyuria?
undeclared presence of antibiotics in the urine treated UTI < 2 weeks prior inadequately treated UTI renal TB chlamydia pyelonephritis bladder tumour appendicitis calculi: prostatitis polycystic kidneys papillary necrosis (i.e. BM) chemical cystitis i.e. cyclophosphamide
why is it extremely important to follow up and treat UTI in children?
there is an association between UTI in children and chronic pyelonephritis (renal damage/scarrin) in adulthood
what is the most common presentation of chronic pyelonephritis?
vague abdominal discomfort
hypertension
impaired renal function only in a minority of patients
what factors predispose someone to a UTI?
pregnancy - stasis of urine
sexual intercourse - damage to urethra, STI’s
female - short urethra & proximity to the colon
obstruction i.e. BPE - stasis of urine
foreign bodies i.e. catheterisation
pre existing renal parenchymal damage i.e. from recurrent pyelonephritis
renal cysts
congenital abnormalities i.e. vesico-ureteric reflux
what organisms are responsible for uncomplicated UTI in women?
e. coli
staph. saprophyticus
