UTIs

Question 1

where can UTIs be located?

Answer 1

upper ( kidney)
lower

Question 2

give one upper UTI?

Answer 2

Pyelonephritis
( there is only one )

Question 3

give four lower UTIs?

Answer 3

• cystitis
• prostatitis
• urethritis
  -epidydmo- orchitis

Question 4

what organisms cause UTIs?

Answer 4

KEEPS
Klebsiella
E-coli
Enterobacter
Proteus
Saprophyticus

Question 5

in 80% of cases what is the causative organism for UTI?

Answer 5

UPEC
- uropathogenic E coli

Question 6

who is most likely to be affected by UTIs? why?

Answer 6

females more likely to be affected
- due to a shorter urethra therefore closer to anus an easier for bacteria to colonise

Question 7

what is the fist line of diagnosis for UTIs?

Answer 7

• urine dipstick
• +ve leukocytes
• +ve nitrates
• +/- haematuria

Question 8

what is the gold standard test for diagnosis for UTIs?

Answer 8

midstream mcs
- confirms UTI + identifies pathogen

Question 9

what is pyelonephritis?

Answer 9

• infection of renal parenchyma and upper ureter

Question 10

how is pyelonephritis spread?

Answer 10

• via ascending transurethral spread ( mc
• also via blood or lymphatics
  -usually caused by UPEC but can be other KEEPS

Question 11

What are the risk factors for pyelonephritis?

Answer 11

• urine stasis ( stones)
• renal structural abnormalities
• catheters
• females < 35

Question 12

what are the symptoms for pyelonephritis?

Answer 12

triad of:
1. loin pain
2. fever
3. pyuria

others: back pain, headache, nausea and vomiting, cystitis symptoms

Question 13

how is pyelonephrtitis diagnosed?

Answer 13

1. urine dipstick
2. mc + s
3. USS

Question 14

how is pyelonephritis treated?

Answer 14

• analgesia
• paracetamol
• antibiotics - ciprofloxacin or co-amoxiclav

Question 15

define cystitis

Answer 15

infection of the bladder

Question 16

what are the risk factors of Cystitis?

Answer 16

• children
• females
• pregnancy
• catheters
• urines stasis
• bladder lining damage

Question 17

what are the cause of cystitis?

Answer 17

• UPEC
• other KEEPS

Question 18

what are the symptoms of cystitis?

Answer 18

• suprapubic tenderness and pain
• hematuria
• polyuria
• dysuria
• increased frequency and increased urgency
• confusion in elderly

Question 19

how is cystitis diagnosed?

Answer 19

1. urine dipstick
2. mc + s

Question 20

how is cystitis treated?

Answer 20

• antibiotics- trimethoprim/ nitrofurantoin
• ( if pregnant- amoxicillin)

Question 21

what Is urethritis?

Answer 21

urethral inflammation due to infectious or non infectious causes

Question 22

what are the types of causes of urethritis?

Answer 22

infective
non infective

Question 23

what are the infective causes of urethritis?

Answer 23

• gonococcal —> gonorrhoea
• non gonococcal—-> chlamidya ( mc)

Question 24

what are the non infective causes of urethritis?

Answer 24

• trauma
• urethral structure
• irritation

Question 25

what are the risk factors for urethritis?

Answer 25

- msm - unprotected sex

Question 26

what are the symptoms for urethritis?

Answer 26

- skin lessons - dysuria +/- discharge - urethral pain - penile discomfort/ pruritus - reactive arthiritis

Question 27

what is the treatment for UTIs?

Answer 27

- NG- IM Ceftriaxone + azithromycin - CT- azithromycin + doxycycline

Question 28

how are UTIs diagnosed?

Answer 28

1. urine dipstick 2. mc + s - gram -ve diplococcus= gonorrhoea 3. NAAT ( nucleic acid amplification test)- detect STIs

Question 29

a way to remember active arthritis symptoms

Answer 29

can't see can't pee- urethritis can't climb a tree

Question 30

what is epididymo- orchitis?

Answer 30

inflammation of epididymis extending to testes

Question 31

what are the causes of epididymo- orchitis?

Answer 31

- urethritis (STI) <35 yrs - cystitis extension > 35yrs - catheters ( elderly)

Question 32

what are the symptoms for epididymo- orchitis?

Answer 32

- unilateral scrotal pain and swelling - pain relieved with elevating testes ( positive prehns sign) - cremaster reflex intact

Question 33

what is a Ddx for epididymo- orchitis?

Answer 33

testicular torsion ( important to therefore rule out)

Question 34

how is epididymo- orchitis diagnosed?

Answer 34

1. NAAT 2. urine dip stick 3. mc + s

Question 35

how is epididymo- orchitis treated?

Answer 35

depends on cause

Question 36

what are uncomplicated UTIs?

Answer 36

- female - healthy - pre-menopausal - not pregnant - anatomically and functionally normal urinary tract

Question 37

what are complicated UTIs?

Answer 37

- post menopausal - pregnant - anatomically or functionally abnormal urinary tract - foreign body in urinary tract - one or more comorbidities

Question 38

what is prostatisis?

Answer 38

inflammation of the prostate gland usually due to bacteria

Question 39

describe acute prostatisis

Answer 39

- pain - frequent peeing - if can't pee- acute urinary retention - lower back pain

Question 40

describe chronic prostatisis

Answer 40

- pain - enlarged prostate - erectile dysfunction

Question 41

how is prostatitis treated?

Answer 41

- antibiotics