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Flashcards in UTIs Deck (23):
1

who do UTIs affect

women commonly

2

what causes the symptoms of UTIs

the inflammatory response of the urothelium to bacterial infection, associated with pyuria and bacteruria

3

common risk factors for UTIs

sex
catheterisation

4

why women more susceptible to UTIs

short urethra & proximity to the anus facilitates transfer of bowel organisms to the bladder

5

most common bacterial causes of UTIs

e coli = most common
then: staph epidermidis, proteus mirabilis, klebsiella aerogenes

6

pathogenesis UTI

colonises flora
colonisation of vagina
colonisation of urethral meatus
ascent of bacteria = bacteriuria
UTI

7

abnormalities that encourage bladder infection (cystitis) ?

urinary obstruction
damage to bladder epithelium
bladder stones
poor bladder emptying
oestrogen depletion

8

clinical features of a lower UTI

freq of micturition
dysuria
suprapubic pain
tenderness
haematuria
smelly urine

9

clinical features of acute pylonephritis

loin pain
tenderness
vomitting
fever
nausea

10

investigations UTI

hx
physical examination
dipstick
urine microscopy and culture
renal tract imagine in persistent cases

11

what looking for on dipstick

presence of nitrites - bacteria break down nitrates to nitrites
leucocyte elastase
pyuria

12

what looking for in microscopy

pathogens
unnecessary in women with symptoms suggestive of cystitis in whom rx is given based on symptoms and dipstick

13

management uti

pre treatment urine culture is desirable
Abx - 3-5d course amoxicillin, nitrofurantoin or trimethoprim
rx modified on culture and sensivity testing

14

UTI in pregnancy

more serious
if untreated bacteriuria can develop acute pyelonephritis and septic shock = low birth weight risk

15

prostatis

inflammation of the prostate gland
common
associated with lower urinary tract symptoms
if bacterial needs urgent rx

16

urethritis

rare
predominantly caused by STI
urethral pain / dysuria / discharge

17

epididymo-orchitis

inflamed epididymis & inflamed testicle
acute presentation
usually unilateral
must rule out torsion - any doubt = surgical scrotal exploration

18

features suggestive of torsion

short duration of pain, sudden onset
nausea and abdo pain
previous short-duration orchalgia

19

cause epididymo-orchitis

age UTI
age > 35 UTI > STI
take a sexual hx
elderly = predom catheter related

20

pyelonephritis what is it and cause

infection of renal parenchyma and soft tissues of renal pelvis / upper ureter
e coli main cause

21

triad symptoms pyelonephritis

loin pain
fever
pyuria

22

rx pylonephritis

IV ABx - gentamicin / cotmox
cant use trimethroprim or nitrofuratoin as secreted too efficiently
drain obstructed kidney
analgesia

23

sepsis 6

3 in 3 out
high flow oxygen
IV ABx
IV fluid resuscitation
Lactate
UO hrly
cultures