UTIs (Diebel) Flashcards
(47 cards)
What are the 4 major defenses of the urinary tract system?
- Chemistry of the urine (pH, lysozyme, lactoferrin)
- Flow/Flushing action (100,000 epithelial cells per void)
- IgA
- Changing surface proteins on epithelial cells between the GI tract and UG tract
What are the 3 major threats to the urinary tract system?
- Microorganisms of the GI tract
- Hematogenous spread from other anatomical locations
- Blocked or decreased urine flow
Urethritis
Infection of the urethra
Cystitis
Infection of the bladder
Pyelonephritis
Infection of the kidney
Signs and symptoms of cystitis
Sudden onset, pain, burning, frequency urges to urinate.
Pyelonephritis signs and symptoms
Pain, burning, frequency urges to urinate. Cloudy urine (WBCs) Orange tinted urine (RBCs) Fever and nausea present (cytokines) Flank pain
If untreated pyelonephritis may develop into
septicemia
An infection in a structurally and neurologically normal urinary tract is referred to as a _____-
Uncomplicated UTI
If an infection has presence of persistent relapsing infection, foreign bodies, obstruction, immunosuppression, renal failure, renal transplant, urinary retention from neurological disease it is referred to as a ______
Complicated UTI
What usually complicates UTIs in men?
Prostatitis
Most common causative agent of UTIs?
E coli (UPEC/ExPEC) 80% of all infections
2nd most common agent of UTIs?
Staphylococcus saprophyticus (10 percent)
Enterococcus, Klebseilla pneum., Citrobacter and proteus make up ____ percent of infections
10%
Is the ecoli causing UTIs the same as the kind that gives you GI distress?
No. UTIs are caused by the UPEC/ExPEC strains of E. coli (normal flora)
Most common type of nosocomial UTI?
catheter
Complication that takes place in the presence of diabetes, Urinary tract obstruction, sickle cell or analgesic abuse
Papillary necrosis
May slough and cause unilateral or bilateral ureteral obstruction
Intrarenal abscess may occur
Why do abscess occur in pyelonephritis
Puss/WBCs come into to fight infection. Clog kidneys.
What are some pathological characteristics of chronic pyelonephritis/chronic interstitial nephritis?
- gross scars - usually uneven
- parenchyma shows interstitial fibrosis with inflammatory infiltrate (neutrophils and lymphocytes)
- Tubules are dilated or contracted with atrophy of the epithelial lining
- Colloid casts
- Concentric fibrosis about the parietal layer of Bowman’s (periglomerular fibrosis)
What type of scarring would you see in chronic glomerulonphritis
symmetrical contracted kiney
Papillary necrosis by infection
- Both kidneys and one or more pyramid
- pyramids replaced by wedge shaped necrotic tissue
- collecting tubules fill with bacteria and polymorphonuclear leukocytes
If a UTI is from hematogenous spread assume it’s ______
staph aureus, microembolism from somewhere else
Gram negative organisms are almost always from _____ origin
ascending
Serotype O
Almost all UPEC ecoli
polysaccraride sugar on outer membrane
