UTIs, Pyelonephritis and Prostatitis Flashcards Preview

14. Nephrology and Urology > UTIs, Pyelonephritis and Prostatitis > Flashcards

Flashcards in UTIs, Pyelonephritis and Prostatitis Deck (19)
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1

Define a lower urinary tract infection (LUTI).

Cystitis, i.e. infection of the bladder

2

Define an upper urinary tract infection (UUTI).

Infection of the urinary system above the bladder, including pyelonephritis, renal abscesses, and renal calculi

3

Define an uncomplicated UTI.

A lower UTI (i.e. cystitis), in a urinary system with normal structure and normal neurology

4

Define a complicated UTI.

An upper UTI, possibly with systemic signs and symptoms (e.g. sepsis), or any catheter associated UTI (CAUTI)

5

When would you treat asymptomatic bacteriuria? (4)

Preschool age children
Pregnant women
Renal transplant patients
Immunocompromised patients

6

How would you treat an uncomplicated UTI in non-pregnant women? (6)

Culture is NOT mandatory at 1st presentation

Investigations:
-Dipstick testing
-Previous culture results

Treatment:
-Antibiotics (3-7 days)

If antibiotics don't work:
-Urine culture
-Change antibiotic

7

Which antibiotics might you give for an uncomplicated UTI? (5)

With which route of administration?

Oral

Amoxicillin
Trimethoprim
Nitrofurantoin
Pivmecillinam
Fosfomycin

8

How would you manage uncomplicated UTIs in pregnant women? (4)

Consider which antibiotics are NOT safe to use in pregnancy.

ALWAYS send urine culture

Antibiotics (7-10 days):
-AVOID: trimethoprim, nitrofurantoin
-SAFE: amoxicillin, cefalexin
-Treat aggressively

9

How would you treat an uncomplicated UTI in children or men? (2)

ALWAYS send urine culture

Treatment:
-Antibiotics (7-10 days)

10

How would you manage recurrent UTIs? (9)

ALWAYS send urine culture

Supportive treatment:
-Hydration
-Encourage urge initiated and post coital voiding
-Cranberry products

Antibiotics:
-Self-administered single dose/short course
-Single dose post-coital antibiotics
-Prophylactic (6 months)

Other treatments:
-Intravaginal/oral oestrogen
-Urology investigation

11

How would you manage acute pyelonephritis (UUTI)? (9)

Include investigations, antibiotics, and what to do if the antibiotics don't work.

Investigations:
-Check recent/previous microbiology
-Urine culture
-Blood culture
-Imaging

Antibiotics:
-In community: trimethoprim, ciprofloxacin, amoxicillin
-In hospital: broad spectrum
-If uncomplicated: 7-14 days
-If complicated: 14+ days

If antibiotics don't work:
-Further investigaiton

12

How would you prevent CAUTIs? (5)

Only catheterise when absolutely necessary
Remove catheter as soon as possible
Remove/replace catheter if infected
Catheter care bundles
Hand hygiene

13

How would you treat a CAUTI? (5)

Check recent/previous microbiology

Catheter removal:
-Remove if not needed
-Replace with a clean one if necessary

Antibiotics:
-Start empirical antibiotics
-Switch later

14

Which investigations would you do for complicated UTIs? (10)

Blood tests:
-FBC
-U&Es
-CRP
-Blood cultures (if pyrexial)

Urine tests:
-Urethral sample
-Catheter specimen (CSU)
-Suprapubic
-Nephrostomy

Imaging:
-Renal US
-CT

15

How would you manage complicated UTIs?

Antibiotics (14+ days)
-IV
-Hospital admission

16

Which antibiotics might you give for a complicated UTI? (5)

Which administration?

IV

Amoxicillin
Vancomycin
Gentamicin
Aztreonam
Temocillin

17

Which investigations would you do for acute bacterial prostatitis? (5)

Urine culture

Blood culture

Imaging:
-Trans-rectal US
-CT
-MRI

18

How would you manage acute bacterial prostatitis? (4)

Check recent/previous microbiology

Antibiotics:
-Ciprofloxacin
-Ofloxacin
-Discuss with microbiology

19

What is Fournier's gangrene?

Necrotising fasciitis in the scrotum