Section 13 - UTIs

Question 1

Which gender has the higher risk of contracting a UTI?

Answer 1

Women

Question 2

Does pregnancy increase or decrease the risk of getting a UTI?

Answer 2

Increase

Question 3

What are 4 things that increase the risk of contracting a UTI?

Answer 3

• Co-morbid conditions (diabetes)
• Spinal cord injuries
• Catheters
• GI tract abnormalities

Question 4

What is the difference between relapse and reinfection?

Answer 4

• Relapse is an infection by the same agent after about 2 weeks of no symptoms
• Reinfection could be caused by the same or a different pathogen, but it must be at least 1 month between infections

Question 5

Which group do uncomplicated UTIs affect the most?

Answer 5

Healthy women

Question 6

What is the treatment for uncomplicated UTIs?

Answer 6

Antibiotics

Question 7

What are the key risk factors for complicated UTIs?

Answer 7

• Underlying diseases
• Kidney stones
• Urinary tract abnormalities
• Catheters

Question 8

What are 5 contributing factors to UTIs?

Answer 8

• Urethra length
• Sexual activity
• Uncircumcised male infants
• Blockage
• Catheterization

Question 9

What are the common symptoms of urethritis?

Answer 9

• Dysuria

- Frequency

Question 10

What is cystitis?

Answer 10

Bladder infection

Question 11

What are the symptoms of cystitis?

Answer 11

• Dysuria
• Frequency
• Urgency
• Pain over bladder area

Question 12

What are signs of cystitis?

Answer 12

• Bloody urine
• Cloudy urine
• Bad odour

Question 13

What are the symptoms of acute urethral syndrome?

Answer 13

Same as cystitis but lower CFU/mL

Question 14

What is the key symptom of pyuria?

Answer 14

8 leukocytes/mm^3 of uncentrifuged urine

Question 15

What is pyelonephritis?

Answer 15

Infection of kidney and renal pelvis

Question 16

What is prostatis?

Answer 16

Infection involving prostate

Question 17

What is cervicitis?

Answer 17

Inflammation of cervix

Question 18

What does prostate enlargement lead to?

Answer 18

Poorer bladder emptying, which means increased UTI incidence

Question 19

What are the important virulence factors for microorganisms that cause UTI?

Answer 19

• Adherence (bacterial adhesins)
• Calculi formation
• Toxin and enzyme production (hemolysins and LPS)
• Capsular polysaccharide
• Biofilms

Question 20

What are host defences against UTIs?

Answer 20

• Flushing action of urinary flow
• Growth inhibitory properties of urine (low pH, osmolarity, high urea, organic acids)
• Mucopolysaccharides
• Preventing reflux

Question 21

What is the normal microflora of the urethra in newborns?

Answer 21

Sterile

Question 22

What is the normal microflora of the urethra in babies 1-3 days old?

Answer 22

• Staph
• Enterococci
• Diptheroids

Question 23

What is the normal microflora of the urethra in babies 3 days to many weeks old?

Answer 23

Lactobacillus acidophilus

Question 24

What is the normal microflora of the urethra in prepubescent children and postmenopausal women?

Answer 24

• Micrococci
• Streptococci
• Coliforms
• Diptheroids

Question 25

What is the normal microflora of the urethra in adults?

Answer 25

- Lactobacillus acidophilus - Staph. edipermidis - Streptococci (alpha and non-hemolytic) - E. coli - Diptheroids - Yeasts

Question 26

What is the normal microflora of the urethra in pregnant women?

Answer 26

- Increased L. acidophilus - Yeasts - S. epidermidis

Question 27

What are the most common etiologic agents of UTIs (general groups)?

Answer 27

- Gram-neg bacilli - Gram-pos cocci - Gram-pos bacilli - Fungi

Question 28

What can fecal E. coli cause?

Answer 28

Uncomplicated UTIs

Question 29

What are the common causes of acute polynephritis?

Answer 29

- Enterobacteriaceae | - Staph aureus

Question 30

What are symptoms of acute polynephritis?

Answer 30

- Fever | - Lower UTI symptoms

Question 31

Which groups does subclinical pyelonephritis generally affect?

Answer 31

- Pregnant women - Young children - Patients undergoing instrumentation in UT - Elderly - Diabetics

Question 32

Urine with over ______ organisms/mL is considered significant bacteriuria

Answer 32

10^5

Question 33

What happens if organisms are found in urine from a catheter?

Answer 33

It is considered significant because the urine is avoiding being contaminated by flora

Question 34

Why are collection and transport methods critical for urine samples?

Answer 34

Because urine is a good growth medium

Question 35

What are the culture and storage methods for urine samples?

Answer 35

- Cultured within 1 hour of collection | - Stored at 4 C for no more than 18 hours

Question 36

What is the treatment for uncomplicated UTIs?

Answer 36

- Antibiotics to ensure complete eradication - Follow up recommended - Drink lots of fluids

Question 37

What is the treatment for complicated UTIs?

Answer 37

- Systemic IV treatment until symptoms subside - Oral therapy afterwards - At least 10 days to sterilize kidneys