Systems 2nd Year Renal > UTI > Flashcards

UTI Flashcards

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1
Q

Kidney Infections called

A

Pyelonephritis

Renal Abscess

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2
Q

Bladder Infection called

A

Cystitis

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3
Q

Highest rate of hospital acquired infection

A

Urinary Tract

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4
Q

Name 7 Factors which are Predisposing Factors Specific to

A 
Female Sex
Sex and Poor Voiding
Congenital Abnormalities
Stasis of Urine
Foreign Bodies
Oestrogen Deficiency in Postmenopausal Women
Fistula between Bladder and Bowel
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5
Q

Why is female sex a predisposing factor specific to urinary tract

A

Short urethra

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6
Q

Which bacteria is most common Gram Neg UTI Organism

A

E Coli

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7
Q

Which bacteria is most common Gram Pos UTI Organism

A

Coagulase Neg Stayphylocci

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8
Q

Which organisms usually in UTI (4)

A

E Coli
Proteus
Klebsiella
Enteroccocus

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9
Q

Clinical Features of UTI in Children

A 
Diarrhoea
Excessive Crying
Fever
Nausea and Vomit
Not Eating
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10
Q

Clinical Features of UTI in Adult

A 
Flank Pain
Dysuria
Cloudy offensive Urine
Urgency
Chill
Strangury
Confusion
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11
Q

Clinical Features of Acute Pyelonephritis (5)

A 
Pyrexia
Poor Localisation
Loin tenderness (Renal Angle)
Signs of Dehydration
Turbid Urine
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12
Q

Investigations for UTI

A

Mid Stream Urine
Urinalysis
Bacteruria >10.5
Culture and Sensitivity

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13
Q

What investigations may be useful for UTI in children or men or frequent UTI’s

A

Ultrasound

IVU

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14
Q

What study may rule out reflux and scarring in UTI

A

Isotope Study

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15
Q

Antibiotics for UTI

A

Amoxicillin, Cephalosporin, Trimethroprim

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16
Q

What is Reflux Nephropathy

A

UTI in Children

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17
Q

Tests for Reflux Nephropathy

A

Micturating Cystogram
Ultrasound
Biochemistry

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18
Q

Treat Reflux Nephropathy

A

Surgery

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19
Q

How much fluid should be taken in to prevent UTI

A

2/L a Day

Void every 2-3 Hours

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20
Q

What is inevitable with Indwelling Urinary Catheter

A

Colonisation

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21
Q

What does Bacteriuria need to be with UTI

A

> 10.5

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22
Q

Chronic Pylonephritis is what type of diagnosis

A

Radiological

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23
Q

which conditions associated with chronic pyelonephritis

A

Hypertension and CRF

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24
Q

what percentage of chronic pyelonephritis can progress to renal failure

A

15%

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25
Schistosomiasis can cause which UTI
Cysitits
26
What percentage of Renal Blood Flow is Cardiac Output
20-25%
27
Resorption of fluid is diminished if what happens to fluid intake
increase then increase urine output
28
Which renal organ does not store urine
Ureters
29
As bladder increases pressure as it fills what happens to ureters
the ureters close off and stops reflux of urine
30
Normal Bacteriostatic properties of normal urinary tract
Low pH, High Osmolarity and High Ammonia (NH3) content of normal urine
31
Prostatic secretions are said to be
bacteriostatic
32
Urinary tract except for where is sterile
Terminal Urethra
33
Suprapubic aspirated of urine. is
sterile
34
Urine specimen is always
Contaminated
35
In Mid Stream Specimen Urine what happens to urethral flora
diminished but always present
36
Urethral Flora will always do what in culture
Grow
37
In Mid Stream Specimen Sample there is no such thing as
negative result
38
If MSSU Culture is 10.3-10.4 then what is the percentage chance of infection if no symptoms
50%
39
Route of UTI infection is almost always
ascending
40
Upper Urethral and Bladder Dilatation can lead to
Bilateral Hydroureter and eventually Chronic Renal Failure
41
Unilateral Hydroureter is at what level
of renal pelvis on 1 side only
42
Consequences of Obstruction
Proximal Dilatation Infection Increased Calculous Formation
43
What triad make up Obstruction in UTI
Infection Calculi Obstruction
44
Obstruction in Children always investigate when
1st presentation
45
Most important type of Obstruction in children
Vesicoureteric Reflux
46
What happens in Vesicoureteric Reflux
Decreased Angulation of Ureter into Bladder
47
Common cause of obstruction in men
Benign Prostatic hyperplasia
48
Common cause of obstruction in women
Uterine Prolapse
49
Spinal Cord/Brain Injury can lead to what happening regarding volume in bladder
High Residual Volume = Stasis
50
In females sex tends to move what up the urinary tract
Lower Urethral Flora
51
Why is diabetes a predisposition to UTI
Glucose in Urine | Poor Function of WBC
52
Acute Complication of UTI
Sepsis/Septic Shock
53
Calculi in UTI can lead to
Obstruction Hydronephrosis
54
Chronic Pyelonephritis can lead to
Hypertension and Chronic Renal Failure
55
A diagnosis of Urinary Tract infection needs
Microbiological evidence and symptoms/signs
56
Microbiological evidence needed for UTI
Bacterial count of 10.4 from MSSU with no more than two species of micro organisms
57
Orchitits is what
UTI of Testis
58
Pyelonephritis especially can lead to what complication
Sepsis
59
UTI can lead to what malignancy as complication
Squamous Cell Caricinoma
60
How to investigate Lower tract UTI
MSSU/CSU Flow Study Residual Bladder Scan cystoscopy
61
how to investigate upper tract UTI
USS Kidneys IVU/CT-KUB MAG-3 Renogram DMSA Scan
62
Is renal colic an emergency
Yes
63
is acute retention an emergency
yes
64
is chronic high pressure retention an emergency
yes
65
is testicular torsion an emergency
yes
66
is paraphimosis an emergency
yes
67
is priapism an emergency
yes
68
Essential Features of Acute Retention
Painful Palpable Bladder Inability to pee Percussible Bladder
69
Which organisms are commonly associated with UTI (4)
E Coli Klebsiella proteus Pseudomonas
70
UTI accounts for approx how much GP Consults
6%
71
Bacteruria in UTI is
The presence of bacteria in urine. Note that the anterior urethra is not sterile and the presence of urethral organisms in urine washed out during micturition is not bacteriuria.
72
Pyuria in UTI is
The presence of pus cells (actually neutrophil polymorphs) in significant quantities in urine. This represents an inflammatory response and is supportive evidence of the presence of a UTI.
73
When to treat women with UTI
3 or more symptoms
74
MSU Sample is collected after first
10-20ml of stream has passed
75
What usually causes UTI in younger men
STI's eg Chlamydia or Gonnorhoea
76
For Kidney UTI antibiotics should be given for
7 Days
77
Culture and Antibiotics should only be given with Catheter related infection when
Patient symptomatic
78
When to treat asymptomatic bacteriuria
Pregnant | Surgery
79
Evidence that asymptomatic bacteriuria in pregnancy associated with
Increased risk pyelonephritis and premature delivery
80
Textbook cause of Sterile Pyuria
Renal Tuberculosis but could be STI
81
How to test for Renal Tuberculosis
Three early morning urines for ZN Stain and TB
82
Patients with Chronic pyelonephritis may show what on radiology
Clubbing of Calyces with Scarring or Cortical Parenchyma
83
If ureters appear dilated on radiograph then what test should be done
micturating cystogram to detect VUR
84
When should urine cultures be taken
Dipstick Inconclusive for Women with Mild or limited symptoms Suspected UTI in Men Suspected Acute Pyelonephritis Pregnant Women After failed antibiotic Recurrent UTI Children with Suspected UTI
85
What is recurrent UTI defined as
>2 UTI's within 6 months or >3 UTIs in a year
86
Where should catheter specimens be obtained from in catheter related urinary infection
catheter sampling port
87
for children with UTI sampling do not use
Cotton Wool balls Gauze sanitary towels
88
for children with UTI sampling
Suprapubic Aspiration useful as no contamination
89
E coli UTI is linked to
p fimbriae
90
Staph Saprophyticus is a coagulase neg staph recognised as cause of UTI in
Sexually active women
91
Proteus in UTI produces which enzyme
Urease which splits urea to release ammonia
92
Urease and Urea do what to urine
Make it alkaline and encourage stone formation
93
Which organisms are more common in UTI in Hospital patients
Proteus Klebsiella Pseudomonas Spp
94
Presence of how many white blood cells in Microscopy of UTI is determined significant pyuria and thus significant inflammation
>10 White Blood Cells
95
Trimethroprim or nitrofurantoin in UTI should not be used when
Pregnancy
96
Treatment for Lower UTI in Men
14 Days of Quinolone eg Ciprofloxacin
97
Acute Pyelonephritis Treatment
Ciprofloxacin for 7 Days
98
Treatment for pregnant UTI
Cephalexin
99
Nitrofurantoin could cause what in pregnant UTI at term
Neonatal Haemolysis
Systems 2nd Year Renal
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