UTIs

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  • Created by: Amh
  • Created on: 08-04-16 12:07
Are UTIs serious
Yes they can cause sepsis and death
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What are lower urinary tract infection
Bladder/urethra cystitis
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What are upper utis
pyelonephritis, and abscess formation
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What is the most likely cause of UTIs
E. coli
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What serogroup is most likely to cause disease
025
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What is ecoli (025)'s virulence factors
Serum resistances, adhesion factors, ability to synthesise nutritional factors, and iron acquisition
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What other organisms are likely to cause UTIs
Klebsiella • Enterobacter • Proteus, enterococci, pseudomonas, staphylococci aurues/saprophyticus, candida, adenovirus?
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Risk factors
Being female (short urethra hormones pregnancy, sexually active. Instumenttation like catheters or congential abnormalities, diabetes
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What are the symptoms of a lower UTI
Frequency OF uination, dysuria, lower abdominal pain
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symptoms of pyelonephritis
Fever, flank pain +/- lower UTI symptoms
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Symptoms of uti in kisDS
non specific, fever, failure to thrive, vomiting
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What are the symptoms in elderly
Aymptomatic, and confused
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What sort of specimen do you need
Clean catch midstream
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What are issues with samples
Contamination with skin/faecal flora, catheter colonisation, kids,
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What is the best way to get a specimen
Suprapubic aspiration
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What are indicators of UTIS
Nitrte, and lysed WBC (leucocyte esterase)
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When looking at a urine sample under the microscope whatare we looking for
RBC RBC bacteria and casts
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What number of bacteriais significant for diagnosis
10^5 cfu/m
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What sort of loop do we use
calibrated loop 0.01ml x 100 for cfu/ml
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What do we culture urine on
CLED (Cystine-lactose electrolyte deficient) or chromogenic agar
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How do you treat an uncomplicated UTI
Oral co-amoxiclav, quinolone, trimethoprim, nitrofurantoin, or cephalexin • 3-5 days
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How would you treat a complecated UTI
IV antibiotics, broader spectrum longer course
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How do you treat recurrent UTIs
prophylaxis or treat structural abnormalities
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if kids have recurrent utis what does this indicate
renal tract abnormalitis
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what can kids you get recuurent renal tract infections get
renal scarring and renal failure
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What can pyelonephritis in pregnant women cause
preterm delivery low birthweight risk of preeclampsia
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How can you reduce uis from catheters
go in supra pubically
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What causes gonorrhoeas
Neisseria Gonorrhoea
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What are the characteristics of Neisseria gonorrhoea
Oxidase positive intracellular diplococci
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How do you diagnose Neisseria gonorrhoea
clinically bus pus
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How do you culture Neisseria gonorrhoea
sensitive to drying and tep, must plate within 6hrs, must be transported in co2 and innoculared on plated immediatly. Grows on thayer matin/new yourk/chocolate agar
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What molecular assays can you do
Genprobe- non amplified DNA probe assay, or Nucleic acid amplification tests e.g. PCR
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How do you treat Neisseria gonorrhoea
Quinolones like ciprofloxacin, Cephlasporins like ceftriaxones and cefiximes
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What is Neisseria gonorrhoea resistant to
tetracylcine and penicillin
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What bacteria causes chlamydia
Chlamydia trachomatis
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What are the characteristics of Chlamydia trachomatis
obligate intracellular bacteria, hard to stain
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How many serovars are there
17 they cause different clinical syndromes
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What are the symptoms Chlamydia trachomatis
may be asymptomatic, may be discharge Cervicitis, proctitis, salpingitis, epididymitis • Pelvic inflammatory disease
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What does pelvic inflammatory disease cause
» Infertility » Ectopic pregnancy
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How do you diagnose »Chlamydia trachomatis
immunofluorescent staining, antigen detection via ELISA, and PCRs
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How do you treat Chlamydia trachomatis
Macrolides, tetracyclines, quinolones
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What causes syphilis
Treponema pallidum
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What is Treponema pallidum
A helical flagellated motile rod parasite
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What are the stages of syphilis
Primary, secondary, tertiary and latent
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What is the presentation of primary syphilils
painless chancre that resolve after 3-8 wks
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What is the secoundary stage
Dissemination 4-10 weeks after chancre, there is a general rash, mucosal ulcers, Condolymata lata • Malaise, fever, lymphadenopathy
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how long does it take for secoundary infections to resolve
3-12 weeks
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What happens after the secondary infection resolves
it becomes a latent infection
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What does tertiary syphilis presnt as
Cardiovascular issues, Visceral issues, neurological issues
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What sort of cardiovascular issues
Aortitis, and valve abnormalitiess
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What sort of visceral abnormalities arise
lesions in bones, and organs
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What sort of neurological symptoms arise
Meningovascular meningitis • General paralysis of the insane • Tabes dorsalis
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When is congenital syphilis at it's highest risk
WHen mother is in the early stages
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Can you prevent congenital syphilis
Yes if treated befpre 16weeks
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What is the presentation of congenital syphilis
Rash, some visceral involvement, fulinant disease,
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What is late presentation of congenital syphylis
keratitis, skeletal abnormalities, meningoencephalitis
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how do you diagnose syphilis
Dark feild microscopy, monoclonal fuoorescent antibodies,
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What do you stain histological slids with when looking for syphilis
Warthin-Starry stain of histopathological samples
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What serology studies can you do
Treponemal enzyme immunoassays, t pallidum haemaglutnation assay, T pallidium particle agglutination assay these are specific. Non specific =Venereal disease reference laboratory (VDRL) • Rapid Plasma Reagin (R
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In primary syphilis What serologies will be positive
Maybe specifc serologies or non-specific serologies
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In 2ndary syphilis what serology is positive
both specific an non-specifc
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How do you treat syphilis
s Depends on stage but Benzathine penicillin • Doxycycline, tetracycline, azythromycin • Neurosyphilis - IV penicillin, ceftriaxone
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What are lower urinary tract infection

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Bladder/urethra cystitis

Card 3

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What are upper utis

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Card 4

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What is the most likely cause of UTIs

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Card 5

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What serogroup is most likely to cause disease

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