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Medicine Phase 2a GU > Infection > Flashcards

Infection Flashcards

1
Q

Examples of GU infections

A 
Pyelonephritis
Cystitis
Prostatitis
Urethritis
Epididymo-orchitis
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2
Q

What is pyelonephritis

A

Infection within the renal pelvis

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3
Q

What is cystitis

A

Infection causing inflammation of the bladder

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4
Q

What is prostatitis

A

Bacterial infection of the prostate gland

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5
Q

What is urethritis

A

Urethral inflammation

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6
Q

What is epididymis-orchitis

A

Pain, swelling and inflammation of the epididymis

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7
Q

Types of pyelonephritis

A

Acute

Chronic

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8
Q

Pathophysiology of acute pyelonephritis

A

Often, infection will rise from the bladder to the renal pelvis.
Haematogenous spread also possible.
Local infection will cause inflammation and damage.

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9
Q

Aetiology of acute or chronic pyelonephritis (and risk factors)

A

Infection by UTI organisms (Escherischia coli, Klebsiella, Proteus, Enterococcus)
RF: Calculi, catheterisation, pregnancy, diabetes

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10
Q

Clinical presentation of acute pyelonephritis

A

Rapid, loin, suprapubic or back pain.
Fever, malaise, nausea, anorexia.
Possibly lower UTI, with frequent dysuria, haematuria or hesitancy.

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11
Q

Epidemiology of acute pyelonephritis

A

Can occur at any age

Generally more frequent in females, except in neonates

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12
Q

Diagnosis of acute pyelonephritis

A

Urine dipstick
Urine is cloudy with an offensive smell
Midstream culture

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13
Q

Treatment of acute pyelonephritis

A

Support
Antibiotics, empirically
*Ciproflaxcin / Co-amoxiclav first line (at PEEK bacteria)

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14
Q

Complications of acute pyelonephritis

A

Septicaemia

Renal abscess

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15
Q

Pathophysiology of chronic pyelonephritis

A

Chronic infection can cause characteristic scarring of the kidney

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16
Q

Clinical presentation of chronic pyelonephritis

A 
Failure to thrive
Possibly hypertension
Rapid, loin, suprapubic or back pain. 
Fever, malaise, nausea, anorexia. 
Possibly lower UTI, with frequent dysuria, haematuria or hesitancy.
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17
Q

Epidemiology of chronic pyelonephritis

A

4/100,000 asymptomatic adults

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18
Q

Diagnostic tests of chronic pyelonephritis

A

Urine dipstick

Midstream culture

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19
Q

Treatment of chronic pyelonephritis

A

Blood pressure control to slow progression of renal failure

Antibiotics (empirically) -> probs ciprofloxacin/co-amoxiclav

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20
Q

Complications of chronic pyelonephritis

A

Septicaemia
Progressive renal scarring
Secondary hypertension

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21
Q

Pathophysiology of cystitis (inflamed bladder from infection)

A

Infection of urine stored in the bladder.

Can be ‘washed out’ with frequent fluids.

22
Q

Aetiology of cystitis

A

Can be caused from incomplete emptying

23
Q

Clinical presentation of cystitis

A 
Frequent urination
Urgency
Dysuria
Abdominal tenderness
Swollen bladder
Confusion (elderly)
24
Q

Epidemiology of cystitis

A

Very common

25
Q

Diagnosis of cystitis

A

History

Midstream urine

26
Q

Treatment of cystitis

A

Often resolves without treatment

Fluids and possibly antibiotics

27
Q

Clinical presentation of Prostatitis (bacterial infection of prostate gland)

A 
Macroscopic haematuria
Fever
Dysuria
Pyrexia
Sharp pelvic/penile/anal pain
28
Q

Aetiology of prostatitis (name specific organisms)

A

Usually gram negative organisms; Escherichia coli, Enterobacter, Serratia. Sometimes STI: Neisseria gonorrhoeae and Chlamydia trachomatis

29
Q

What sexually transmitted gram negative organisms can cause prostatitis

A

Neisseria gonorrhoeae

Chlamydia trachomatis

30
Q

Epidemiology of prostatitis

A

15% of men experience symptoms at some point in their life

31
Q

Diagnosis of prostatitis

A

DRE (digital rectal examination): Gland can feel nodular, ‘boggy’, tender and hot

32
Q

Treatment of prostatitis (what is 1st line)

A

Antibiotics (empirically)

Quinolones (1st line!) e.g. Ciprofloxacin (A Quinalone)

33
Q

Types of urethritis

A

Gonococcal

Non-gonococcal

34
Q

Clinical presentation of gonococcal urethritis

A

May be asymptomatic. Usually is asymptomatic in women. Urethral discharge, more noticeable after holding urine overnight. Dysuria

35
Q

What is the difference in presentation of non-gonococcal urethritis (compared to gonococcal)

A

Same except NO DISCHARGE in Non-gonococcal

36
Q

Aetiology of Gonococcal Urethritis

A

Neisseria gonorrhoeae

As a result of STI

37
Q

Aetiology of Non-gonococcal urethritis (2 most common causes)

A

Number of organisms can cause this.

*Chlamydia trachomatis, Mycoplasma genitalium most commonly

38
Q

Epidemiology of urethritis

A

Non-gonococcal urethritis is most common condition diagnosed and treated in men in genitourinary

39
Q

Diagnosis of urethritis

A

Urethral smear

Screen for STIs

40
Q

Treatment of Gonococcal urethritis

A

Antibiotics (empirically)

Quinolones (1st line!) e.g. Ciprofloxacin (A Quinalone)

41
Q

Treatment of Non-Gonococcal urethritis

A 
Antibiotics
Specifically Ceftriaxone (A Quinolone)
42
Q

Complications of prostatitis

A

Chronic infection

43
Q

Complications of urethritis

A 
Non-Gonococcal = Epididymitis, Prostatitis
Gonococcal = same but also risk of gonococcal arthritis; can remit spontaneously if untreated
44
Q

Most common routes of infection leading to epididymo-orchitis infection

A

Most common route of infection is infection spreading from the urethra.
Second is from the bladder.

45
Q

Clinical presentation of epididymo-orchitis

A

Unilateral scrotal pain and swelling.

In STI: urethral discharge also. Tenderness to palpation on affected side. Palpable swelling

46
Q

Aetiology of epididymo-orchitis

A

Men <35 = most commonly STI
>35 = generally gram negative enteric organisms
Can also be viral

47
Q

Epidemiology of epididymo-orchitis

A

25/10,000 (may have dropped)

48
Q

Diagnosis of epididymo-orchitis

A

Culture urethral smear

49
Q

Treatment of epididymo-orchitis

A

Check for torsion
STI advice
Empirical antibiotics if appropriate:
Doxycycine and Cefixime or Ciprofloxazin (Quinolone)

50
Q

Complications of epididymo-orchitis

A

Reactive hydrocele

Abscess formation

51
Q 
Which 2 of these would you not treat with Ciprofloxacin:
Pyelonephritis 
Cystitis
Prostatitis
Gonococcal urethritis
Non-gonococcal urethritis
Epididymo-orchitis
A

Cystitis = Trimethoprin

Non-gonococcal urethritis = Ceftriaxone

Medicine Phase 2a GU (18 decks)

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