Infections

Question 1

presentation of epididymo orchitis

Answer 1

swollen, painful, unilateral scrotal swelling, systemic signs of fever / rigors. Preens + and cremasteric reflex in tact.

Question 2

investigations for epididymo orchitis

Answer 2

urine dip (MC+S), NAAT if any RF, US if unsure but normally clinical diagnosis

Question 3

complications of epididymo orchitis

Answer 3

reactive hydrocele, abscess, subfertiliy

Question 4

RF of fourniers gangrene (polymicrobial)

Answer 4

DM, poor nutritional intake, gliflozons

Question 5

what cause epididymo orchitis

Answer 5

local extension of infection

Question 6

presentation of pyelonephritis

Answer 6

fever, loin pain, rigors, cystitis symptoms

Question 7

RF for pyelonephritis

Answer 7

female, vesicoureteric reflux, diabetes

Question 8

Ix for pyelonephritis

Answer 8

bloods (FBC, CRP, U+E), urine dip and MSU, CT KUB no contrast if any chance of obstruction

Question 9

Mx of pyelonephritis

Answer 9

10 days of cephalosporin or quinolone

Question 10

why do you treat asymptomatic bacteriuria in pregnancy

Answer 10

risk of preterm labour

Question 11

name two other bacterias that cause UTI as well as e coli

Answer 11

klebsiella pneumoniae and staphylococcus saprophyticus

Question 12

why does trimethoprim have to be avoided in first trimester

Answer 12

folate antagonist

Question 13

who are at risk of MDR UTI

Answer 13

old people, immunosupprssed, long term catheters

Question 14

why is UTI more common in pregnancy

Answer 14

progesterone - SM relaxation so get urine stasis and gravid uterus causes urethral dilation

Question 15

Mx of UTI in pregnancy

Answer 15

7 days nitro

Question 16

what causes acute prostatitis

Answer 16

ascending infection normally from Ecoli

Question 17

how does prostatitis present

Answer 17

pain (may be perineal pain or suprapubic pain), fever, rigors, LUTS

Question 18

RF for prostatitis

Answer 18

UTI or urogenital instrumentation

Question 19

Ex on prostatitis

Answer 19

feels tender and boggy and inguinal lymphadenopathy

Question 20

Mx of prostatitis

Answer 20

14 day course of quinolones

Question 21

when does acute prostatitis become chronic

Answer 21

when present for longer than 3 months, normally due to a poorly treated acute infection

Question 22

complications of prostatitis

Answer 22

acute retention, prostate abscess, sepsis

Question 23

under what circumstances do you send a urine sample for MC+S for non pregnant women

Answer 23

if there is visible or non visible haematuria or if the woman is >65

Question 24

what antibiotic is prescribed for a pregnant woman

Answer 24

nitro firstline but if in third trimester then prescribe amoxicillin or cefalexin

Question 25

is a urine culture needed to be sent for men

Answer 25

yes always

Question 26

how should a UTI be treated in catheterised patient

Answer 26

if asymptomatic - no Tx
If symptomatic - Tx for 7 days and consider replacing the. catheter