L10: Microbiology of the urinary tract

Question 1

5 symptoms of UTI

Answer 1

polyuria 
dysuria 
urgency 
suprapubic discomfort 
fever low grade/ absent

Question 2

symptoms of UTI in infants (2)

Answer 2

failure to thrive

poor feeding

Question 3

symptoms of UTI in elderly

Answer 3

absent signs

sudden confusion

Question 4

symptoms of pyelonephritis (4)

Answer 4

loin pain
fever
rigors
renal angle tenderness

Question 5

7 risk factors for UTI

Answer 5

female 
anatomical abnormality 
functional abnormality 
catheterisation 
pregnancy 
foreign body
urinary tract surgery

Question 6

why is female sex a risk factor

Answer 6

shorter urethra
urethra opens into introitus
closer to anus

Question 7

what does catheterisation lead to

Answer 7

biofilm formation

Question 8

what happens in pregnancy increase UTI risk (3)

Answer 8

dilated ureters
incomplete bladder emptying
gestational glycouria

Question 9

what are UTIs in pregnancy associated with

Answer 9

low birth rate
premature
perinatal morbidity

Question 10

what will eventually happen to all catheters

Answer 10

get colonised

Question 11

can you have a UTI with negative urine cultures

Answer 11

YES- 50% of women

Question 12

reasons for a negative urine culture with a UTI (4)

Answer 12

• low bacteria count
• fastidious bacteria don’t grow on culture
• non-infective inflammation
• Sexually transmitted pathogens

Question 13

commonest bacteria cause of UTI

Answer 13

E.coli

Question 14

where does E.coli live normally

Answer 14

in bowel

Question 15

what E.coli can cause UTIs

Answer 15

uropathogenic E.coli (UPEC)

Question 16

what do UPECs have to enable UTIs

Answer 16

virulence factors for urinary tract

Question 17

3 non-bacterial cause of UTI

Answer 17

viruses
mycobacterium tuberculosis
parasitic infection

Question 18

what are BK and JC viruses associated with

Answer 18

infection and graft failure in patients following kidney transplant

Question 19

most common route of UTI acquisition

Answer 19

ascending from urethra to bladder to kidney

Question 20

less common UTI acquisition route

Answer 20

haematogenous

Question 21

UTI from urethra to bladder=

Answer 21

cystitis

Question 22

UTI from bladder to kidney=

Answer 22

pyelonephritis

Question 23

4 host defences of UTI

Answer 23

urine flow
urine osmolarity/ pH/ organic acids
secreted sIgA
mucosal defences

Question 24

3 UPEC virulence features

Answer 24

type 1 fimbriae
type p fimbriae
bacterial capsule

Question 25

what is type p fimbriae associated with

Answer 25

pyelonephritis

Question 26

what is type 1 fimbriae associate with

Answer 26

cystitis causing strains

Question 27

what is bacterial capsule associated with

Answer 27

pyelonephritis causing strains

Question 28

what does type 1 fimbriae bind to

Answer 28

mannose residue on bladder endothelial cells membrane

Question 29

what do type p fimbriae bind to

Answer 29

glycolipid residues on host cells

Question 30

E.coli gram stain=

Answer 30

negative

Question 31

other gram negative causing UTIs

Answer 31

proteus species

Question 32

commonest proteus species

Answer 32

proteus mirabilis

Question 33

how is proteus protected

Answer 33

it produces magnesium ammonium phosphate stones which surround it

Question 34

what is changed on a urinalysis with UTI

Answer 34

protein blood leucocyte esterase nitrites

Question 35

most specific signs for UTI

Answer 35

nitrites | leucocyte esterase

Question 36

what is urinalysis good at

Answer 36

ruling out UTI (negative predictive value)

Question 37

what is a Negative predictive value

Answer 37

is the probability that subjects with a negative screening test truly don't have the disease.

Question 38

what is urinalysis bad at

Answer 38

ruling in UTI

Question 39

how do you avoid urine specimen contamination

Answer 39

midstream urine specimens

Question 40

what acid is placed in urine samples

Answer 40

boric acid

Question 41

what does boric acid do

Answer 41

stuns the bacteria

Question 42

what suggests contamination in a urine sample

Answer 42

epithelial cells

Question 43

colour of E.coli in CLED agar

Answer 43

yellow

Question 44

colour of proteus in CLED agar

Answer 44

pale blue

Question 45

in children how are UTIs thought of

Answer 45

complicated

Question 46

2 managements of UTIs

Answer 46

good hydration | antibiotics (if indicated)

Question 47

antimicrobial active against most agents of uropathogens

Answer 47

Trimethoprim

Question 48

trimethoprim affect on bacteria =

Answer 48

bacteriostatic

Question 49

treatment of lower UTIs in children (3)

Answer 49

amoxicillin trimethoprim cephalexin

Question 50

treatment of upper UTIs in children

Answer 50

co-amoxiclav

Question 51

treatment of severe UTIs in children

Answer 51

cefotaxime | gentamicin