Micro - UTI

Question 1

Uncomplicated urinary tract infection?

Answer 1

x

Question 2

Complicated urinary tract infection?

Answer 2

x

Question 3

Complicated UTIs occur in …

Answer 3

men, pregnant women, children, patients who are hospitalised or in healthcare-associated settings

Question 4

Incidence?

Answer 4

…

Question 5

More than 95% of UTI are caused by

Answer 5

…

Question 6

E.coli is

Answer 6

most common causative organism

Question 7

UTI caused by many species of microorganisms but only a few serogroups of E.coli cause a high proportion of infections. Which types?

Answer 7

…

Question 8

the more virulence factors a strain expresses …

Answer 8

the more severe an infection it is able to cause

Question 9

Other organisms apart from E.coli

Answer 9

Proteus mirabilis, Klebsiella aerogenes, enterococcus faecalis, staphylococcus saprophyticus, staphylococcus epidermis

Question 10

What is proteus mirabilisassociated with

Answer 10

kidney stones

Question 11

What organism is associated with staghorn calculus?

Answer 11

..

Question 12

When is the relative frequency of these other types of causative organisms increased greatly?

Answer 12

In recurrent urinary tract infections. In the hospital rather than the community.

Question 13

Antibacterial host defences in the urinary tract?

Answer 13

Urine (osmolality, pH, organic acids), urine flow and micturition, urinary tract mucosa (bactericidal activity, cytokines)

Question 14

Why women are more likely to get UTI?

Answer 14

The female urethra is short and is in proximity to the warm moist vulvar and perianal areas, making contamination likely

Question 15

What areas colonised before urinary infection results?

Answer 15

colonise the vaginal introitus and periurethral area

Question 16

ascending uti

Answer 16

once within the bladder, bacteria may multiply and then pass up the ureters, especially if vesicoureteral reflux is present, to the renal pelvis and parenchyma

Question 17

renal tract abnormalities

Answer 17

…

Question 18

obstruction can be

Answer 18

mechanical, extrarenal or intrarenal

Question 19

extrarenal obstruction

Answer 19

…

Question 20

intrarenal obstruction

Answer 20

…

Question 21

Neurogenic malfunction causing obstruction

Answer 21

poliomyelitis, …

Question 22

Vesicoureteral reflux

Answer 22

tends to …

Question 23

Infections mainly through ascending route but there is also the …

Answer 23

haematogenous route

Question 24

The kidney is frequently the site of abscesses in patients with …

Answer 24

Staphylococcus aureus bacteremia or endocarditis or both

Question 25

in humans, infection of the kidney with gram negative bacilli occurs rarely bythe

Answer 25

haematogenous route

Question 26

staph aureus may not be a uti but can be seen in urine ... true or false?

Answer 26

true

Question 27

Children older than 2 years symptoms ...

Answer 27

...

Question 28

Lower uti symptoms

Answer 28

Result from bacteria producing irritation of urethral ad vesical mucosa, causing frequent and painful urination of small amounts of turbid urine. Suprapubic heaviness or pain. Ocassionally, grossly ...

Question 29

Upper UTI symptoms

Answer 29

fever (Sometimes with rigors), flank pain, and frequently lower tract symptoms (e.g. frequency, urgency, and dysuria), at times, the lower tract symptoms antedate the appearance of fever and upper tract symptoms by 1 or 2 days .............

Question 30

Older patient symptoms

Answer 30

Symptoms of upper tract infection are often atypical e.g. abdominal pain, change in mental status. Symptoms are often not diagnostic, ..

Question 31

What does flowchart for adults over 65 years with suspected UTI show?

Answer 31

Do not perform urine dipsticks - becomes more unreliable with increasing age over 65 years. Up to half of older adults and most with a urinary catheter, will have bacteria present in the bladder/urine without an infection. 'Asymptom....

Question 32

Investigation of UTI for uncomplicated uti/pyelonephritis

Answer 32

Urine dipstick; MSU for urine microscopy, culture and sensitivities; bloods - FBC, U&Es, CRP (inflammatory markers and renal function)

Question 33

Investigation of complicated UTI

Answer 33

...

Question 34

Send a urine culture in if ...

Answer 34

...

Question 35

Consider risk factors for resistance and send urine for culture if ...

Answer 35

...

Question 36

sampling in all men and women

Answer 36

...

Question 37

How do I interpret a urine culture result if I suspect a UTI?

Answer 37

...

Question 38

How to interpret ...

Answer 38

...

Question 39

Sampling for UTI

Answer 39

MSU, catheter, aspiration?

Question 40

positive nitrates?

Answer 40

...

Question 41

What do white cells pyuria suggest

Answer 41

indicative of infection

Question 42

What do squamous epithelial cells indicate

Answer 42

contamination

Question 43

Treatment for UTI

Answer 43

...

Question 44

Complications of UTI

Answer 44

Perinephric abscessm chronic pyelopnephritis, septic hock, acute papillary necorsis

Question 45

Prophylaxis for UTI

Answer 45

Controversial ....

Question 46

Which of the following dipstick parameters is a product of nitrate reductase and suggestive of uti?

Answer 46

nitrites

Question 47

egg shaped cells

Answer 47

squamous epithelial cells

Question 48

Presence of which cells indicate a poorly taken sample?

Answer 48

Squamous epithelial cells