Microbio - UTIs

Question 1

Define uncomplicated UTI

Answer 1

Infection of the urinary tract without any structural or functional abnormality

Question 2

Define complicated UTI

Answer 2

infection of the urinary tract with functional or structural abnormalities

Question 3

Complicated UTI is generally an infection in which kind of patients?

Answer 3

Male
pregnant
Indwelling catheters
Children

Question 4

Prevalence of bacteriuria in young non-pregnant women?

Answer 4

1-3%

Question 5

List the 4 most common bacterial causes of UTI

Answer 5

E. Coli
Staph. Saprophyticus
Proteus
Klebsiella

Question 6

Clinical features of lower UTI in diff patients?

Answer 6

Generally: dysuria, frequency, urgency, haematuria

Children - vague (fever, irritability, vomiting)

Elderly - asymptomatic

Question 7

Clinical features of pyelonephritis

Answer 7

Fever
Rigors
Flank pain

Question 8

Gram +ve, coagulase -ve, UTI

• name 2 common causes

Answer 8

S. Saprophyticus

S. Epidermis (prostheses)

Question 9

Extra renal causes of urinary tract obstruction

Answer 9

BPH, Calculi

Question 10

Intrarenal causes of urinary tract obstruction

Answer 10

PCKD
SCD
Hypokalemic nephropathy?!

Question 11

Neurogenic causes of renal tract obstruction

Answer 11

Poliomyelitis
Diabetic neuropathy
Spinal cord injury

Question 12

Haematogenous route of UTI - what tends to cause this?

Answer 12

S. aureus bacteremia or endocarditis

Question 13

If urine dip shows +ve leukocytes alone, what step should you take next?

Answer 13

Urine culture

Treat if severe Sx

Question 14

what culture result is diagnostic of UTI?

^exception to this rule?

Answer 14

Culture of single organisms >10^4 colony forming units/mL

Accept lower number if E.Coli or S. saprophyticus

Question 15

Urine microscopy - which cells, if you saw them, would be indicative of sample contamination

Answer 15

squamous epithelial cells

Question 16

Causes of sterile pyuria = WBCs presentand nothing on culture

Answer 16

Prior treatment with Abx = top cause

calculi
catheterisation
bladder ca
TB or STD (not grown in normal culture)

Question 17

Tx of pyelonephritis

Answer 17

Coamoxiclav

Question 18

Uncomplicated UTI in female - tx?

Answer 18

Cephalexin or nitrofurantoin

Question 19

UTI in man - Tx?

Answer 19

Cephalexin or ciprofloxacin

Question 20

Catheter associated UTI - tx?

Answer 20

Gentamicin or amikacin

Question 21

In whom would you consider a 7 day abx course for uncomplicated lower UTI ? list 3

Answer 21

1. Men
2. previous UTI with resistant organism
3. > 7 days of Sx

Question 22

Candida UTI - main cause?

Answer 22

Indwelling catheter

Question 23

Complications of pyelonephritis - state 4

Answer 23

Chronic pyelonephritis
Abscess
Acute papillary necrosis
Septic shock