Renal microbiology

Question 1

What is a UTI?

Answer 1

the presence of micro-organism in the urinary tract that are causing clinical infection

Question 2

What does a lower UTI mean?

Answer 2

Infection confined to the bladder (cystitis)

Question 3

What is a complicated UTI?

Answer 3

UTI coplicated by systemic sepsis or urinary structural or stones

Question 4

What is bateruria

Answer 4

Presence of bacteria in the urine

Question 5

Who is more prone to UTIs?

Answer 5

Females
Catheterized patients
Patients with anatomical abnormalities

Question 6

Examples of causal organism of UTI?

Answer 6

E. coli
Klebsiella
Enterobacter sp.

Question 7

Which is more sensitive to antibiotics Enterococcus faecalis ro enterococcus faecium?

Answer 7

Enterococcus faecalis

Question 8

What other renal conditions is poteus infection associated wiht?

Answer 8

Formation of stones

Question 9

What might clinically suggest the infective organism is proteus?

Answer 9

Foul smelling urine

Question 10

Why does proteus cause an increase in urinary pH?

Answer 10

Produces urease which breaks down urea

Question 11

Why organism usually affects women of child bearing age?

Answer 11

Staphylococcs saphrophyticus

Question 12

Which organism is associated with catheterised patients

Answer 12

Pseudomonas aeruginosa

Question 13

Which antibiotic is used to treat pseudomonas?

Answer 13

Ciprofloxacin

Question 14

Symptoms of lower UTI

Answer 14

Dysuria
Frequency
Haematuria

Question 15

Symptoms of upper UTI

Answer 15

Same as lower but with fever, loin pain, rigors

Question 16

What is the ideal urine sample for culture?

Answer 16

MSSU

Question 17

When does suprapubic aspiration tend to be used to get a urine sample?

Answer 17

Baies & young children

Question 18

Which organism does not give a positive result for nitrates on dipstick?

Answer 18

Enterococcus spp.

Question 19

usual findings of UTI on dipstick

Answer 19

Blood
Protein
Nitries
Leuckocyte osterase

Question 20

According to Kass’ criteria what does >10^5 organisms suggest

Answer 20

Probable UTI

Question 21

According to Kass’ criteria what does

Answer 21

Bacteruria

Question 22

What affect does ESBL have on bacteria?

Answer 22

Makes them resistant to all cephalosporins and almost al penicillins

Question 23

Which antibiotics can be useful against ESBL?

Answer 23

Nitrofuratoin (oral)
Temocillin (IV)
Meopenem (IV)

Question 24

First line in uncomplicated female lower UTI?

Answer 24

Trimethoprim (3 days)

Question 25

First line management in pyelonephritis

Answer 25

Send MSSU

Co-amoxiclav or co-trimoxazole (7 dyas)

Question 26

First line in uncatheterised male UTI

Answer 26

Send MSSU

trimethoprim or nitrofuratoin (7 days)

Question 27

Management of UTI or bacteruria in 1st/2nd trimester

Answer 27

Nitrofuratoin

Question 28

Management of UTI or bacteruria in 3rd trimester

Answer 28

Trimethoprim

Question 29

Second line for UTI in pregnancy (any trimester)

Answer 29

Cefalexin

Question 30

Management of recurrent UTI women

Answer 30

Trimethoprim or nitrofuratoin

Question 31

Why is trimethorpim avoided in 1st trimester?

Answer 31

Inhibits folic acid synthesis (spina bifida)

Question 32

Why is nitrofurtoin avoided in late pregnancy, breast feeding & children

Answer 32

Can cause neonatal haemolysis

Question 33

What is the mximum amount of time gentamicin should be prescribed for?

Answer 33

3 days

Question 34

Which antibiotic is associated with C/ diff infection?

Answer 34

Co-amoxiclav