urinary

Question 1

what does UTIs usually lead to

Answer 1

cystitis ( inflammation of bladder )

pylonephritits ( inflammation of kidneys )

Question 2

upper urinary tract incudes

Answer 2

renal & ureters

Question 3

lower urinary tract

Answer 3

bladder
urethra
prostate
cervix

Question 4

symtoms of UTI

Answer 4

under 2 - failure to thrive, vomiting, lethargy, fever

children - dysturia, frequency and abdominal or flank pain

adults- dysuria, frequency, urgency, suprapubic pain and hematuria

Question 5

what can cause UTIs and may need special cultures

Answer 5

herpes simplex virus
chlamydia tachomatis
neisseria gonorrhea

Question 6

what causes most uncomplicated UTIs

Answer 6

Escherichia coli

Question 7

causes of UTIs
- hospitalization and catheterization

Answer 7

pseudomonas
proteus
klebsiella
acintobacter
enterobacter

Question 8

causes of UTIs
- gram pos cocci

Answer 8

group B strep ( important in pregnancy bc can cause meningitis in infant if passed on to baby )

enterococci

staph saprophyticus

staph epidermidis

Question 9

what is the second most common UTI in sexually active women of child bearing age

Answer 9

staphylococcus saprophyticus

Question 10

causes of UTIs
gram postive bacilli

Answer 10

bacillus spp
diphtheroids
listeria monocytogenes
gardnerella

Question 11

causes of UTIs
fungi

Answer 11

candida spp

Question 12

what is the most important consideration when collecting a clinically relevant urine specimen

Answer 12

prevention of contamination

Question 13

voided mid stream

Answer 13

discard initial voided urine to remove contaminants

Question 14

catheterization

Answer 14

clean urethral opening with soap solution
initial flow discarded to prevent contamination

indwelling catheter
- clean with alcohol swab and puncture with a needle & syringe

Question 15

what is the definitive method to prevent contamination

Answer 15

suprapubic aspiration
- very invasive

Question 16

urine volume

Answer 16

10-20 mL

Question 17

what sample is unsatisfactory for culture workup

Answer 17

24 hr collection

Question 18

what specimen is best and how long must urine incubate in bladder

Answer 18

first morning best
if not incubate in bladder for minimum of 4 hrs

Question 19

sodium borate preservative

Answer 19

good for 48 hrs at RT

wbcs may not be preserved

Question 20

how long can an unpreserved urine be left at RT

Answer 20

2 hrs

Question 21

rejection criteria for urines

Answer 21

inadequate or inappropriate collection and transport

24 urines or foley catheters for cultures

Question 22

routine urine culturing

Answer 22

1 non selective and one selective plate
- BA & MAC
calibrated loop ( 1-10 ul) for quantitation
incubate for 24hrs

Question 23

when do you not do a workup from culture plates

Answer 23

3 or more uropathogens are likely contamination especially in low numbers