Urinary Tract

Question 1

Organsims causing UTIs

Answer 1

E.coli
Enterococci
Proteus
Klebsiella
Pseudomonas

Question 2

Risk factors for UTI

Answer 2

FEMALE
Urinary catheter
Abnormalities of urinary tract
Kidney stones
Enlarged prostate
Diabetes

Question 3

Which organism is associated with catheter UTIs?

Answer 3

Pseudomonas aeruginosa 
(resistant to most oral antibiotics except Ciprofloxacin)

Question 4

In which patients should urinalysis not be used?

Answer 4

Elderly and catheterised (will almost always have bacteruria - only treat if symptomatic)

Question 5

Treatment and duration of uncomplicated UTI

Answer 5

Nitrofurantoin or Trimethoprim
3 days female
7 days male

Question 6

Treatment of complicated UTI/pyelonephritis/urosepsis

Answer 6

IV amoxicillin and gentamicin

Question 7

Which antibiotic should be avoided in 1st trimester?

Answer 7

Trimethoprim

Question 8

What antibiotic should be avoided in late pregnancy?

Answer 8

Nitrofurantoin

Question 9

What is the maximum duration of gentamicin use?

Answer 9

72 hours

Question 10

What are the side effects of gentamicin?

Answer 10

Renal toxicity and ototoxicity

Question 11

Which antibiotic can be used instead of gentamicin in patients with poor kidney function?

Answer 11

Aztreonam IV
(not as good as gentamicin - doesn't cover gram +ve or anaerobes)

Question 12

Characteristics of proteus UTI

Answer 12

foul smelling, burnt chocolate, causes stones as it produces urease which breaks down urea to form ammonia which increases urinary pH –> precipitation of struvite (triple phosphate) stones