Urinary Tract Infection

Question 1

In children <1 years old, are UTI more common in boys or girls?

Answer 1

• boys

Question 2

In children of school age, are UTIs more common in boys or girls?

Answer 2

• girls

Question 3

Which of the following is the most common risk factor for developing UTIs in children?

1 - STI
2 - previous UTI
3 - congenital abnormalities
4 - poor hygiene
5 - diabetes

Answer 3

3 - congenital abnormalities

Changes in the flow or urine, such as obstruction, stones etc can all increase risk of UTI

Question 4

Does constipation contribute to the risk of UTI?

Answer 4

• yes

Can cause obstruction in urethra and causing urine stasis and increase risk of UTI

Question 5

UTI are typically caused by the bugs from the GIT, transmitted from anus to urethra. All of the following organisms can cause a UTI, but which is most common?

1 - E. coli
2 - Klebsiella
3 - Citrobacter species
4 - P. mirabilis

Answer 5

1 - E. coli

Accounts for 70% of cases.

Question 6

A lower UTI is an infection of the bladder, called what?

1 - pyelonephritis
2 - orchitis
3 - epididymitis
4 - cystitis

Answer 6

4 - cystitis

Question 7

An upper UTI is an infection of the ureters and kidney, called what?

1 - pyelonephritis
2 - orchitis
3 - epididymitis
4 - cystitis

Answer 7

1 - pyelonephritis

Question 8

A UTI can be either complicated or un-complicated. Which 2 of the following would be included under the definition of a complicated UTI?

1 - >6 months in duration
2 - UTI with anatomical or functional abnormality
3 - UTI in patient with reduced immunity e.g. diabetes, chemotherapy, immunosuppression
4 - >2 UTIs in 6 months

Answer 8

2 - UTI with anatomical or functional abnormality
3 - UTI in patient with reduced immunity e.g. diabetes, chemotherapy, immunosuppression

Essentially, immunocoprimsied people have increased susceptibility to infection

Question 9

All of the following are common risk factors for UTIs, EXCEPT which one?

1 - dysuria
2 - polyuria
3 - foul smelling
4 - increased bed wetting
5 - bowel obstruction
6 - darker and cloudy urine
7 - fever
8 - loin to groin and abdo pain
9 - haematuria
10 - reduced fluid intake

Answer 9

5 - bowel obstruction

Question 10

Which of the following is the definition of bacteriuria?

1 - WBC in urine
2 - sepsis due to UTI
3 - bacteria in the blood
4 - bacteria in the urine

Answer 10

4 - bacteria in the urine

Question 11

Which of the following is the definition of pyuria?

1 - WBC in urine
2 - sepsis due to UTI
3 - bacteria in the blood
4 - bacteria in the urine

Answer 11

1 - WBC in urine

Question 12

Which of the following would match the definition of an isolated UTI?

1 - >6 months in duration
2 - UTI with anatomical or functional abnormality
3 - 6 months between infections
4 - >2 UTIs in 6 months

Answer 12

3 - 6 months between infections

Question 13

Which of the following would match the definition of an recurrent UTI?

1 - >6 months in duration
2 - UTI with anatomical or functional abnormality
3 - 6 months between infections
4 - >2 UTIs in 6 months or 3 in 12 months

Answer 13

4 - >2 UTIs in 6 months or 3 in 12 months

Question 14

Which of the following would match the definition of an persistent UTI?

1 - recurrence with the same organisms after treatment
2 - UTI with anatomical or functional abnormality
3 - 6 months between infections
4 - >2 UTIs in 6 months or 3 in 12 months

Answer 14

1 - recurrence with the same organisms after treatment

Question 15

All of the following are symptoms of a UTI, EXCEPT which one?

1 - storage symptoms
2 - voiding symptoms (urine stream issues)
3 - haematuria
4 - dysuria and pain
5 - dyspareunia

Answer 15

5 - dyspareunia
- this is pain during sex

Question 16

In a patient with suspected UTI, which of the following would we expect to be raised?

1 - blood levels
2 - pH
3 - nitrites
4 - protein
5 - leukocytes
6 - glucose
7 - all of the above

Answer 16

7 - all of the above

Question 17

In a patient with a UTI, we may image to rule out renal calculi or transitional cell cancer. What imaging would be 1st choice in this instance?

1 - CT
2 - ultrasound
3 - MRI
4 - X-ray

Answer 17

2 - ultrasound

Question 18

In a patient with a UTI, we may consider giving the patient antibiotics. What other advice should patients with a UTI be given?

1 - high fluid intake
2 - cranberry juice
3 - bladder emptying
4 - avoid bubblebaths
5 - probiotics
6 - all of the above

Answer 18

6 - all of the above
- these can be done by patients to reduce the risk of UTIs

Question 19

The location and type of UTI a patient has affects the antibiotics they are given. Which of the following would typically be 1st line in a patient with a lower urinary tract infection?

1 - Nitrofurantoin
2 - Gentamicin
3 - Ceftriaxone
4 - Cefalexin

Answer 19

1 - Nitrofurantoin
Or trimethoprim

Treatment may need need to be adjusted based on the urine culture.

Question 20

The location and type of UTI a patient has affects the antibiotics they are given. Which of the following would typically be 1st line in a patient with urosepsis?

1 - Nitrofurantoin
2 - Gentamicin
3 - Ceftriaxone
4 - Cefalexin

Answer 20

2 - Gentamicin
- this is an aminoglycaside

Treatment may need need to be adjusted based on the urine culture.

Question 21

In Infants and children who have bacteriuria and fever >38°C, is this more likely to be cystitis or pyelonephritis?

Answer 21

• pyelonephritis

Question 22

In infants and children presenting with fever <38°C with loin pain/tenderness and bacteriuria, is this more likely to be cystitis or pyelonephritis?

Answer 22

• pyelonephritis

Question 23

According to NICE, which of the following is NOT a characteristic of atypical UTI?

1 - Poor urine flow
2 - Abdominal or bladder mass
3 - Raised creatinine
4 - Septicaemia
5 - Failure to respond to treatment with suitable antibiotics within 48hours
6 - Infection with E. coliorganisms

Answer 23

6 - Infection with E. coliorganisms

Typically an infection with non-E. coliorganisms

If UTI is atypical need to admit if they get worse

Question 24

If a urine sample cannot be collected and you suspect a UTI, should treatment be delayed?

Answer 24

• no

Mid stream = gold standard

If mid-stream is not possible, use urine collection pads

Question 25

Children under what age should be referred to a paediatric specialist if a UTI is suspected?

1 - <16
2 - <10
3 - <3 months
4 - <12 months

Answer 25

3 - <3 months

Question 26

The location and type of UTI a patient has affects the antibiotics they are given. Which of the following would typically be 1st line in a patient with acute pyelonephritis or prostatitis?

1 - Nitrofurantoin
2 - Gentamicin
3 - Ceftriaxone
4 - Cefalexin

Answer 26

4 - Cephalexin
- this is a Cephalosporins

OR cefuroxime/ceftriaxone or IV gentamicin

Treatment may need need to be adjusted based on the urine culture.

Question 27

If a patient has a catheter in and they have developed bacteriuria, but they are asymptomatic, should they be prescribed antibiotics?

Answer 27

• no
• should only be prescribed if symptoms of infection or if there is a catheter associated UTI

Question 28

If a patient has developed a urinary catheter infection, which antibiotic is 1st line?

1 - Nitrofurantoin
2 - Gentamicin
3 - Ceftriaxone
4 - Cefalexin

Answer 28

2 - Gentamicin
- should be given 30-60 minutes before removing the catheter

Treatment may need need to be adjusted based on the urine culture.