Urinary Tract infection

Question 1

What are the three types of lower urinary tract infections

Answer 1

cystitis (bladder), urethritis, prostatitis

Question 2

What is the main upper urinary tract infection

Answer 2

pyelonephritis

Question 3

T/F: Most urinary tract infections are lower urinary tract and they are not systemic compared to upper urinary tract infections

Answer 3

True

Question 4

What is the difference between complicated and uncomplicated urinary

Answer 4

Uncomplicated UTIs are defined as women who have a UTI at the childbearing age of 15-45 years old

Question 5

What is asymmtomatic bacteriuria, symptomatic abacteriurua

Answer 5

No symptoms and no bacteria in the urine, symptoms are present but no bacteria in the urine

Question 6

What varies prevelance of UTIs

Answer 6

Gender, age and co-morbidities

Question 7

What organism usually causes uncomplicated UTIs, what other organisms cause uncomplicated UTIs

Answer 7

E. coli, Staphylococcus saprophyticus, enterococcus faecalis, Klebsiella, Proteus, Pseudomonas

Question 8

What organism usually causes complicated UTIs, other organisms

Answer 8

E. coli, Klebsiella, Enterobacter, staphylococci

Question 9

What are organisms that may be in the urine but usually do not cause UTIs, why are they in the urine

Answer 9

Staph epidermidis: contaminates the test, S. aureus: usually a systemic infection, Candida species: common in critically ill and chronically catheterized patients

Question 10

T/F: A majority of UTIs are caused by many organisms

Answer 10

False: Majority of UTIs are caused by a single organism

Question 11

What are the host defense against UTI

Answer 11

urine,bacteria in the bladder stimulates urination, antiadherance mechanism to prevent bacterial attachment to the bladder

Question 12

What are predisposing factors for UTIs

Answer 12

Obstruction, nueurological malfucntions not allowing uriniation, urine is forced up the ureter to the kidney, catheters, pregnancy

Question 13

What are signs and symptoms of lower tract UTIs

Answer 13

Dysuria, urgency and frequency, discomfort in genital area

Question 14

What are signs and symptoms of upper tract UTIs

Answer 14

Abdominal pain, fever, rigors, nausea and vomiting, malise

Question 15

What is a symptom of UTIs that is usually only seen in the elderly

Answer 15

Mental status changes

Question 16

What are the diagnostic tests done to see if a UTI is present

Answer 16

Urinalysis and Urine Culture

Question 17

List the methods of urine collection from least invasive to most invasive

Answer 17

Midsteam clean-catch, catheterization, suprapubic bladder aspiration

Question 18

What is being monitored for in a urinalysis

Answer 18

Bacteria and WBCs

Question 19

T/F: WBCs found in the urine automatically mean there is a UTI

Answer 19

False: UTIs can mean there is an infection but not necessarily a UTI

Question 20

T/F: Urine culture is used to find a bacteria and grow it to find susceptibility

Answer 20

True

Question 21

What is a non-specific therapy for UTIs

Answer 21

Cranberry juice

Question 22

What is the most common type of UTI

Answer 22

acute uncomplicated cystitis

Question 23

What is the first line antibiotic treatment for a UTI, second line

Answer 23

Nitrofurantoin 100 mg by mouth BID for 5 days, Bactrim 160/800 by mouth BID for 3 days

Question 24

What are two reasons that a patient may have symptomatic abacteriuria

Answer 24

small numbers of E. coli or other coliforms, patient may have chlamydia

Question 25

What short course therapy would be given to someone if they have symptomatic abacteriuria

Answer 25

Nitrofurantoin 100 mg by mouth BID for 5 days OR Bactrim 160/800 BID for 3 days

Question 26

What should be done if symptomatic abacteriuria does not resolve when given UTIs antibiotics

Answer 26

Suspect chlamydia and give either Doxycycline 100 mg BID for 7 days or Azithromycin 1 gram by mouth once

Question 27

T/F: If any patient has asymptomatic Bacteriuria they will not be treated with antibiotics

Answer 27

False: Most patients with asymptomatic Bacteriuria will not be treated with antibiotics. The patients that will be are Children, pregnant women and patients who will get a catheter

Question 28

If a patient has acute pyelonephritis with MILD to MODERATE symptoms what antibiotics should be given for how long

Answer 28

Bactrim 160/800 BID for 14 days or Ciprofloxacin/Levofloxacin for 14 days

Question 29

If a patient has acute pyelonephritis with MILD to MODERATE symptoms what antibiotics should be given if it is identified as enterococci

Answer 29

Ampicillin or Amoxicillin for 14 days

Question 30

If someone has acute pyelonephritis with SERIOUS symptoms in the ICU what antibiotics should be taken

Answer 30

Aminoglycosides with beta-lactam OR quinolone +/- beta-lactam

Question 31

When effective therapy for acute pyelonephritis is used when should the patient be stabilized,reduction in urine colony, continue parenteral therapy until what

Answer 31

12-24 hours, 48 hours, patient is afebrile 24 to 48 hours

Question 32

When should follow up cultures be obtained for acute pyelonephritis

Answer 32

2 weeks

Question 33

T/F: UTIs in males are always considered complicated and should be for 14 days

Answer 33

True

Question 34

What is the difference between relapse and reinfection

Answer 34

Relapse: same bug, reinfection: different dug

Question 35

How long should treatment be if the patient has a relapse after 2 weeks of therapy

Answer 35

Treat for another 2-4 and if there is a relapse after 6 weeks treat for 6 months or longer

Question 36

If a patient is pregnant with significant bacteriuria what antibiotic regimens can be given

Answer 36

Cephalexin 500 mg QID for 7 days OR Amoxicillin 250 mg TID for 7 days

Question 37

If a patient has a cathetheter when should they be treated, how and how long

Answer 37

ONLY treat those who are SYMPTOMATIC, Bactrim 14 days or Cirproloxacin/Levofloxacin for 14 days

Question 38

What is acute prostatitis, chronic prostatitis

Answer 38

Inflammation of the prostate with severe illness with fever and urinary and constitutional symptoms, relapse but not as serious

Question 39

What are the organisms that cause prostatitis

Answer 39

E. coli, klebisella, proteus, pseudomonas, and enterobacter

Question 40

What are the antibiotics for acute prostatitis treatment

Answer 40

Aminoglycoside (Gentamicin, Tobramycin or Amikacin) PLUS a beta lactam (Pip-Taz, Aztreonam or generation 3 cephalosporin)

Question 41

T/F: Acute prostatitis should always start parenterally and then be transitioned to PO after 10 days and duration should be 4-6 weeks including the time of IV

Answer 41

False:Acute prostatitis should always start parenterally and then be transitionted to PO after 5-7 days and duration should be 4-6 weeks NOT including the time the patient was given antibiotics IV

Question 42

If treating for chronic bacterial prostatitis what antibiotics should be given and for how long

Answer 42

Cirpofloxacin 500 mg every 12 hours OR Levofloxacin 500 mg every daily or Bactrim 180/600 mg BID, AT LEAST 6 weeks