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Surg Spec (Urology) > Urinary Tract Infections > Flashcards

Urinary Tract Infections Flashcards

1
Q

What are two examples of factors which make a UTI ‘complicated’?

A

Systemic symptoms or a renal tract structural abnormality

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2
Q

What are some risk factors for the development of a UTI?

A

Diabetes, catheterisation, sexual activity/pregnancy in women

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3
Q

What organism is the most common cause of a UTI?

A

E. coli

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4
Q

Which organism causing UTI produces a ‘burnt chocolate’ smell on culture, and shows a ‘swarming’ pattern?

A

Proteus spp.

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5
Q

Which organism causing UTI can result in the formation of struvite (triple phosphate) stones?

A

Proteus spp.

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6
Q

S. saprophyticus is an organism which can cause UTI- it is most common in who?

A

Women of child-bearing age

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7
Q

Symptoms of dysuria, haematuria, frequency/urgency and suprapubic pain are characteristic of which UTI?

A

Acute cystitis

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8
Q

Other than the characteristic features of cystitis, what are some additional features of acute pyelonephritis?

A

Fever/rigors, nausea/vomiting, loin pain

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9
Q

What are some presenting symptoms of prostatitis?

A

Flu-like symptoms, lower backache, haematospermia

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10
Q

A swollen/tender/boggy prostate on examination suggests what possible diagnosis?

A

Acute prostatitis

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11
Q

If an MSSU cannot be taken for any reason, what are some other methods of obtaining an uncontaminated urine sample for microscopy, culture and sensitivity?

A

Suprapubic aspiration or straight catheter

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12
Q

Which two elements of urinalysis testing are most specific for a UTI?

A

Nitrites and leukocytes

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13
Q

What investigation is used as a first line investigation for UTI in hospital, or to confirm a diagnosis suspected on urinalysis in primary care?

A

Urine cultures

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14
Q

What investigation should be performed on every uncatheterised male who presents with a UTI?

A

Urine cultures

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15
Q

If patients with a UTI are systemically unwell, what blood tests should be taken?

A

FBC, U&E, CRP, blood cultures

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16
Q

What is the first line investigation if imaging is necessary for someone with a UTI?

A

Renal ultrasound

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17
Q

If nothing is detected on renal ultrasound, what is the second line imaging test for UTI?

A

Cystoscopy

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18
Q

Which antibiotic commonly used to treat UTIs must be avoided in the first trimester of pregnancy?

A

Trimethoprim

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19
Q

Which antibiotic commonly used to treat UTIs must be avoided in late pregnancy, breastfeeding and children aged < 3 months?

A

Nitrofurantoin

20
Q

What is the risk of using nitrofurantoin in late pregnancy, breastfeeding and children aged < 3 months?

A

Neonatal haemolysis

21
Q

Which antibiotic commonly used to treat UTIs comes with a risk of severe pulmonary reactions and should be avoided in those with pre-existing interstitial lung disease?

A

Nitrofurantoin

22
Q

If a patient has an eGFR < 20ml/min, what antibiotic should be used instead of gentamicin?

A

Aztreonam

23
Q

What lifestyle advice should be given to all patients with a UTI?

A

Drink lots of fluids and urinate often

24
Q

What is meant by the term abacterial cystitis?

A

The patient has symptoms of a UTI but no significant growth on culture

25
Q

Symptomatic relief is the treatment advised for abacterial cystitis or urethral syndrome. What can be used to alkalinise the urine for this purpose?

A

Potassium citrate

26
Q

What is meant by the term asymptomatic bacteriuria?

A

The patient has bacteria in the urine but remains asymptomatic

27
Q

When is antibiotic treatment required for asymptomatic bacteriuria and why?

A

In pregnant women- if untreated, this risks progressing to pyelonephritis or causing IUGR/premature delivery

28
Q

How should pregnant women with asymptomatic bacteriuria be treated?

A

Antibiotics for 7 days and a test of cure

29
Q

What is the antibiotic of choice for the treatment of asymptomatic bacteriuria or UTI in the first two trimesters of pregnancy?

A

Nitrofurantoin

30
Q

What is the antibiotic of choice for the treatment of asymptomatic bacteriuria or UTI in the third trimester of pregnancy?

A

Trimethoprim

31
Q

What is the first line antibiotic treatment for an uncomplicated lower UTI?

A

PO nitrofurantoin (100mg bd)

32
Q

What is the second line antibiotic treatment for an uncomplicated lower UTI?

A

PO trimethoprim (200mg bd)

33
Q

How long should antibiotic treatment be given for a lower UTI in men and women?

A

7 days for men, 3 days for women

34
Q

What is the antibiotic treatment required for a complicated UTI or pyelonephritis in primary care?

A

PO co-amoxiclav or co-trimoxazole for 7 days

35
Q

What is the empirical antibiotic therapy for a complicated UTI or pyelonephritis in secondary care?

A

IV amoxicillin and gentamicin

36
Q

When treating a complicated UTI or pyelonephritis, how long should antibiotics be given for (PO/IV)?

A

7 days

37
Q

If a patient is penicillin allergic, what should amoxicillin be substituted for in the empirical treatment of pyelonephritis?

A

Co-trimoxazole

38
Q

If there is a definite UTI in a catheterised patient, how should they be treated?

A

As for a complicated UTI

39
Q

What is the advice regarding removing the catheter in catheterised patients who have a UTI?

A

It should be removed and replaced within 24-72 hours of starting antibiotics

40
Q

How is prostatitis treated?

A

28-day course of ofloxacin or ciprofloxacin

41
Q

UTIs with extended spectrum beta lactamase producing bacteria can only be treated with what?

A

IV meropenem

42
Q

What is the definition of a recurrent UTI?

A

2 or more in 6 months, 3 or more in a year

43
Q

Which antibiotics can be given as prophylaxis for recurrent UTIs?

A

Methanamine, trimethoprim or nitrofurantoin

44
Q

Use of prophylactic antibiotics for recurrent UTI should be stopped after how long?

A

6 months

45
Q

In post-menopausal women with recurrent UTIs, what treatment (other than antibiotics) can be considered?

A

Oestrogen pessary or cream

46
Q

In individuals who are immunosuppressed and have sterile pyuria, you should have a high index of suspicion for what diagnosis?

A

Tuberculous pyelonephritis

Surg Spec (Urology) (8 decks)

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