Urinary Tract infections (half lecture)

Question 1

What is the clinical triad for UTI?

Answer 1

dysuria, frequency, lack of vaginal symptoms. This triad means a >90% chance of UTI - NO further testing needed!! Treat right away.

Question 2

Male with a frequency, urgency, and dysuria comes in, also urinary hesitancy, post void dribbling. Further workup needed?

Answer 2

Yes! Always needed in males (rare, so something else might be going on)

-hesitancy / post void dribbling and incomplete void typical of prostate disease.

They would probably do a catheter + cystoscopy (need it for the hematuria)

Question 3

Diabetic Woman comes in with dysuria, urgency, and frequency. no vaginal symptoms. Urine culture shows Staph Aureus. Further workup needed?

Answer 3

YES!

staph aureus is a very unusual pathogen in the urine., and mandates further testing.

Check her heart (Staph might have seeded there - there are signs of mitral regurg in this case)

Question 4

Case: pt comes in with history of flank pain and urinary findings off and on for years. His urinalysis comes back with a urine pH of 7.5. Is this normal? What could cause it?

Answer 4

No, abnormal. A bacteria producing urease, which cleaves urea into
bicarb and ammonia, alkalizing the urine.