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Nephrology > UT1 > Flashcards

UT1 Flashcards

1
Q

How does an infection reach the urinary tract?

A
  • Ascending route (most com)

- Haematogenous route.

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2
Q

most common bacterial infections acquired in the

community/hospitals

A

UTI

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3
Q

UTI is second most common cause of ___ in hospitalized patients

A

bacteremia

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4
Q

Who gets uncomplicated UTI?

A

Women with acute cystitis or acute pyelonephritis

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5
Q

Pregnant lady with UTI, which month determines if its complicated or not?

A

If she’s pregnant its COMPLICATED regardless of the month.

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6
Q

Biofilm formation can be formed by

A

S. epidermitis

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7
Q

Why are postmenopausal women prone to UTI?

A

high prevalence of cystocele

altered vaginal normal flora bc of estrogen lack

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8
Q

common organisms causing UTI

A

E. coli

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9
Q

Urinary tract normal flora

A

Gardnerella vaginalis

Alpha-hemolytic Streptococcus sp

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10
Q

When do we treat yeast?

A

If the patient is diabetic

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11
Q

most common UTI staph in hospital if the patient is on catheter

A

epidermitis

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12
Q

Most common UTI staph in the community if the

patient is a young sexually active female is

A

saprophyticus

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13
Q

Virulence factors of uropathogens

A

Adhesions
Enzymes
Toxins
Sidosphores

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14
Q

Sidosphores

A

iron acquisition

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15
Q

UPEC are different from other E. coli strains in

A

that it inhabits GI

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16
Q

Uropathogenic E. coli (UPEC) is characterized from other E.coli strains by

A

Biofilm formation

urothelial cell invasion a

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17
Q

What’s different if u can’t find pyuria ?

A

The diagnostic criteria changes

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18
Q

What specimens do we reject?

A

Leaking container
foley Cath. tip
bedpan urine
24-h urine (pooled urine)

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19
Q

+ abt suprapubic aspiration?

done for who?

A

Avoid contamination

pediatrics

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20
Q

Which urine collection method might introduce bacteria into the bladder ?

A

Single catheter

21
Q

Single catheter used for

A

patients with quadraplagia

22
Q

Most common urine collection method ?

A

midstream technique

23
Q

urine from midstream technique might be contaminated by ___

A

commensal bacteria from distal urethra.

24
Q

urine specimens must be CULTURED within ___

A

2 hrs unless refrigerated/preserved

25
Q

NON-CULTURE METHODS FOR THE LABORATORY DIAGNOSIS OF UTI

A

Microscopy

chemical

26
Q

What can be found in urine microscopy

A

Pus cells
RBC
Epithelial cells
Bacteria

27
Q

Gram staining + and -?

A

+: immediate infooo
-: insensitive (requires specific concentration)
and tooo much work

28
Q

conc. required for gram stain?

A

10^5

29
Q

PYURIA

A

the presence of at least 10
leukocytes/mm3 of un-centrifuged urine

or 5-10 if centrifuged

30
Q

When do UTI produce pyuria without bacteriuria?

A

TB
Chlamydia
Mycoplasma

31
Q

bacteria produce ____ reducing enzyme

A

nitrAte

32
Q

nitrite test is useless when

A

agent not a member of the family Enterobacteriaceae

33
Q

nitrite test is tested when?

A

FIRST thing in the morningg

34
Q

The main reason for esterase production?

A

neutrophils

35
Q

Routine cultures include

A

sheep blood agar (SBA) and MacConkey’s agar(MAC)

36
Q

Which culturing methods is used?

A

Semi-quantitative (Standard loop)

37
Q

Blood agar gives a ___ measurement of bacteriuria

A

quantitative

38
Q

MacConkey’s gives ____ of the bacteria

A

presumptive diagnosis

39
Q

What to do if you found significant bacteriuria? and what’s the count?

A

antibiotics, more than 10^5

40
Q

What to do if you found doubtful significance bacteriuria? the count?

A

another specimen, 10^4-10^5

41
Q

When to treat non-significant bacteria growth and what’s the limit?

A

<10^3

pregnancy and cystitis

42
Q

how does Proteus spp grow and where?

A

Swarming growth on blood agar

43
Q

E coli grows on ___ and is oxidase pos/neg

A

lactose fermenter, negativve

44
Q

pseudomonas is oxidase pos/neg

A

positive

45
Q

Staphylococcus Saprophyticus is ___ resistant

A

novobiacin

46
Q

False-negative results are due to

A

Recent antibiotic use

47
Q

In which of the following patients, is treatment for UTI considered unnecessary?
A- E.coli
B- pseudomonas
C- A. Hemolytic streptococci D- klebsilla

A

C- A. Hemolytic streptococci

48
Q

2- what is the most common cause of UTI in hospitalized patients ?
A- E.Coli
B- S.saprophyticus C- Pseudomonas D- S. Epidermitis

A

A- E.Coli

Nephrology (6 decks)

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