UTI

Question 1

21 yr women , symptoms started yesterday with no PMH of UTI
Sx - frequency, urgency, dysuria, mild suprapubic pain
Urine analysis positive for nitrites , leukocytes and blood

Answer 1

Don’t send a MSU for testing as pretty obvious

treatment drink fluids and analgesia, delayed antibiotics ( nitrofurantoin) as a safety net - might get better on self

Question 2

34yr women , symptoms 2 days ago , been practicing self care, seen 4 weeks ago with similar resolved without antibiotics
Sx
frequency - urgency , dysuria, mild suprapubic pain
Urinalysis - positive for leukocytes and blood

Answer 2

send MSU for MCS
treatment with nitrofurantoin 3/7 - review when culture and sensitivity return

consider interstitial cystitis if culture is negative

Question 3

23yr woman - 2 days of worsening symptoms of frequency , urgency , dysuria , flank plain and fever no history of UTI
urinalysis positive fro nitres , leukocytes , blood

Answer 3

Send MSU for MCS

consider whether hospital admission required - cefalexin proscribed 7/7 and request patient returns if no improvement in 24hr - review when results available

Question 4

81yr woman - routine type 2 check up
Symptoms - slight increase in urinary frequency, no other urinary symptoms and no confusion
Urinalysis - positive for nitres and leukocytes and glucose

Answer 4

dont send MSU for testing

treatment encourage self care and encourage fluid intake , safety net

Question 5

will mild cystitis normally clear up on its own?

and what self care advice can be given

Answer 5

yes
paracetamol or ibuprofen fro pain or fever, drink adequate fluids to avoid dehydration
cranberry products and alkalinising agents

Question 6

for men and women over the age of 65 with suspected lower UTI what shouldn’t you do

what do you do with children

Answer 6

perform urine dipsticks - half of adults will have bacteria present in urine without infection

children under 3 months of age should seen paediatric specialist and under 16 immediate antibiotics - trimethoprim

nitrofuratoin

Question 7

what is prostatitis

Answer 7

bacterial infection of the prostate which needs treatment with antibiotics - if needed ciprofloxacin

Question 8

chronic pelvic pain syndrome CPPS Sx

Answer 8

3 months of pain in the perineum or pelvic floor, often associated with lower UTI and sexual dysfunction

Question 9

what is pyelonephritis and what do you do to treat it

Answer 9

infection of one or both kidneys usually caused by bacteria travelling up from the bladder.
support wth drink lots and pain killers - prescribe cefalexin

Question 10

symptoms of UTI

Answer 10

pain or a burning sensation when peeing (dysuria)
needing to pee more often than usual during the night (nocturia)
pee that looks cloudy - case
needing to pee suddenly or more urgently than usual
needing to pee more often than usual
blood in your pee
lower tummy pain or pain in your back, just under the ribs - case
a high temperature, or feeling hot and shivery
a very low temperature below 36C

urethra - burning and discharge whereas as bladder blood in urien and low abdomen discomfort