UTI

Question 1

UTI

Answer 1

Bacteriuria: bacteria in urine, symptomatic or asympto

UTI: symptomatic with +ve culture or dipstick

Question 2

Classification of UTI

Answer 2

Uncomplicated:

• Normal GU tract and function.
• Normal causative organism

Complicated:

• abnormal GU tract
• outflow obstruction
• ↓renal function
• impaired host defence
• virulent organism

Recurrent: further infection with new organism

Relapse: further infection with same organism

Question 3

Pyelonephritis presentation

Answer 3

Fever, rigors
Loin pain and tenderness
Vomiting
Oliguria if acute renal failure

Question 4

Cystitis presentation

Answer 4

Frequency and urgency
Polyuria
Haematuria
Dysuria
Suprapubic tenderness
Foul smelling urine

Question 5

Prostatitis presentation

Answer 5

Flu-like symptoms
Low backache
Dysuria
Tender swollen prostate on PR

Question 6

Risk factors

Answer 6

Female
Pregnancy
Menopause
DM
Abnormal tract: stone, obstruction, catheter,
malformation

Question 7

Common organism

Answer 7

Most common: E.coli

Question 8

Common UTI presentation

Answer 8

Burning sensation - dysuria
Frequency and urgency
Polyuria
Haematuria
Suprapubic tenderness

Question 9

Ix

Answer 9

Dipstick
Mid stream sample or MCS
Bloods: FBC, U+E, blood cultures (if systemic signs)
USS: children, men, recurrence, pyelonephritis

Question 10

General Mx

Answer 10

Drink plenty of fluid
Urinate often
Wipe front to back

Cystitis
 Rx for 3-6d
 Trimethoprim 200mg BD
 Nitrofurantoin 50mg QDS (not in RF)
 Cefalexin 500mg BD (good in RF)
 Co-amoxiclav 625mg TDS
Pyelonephritis
 Cefotaxime 1g IV BD for 10d
 No response: Augmentin 1.2g IV TDS + gentamicin

Question 11

Mx of uncomplicated UTI

Answer 11

Trimethoprim

or Nitrofurantoin for 3 days

Question 12

Mx of complicated UTI

Answer 12

Trimethoprim

or Nitrofurantoin for 5 days

Question 13

Pyelonephritis Mx

Answer 13

Cefotaxime