UTI

Question 1

Risks for UTI

Answer 1

Female 
Atrophic vaginitis 
Sexually active 
Using diaphragms 
Vseicourethral reflux 
History of UTI 
Posterior urethral valves

Question 2

Most common causes of UTI (microbiology)

Answer 2

Ecoli

Klebsiella
Enterobacter
Proteus mirabilis
Staphylococcus saprophyticos

(KEEPS)

Question 3

What makes a UTI complicated

Answer 3

Male
Pregnancy
Recent catheter or instrumentation 
Anatomical abnormailities 
Chronic Renal disease 
Immunosuppressed
DM

Question 4

How to diagnose a UTI

Answer 4

Can do it on history
Dysuria, urgency, frequency with no Vaginal symptoms =70-80%

If vaginal symptoms decreases to 25%

If flank pain, abdo pain, Nausea vomiting, fever or chills then pyelo

Question 5

When is the only time we care about asymptomatic bacteriuria

Answer 5

Pregnancy

Question 6

When should we send for culture

Answer 6

If unclear on the diagnosis, pyelo peds, or recurrent UTI

Question 7

List five ways to empirically treat uncomplicated UTI

Answer 7

Septra x 3 days 
Nitrofurantoin x 5 days 
Amox-clav x 7 days 
Cefixime x 5 days 
Fosfomycin (Less effective)

Question 8

List five ways to treat complicated UTI

Answer 8

Fluroquinolones (Ciprofloxacin, levofloxacin) 
TMP SMX 
2rd gen cephalosporins 
Ertapenem
Meropenem
Pip-Taz

Can’t use nitrofurantoin in pyelonephritis because not baceriocidal

Question 9

How to treat in children

Answer 9

TMP SMX
Cephalexin x 10 days

Amox
Amox-clav

Question 10

How to get a urine in children

Answer 10

Catheter
Bag
Bladder tapping to get them to pee and catch mid stream

Question 11

What children need imaging

Answer 11

<2 with a fever
Recurrent
Complicated

Get Renal Bladder Ultrasound
If abnormal go to voiding cystourethrogram

Question 12

When to admit to hospital

Answer 12

Impacted stone 
Renal failure 
Retention 
Sepsis
Pyelo*

Question 13

How to treat recurrent UTI

Answer 13

Get a culture 
Drink more fluids 
Give self treatment doses 
TMP SMX post coital or 3 x per week 
Macrobid postcoital