UTI

Question 1

What is acute pyleonephritis?

Answer 1

UTI travelled to kidneys -> scarring and rreduction in function

Question 2

Symptoms of UTI in children

Answer 2

Fever may be only symptoms esp if young

Question 3

Babies symptoms with UTI

Answer 3

Non specific:
Fever
Lethargy
irritability
Vomitting
Poor feeding
Urinary frequency

Question 4

Signs and symptoms UTI in older infants and children

Answer 4

Fever
Abdominal pain particuarly suprapubic
Vomitting
Dysuria - painful urination
Urinary frequency
Incontinence

Question 5

Acute pylonephritis diagnosis by

Answer 5

Temperature greater than 38
Loin pain or tenderness

Question 6

Nitrites in urine suggest

Answer 6

Bacteria present - gram negative eg e coli break down nitrates to nitrites

Question 7

How does urine dip test for leukocytes

Answer 7

Leukocyte esterase - number

Question 8

What is best indication of infection on urine dip

Answer 8

Nitrites better than leukocytes

Question 9

When treat UTI with antibiotics from urine dip?

Answer 9

If nitrites alone or nitrites and leukocytes
Leukocytes alone dont treat unless also clinical evidence

Question 10

What do after + urine dipstick for UTI?

Answer 10

Midstream urine sample send for culture and sensitiivty

Question 11

What should all children with a fever under 3 months be started on?

Answer 11

IV antibitoics, often ceftriaxone
Full septic screen - blood cultures, blood and lactatte. Consider Lumbar puncture

Question 12

IV vs oral antibiotics in children

Answer 12

IV - any fever under 3 months. Sepsis or pyelonephritis
Oral - UTI but otherwise well

Question 13

Typial antibiotic choices UTI

Answer 13

• Trimethoprim
• Nitrofurantoin
• Cefalexin
• Amoxicillin

Question 14

What to investigate in recurrent UTIs

Answer 14

Underlying cause and kidney damage

Question 15

What children should have an US for UTI

Answer 15

Under 6 months with first UTI - abdo US in 6 weeks or during illness if recurrent or atyoical bacteria
Recurrent - abdo US in 6b weeks
Atypical UTI - during illness

Question 16

What is a DMSA scan?

Answer 16

Dimercaptosuccinic acid scan 0 inject DMSA (radioactive) into urinary tract and using gamma camera to assess how well material taken up by kidneys

Question 17

What is vesico-ureteric reflux?

Answer 17

Urine has tendency to flow back into ureters from bladder
Predisposes to UTIs and renal scarring

Question 18

How is vesico-ureteric reflex diagnosed?

Answer 18

Micurating cystourethrogram

Question 19

Management of vesico-uteric reflux

Answer 19

Avoid constipation
Avoid and excessively full bladder
Prophylactic antibitoics
Surgical input from paeds urology

Question 20

MCUG what used to investigate

Answer 20

Atypical or receurrent UTIs in children under 6 months
FH - vesico-ureteric reflux, dilatation of the ureter on US or poor urinary flow
Used to diagnose VUR
Have to cathetirise

Question 20

MCUG what used to investigate

Answer 20

Atypical or receurrent UTIs in children under 6 months
FH - vesico-ureteric reflux, dilatation of the ureter on US or poor urinary flow
Used to diagnose VUR

Question 21

What is given to children who are having an MCUG?

Answer 21

Prophylactic antibiotics for 3 days