UTI

Question 1

Defense mechanisms against urinary tract infection

Answer 1

Flushing of urine
Physical barrier
Acidic pH
Antimicrobial substances
Desquamation

Question 2

Sterile parts of urinary tract

Answer 2

Kidneys, ureters, and bladder

Question 3

Normal flora of urethra

Answer 3

S epidermidis
Enterococci
Diphtheroids
Coliforms
Candida

Question 4

Groups at risk for asymptomatic UTI

Answer 4

Elderly
Pregnant
Children

Question 5

What causes a complicated UTI?

Answer 5

Structural, functional, and/or metabolic abnormalities

Question 6

Viruses that may cause UTI

Answer 6

Adenovirus
BK polyoma
CMV

Question 7

Fungi that may cause UTI

Answer 7

Candida
Histoplasma capsulatum –> descending

Question 8

Parasite that may cause UTI

Answer 8

Schistosoma hematobium

Question 9

Motile, gram negative bacilli that ferments lactose.

Answer 9

E coli

Question 10

Virulence factor of E coli that contributes to development o sepsis

Answer 10

Endotoxin –> Lipid A of lipopolysaccharide (LPS)

Question 11

Highly motile, flagellated, gram negative, pleomorphic bacilli. Grows in confluent films and does not ferment lactose. Positive for urease.

Answer 11

Proteus mirabilis

Question 12

Virulence factor that mediates sepsis in Proteus UTI

Answer 12

Endotoxin (LPS)

Question 13

Gram negative, motile, oxidase positive bacilli that does not ferment lactose. Produces pyocyanin and pyoverdin pigments.

Answer 13

Pseudomonas aeruginosa

Question 14

UTI causing bacteria that can form biofilms in catheters. It does not ferment lactose.

Answer 14

Pseudomonas aeruginosa

Question 15

Virulence factor of pseudomonas aeruginosa that inhibits protein synthesis by interfering with EF-2

Answer 15

Exotoxin-A

Question 16

Gram positive, catalase negative, PYR positive, spherical or oval cocci in pairs at acute angles. Non-hemolytic, resistant to bile salts, and hydrolyzes esculin. Resistant to NaCl and high temp.

Answer 16

Enterococcus fecalis and fecium

Question 17

What antibiotics work for antibiotic resistant enterococcus species?

Answer 17

Oxacillin
Cephalosporin

Question 18

Gram positive, catalase positive, coagulase negative cocci in clusters. Resistant to novobiocin.

Answer 18

Staph saprophyticus

Question 19

Endemic areas for Schistosoma

Answer 19

Africa
Middle East
Japan

Question 20

Infective form of Schistosoma

Answer 20

Cercaria –> larval form that penetrates skin

Question 21

Intermediate host of Schistosoma

Answer 21

Snail

Question 22

Cytokines that respond to Th2 to induce production of IgE and eosinophils in response to helminth infection

Answer 22

IL-4
IL-5
IL-13
IL-10

Question 23

Risk with chronic cases of Schistosomiasis

Answer 23

SCC of bladder

Question 24

Cytokines responsible for granuloma formation and intense fibrosis in Schistosomiasis

Answer 24

IL-4 and IL-13

Question 25

icosahedral, naked, dsDNA virus with penton fibers. Rare cause of UTI associated with hemorrhagic cystitis.

Answer 25

Adenovirus

Question 26

Cut of pathologic pyuria

Answer 26

> 5 PMNs/hpf

Question 27

What is suggested by UTI symptoms with sterile pyuria and negative culture?

Answer 27

Chlamydial or mycobacterium infection
Collected after start of antibiotics

Question 28

What is indicated by positive nitrites on UA?

Answer 28

Infection with gram negative organism

Question 29

What is the cut of for significant bactiuria?

Answer 29

> /= 10^5 CFU/mil of single pathogen

Question 30

When does asymptomatic, but significant, bacteriuria require treatment?

Answer 30

Pregnancy

Question 31

Treatments for uncomplicated cystitis

Answer 31

Nitrofurantoin
Trimethoprim-sulfamethoxazole
Fosfomycin
Pivmecillinam
Augmentin –> enterococci

Question 32

Treatments for complicated UTI (pyelonephritis)

Answer 32

Fluoroquinolone (levofloxacin or ciprofloxacin)
IV Ceftriaxone
Trimethoprim-sulfamethoxazole

Question 33

Specific treatment required for perinephric abscess with UTI

Answer 33

Surgical drainage