UTI 2020

Question 1

Urinary symptoms used to direct ordering UA and culture

Answer 1

Dysuria
Urinary frequency
Hematuria
Abdominal pain
Back pain
New daytime incontinence

Question 2

Criteria used for ruling in/out UTI in girls <24 months (UTI calc criteria)

Answer 2

Age <12 months
White race
Temp >39
Fever for >48 hours
No alternative source

Question 3

Nitrite test

Answer 3

Measures conversion of nitrate to nitrite by gram negative bacteria
Positive nitrites makes UTI very likely

Question 4

Leukocyte esterase test

Answer 4

Indirect measure of pyuria in UTIs

Question 5

Common bacteria causing UTIs

Answer 5

E coli
Klebsiella pneumoniae
Enterobacter
Citrobacter
Serratia
Stap saprophyticus

Question 6

How long should a febrile UTI be treated for?

Answer 6

7 to 10 days

Question 7

Initial PO choice of antibiotics for UTI

Answer 7

Cefixime

Alternative choices: amoxicillin, amox/calv, cephalexin, ciprofloxacin

Question 8

IV antibiotics commonly used for UTI

Answer 8

Gentamicin
With or without ampicillin
Can sometimes use cefotaxime or ceftriaxone

Question 9

Signs of a complicated UTI

Answer 9

Hemodynamically unstable
Elevated Cr
Bladder or abdominal mass
Poor urine flow
Not improving clinically within 24 hours
Fever not decreasing within 48 hours

Question 10

What imaging modality is used for children <2 with a first febrile UTI

Answer 10

Renal and bladder ultrasound

Question 11

What imaging modality is indicated for children < 2 with a second well documented UTI

Answer 11

VCUG

Optimal method for diagnosing VUR and assessing the degree of VUR and anatomy of male urethra