UTI

Question 1

T/F During the 1st year of life, UTI occurs more in boys than in girls

Answer 1

T

Question 2

T/F UTIs are much more common in uncircumcised boys

Answer 2

T

Question 3

In girls, the first UTI usually occurs by the age of

Answer 3

5

Question 4

UTI in female children peak when

Answer 4

Infancy and toilet training

Question 5

T/F UTIs are caused primarily by colonic bacteria

Answer 5

T

Question 6

In girls, 75-90% of all infections are caused by

Answer 6

Escherichia coli, followed by Klebsiella spp. and Proteus spp

Question 7

MC organism causing UTI in males

Answer 7

E. coli

Question 8

MC cause of UTI in boys older than 1 yr

Answer 8

Proteus=E.coli

Question 9

Organism: Cystitis+hematuria

Answer 9

Adenocirus and other viral infections

Question 10

Nephronia is

Answer 10

Focal pyelonephritis

Question 11

T/F: Fever may be the only manifestation of clinical pyelonephritis

Answer 11

T

Question 12

Most common serious bacterial infection in infants younger than 24 mo of age who have fever without an obvious focus

Answer 12

Clinical pyelonephritis

Question 13

A renal mass caused by acute focal infection without liquefaction

Answer 13

Acute lobar nephronia

Question 14

A rare type of renal infection characterized by granulomatous inflammation with giant cells and foamy histiocytes

Answer 14

Xanthogranulomatous pyelonephritis

Question 15

Management for Xanthogranulomatous pyelonephritis

Answer 15

Partial or total nephrectomy

Question 16

T/F Cystitis does not cause fever

Answer 16

T

Question 17

Acute hemorrhagic cystitis often is caused by

Answer 17

E. coli

Question 18

Acute hemorrhagic cystitis often is caused by E. coli has also been attributed to

Answer 18

Adenovirus types 11 and 21

Question 19

Interstitial cystitis most often affects which age group

Answer 19

Adolescent girls

Question 20

Asymptomatic bacteriuria is most common in what gender

Answer 20

Female

Question 21

T/F Asymptomatic bacteriuria does not cause renal injury

Answer 21

T, except in pregnant women in whom, if left untreated can result in symptomatic UTI

Question 22

T/F Nearly all UTIs are ascending infections

Answer 22

T

Question 23

Children of any age with a febrile UTI can have acute pyelonephritis and subsequent renal scarring, but the risk is highest in what age group

Answer 23

Younger than 2 years old

Question 24

Risk factors for UTI

Answer 24

Female gender, Uncircumcised male, Vesicoureteral reflux*, Toilet training, Voiding dysfunction, Obstructive uropathy, Urethral instrumentation, Wiping from back to front in girls, Bubble bath?, Tight clothing (underwear), Pinworm infestation, Constipation, Bacteria with P (type II) fimbriae, Anatomic abnormality (labial
adhesion), Neuropathic bladder, Sexual activity, Pregnancy

Question 25

In girls, UTIs often occur at the onset of toilet training because of

Answer 25

Bladder/bowel dysfunction that occurs at that age

Question 26

T/F According to the 2011 American Academy of Pediatrics (AAP) Clinical Guideline for children 2-24 mo, in children who are not toilet trained, a catheterized or suprapubic aspirate urine sample should be obtained

Answer 26

T

Question 27

T/F If the child is symptomatic, a UTI is possible, even if the urinalysis result is negative

Answer 27

T

Question 28

T/F Infection can occur in the absence of pyuria

Answer 28

T

Question 29

T/F Pyuria can be present without UTI

Answer 29

T

Question 30

Sterile pyuria (positive leukocytes, negative culture) may occur in what conditions

Answer 30

1) Partially treated bacterial UTIs 2) Viral infections 3) Renal tuberculosis 4) Renal abscess 5) UTI in the presence of urinary obstruction 6) Urethritis as a consequence of a sexually transmitted infection 7) Inflammation near the ureter or bladder (appendicitis, Crohn disease), or 8) Interstitial nephritis (eosinophils)

Question 31

T/F Refrigeration is a reliable method of storing the urine until it can be cultured

Answer 31

T

Question 32

With a renal abscess, the white blood cell count is markedly elevated to ___

Answer 32

> 20,000-25,000/mm3

Question 33

T/F Sepsis is not common in pyelonephritis, hence blood cultures should not be drawn before starting antibiotics

Answer 33

F

Question 34

Indication for hospitalization of child with UTI

Answer 34

Dehydrated, vomiting, unable to drink fluids, 1 mo of age or younger, complicated infection, urosepsis is a possibility

Question 35

UTI: Treatment with ___ is particularly effective against Pseudomonas spp., and alkalinization of urine with sodium bicarbonate increases its effectiveness in the urinary tract.

Answer 35

Aminoglycosides