UTI Flashcards
T/F During the 1st year of life, UTI occurs more in boys than in girls
T
T/F UTIs are much more common in uncircumcised boys
T
In girls, the first UTI usually occurs by the age of
5
UTI in female children peak when
Infancy and toilet training
T/F UTIs are caused primarily by colonic bacteria
T
In girls, 75-90% of all infections are caused by
Escherichia coli, followed by Klebsiella spp. and Proteus spp
MC organism causing UTI in males
E. coli
MC cause of UTI in boys older than 1 yr
Proteus=E.coli
Organism: Cystitis+hematuria
Adenocirus and other viral infections
Nephronia is
Focal pyelonephritis
T/F: Fever may be the only manifestation of clinical pyelonephritis
T
Most common serious bacterial infection in infants younger than 24 mo of age who have fever without an obvious focus
Clinical pyelonephritis
A renal mass caused by acute focal infection without liquefaction
Acute lobar nephronia
A rare type of renal infection characterized by granulomatous inflammation with giant cells and foamy histiocytes
Xanthogranulomatous pyelonephritis
Management for Xanthogranulomatous pyelonephritis
Partial or total nephrectomy
T/F Cystitis does not cause fever
T
Acute hemorrhagic cystitis often is caused by
E. coli
Acute hemorrhagic cystitis often is caused by E. coli has also been attributed to
Adenovirus types 11 and 21
Interstitial cystitis most often affects which age group
Adolescent girls
Asymptomatic bacteriuria is most common in what gender
Female
T/F Asymptomatic bacteriuria does not cause renal injury
T, except in pregnant women in whom, if left untreated can result in symptomatic UTI
T/F Nearly all UTIs are ascending infections
T
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
Younger than 2 years old
Risk factors for UTI
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
In girls, UTIs often occur at the onset of toilet training because of
Bladder/bowel dysfunction that occurs at that age
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
T
T/F If the child is symptomatic, a UTI is possible, even if the urinalysis result is negative
T
T/F Infection can occur in the absence of pyuria
T
T/F Pyuria can be present without UTI
T
Sterile pyuria (positive leukocytes, negative culture) may occur in what conditions
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)
T/F Refrigeration is a reliable method of storing the urine until it can be cultured
T
With a renal abscess, the white blood cell count is markedly elevated to ___
> 20,000-25,000/mm3
T/F Sepsis is not common in pyelonephritis, hence blood cultures should not be drawn before starting antibiotics
F
Indication for hospitalization of child with UTI
Dehydrated, vomiting, unable to drink fluids, 1 mo of age or younger, complicated infection, urosepsis is a possibility
UTI: Treatment with ___ is particularly effective against Pseudomonas spp., and alkalinization of urine with sodium bicarbonate increases its effectiveness in the urinary tract.
Aminoglycosides
