UTI in Children

Question 1

Non-bacterial causes of UTI

Answer 1

Adenovirus

Candida

Question 2

T or F Group B strep is the most common org encountered in pediatric UTI

Answer 2

F: seldom encountered

Question 3

Form of UTI that involves the renal parenchyma

Answer 3

Acute pyelonephritis

Question 4

UTI that involves the bladder

Answer 4

Acute cystitis

Question 5

T or F: Gold standard for the treatment of ASB in children is empiric antibiotics

Answer 5

False It’s better NOT to treat with antibiotics in ASB

Question 6

Amount of WBC in urinalysis to be classified as pyuria

Answer 6

> 10 WBC/mm3 in unspun

>5 in spun

Question 7

False positive pyuria may be a result of

Answer 7

Contamination by antiseptics
Contamination with ammounium containing detergent
Dipstick left for too long

Question 8

False negative pyuria may ba a result of

Answer 8

Dilute urine
Acidic urine
LMW or non-albumin protein
Outdated strip

Question 9

GOLD STANDARD in diagnosing UTI in children

Answer 9

Urine Culture

Question 10

Principle behind Nitrite test

Answer 10

Bacterial conversion of nitrate to nitrite in urine, negative result cannot rule out UTI

Question 11

Bag Urine is the mthod of choice in collection of urine for culture

Answer 11

False, not suitable for urine culture, but negative growth may rule out UTI

Question 12

What can cause negative urine culture

Answer 12

Prior antibiotics
Increased H20 intake
Intake of high doses of Vit C
Some bacteria take several yrs to grow

Question 13

Refers to structural and functional causes of abnormalities of bladder storage and emptying

Answer 13

Voiding dysfunction

Question 14

Why does holding urine more likely to develop UTI?

Answer 14

It allows bacteria to grow

Question 15

When is circumcision considered in newborn infants?

Answer 15

Those with significant perinatal hydronephrosis or reflux; those with recurrent UTI

Question 16

This is used to loosen the phimotic band

Answer 16

Corticosteroid

Question 17

Diagnostic method used to describe bladder volume, bladder wall thickness, presence of renal and bladder calculi

Answer 17

Renal and Bladder UTZ

Question 18

Disadvantage of Renal and Bladder UTZ

Answer 18

Poor detection rate of parenchymal defects and VUR

Question 19

Diagnostic method used to define permanent loss of renal parenchyma

Answer 19

DMSA renal scan

Question 20

Timing of VCUG

Answer 20

When the child is dead, de joke lng.. once the child is afebrile and has a negative urine culture

Question 21

T or F: Childhood UTI progressing to CKD will never happen

Answer 21

False. It does, but It’s rare

Question 22

Long term complications of UTI includes

Answer 22

HPN

CKD

Question 23

T or F: Children with non-febrile UTI needs imaging that focuses on bladder function

Answer 23

False. Kids with non febrile – no need imaging while those who have had several attacks need imaging that focuses on bladder fxn

Question 24

Features of high risk children

Answer 24

Recurrent inf
Poor urinary stream/ palpable kidneys
Bacteremia/septicemia
Older boy
Known dilatation or abnormality on antenatal US screening of UT

Question 25

Common bacterial drugs used as empiric therapy in childhood UTI include

Answer 25

Ampicillin derivatives
Cephalosporin
Aminoglycosides

Question 26

Length of treatment for childhood UTI

Answer 26

7-14 days

Question 27

Antibiotics commonly used for prophylaxis

Answer 27

Nitrofurantoin
Cephalexin
Cotrimoxazole

Question 28

Antibiotic prophylaxis is recommended for children under 5 with ______

Answer 28

Vee You Are, also for those kids with gr 4 or 5 VUR, or kids with recurrent febrile UTI

Question 29

T or F: Routine dipstick is a good screening test, but NOT ALL pyuria is considered UTI

Answer 29

True