UTIs

Question 1

main source of bacteria

Answer 1

faeces - e.coli

Question 2

presentation: lower UTIs

Answer 2

dysuria 
suprapubic pain 
frequency 
urgency 
incontinence
confusion - frail patients

Question 3

presentation: pyelonephritis

Answer 3

fever
loin, suprapubic, back pain 
vomit 
loss appetite
malaise
haematuria 
renal angle tenderness OE

Question 4

duration of antibx: when to give 3 days

Answer 4

simple lower UTI in women

Question 5

duration of antibx: when to give 5-10days

Answer 5

women that are immunosupressed, have abnormal anatomy or impaired kidney function

Question 6

duration of antibx: when to give 7 days

Answer 6

men, pregnant women or catheter-related UTI

Question 7

antibiotic choice

Answer 7

trimethoprim

nitrofurantoin

Question 8

UTI in pregnancy increases risk of

Answer 8

pyelonephritis
PROM
pre-term labour

Question 9

UTI in pregnancy Mx

Answer 9

7 days antib

urine for culture and sensitivities

Question 10

antib in pregnant UTI

Answer 10

1st line - nitrofurantoin (avoid in 3rd trimester)

2nd line - cefalexin or amoxicillin

Question 11

nitrofuratoin in pregnancy

Answer 11

avoided in 3rd trimester as it is linked with heamolytic anaemia in newborn

Question 12

trimethoprim in pregnancy

Answer 12

avoid in 1st trimester or if they are on another medication that affects folic acid (e.g. anti-epileptics)

Question 13

antibx choice for pyelonephritis

Answer 13

cefalexin
co-amoxiclav
trimethoprim
ciprofloxacin