UTIs

Question 1

What marker in urine is specific for a UTI?

Answer 1

+ Nitrites

Normally shows +nitrites & +leucocytes

Question 2

Which groups should you not use a urine dipstick to diagnose a UTI?

Answer 2

> 65, catheterised

Question 3

What is diagnostic in MC&S for UTI?

Answer 3

Culture of >10^4 units/ml (10^3 for E. coli/ S. saprophyticus) or >10^5 - 1 predominant organism in mixed growth

Question 4

The presence of what in MC&S indicates contamination?

Answer 4

Squamous epithelial cells or mixed growth

Question 5

Most common organism causing a UTI?

Answer 5

E. coli

Question 6

Organism causing a UTI in young females with negative nitrites in urine dipstick?

Answer 6

Staphylococcus saprophyticus

Question 7

Common UTI organism in indwelling catheter?

Answer 7

Candida

Question 8

Common organisms of a UTI in abnormal urinary tracts?

Answer 8

Proteus, klebsiella

Question 9

Which Abx for a UTI in a pregnant woman?

Answer 9

Cephalexin PO 7 days

Trimethoprim CI in first term (folate antagonist - also avoid if on methotrexate)
Nitrofurantoin CI near term (haemolytic anaemia)

Question 10

Mx of Lower UTI?

Answer 10

Nitrofurantoin or trimethoprim or cephalexin PO (3 days in uncomplicated, 7 days if complicated/male)

Question 11

Mx of pyelonephritis?

Answer 11

admit, IV co-amox + gentamicin

Question 12

Mx for UTI with long-term catheter?

Answer 12

gentamicin or amikacin 140mg, remove catheter

Only treat if symptomatic