UTIs

Question 1

Is the threshold for indicating an infection lower or higher in catheter sample?

Answer 1

Lower (>10^2)

Question 1

Are recurrent UTIs in women caused by relapse or reinfections most commonly?

Answer 1

Reinfections

Question 2

Which bacteria can cause UTIs via haematogenous spread?

Answer 2

Staph aureus

TB

Salmonella Typhi

Question 2

What is the problem with females having short urethras?

Answer 2

Shorter distance for bac to travel to infected

Opening is closer to the anus

Question 2

How does sexual intercourse predispose one to a UTI?

Answer 2

Bac are pushed up the urethra

Question 2

Type I fimbriae are important because…

Answer 2

Most host cells have receptors for them

Question 2

What concentration of bac in the urine suggests an infection?

Answer 2

>10^5/ml CFU

Question 4

Where are commensal bacteria expected to be found in the UT?

Answer 4

Below the spincter of the bladder

Question 6

What is asymptomatic bacteriuria?

Answer 6

Bacteria in the urine without symptoms

Question 7

What antibiotics do you use for UTIs?

Answer 7

Co-amoxyclav

Cephalexin

Trimethoprin

Question 8

Which virus causes haemorrhagic cystitis?

Answer 8

Adenovirus

Question 9

When does the bladder usually hold *Salmonella *Typhi asymptomatically?

Answer 9

When there is unlying damage eg by after Schistomiasis

Question 9

What result from a bag sample is significant?

Answer 9

Sterile: no UTI

Question 10

T/F Rised WBC in urine means infection.

Answer 10

False could be stones or tumours as well

Question 11

What is the most likely *Staph *species to cause UTIs?

Answer 11

saprophyticus

Question 11

What are some innate defences of the bladder?

Answer 11

Urine flushing

Bac don’t like to grow in urine

Epithelium is hard to colonise

Transitional epithelium resists colonisation

Question 12

Which viruses are sometime shed in urine?

Answer 12

CMV

Rubella

Polyomaviruses

Question 14

What is sterile pyuria?

Answer 14

Pus in the urine without bacteria

Question 15

What are the symptoms of UTIs?

Answer 15

Burning on urination

Fever

Chills

Tenderness to palpation

Question 15

Why alkalinise urine in UTIs?

Answer 15

Prevent acidification caused by bac

Question 17

What is the vesico-ureteric reflux?

Answer 17

When contraction of the bladder pushes urine up the ureters

Question 18

Which has greater affinity for Fe transferrin or siderophore?

Answer 18

Siderophore

Question 19

When does not being circumcised cause more UTIs?

Answer 19

In boys

Question 20

What does bacteraemia in UTIs indicate?

Answer 20

Pyelonephritis

Question 21

Which bacteria uses urease?

Answer 21

*Proteus*

Question 22

When is asymptomatic bacteriuria bad?

Answer 22

In pregnant women

Question 24

Which organ does Salmonella Typhi inhabit in carriers?

Answer 24

The gall bladder

Question 25

What result from a suprapubic aspirate is significant?

Answer 25

Any bacteria as bladder should be sterile

Question 26

What can cause sterile pyuria?

Answer 26

Non-infectious condition Partial treatment Difficult to growth bacteria (eg TB)

Question 27

What is an infection of the kidneys called?

Answer 27

Pyelonephritis

Question 28

What is a siderophore?

Answer 28

Complex bacteria produce to acquire Fe

Question 29

What is haemolysin?

Answer 29

A bacterial toxin that breaks down RBCs

Question 30

What should you do when one gets pyeonephritis?

Answer 30

Check for anatomical abnormality

Question 32

What are the 4 type of urine sampling techniques?

Answer 32

MSU Bag sample Catheter sample Suprapubic aspirate

Question 33

What is the most common aetological cause of community acquired of UTIs?

Answer 33

*E. coli*

Question 34

What level of WBCs in the urine is significant?

Answer 34

\>10^5/ml

Question 36

How often do sexually active women get UTIs?

Answer 36

Once every two years

Question 37

How do you confirm a UTI when a patients CFU is borderline?

Answer 37

Take multiple samples

Question 39

What clinical syndromes can viral UTIs caused?

Answer 39

Usually asymptomatic shedding however Rarely: Haemorrhagic cystitis Renal disease

Question 40

How many squamous cells are there in a normal urine sample?

Answer 40

None, having them indicates a poorly collected sample

Question 41

Which are more suspectible to relapse, men or women?

Answer 41

Men

Question 42

What can recurrent UTIs in women mean?

Answer 42

Genetic predisposition Anatomical abnormality Intercourse, spermicide, incontinence

Question 43

Why use a bag sample for babies?

Answer 43

Don't want to catheterise as might introduce microbes Can't take a MSU sample with babies

Question 44

How do you collect a sample from a catheter?

Answer 44

Directly from stream in the collecting tube - not from the bag!

Question 45

What is an infection of the bladder called?

Answer 45

Cystitis