UTIs

Question 1

Most common organism causing UTI

Answer 1

E. coli

Question 2

Risk factors for UTIs

Answer 2

Female, sex, indwelling catheters, pregnancy, diabetes, spinal cord injury

Question 3

Male risk factors for UTIs

Answer 3

Uncircumcised, anal intercourse, vaginal intercourse w/ female colonized w/ uropathogens

Question 4

What is absent in lower UTIs that is usually present in upper UTIs?

Answer 4

Fever

Question 5

Dipstick urinalysis findings in UTI

Answer 5

+ leukocyte esterase, +nitrite

Question 6

+ nitrite test for bacteria indicates what?

Answer 6

Sensitive and specific for enterobaceriaceae

Question 7

Presence of what in clean catch urinalysis indicates vulvar or urethral contamination

Answer 7

Squamous (epithelial) cells

Question 8

What do if you have squamous cells on urinalysis

Answer 8

Straight cath

Question 9

When is a urine culture warranted?

Answer 9

If UTI symptoms are atypical, course is complicated, or symptoms persist despite antibiotics

Question 10

Risk factors for upper UTI

Answer 10

Diabetes, vesicoureteral reflux, pregnancy

Question 11

Treatment options for uncomplicated cystitis

Answer 11

Oral TMP/SMX (Bactrim) for 3 days, nitrofurantoin (5-7 days), fosfomycin (single dose), fluoroquinolones (cipro)

Question 12

When should you NOT give nitrofurantoin or fosfomycin?

Answer 12

If you suspect early pyelonephritis

Question 13

What can you give for symptomatic treatment of dysuria?

Answer 13

Phenazopyridine (urinary analgesic)

Question 14

How to treat a preggar w/ UTI

Answer 14

Ampicillin, amoxicillin, or oral cephalosporins for 7-10 days

Question 15

What should you avoid giving in pregnant woman with UTIs

Answer 15

Fluoroquinolones (cause fetal athropathy)

Question 16

Difference in treating uncomplicated UTIs in men compared to women

Answer 16

Treat the same, but continue treatment for 7 days

Question 17

Most frequent cause of pyelonephritis

Answer 17

E. coli

Question 18

Complications of pyelonephritis

Answer 18

Sepsis, emphysematous pyelonephritis (gas-producing bacteria in diabetics), chronic pyelonephritis and scarring

Question 19

Most important finding in urinalysis for diagnosing pyelonephritis

Answer 19

WBC casts (leukocyte casts)

Question 20

Should you get urine cultures if you suspect pyelonephritis?

Answer 20

Yes

Question 21

When should you get blood cultures in pyelonephritic pts?

Answer 21

If they are ill-appearing or septic

Question 22

Treatment for uncomplicated pyelonephritis

Answer 22

TMP/SMX or a fluoroquinolone (cipro) for 10-14 days for GNRs; amoxicillin for gram positive cocci

Question 23

What should you do if you suspect urosepsis?

Answer 23

Hospitalize the pt and give IV fluids

Question 24

Antibiotic treatment in uroseptic pts

Answer 24

IV broad spec antibiotics (ampicillin plus gentamycin for ciprofloxacin)

Question 25

Is acute bacterial proctitis more common in old or young men?

Answer 25

Young

Question 26

Types of organisms common in acute bacterial prostatitis

Answer 26

Gram-negative organisims (E. coli, Klebsiella, Proteus, Pseudomonas, Enterobacter, Serratia)

Question 27

Treatment of mild acute prostatitis

Answer 27

TMP/SMXX or a fluoroquinolone + doxycycline

Question 28

Treatment of sever acute prostatitis

Answer 28

Hospitalize and give IV antibiotics

Question 29

Tx of chronic prostatitis

Answer 29

Fluoroquinolone