UTIs

Question 1

Best initial test for UTI

Answer 1

Urinalysis shows increased WBC

Question 2

Anatomic defects leading to UTIs

Answer 2

Stones, strictures, tumors, obstructions, diabetes (not an anatomic defect but whatever)

Question 3

Sx of cystitis

Answer 3

Dysuria and suprapubic pain/discomfort, mild/absent fever

Question 4

Best initial test for cystitis

Answer 4

Urinalysis >10 WBC

Question 5

Most accurate test for cystitis

Answer 5

Urine culture

Question 6

Cystitis initial tx

Answer 6

TMP/SMX if we know the resistance is low

Ciprofloxacin, cephalexin, notrofurantoin (pregnant)

Question 7

A 37 year old woman comes with urinary frequency and burning. UA>50 WBC, what is the next best step in management?

Answer 7

TMP/SMX 3d

Question 8

Sx of pyelonephritis

Answer 8

Dysuria with flank of CVA tenderness, high fever, occasional abdominal pain, UA with high WBCs

Question 9

When do you do imaging studies?

Answer 9

CT or sonogram are performed when

1. The dx is not clear
2. To look for anatomic abnormalities to prevent recurrences

Question 10

Treatment for pyelonephritis

Answer 10

Ampicillin and gentamicin
Ciprofloxacin
Change based on culture and sensitivity

Question 11

Sx of prostatitis
Dx
Tx

Answer 11

Dysuria and perianal pain, tender prostate on examination
Prostate exam
TMP/SMX or cipro for 6-8weeks for chronic prostatitis

Question 12

Perinephric abscess presentation

Tx

Answer 12

Pyelonephritis not resolving with appropriate tx when drug choice and dose are correct (still fever and pain after tx).
Do sonogram or CT
Drainage of fluid collection is mandatory

Question 13

UTI presentation

Answer 13

Frequency, urgency, burning, dysuria, maybe fever