UTIs

Question 1

What is the most common pathogen that causes a UTI?

Answer 1

E. coli

Question 2

UTIs are uncommon in healthy individuals. True or false?

Answer 2

False

Question 3

Why are women more prone to UTIs than men?

Answer 3

Because they have a shorter urethra, predisposing to infection with G-ve bacteria from GIT

Question 4

What are the signs of UTI?

Answer 4

Frequency - visit the toilet more often than usual
Dysuria - pain, stinging, burning sensations
Urgency - feel the need to go to the toilet a lot
Haematuria - blood in urine

Question 5

The urinary tract is usually completely sterile. True or false?

Answer 5

True

Question 6

How is cystitis managed in community?

Answer 6

OTC potassium and sodium citrate - alkaline so make urine less painful to pass
OTC analgesia

Question 7

When should a case of cystitis be referred, in community?

Answer 7

Pregnancy
Diabetes
Men and children
Re-current

Question 8

What is pyelonephritis?

Answer 8

An ascending infection in UT -> Inflammation of the kidney due to bacterial infection

Question 9

What are the symptoms of pyelonephritis?

Answer 9

Fever
Loin pain
Malaise

Question 10

How is a UTI diagnosed?

Answer 10

Symptoms
Urine dipstick - nitrates and leukocytes (protein and blood even though these are not diagnostic)
Mid Stream Sample of Urine - indicates organism responsible

Question 11

What does a presence of nitrates in urine indicate?

Answer 11

Bacterial infection as nitrates are a breakdown product

Question 12

Recurrent UTIs carry an increased risk of renal damage. When should a patient be referred?

Answer 12

Refer if patient has had more than 3 episodes in one year

Question 13

What is meant by an uncomplicated UTI?

Answer 13

Women (including pregnant)

Single episode in children

Question 14

What is meant by a complicated UTI?

Answer 14

Men

Structural abnormality - indwelling catheter, prostatic hypertrophy etc.

Question 15

When should a UTI be treated?

Answer 15

If patient is symptomatic AND urine dipstick is positive (i.e. nitrates and leukocytes)

Question 16

What advice can be given to patients on symptom control and prevention of UTIs?

Answer 16

Drink plenty of fluids
Avoid caffeine
Empty bladder after sex
Empty bladder often and ensure full emptying - wipe front to back

Question 17

UTIs are uncommon in pregnancy - it is an emergency and needs immediate referral. True or false?

Answer 17

False - very common and often asymptomatic - risk of progression to pyelonephritis

Question 18

For UTIs in pregnancy, what are women screened for at their first visit?

Answer 18

Bacteruria

Question 19

Pregnant women with bacteruria are not given antibiotics if they are asymptomatic. True or false?

Answer 19

False - given , even if asymptomatic

urine culture performed 7 days after AB treatment

Question 20

When are children treated for UTIs?

Answer 20

When urine dipstick positive

Question 21

How many days is the treatment for children with cystitis/lower UTI?

Answer 21

3 days

Question 22

If child has UTI and is at risk of pyelonephritis/upper UTI, how many days is treatment?

Answer 22

10 days

Question 23

What is first line treatment for UTIs?

Answer 23

Trimethoprim

Nitrofurantoin

Question 24

What is the treatment for recurrent UTI and what is the duration?

Answer 24

Treat as UTI and also consider prophylaxis with trimethoprim - duration 3-6 months

Question 25

What drugs are given for acute pyelonephritis?

Answer 25

2nd gen cephalosporins
Quinolones
Gentamicin
For 14 days

Question 26

What drug are given in pregnancy for asymptomatic bacteruria?

Answer 26

Amoxicillin for 7 days