UTIs

Question 1

Bacterial causes of UTI

Answer 1

• E Coli (most common)
• Staph saprophyticus
• Klebsiella

Question 2

Risk factors for UTI

Answer 2

• Female
• Sex
• Diabetes
• Immunocompromise eg HIV, IVDU
• Old people
• BPH in men
• Neuropathic bladder, horseshoe kidney
• Urine catheters
• Kidney stones

Question 3

How much bacteria in urine is considered UTI

Answer 3

> 10^5 organisms per mL of fresh MSU

Question 4

What is classified as upper UTI

Answer 4

kidney and ureters (pyelonephritis)

Question 5

What is classified as lower UTI

Answer 5

bladder and urethra (cystitis, prostitis, urethritis)

Question 6

Who gets treated for asymptomatic bacteruria

Answer 6

pregnant women

urology procedure patients with expected mucosal bleeding (making cuts)

Question 7

Definition of short term catheter

Answer 7

<28 days

Question 8

When should USS be done in UTI

Answer 8

• everyone with pyelonephritis

- first simple UTI in males (to exclude structural abnormality)

Question 9

What might be seen on a suprapubic USS

Answer 9

• dilated ureter (lots of back pressure from reflux)
• stones
• enlarged kidney
• hydronephrosis (secondary to stone obstruction)

Question 10

What blood test should be done if a patient has renal stones

Answer 10

Calcium levels in blood

Question 11

Why is it important to exclude hydronephrosis on USS

Answer 11

If left untreated, may lead to chronic renal failure

Question 12

Definition of catheter associated infection

Answer 12

Infection in anyone who has had catheter removed in last 48h

Question 13

How to diagnose UTI in a patient with a catheter

Answer 13

Diagnosis of exclusion from fever

Do NOT use dipstick testing (not reliable)

Question 14

Definition of AKI

Answer 14

• increased serum creatinine to 1.5x baseline in last 7 days

* Urine volume <0.5ml/kg/hour for 6h

Question 15

Definition of CKD

Answer 15

eGFR <60 for 3 months, with or w/o kidney damage

Question 16

How long should females be treated in an uncomplicated UTI

Answer 16

3 days

Question 17

How long should males be treated in an uncomplicated UTI

Answer 17

5 days

Question 18

In which groups of people is urine collected prior to commencing therapy

Answer 18

• Men
• Pregnant women
• Children <3 yr
• Suspected pyelonephritis
• Recurrent infection
• Suspected resistant organisms
• Single positive on urine dipstick (Leucocyte or Nitrite)
• Clinical symptoms not in keeping with urine dipstick testing

Question 19

Cancers that can present with haematuria

Answer 19

• Endometrial cancer
• Prostate cancer
• Renal cancer/ Wilm’s tumour (nephroblastoma in children)
• Bladder cancer
• Urethral cancer

Question 20

Infections that can present with haematuria

Answer 20

• UTI
• TB
• Schistosomiasis
• Infective endocarditis

Question 21

Drugs that can cause haematuria

Answer 21

• NSAIDs
• sulfonamides
• cyclophosphamide

Question 22

7 Causes of sterile pyuria

Answer 22

1. Urinary stones
2. Urinary tract tumours
3. Drug reaction
4. Chlamydia
5. Brucellosis
6. TB
7. UTI partially suppressed by a/b

Question 23

In UTIs, what do elevated PCT levels correspond with

Answer 23

Associated bacteraemia