UTIs

Question 1

Pyelonephritis is infection of what portion of the urinary tract?

Answer 1

Kidneys and ureters

Question 2

Cystitis is infection of what portion of the urinary tract?

Answer 2

bladder

Question 3

High fever and flank pain are concerning for cystitis/urethritis or pyelonephritis?

Answer 3

Pyelonephritis

Question 4

CLED/EMB culture (contains bile salts) is differential and selective for what organisms?

Answer 4

Lactose fermenting (CLED)
Gram -  (EMB)

Question 5

What two tests are used to evaluate urine?

Answer 5

Dipstick

Microscopy

Question 6

What additional test should you preform for men with UTI sx?

Answer 6

Prostate exam

Question 7

Uropathogenic E. coli (UPEC) is the most common cause of UTI. What is its gram stain and morphology and motility status?

Answer 7

Gram-, bacillus

Flagellated

Question 8

What urinary pathogen uses P fimbriae (pili) and Dr adhesions to bind to uroepithelial cells and RBCs?

Answer 8

E. coli

Question 9

UPEC produces what that is typically seen w/ upper UTI and chronic UTIs due to increased formation of biofilms?

Answer 9

K (capsular) antigen

Question 10

In what direction does bacteria travel within the urinary tract?

Answer 10

Ascending

Question 11

Encapsulated K1 strains of e. coli are associated with what disease?

Answer 11

Meningitis

Question 12

P. vulgaris is a G- bacilli that typically infects what pt populations? (2)

Answer 12

Infants

IMC

Question 13

Culture of p. vulgaris will exhibit what?

Answer 13

“Swarming”

Question 14

P. vulgaris possess what that will target tissue of the urinary tract?

Answer 14

fimbriae

Question 15

The following in the infection pathway for what organism?

1. Bacteria access UT following introduction of fecal contamination
2. P fimbriae (pili) and DR adhesions bring to uroepithelial cells and RBCs
3. Production of alpha and beta hemolysis results in lysis of uroepithelial cells and RBCS

Answer 15

E. coli

Question 16

After attachment of Proteus spp. to the uroepithelial cells by fimbriae, what enzymes will make urine more alkaline by hydrolyzing urea to ammonia?

Answer 16

Urease

Question 17

Increased urine pH by urease will lead to the formation of what?

Answer 17

Struvite stones (magnesium ammonium phosphate)

Question 18

What UTI pathogen is G+ and coagulase negative?

Answer 18

Staph. saphrophyticus

Question 19

What UTI pathogen has increased incidence sexually active females and is the cause of “honeymoon cystitis”?

Answer 19

S. saphrophyticus (displaced normal flora to the urethra)

Question 20

What UTI pathogen processes adhesions (lactosamine) but no exotoxin?

Answer 20

S. saphrophyticus

Question 21

Novobiocen resistance differentiates what UTI pathogen from other coagulase negative forms of staph?

Answer 21

S. saphrophyticus

Question 22

What UTI pathogen is G+ coccus more common in neonates?

Answer 22

Strep. agalactiae (aka group B streptococcus, GBS)

Question 23

What will you see on blood agar culture of Strep. agalactiae?

Answer 23

Grey-white colonies w/ narrow zone of B-hemolysis

Question 24

What UTI pathogen has the following virulence factors?

1. Capsular polysaccharide
2. Hyalouronidase
3. Collagenase
4. Hemolysin

Answer 24

Strep. agalactiae

Question 25

Detection of CAMP factor on a presumptive lab test is associated w/ DX of what pathogen?

Answer 25

S. agalactiae

CAMP factor = Christie, Atkinas, Munch-Peterson

Question 26

What is the effect of CAMP factor on staph w/ B-lysins?

Answer 26

Accentuation of hemolysis due to interaction w/ staph B-lysin

Question 27

UTI pathogen: What is the gram stain of Klebsiella spp?

Answer 27

Gram -

Question 28

UTI pathogen: What is the gram stain of enterococcus spp?

Answer 28

Gramp +

Question 29

UTI pathogen: What is the gram stain of pseudomonas aeruginosa?

Answer 29

Gram -

Question 30

What is prognosis for uncomplicated UTIs?

Answer 30

Good

*Pyelonephritis and complicated cases can lead to scaring of urinary tract and/or kidney damage