UTIs I and II

Question 1

What is the most common cause of all UTIs?

Answer 1

E. coli

Question 2

What is the second most common cause of UTIs?

Answer 2

S. saprophyticus

Question 3

Staphylococcus saprophyticus:

Answer 3

Coagulase-negative

Question 4

What is the third most common cause of UTIs?

Answer 4

Proteus mirabilis

Question 5

What is proteus mirabilis?

Answer 5

Urease positive enterobe

Question 6

What do urease positive bacteria do?

Answer 6

Convert urea to carbon dioxide and ammonia causing alkalization of urine

Question 7

What stones form in alkaline urine?

Answer 7

Struvite (NH4MgPO4x6H2O)

Question 8

What is the most important risk factor on bacteria for UTIs?

Answer 8

Fimbriae

Question 9

Most common E. coli to cause UTI?

Answer 9

Uropathogenic E. coli (UPEC)

Question 10

What causes most UTI in men?

Answer 10

Prostate inflammation

Question 11

Why don’t you use urine in a catheter bag?

Answer 11

Bacteria multiply in the urine and human cells disintegrate in the urine

Question 12

What are the three lower UTI symptoms of irritation?

Answer 12

Dysuria: burning pain
Urgency
Frequency of micturition

Question 13

Why aren’t antibodies produced in lower UTIs?

Answer 13

It is a superficial infection

Question 14

Important symptoms in an upper UTI?

Answer 14

Fever
Lower back pain
Vomiting

Question 15

What often causes renal abscesses?

Answer 15

Staphylococcus aureus

Question 16

What drugs do you give for upper and lower respectively?

Answer 16

Upper: non-oral (vomiting)
Lower: oral

Question 17

What is pyuria?

Answer 17

Pus cells in the urine

Question 18

What threshold of bacteriuria denotes a UTI?

Answer 18

100,000/mL of urine

Question 19

What does one bacteria predominating the urine suggest?

Answer 19

UTI

Question 20

What does more than one bacteria making up the 100,000/mL?

Answer 20

Contamination of the sample somehow not necessarily an UTI

Question 21

What can cause sterile pyuria?

Answer 21

M. tuberculosis

Chlamydia

Question 22

What type of stones does proteus mirabilis cause?

Answer 22

Struvite and calcium carbonate

Question 23

What does the oxidase test distinguish between?

Answer 23

Enterobes (negative) and pseudomonas (positive)

Question 24

What is found in all enterobes?

Answer 24

Nitrate reduction (nitrate to nitrite)

Question 25

What can a urease test distinguish between?

Answer 25

E. coli and Proteus mirabilis

Question 26

What are the lactose fermenters?

Answer 26

E. coli K. pneumoniae E. aerogenes

Question 27

What color are the lactose fermenters on McConkey agar?

Answer 27

Red

Question 28

What is staphylococcus' coagulase test?

Answer 28

Positive

Question 29

What is streptococcus' coagulase test?

Answer 29

Negative

Question 30

Three antibiotics to treat UTI?

Answer 30

1. ) Bactrim (SMZ-TMP) 2. ) Nitrofurantoin 3. ) Quinolones

Question 31

How to treat patient with pyelonephritis that cannot eat or drink?

Answer 31

Hospitalization and IV beta-lactams or fluoroquinolones

Question 32

What are schistosomas?

Answer 32

Trematode flukes that have an intermediate snail host, infect through the skin, mature in the liver, can migrate to veins or colon/bladder,

Question 33

What does Schistosoma hematobium do?

Answer 33

Eggs cross into the bladder causing granulomatous inflammation, ulcer, polyps, and scaring-hematuria, dysuria

Question 34

What does S. japonicum and S. mansoni do?

Answer 34

Eggs cross into colon, causing hemorrhage and diarrhea

Question 35

How do you treat schistosomiasis?

Answer 35

Praziquantel to remove worms but may not reverse pathology

Question 36

What can S. mansoni cause?

Answer 36

Hepatomegaly and fibrosis; ascites and splenomegaly due to portal hypertension

Question 37

What schistosomas are found in China and Brazil?

Answer 37

S. japonica | S. mansoni

Question 38

What schistosomas are found in the middle east?

Answer 38

S. hematobium

Question 39

What do spirochetes have?

Answer 39

A flagella filament that their body wraps around

Question 40

How does Leptospira interrogans enter the body?

Answer 40

Through breaks in the skin or mucus from water that was infected by urine of animals

Question 41

What are the systemic symptoms of Leptospira interrogans?

Answer 41

Endothelial blood vessel damage

Question 42

What can leptospirosis cause?

Answer 42

Fever, chills, muscle pain, conjunctivitis, liver and kidney damage (Weil's disease)

Question 43

What do you treat all spirochetes with?

Answer 43

Penicillin | Doxycycline

Question 44

How to diagnose leptospirosis?

Answer 44

Culture blood, urine, CSF

Question 45

What can carry RMSF?

Answer 45

American dog tick | Rocky mountain wood tick

Question 46

What can carry Lyme's disease?

Answer 46

Blacklegged ticks

Question 47

What does rickettsia rickettsii cause?

Answer 47

RMSF

Question 48

What type of bacteria are rickettsia rickettsii?

Answer 48

Gram negative bacilli that are intracellular

Question 49

What does rickettsia rickettsii infect?

Answer 49

Endothelium leading to vasculitis in skin, lungs, spleen, CNS, heart, kidneys, thrombosis and hemorrhaging

Question 50

What does Transovarian infection mean?

Answer 50

If a tick is infected all of the eggs it lays are also infected meaning once there is disease in the area then there will always be the disease there

Question 51

When does the rash from RMSF start?

Answer 51

A day or two after the fever starts

Question 52

What type of progression does RMSF rash have?

Answer 52

Centripetal: starts on palms and soles

Question 53

What do you screen early with?

Answer 53

Finding antigen

Question 54

What do you screen late with?

Answer 54

Antibodies

Question 55

What to treat RMSF with?

Answer 55

Tetracyclines because they enter the cells

Question 56

What causes epidemic typhus?

Answer 56

Rickettsia prowazekii

Question 57

What is the carrier or R. prowazekii?

Answer 57

Pediculus humanus (louse)

Question 58

What causes endemic typhus?

Answer 58

Rickettsia typhi

Question 59

What carries Rickettsia typhi?

Answer 59

Rat fleas

Question 60

What does typhus cause?

Answer 60

Bacterial replication in endothelium causing vasculitis

Question 61

What does endemic mean?

Answer 61

Only animals (select population)

Question 62

What does epidemic mean?

Answer 62

Can affect humans (widespread)

Question 63

How to differentiate between typhus and RMSF?

Answer 63

Typhus rash starts on core and works out and is 5-9 days after the fever

Question 64

What do typhus antibodies cross react with?

Answer 64

Proteus vulgaris

Question 65

What can typhus cause?

Answer 65

Confusion, delirium

Question 66

What test tests for leukocytes in the urine?

Answer 66

Leukocyte esterase

Question 67

What is indicative of pyelonephritis?

Answer 67

Leukocyte casts

Question 68

Where are leukocyte casts formed?

Answer 68

Nephron tubules