UTI

Question 1

why are UTIs more common in women?

Answer 1

shorter urethra allows bacteria entry into bladder

Question 2

Main source of bacteria

Answer 2

faeces - E.coli

Question 3

risk factors for UTI

Answer 3

women
sexually active
incontinence/hygiene problem
catheter

Question 4

Lower UTI symptoms

Answer 4

dysuria 
suprapubic pain 
frequency 
urgency 
confusion - elderly

Question 5

dysuria

Answer 5

pain, stinging or burning when passing urine

Question 6

pyelonephritis presenting features

Answer 6

fever
loin, suprapubic or back pain
vomiting
haematuria

Question 7

examination finding of pyelonephritis

Answer 7

renal angle tenderness

Question 8

explain nitrites on urine dipstick

Answer 8

gram negative bacterial eg Ecoli break down nitrates to nitrites

Question 9

what do urine dipsticks look for in leucocytes?

Answer 9

leucocyte esterase

Question 10

Are nitrites or leukocytes a better indication of infection?

Answer 10

nitrites

Question 11

What to do if leucocytes/nitrites present

Answer 11

send an MSSU to microbiology for culture and sensitivities

Question 12

Describe E.coli

Answer 12

gram-negative
anaerobic 
rod shaped 
lower intestinal microbiome
found in faeces

Question 13

Other causative agents of UTIs

Answer 13

klebsiella pneumoniae
enterococcus
pseudomonas aeruginosa
candida albicans

Question 14

duration of antibiotics - 3 different possibilities

Answer 14

3 days - women LUTI
5-10 days = immunosuppressed women/impaired renal function
7 days = men, pregnancy or catheter

Question 15

appropriate initial anitibiotic in community? (2)

Answer 15

trimethoprim

nitrofurantoin

Question 16

Alternative antibiotics

Answer 16

amoxicillin

cefalexin

Question 17

What 3 things does UTI in pregnancy increase the risk of?

Answer 17

pyelonephritis
PROM
pre-term labour

Question 18

Managing UTI in pregnancy

Answer 18

7 days antibiotics
nitrofurantoin
or amoxicillin

Question 19

do you treat aymptomatic bacteruria in pregnancy?

Answer 19

yes

Question 20

Is trimethoprim safe in pregnancy?

Answer 20

avoided in first trimester or if on meds which affect folic acid eg anti-epileptics due to anti-folate effects

Question 21

When is nitrofurantoin avoided in pregnancy?

Answer 21

3rd trimester

haemolytic anaemia in the newborn

Question 22

When should pyelonephritis be referred to the hospital?

Answer 22

sepsis

Question 23

Antibiotics for pyelonephritis in the community

Answer 23

co-amoxiclav
cefalexin
trimethoprim
ciprofloxacin