Microbio

Question 1

Which urine sample is collected in people with UTI?

Answer 1

washout the 1st part distal end of urethra and the middle part collected

Question 2

In whom should dipstick not be done?

Answer 2

older patients and catheterised patients

Question 3

Which urine sample is collected in those with genital infections?

Answer 3

the 1st bit

Question 4

biggest cause of UTI?

Answer 4

bacillus –> ECOLI (lactose fermenters0

Question 5

What are the other coliform lactose fermenters that cause UTI?

Answer 5

E.coli
Klebsiella sp.
Serratia ap.
Proteus
Citrobacter sp.

Question 6

is pseudomonas a coliform?

Answer 6

No

Question 7

What makes E.coli the biggest cause of UTI?

Answer 7

Endotoxin

Fibriae - helps it stay on and go up the UTI

Question 8

Another common

Answer 8

Proteus

Question 9

Which individuals have a higher chances of getting a proteus infection?

Answer 9

Big stones - staghorm calculi

produces ammonia and precipitates salt in the urinary tract

Question 10

Smell of proteus plate

Answer 10

burnt chocolate –> produces ammonia and precipitates salt s in the urinary tract

Question 11

Features of Pseudomonas aeruginosa

Answer 11

Gram negative bacillus
NOT COLIFORM

ONly quinolone

Question 12

How do quinolones work on

Answer 12

prevents supercoiling of the bacterial DNA

Question 13

Side effects of ciprofloxacin

Answer 13

reduces seizure threshold

Question 14

Gram positive organisms which cause UTI

Answer 14

Enterococcus spp.
Enterococcus faecalis
Entercoccus faecium
S. aureus

Question 15

Most common g. positive

Answer 15

Enterococcus faecalis

Question 16

Who are the individuals who gets enterococcus faecalis?

Answer 16

hospital associated

Question 17

UTI in women of child-bearing age caused by>

Answer 17

Staphylococcus saphrophyticus

Question 18

Symptoms and signs of UTI

Answer 18

dysuria (pain passing urine)
frequency of urination
nocturia
haematuria

fever }
loin pain } suggest involvement of
rigors } upper urinary tract

Question 19

What should be considered if someone has fever, loin pain and rigors associated with UTI?

Answer 19

Upper tract UTI

Question 20

Best Specimen collection in UTI

Answer 20

midstream specimen of urine

Question 21

Staph aureus in UTI

Answer 21

not common

bacteriaemia

Question 22

Where does the balloon of the catheter sit?

Answer 22

neck of the baldder

Question 23

Which container is used if the time to orevent bacterial multiplication esp in places where it can’t reach the lab within 2 hours of collection?

Answer 23

Boricon container -

Question 24

is CSU useful?

Answer 24

not much unless there is UTI

Question 25

Dipstick urine testing used only in which patients?

Answer 25

Younger patients who might have cyctitis

Question 26

When is microscopy of urine done?

Answer 26

specific renal manifestations --> casts rarely upfront, if done after culture

Question 27

causes of mixed culture sample results

Answer 27

poor sample, or semi-treated infection

Question 28

What is a significant result in a culture?

Answer 28

> 10 raised to 5/ ml

Question 29

What are the ideal antibiotics in uncomplicated lower UTI?

Answer 29

``` Ideal antibiotic should be: excreted in urine in high concentration oral inexpensive few side effects ```

Question 30

How many days should individuals with UTI be treated for?

Answer 30

3 days

Question 31

Abacterial urethral syndrome

Answer 31

early phase of UTI urethral trauma - honeymoon cystitis urethritis due to clamydia or gonorrhoea

Question 32

When is abacterial bacteriuria treated?

Answer 32

PREGNANT WOMEN even if they are asymptomatic

Question 33

When should catheterised patients be given antibiotics?

Answer 33

only if they have symptoms that are consistent with catheter higher rates of antibiotic resistance

Question 34

which antibiotic for Female lower UTI?

Answer 34

Nitrofurantoin or trimethoprim orally (3 days)

Question 35

Which antibiotic for Uncatheterised male UTI?

Answer 35

(get cultures !!) | nitrofurantoin or trimethoprim orally (7 days)

Question 36

Which drugs are needed for Complicated UTI or pyelonephritis (GP)?

Answer 36

Co-amoxiclav or co-trimoxazole (14 days)

Question 37

Which drug for Complicated UTI or pyelonephritis (Hospital)?

Answer 37

Amoxicillin(40% of our g.negatives are resistant for it) and gentamicin (for all g.negative) IV for 3 days (cotrimoxazole and gentamicin if penicillin allergy), stepdown as guided by antibiotic sensitivities

Question 38

Not useful mostly

Answer 38

co-trimoxazole

Question 39

Which drugs for ESBLS?

Answer 39

pivmecillinam (oral) temocillin (IV) cefalexin (oral) co-amoxiclav = amoxicillin + clavulanic acid (IV, oral) ciprofloxacin (IV, oral)

Question 40

When should blood be checked for gentamicin after it's admin?

Answer 40

6-14 hrs later to make sure gentamicin is completely removed from the blood

Question 41

Why is the blood checked after gentamicin?

Answer 41

to check for nephrotoxicity

Question 42

How should gentamicin be administered?

Answer 42

IV

Question 43

Gentamicin contraindication

Answer 43

Pregnancy

Question 44

What is the dosing for gentamicin?

Answer 44

7 mg/kg