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Flashcards in Microbiology Deck (53):
1

What normally cause UTIs?

coliforms and enterococci

2

Urine is normally not sterile where?

urethra

3

What may an upper UTI lead to?

pylonephritis

4

Does bacteria in the urine always mean a UTI?

no

5

What is a complicated UTI?

UTI with systemic sepsis/urinary structural abnormality or stones

6

Why are UTIs more common in women?

proximity of urethra to anus
short wide urethra
pregnancy/common after sexual activity

7

What congenital condition may cause increased UTI risk?

posterior urethral valces

8

Most common route of infection?

ascending (bowel-perianal-urinary tract)

9

What other route of infection exists?

bloodstream

10

What bacteria causes 70% of UTIs?

E.coli

11

Which bacteria causing UTIs is associated with stones and is very foul smelling?

proteus sp

12

How does proteus sp lead to stones?

produces urease, breaks down urea, increasing the pH and leading to precipitation of salts and therefore stones

13

Which enterococci is sensitive to antibiotics, faecalis or faecalum?

faecalis

14

In whom is staph saphrophytis a causal organism of UTI?

young women

15

What antibiotic should be used for pseudomonas aeruginosa?

ciprofloxacin

16

What is pseudomonas related to in terms of UTIs?

catheters

17

Is pseudomonas a coliform?

no

18

Give 3 symptoms of a UTI.

frequency
dysuria
haematuria

19

How should a urine specimen be collected?

mid stream specimen - as first urine past wille contaminated with other bacteria from urethra

20

In whome may you need to use a bag to catch the urine and is this reliable?

babies
less reliable as other bacteria are likely to be present, so more useful if negative result to rule out UTI

21

In whom may suprapubic aspiration be used?

babies/young kids

22

What type of container is recommended to collect urine samples?

boricon

23

What in urinalysis indicates WBCs?

leukocyte enterase

24

What are nitrites useful to point out in urinalysis?

mainly coliforms

25

What type of bacteria does not give a positive nitrite result on urinalysis?

enterococci

26

What should be looked for in microscopy and in whom is microscopy done?

urgent case of UTI
look for pus cells

27

Are UTIs in non catheterised patients usually caused by one or more organisms?

one

28

Which antibiotic resistant bacteria is becoming more common due to imported chicken?

ESBL

29

Which antibiotic resistant bacteria is linked to travel to India?

CPE

30

How many days should antibiotics be given for a female with uncomplicated UTI?

3

31

How many days should antibiotics be given for a male with uncomplicated UTI?

7

32

Is trimethoprim safe in pregnancy?

not in first trimester

33

Which antibiotic used for UTIs is linked to Steven-Jonson syndrome?

trimethoprim

34

When is nitrofurantoin not used?

late pregnancy
to treat pylonephritis

35

Is gentamycin safe in pregnancy?

NO

36

What is first choice antibiotic when there is urosepsis?

gentamicin

37

Which antibiotic prevents supercoiling and inhibits DNA gyrase?

ciprofloxacin

38

What treatment should be given to a female with uncomplicated UTI?

3 days of trimethoprim OR nitrofurantoin

39

What treatment should be given to a male with uncomplicated UTI?

7 days of trimethoprim OR nitrofurantoin

40

What treatment should be given to a patient with a complicated UTI?

co-amoxiclav/cotrimoxazole (14 days)

41

What treatment should be given to a UTI patient in hospital?

Amoxicillin AND gentamicin IV 3 days ONLY
then step down

42

What should be used instead of amoxicillin if penicillin allergic?

cotrimoxazole

43

What is asymptomatic bacteruria?

patient has no symptoms but bacteria present
No Pus Cells

44

Are antbiotics normally given for asymptomatic bacteruria?

No - only in pregnancy

45

Why are antibiotics given in pregnancy/screened for asymptomatic bacteruria?

if untreated can lead to:
- pyelonephritis (20-30%)
-premature labour and intra unterine growth retardation

46

What is abacterial cystitis?

symptoms of UTI but no signifigant bacterial growth
Pus cells ARE present

47

What may cause abacterial cystitis?

- early UTI
- urethral trauma caused by honeymoon cystitis
- urethritis caused by chlamydia/gonorrhea

48

What may help in abacterial cystitis?

alkanising urine - eg bicarbonate sachets

49

What is one of the most common causes of hospital acquired infection?

UTI in catheterized patients

50

Why should you only give antibiotics if patient has symptoms of UTI?

- antibiotic resistance
- C.Diff

51

Is the bladder normally sterile?

Yes

52

In which case other than in hospital may you need to consider giving IV antibiotics?

if patient is vomiting

53

Why is erythromycin not used in penicillin allergic patients?

likely organisms are resistant and NOT excreted in urine
do NOT prescribe erythromycin/clarithromycin for a UTI