Microbiology

Question 1

What normally cause UTIs?

Answer 1

coliforms and enterococci

Question 2

Urine is normally not sterile where?

Answer 2

urethra

Question 3

What may an upper UTI lead to?

Answer 3

pylonephritis

Question 4

Does bacteria in the urine always mean a UTI?

Answer 4

no

Question 5

What is a complicated UTI?

Answer 5

UTI with systemic sepsis/urinary structural abnormality or stones

Question 6

Why are UTIs more common in women?

Answer 6

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

Question 7

What congenital condition may cause increased UTI risk?

Answer 7

posterior urethral valces

Question 8

Most common route of infection?

Answer 8

ascending (bowel-perianal-urinary tract)

Question 9

What other route of infection exists?

Answer 9

bloodstream

Question 10

What bacteria causes 70% of UTIs?

Answer 10

E.coli

Question 11

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

Answer 11

proteus sp

Question 12

How does proteus sp lead to stones?

Answer 12

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

Question 13

Which enterococci is sensitive to antibiotics, faecalis or faecalum?

Answer 13

faecalis

Question 14

In whom is staph saphrophytis a causal organism of UTI?

Answer 14

young women

Question 15

What antibiotic should be used for pseudomonas aeruginosa?

Answer 15

ciprofloxacin

Question 16

What is pseudomonas related to in terms of UTIs?

Answer 16

catheters

Question 17

Is pseudomonas a coliform?

Answer 17

no

Question 18

Give 3 symptoms of a UTI.

Answer 18

frequency
dysuria
haematuria

Question 19

How should a urine specimen be collected?

Answer 19

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

Question 20

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

Answer 20

babies

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

Question 21

In whom may suprapubic aspiration be used?

Answer 21

babies/young kids

Question 22

What type of container is recommended to collect urine samples?

Answer 22

boricon

Question 23

What in urinalysis indicates WBCs?

Answer 23

leukocyte enterase

Question 24

What are nitrites useful to point out in urinalysis?

Answer 24

mainly coliforms

Question 25

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

Answer 25

enterococci

Question 26

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

Answer 26

urgent case of UTI | look for pus cells

Question 27

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

Answer 27

one

Question 28

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

Answer 28

ESBL

Question 29

Which antibiotic resistant bacteria is linked to travel to India?

Answer 29

CPE

Question 30

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

Answer 30

3

Question 31

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

Answer 31

7

Question 32

Is trimethoprim safe in pregnancy?

Answer 32

not in first trimester

Question 33

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

Answer 33

trimethoprim

Question 34

When is nitrofurantoin not used?

Answer 34

late pregnancy | to treat pylonephritis

Question 35

Is gentamycin safe in pregnancy?

Answer 35

NO

Question 36

What is first choice antibiotic when there is urosepsis?

Answer 36

gentamicin

Question 37

Which antibiotic prevents supercoiling and inhibits DNA gyrase?

Answer 37

ciprofloxacin

Question 38

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

Answer 38

3 days of trimethoprim OR nitrofurantoin

Question 39

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

Answer 39

7 days of trimethoprim OR nitrofurantoin

Question 40

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

Answer 40

co-amoxiclav/cotrimoxazole (14 days)

Question 41

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

Answer 41

Amoxicillin AND gentamicin IV 3 days ONLY | then step down

Question 42

What should be used instead of amoxicillin if penicillin allergic?

Answer 42

cotrimoxazole

Question 43

What is asymptomatic bacteruria?

Answer 43

patient has no symptoms but bacteria present | No Pus Cells

Question 44

Are antbiotics normally given for asymptomatic bacteruria?

Answer 44

No - only in pregnancy

Question 45

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

Answer 45

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

Question 46

What is abacterial cystitis?

Answer 46

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

Question 47

What may cause abacterial cystitis?

Answer 47

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

Question 48

What may help in abacterial cystitis?

Answer 48

alkanising urine - eg bicarbonate sachets

Question 49

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

Answer 49

UTI in catheterized patients

Question 50

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

Answer 50

- antibiotic resistance | - C.Diff

Question 51

Is the bladder normally sterile?

Answer 51

Yes

Question 52

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

Answer 52

if patient is vomiting

Question 53

Why is erythromycin not used in penicillin allergic patients?

Answer 53

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