MLSCI340 Urines

Question 1

Describe MSU specimen type

Answer 1

• midstream urine, “clean catch”
• collected first thing in the morning
• received in laboratory within 2 hours of collection or refrigerated <24 hours

Question 2

Describe suitable specimen types

Answer 2

• MSU
• catheterization
• suprapubic needle aspiration of bladder
• cytoscopy

Question 3

Where are transient organisms found in the female urinary tract ?

Answer 3

lower end of female urinary tract

Question 4

__, __, and __ of the normal individual are bacteria free

Answer 4

KIDNEYS, URETERS, and BLADDER of the normal individual are bacteria free

Question 5

The ureter connects the __ and the __.

Answer 5

The ureter connects the KIDNEY and the BLADDER.

Question 6

Why are suprapubic needle aspirates a useful specimen type ?

Answer 6

• urine collection from babies
• only technique used for suspected anaerobic infections

Question 7

Indwelling catheters is notorious for __ and __.

Answer 7

Indwelling catheters is notorious for GRAM NEG BACTERIURIA and SEPSIS.

Question 8

Common pathogens of the urinary tract

Answer 8

• Enterobacteriaceae
• β hem Strep (A and B)
• P. aeruginosa (+ other non-fermentative bacilli)
• Aerococcus sp.
• Enterococcus sp.
• S. aureus
• S. saprophyticus

Question 9

Contaminating flora in the urinary tract

Answer 9

• Non-hem Streptococcus
• CNS
• Viridans group Streptococcus
• Diphtheroids
• Lactobacillus sp.
• Neisseria sp.

Question 10

Clinical significance of Enterobacteriaceae in urine

Answer 10

Urinary tract infections

Question 11

Clinical significance of S. pyogenes in urine

Answer 11

Urinary tract infections

Question 12

Clinical significance of S. agalactiae in urine of pregnant mother

Answer 12

• neonatal infection
• mom = carrier

Question 13

Clinical significance of S. saprophyticus in urine

Answer 13

UTI infection in YOUNG WOMEN

Question 14

Outline the rationale for selection of media

Question 15

Explain the relevance of culture quantitation

Question 16

Describe colonial and microscopic morphology of common organisms (both normal and
pathogenic

Question 17

Explain tests and media performed, with results, to identify each organism

Question 18

Define cystitis

Answer 18

inflammation of bladder

Question 19

Define dysuria

Answer 19

abnormalities in urinations (pain, burning, frequency, dripping, pyuria)

Question 20

Define glomerulonephritis

Answer 20

• inflammation of kidney glomeruli
• “allergic/hypersensitivity reaction after S. pyogenes infection”

Question 21

Define non-specific urethritis

Answer 21

inflammation of urethra

Question 22

Define pyelonephritis

Answer 22

inflammation of both kidneys and pelvis (parenchyma)

Question 23

Define cytoscopy

Answer 23

examination of bladder lining and urethra lining

Question 24

Tests to confirm Aerococcus urinae

Answer 24

cat wk+/-
PYR -
BEA -
NaCl +

Question 25

Tests to confirm Enterococcus faecalis

Answer 25

cat wk+/-
PYR +
BEA +
NaCl +

Question 26

Test & results to differentiate group A from group B strep

Answer 26

S. pyo is PYR +
Latex grouping A vs B
S. pyo is CAMP -
Taxos A = S

NOTE:
- “P” for “PYR Pos”
- “pyogenes” has no c = CAMP neg
- strep throat is readily susceptible to antibiotics

Question 27

Which of the following mechanisms protect the lower urinary tract from infection?

Select all that apply:

a.
Low urine pH

b.
High urine osmolarity

c.
Flushing action from urination

d.
High urine normal flora counts

Answer 27

Which of the following mechanisms protect the lower urinary tract from infection?

a.
Low urine pH

b.
High urine osmolarity

c.
Flushing action from urination

Question 28

Which of the following antimicrobials is only used for UTIs?

a.
Penicillin G

b.
Amphotericin

c.
Sulfamethoxazole

d.
Nitrofurantoin

Answer 28

d.
Nitrofurantoin

Question 29

Which of the following organisms match an A/A TSI?

Select all that apply:

a.
Morganella morganii

b.
Enterobacter cloacae

c.
Klebsiella pneumoniae

d.
Proteus mirabilis

Answer 29

Which of the following organisms match an A/A TSI?

b.
Enterobacter cloacae

c.
Klebsiella pneumoniae

Question 30

Which of the following reagents is used for a test that has a green reaction with a positive organism?

a.
Ferric chloride

b.
Kovac’s reagent

c.
Para-dimethylaminocinnameldahyde

d.
Tetramethyl-p-phenylenediamine dihydrochloride

Answer 30

a.
Ferric chloride

Question 31

Which of the following descriptions best fit a “typical” strain of Escherichia coli?

a.
Motile, anaerogenic, non-lactose fermenting, indole positive

b.
Motile, aerogenic, lactose fermenting, indole positive

c.
Motile, aerogenic, non-lactose fermenting, citrate negative

d.
Non-motile, aerogenic, lactose fermenting mucoid colony

Answer 31

b.
Motile, aerogenic, lactose fermenting, indole positive

Question 32

Which organism is the most common cause of urinary tract infections?

a.
Streptococcus bovis

b.
Escherichia coli

c.
Enterococcus faecalis

d.
Staphylococcus saprophyticus

Answer 32

b.
Escherichia coli

Question 33

Which of the following urine specimens is acceptable for bacterial culture?

a.
Unpreserved midstream urine at 4°C for 12 hours

b.
Midstream urine with SAF at 22°C for 2 hours

c.
24 hour urine at 4°C for 12 hours

d.
Collection bag urine at 22°C for 2 hours

Answer 33

a.
Unpreserved midstream urine at 4°C for 12 hours

Question 34

How can Aerococcus urinae be differentiated from non-hem Strep?

Answer 34

%= gpc tet/ cl

pos 6.5% NaCl

Question 35

List 3 antibiotics routinely used for UTIs

Answer 35

1. Fosfomycin
2. Nitrofurantoin
3. Sulfamethoxazole-trimethoprim