Necla Flashcards
An 18-year-old woman has symptoms of a lower urinary tract infection. Which of the following statements about the nitrate test is true?
A. Detects the presence of bacterial nitrate reductase
B. Specificity is below 80% for indicating a urinary tract infection
C. Sensitivity is above 90% for detecting a urinary tract infection
D. False positives arise with Enterococcus spp.
E. False positives arise when urine has been in the bladder for less than 4 hours
A. Detects the presence of bacterial nitrate reductase
An 18-year-old woman has symptoms of a lower urinary tract infection. Which of the following statements about the leukocyte esterase test is true?
A. False negatives arise as a result of contamination with vaginal secretions
B. False positives arise in patients with neutropaenia
C. False positives arise in patients with proteinuria
D. A positive result can occur with damaged or lysed leukocytes
E. A positive result indicates a successful antimicrobial treatment course
D. A positive result can occur with damaged or lysed leukocytes
An 18-year-old woman has symptoms of a lower urinary tract infection. Which of the following statements about specimen collection is true? A. Unpreserved urine should be processed in less than 4 hours from collection time
B. Preservatives such as iodine stabilise bacterial counts for 24–72 hours from collection
C. A suprapubic aspirate should be obtained
D. The first void urine of the day should be collected
E. A pure growth of an organism in a mid-stream urine is indicative of a pathogen
A. Unpreserved urine should be processed in less than 4 hours from collection time
A 23-year-old female presents with a urinary tract infection. Why are urinary tract infections more common among women?
A. Density of bacterial receptors for uropathogens is higher in women B. Urethral distance is shorter in women
C. Vulval conditions propagate bacterial growth
D. Rate of infection is the same in women and men
E. Men are more likely to urinate after sex
B. Urethral distance is shorter in women
Which of the following findings in urinalysis are consistent with urinary tract infections?
A. Many epithelial cells
B. Negative nitrite
C. Large leukocyte esterase D. Yellow color
C. Large leukocyte esterase
When deciding on an antibiotic to empirically treat a first-time urinary tract infection, the most important consideration should be:
a. Cost of the medication
b. A spectrum of activity that includes E. coli c. Oral versus intravenous formulation
d. Dosing regimen of the medication
b. A spectrum of activity that includes E. coli
A 35 year-old female presents to your office with dysuria and increased urinary frequency. What etiologic agent is responsible for most cases of acute cystitis?
• Escherichia coli
• Enterococcus faecalis
• Klebsiella pneumoniae
• Proteus mirabilis
• Staphylococcus saprophyticus
• Escherichia coli
A 55-year-old male presented to his general practitioner with fever. On examination, he was tachycardic and febrile. There were no localising signs or symptoms. A urine culture was sent and a pure growth of an organism was identified. Which bacteria are normally associated with haematogenous dissemination when found in a mid-stream urine?
A. Staphylococcus aureus
B. Staphylococcus saprophyticus C. Escherichia coli
D. Salmonella Typhi
E. Mycobacterium tuberculos
A. Staphylococcus aureus
23-year-old female presents with a urinary tract infection. Which factor increases the frequency of urinary tract infection?
A. Use of a spermicidal gel
B. Avoiding anal sex
C. Use of a condom
D. Consumption of cranberry juice E. Postcoital micturition
A. Use of a spermicidal gel
A 73-year-old male presents with a urinary tract infection. Why are urinary tract infections more common among elderly men?
A. Urethral catheterisation
B. Normal-sized prostate
C. Increase of prostatic secretions D. Dilation of the ureter
E. Vesicoureteral reflux
A. Urethral catheterisation
A 73-year-old female presents with a urinary tract infection. Why are urinary tract infections more common among elderly women?
A. Increased vaginal lactobacilli
B. Vesicoureteric reflux
C. Cognitive decline
D. Increased albumin in urine
E. Oestrogen replacement therapy
C. Cognitive decline
23-year-old pregnant woman has a mid-stream urine submitted. How should a mid-stream urine in a pregnant woman be interpreted?
A. Asymptomatic bacteriuria develops in 20–40% of pregnant women
B. Asymptomatic bacteriuria is diagnosed with a bacterial count higher than 105 CFU/mL
C. Asymptomatic bacteriuria should always be treated in pregnancy
D. Risk of pyelonephritis is comparable between pregnant and non- pregnant women
E. Urinary tract infections in pregnancy have no effect on foetal development
B. Asymptomatic bacteriuria is diagnosed with a bacterial count higher than 105 CFU/mL
23-year-old woman is symptomatic of a lower urinary tract infection but when a urine sample is sent is demonstrated to have sterile pyuria. What condition is sterile pyuria not characteristic of?
A. Renal tract Mycobacterium tuberculosis infection
B. Chlamydia trachomatis urethritis
C. Antibiotic-treated Escherichia coli urinary tract infection D. Neisseria gonorrhoeae infection
E. Staphylococcus saprophyticus urinary tract infection
E. Staphylococcus saprophyticus urinary tract infection
Empiric treatment of an asymptomatic UTI is not recommended. What is the one exception to this rule?
• Children under 18 years of age • Elderly men 75+
• Elderly women 75+
• Pregnant women
• Young women of childbearing age
• Pregnant women
23-year-old female presents with a urinary tract infection. Which of the following is true about urease producing bacteria?
A. Urease acidifies the urine rendering neutrophils inactive
B. Escherichia coli is urease positive
C. Acidifying the urine can lead to precipitation of struvite calculi D. Morganella morganii is potentially a urea-splitting bacteria
E. Are commensal organisms that prevent hepatic encephalopathy
D. Morganella morganii is potentially a urea-splitting bacteria
