Renal/Urology

Question 1

What kind of bacteria is e coli?

Answer 1

Gram negative bacillus coliform

Question 2

What are the common organims that cause UTI?

Answer 2

E coli
Proteus
Pseudomonas

Question 3

What kind of bacteria is proteus?

Answer 3

Gram negative coliform

Question 4

What kind of bacteria is pseudmonas aerginosa?

Answer 4

Gram negative bacilli (not a coliform)

Question 5

How do you treat pseudomonas UTI?

Answer 5

Ciprofloxacin oral

Question 6

Who gets pseudomnas UTI?

Answer 6

People with catheters/instrumentation

Question 7

What are some gram positive causes of UTI?

Answer 7

Enterococcus spp
Enterococcus faecalis (more common in hospital acquired infection)
Staph saphrophyticus (a coag negative staph that affects women of child bearing age)
Staph aureus (uncommon, seen in bacteraemia)

Question 8

Why does pseudomonas not give a positive test for nitrites?

Answer 8

It does not reduce nitrates to nitrites

Question 9

What bacteria reduce nitrates to nitrites?

Answer 9

Mainly coliforms

Question 10

Which bacteria do NOT give a positive test for nitrites on dipstick?

Answer 10

Enterococcus
Staphylococci
Pseudomonas

Question 11

What is Kass’s criteria for bacteruria?

Answer 11

Less than 10^3 organisms = not significant bacteriuria
10^4 organisms = repeat
10^5 = Probably UTI

Question 12

What is the treatment for an uncomplicated UTI in women?

Answer 12

Trimethoprim - 3 days

Nitrofurantoin - 3 days

Question 13

What is the treatment for an uncomplicated UTI in men?

Answer 13

Trimethoprim - 7 days

Nitrofurantoin - 7 days

Question 14

What is the prophylaxis regime for recurrent UTI?

Answer 14

Trimethorprim or nitrfurantoin once daily at night

Question 15

What is the treatment for acute bacterial prostatitis?

Answer 15

Ofloxacin or Ciprofloxacin

If IV required than Amox + Gent

Question 16

What is the treatment for pyelonephritis?

Answer 16

Primary care: Co amoxiclav or Co trimoxacole 14 days
Secondary care: Amoxicillin IV + Gentamicin IV for 3 days
Co trimoxazole if penicillin allergic
All patients stepped down to co trimoxazole

Question 17

What is the treatment for UTI in pregnancy?

Answer 17

1st or 2nd semester: Nitrfuranotin

3rd trimester: Trimethoprim

Question 18

What is the treatment for pyelonephritis in pregnancy?

Answer 18

Co Amoxiclav oral or IV

Question 19

Which antibiotics are best for covering coliforms?

Answer 19

Gentamicin IV
Amoxicillin (40%)
Trimethoprim
Co-trimoxazole

Question 20

What antibiotics are best for covering enterococci?

Answer 20

Co trimoxazole

Question 21

How long in gentamicin prescribed for?

Answer 21

3 days only unless specific guidance given

Question 22

What is ESBL?

Answer 22

Extended spectrum beta lactamase

Makes all bacteria resistant to cephlasporins and to almost all penicillins

Question 23

What antibiotics are useful in ESBL producing bacteria?

Answer 23

Nitrfurantoin

Pivmecllian

Question 24

What is in co trimoaxole?

Answer 24

Sulphamethoxazole (risk of stevens johnsons syndrome)

Trimethoprim

Question 25

Is pseudomonas sensitive to trimethoprim?

Answer 25

No

Question 26

Why is nitrofurantoin not useful in upper respiratory tract infection?

Answer 26

Only reaches effective concentrations in the bladder

Question 27

Why do you avoid nitrofurantoin in late pregnancy?

Answer 27

Can cause neonatal haemolysis

Question 28

What does nitrofurantoin treat and not treat?

Answer 28

``` Treats - Coliforms - Enterococci Staph aureus (+ MRSA) Doesn't treat - Proteus Pseudomonas ```

Question 29

What are the most common organisms that cause catheter associated UTI?

Answer 29

Psuedomonas | Proteus

Question 30

What does trimethoprim treat and not treat?

Answer 30

Treats - Most coliforms - Staph aureus + MRSA Psuedomans