UTI

Question 1

Asymptomatic bacteriuria usually represents…

Answer 1

bacterial colonization

**It has not clinical features of UTI

Question 2

Urethritis in isolation is suggestive of…

Answer 2

STI

Question 3

Infection of kidneys and ureter

Answer 3

Pyelonephritis

Question 4

Risk factors for Complicated UTIs

Answer 4

Male sex
Pregnancy
Postmenopausal
Immunosuppresion
Renal failure
Metabolic Disorders (Diabetes)
Anatomical or Functional abnormalities

Question 5

Health care associated UTIs are classified as

Answer 5

Complicated UTI

Question 6

T or F: UTIs are the most common infections leading to septic shock

Answer 6

T

Question 7

Reccurent UTI

Answer 7

≥ 3 episodes of symptomatic, culture proven UTI @1 year OR
≥ 2 episodes @6 months

Question 8

Route of Transmission of UTI

Answer 8

Ascendente
Hematogena *Stapg aureus
Inoculacion directa al riñon

Question 9

Bacteria commonly associated with UTIs

Answer 9

SEEK PP
Staph. saprophyticus
E.coli (UPEC)
Enterococcus
Klebsiella

Proteus
Pseudomonas

Question 10

Bacteria associated with UTIs that produces ureasa y alacaliniza orina (7-8 pH)

Answer 10

Proteus mirabillis

Question 11

Bacteria associated with UTI that produces ammonia and causes a pungent/irritating smell

Answer 11

Proteus mirabillis

Question 12

Nosocomial UTI infection by bacteria (enterococci, pseudomonas) is associated with

Answer 12

Drug resistance

Question 13

T or F: Adenovirus can also cause UTI @Immunocompromised Px and children

Answer 13

T

Question 14

Virulence factor if UPEC

Answer 14

Type 1 Fimbrae

Question 15

Virulence factor of Staph. saprophyticus

Answer 15

Adehisins

Question 16

Why is diabetes a risk factor for UTIs?

Answer 16

They inhibit phagocytosis and diapedesis of neutrophils

Question 17

Sex as Risk Factor in UTIs

Answer 17

W: shorter urethra + close anal-genital regions
M: uncirmcised

Question 18

Postmenopause as risk factor of UTI

Answer 18

↓ Estrogen levels –> ↓ vaginal lactobacilli —> ↑ vaginal pH –> E.coli colonization

Question 19

Structural or functional abnormalities of the UT

Answer 19

Prevent bladder emptying and/or result in urinary stasis

-Bening prostatic hyperplasia
-Congenital malformations
-Neurological bladder
-Urinary tract calculi

Question 20

T or F: Complicated UTI can happen equally at all people

Answer 20

F

They usually happen at predisposing factors

Question 21

How does the urine look in a UTI?

Answer 21

Cloudy (Turbia)

Question 22

Hypogastric pain

Answer 22

Cystitis

Lower UTI

Question 23

Immune response at Upper UTI

Answer 23

↑IL-6

Question 24

T or F: Pyelonephritis can cause bacteremia

Answer 24

T

Question 25

Sintoma distintivo de Upper UTI

Answer 25

Fever

Question 26

Flank pain @_____ UTI

Answer 26

Upper

Question 27

Clinical Features @Lower UTI

Answer 27

↑ Urinary frequency Urinary urgency Dysuria Hematuria Tenesmus

Question 28

ACUTE Pyelophreitis can cause

Answer 28

Necoris Abscess

Question 29

CHRONIC Pyelonephritis can lead to

Answer 29

Scarring

Question 30

Male with UTI usually refer ___ as symptom @UTIs

Answer 30

Pain @prostatic/perineal area

Question 31

Atypical symptoms @Older Adults

Answer 31

Urinary incontinence Constipation Altered mental status

Question 32

UTI complications @Pregnant women

Answer 32

↑ risk of Preterm labor Hypertension and Preeclampsia Chorioamnionitis

Question 33

What makes a pregnant women a risk px for UTIs?

Answer 33

↑ Progesterone levels --> urinary stasis + ureteral smooth muscle relaxation + dilation --> Vesicouretral reflux Gravid Uterus --> ↑ pressure @bladder --> Vesicouretral reflux Relative immunosuppression

Question 34

When is it recommended to do a screening test for UTIs @Preganant women?

Answer 34

1st Trimester

Question 35

What part of the urethra is colonized by E.coli?

Answer 35

1/3 parte distal

Question 36

When is an Urinalysis indicated?

Answer 36

To ALL Px with suspected UTI

Question 37

4 cosas que indican UTI @Urinalysis

Answer 37

Pyuria (>10,000) Nitrates (producto de metabolismo de bacteria) Esterasa Leucocitaria (producida por leucocitos activos) Bacteria

Question 38

When is an Uriculture indicated?

Answer 38

Suspicion of: - complicated UTI - uncomplicated cystitis with: · history of recurrent UTI · ≥ 65 yo * concern of multi resistant pathogens * atypical symptoms

Question 39

Methods of collection for Uriculture

Answer 39

Clean catch (mid stream) = ≥10^5 Catheter = ≥ 5 x 10^4 Suprapubic = any

Question 40

T or F: Px with complicated or recurrent UTI, uriculture should be obtained AFTER initiating antibiotic tx

Answer 40

F = BEFORE, because of false negatives

Question 41

When is imaging indicated? @UTI

Answer 41

Urinary tract obstruction Severe Illness (complicated pyelonephritis or urosepsis) Early recurrence of UTI Descartar litiasis como dx diferencial

Question 42

Tx for uncomplicated UTI infecctions

Answer 42

Beta lactams (@examen) Nitrofuranation Trimethoprim/Sulfamethazole

Question 43

Tx for complicated UTI

Answer 43

Fluorquinolones TMP/SMX

Question 44

T or F: UTI in men is classified at uncomplicated UTI

Answer 44

F

Question 45

What antibiotic cannot be used in men with UTI?

Answer 45

Nitrofuranation anf Fosfomycin because they are not able to penetrate the prostate tissue

Question 46

General recommendations to Tx UTI

Answer 46

Ir al baño = Flujo urinario = tomar mucha agua Citricos = ↓pH @orina

Question 47

T or F: Antibiotic Tx only for complicated UTI

Answer 47

F = for ALL symptomatic UTI

Question 48

Dysuria + Abnormal vaginal/urethral discharge

Answer 48

Diferential Dx = Vaginitis or STI