Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MC > UTI > Flashcards

UTI Flashcards

1
Q

_________) is a common problem
affecting all ages and accounts for approximately
1% of all attendances in general practice

A

Urinary tract infection (UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

T OR F

Organisms causing UTI in the community are
usually sensitive to most of the commonly used
antibiotics.

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Screening of asymptomatic women has shown that

about ______ have bacterial UTI

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

About 1% of neonates and 1–2% of schoolgirls

have _____

A

asymptomatic bacteriuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

About one-third of women have been estimated to
have symptoms suggestive of_______ at some stage
of their life

A

cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Ascending infection accounts for ______

of UTIs.

A

93%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

All males and females less than 5 years old
presenting with a UTI require investigation for an
underlying ________

A

abnormality of the urinary tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Infants less than six months old with a UTI have a

significant risk of ____

A

bacteraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Consider the ________ as a cause of

non-infective cystitis

A

NSAID tiaprofenic acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This is defined as the presence of pus cells but a

sterile urine culture.

A

Sterile pyuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Common causes of Sterile pyuria

• contamination of poorly collected urine
specimens
• urinary infections being treated by antibiotics,
i.e. inadequately treated infections

1
2
3
4
5
6
7
A
  • analgesic nephropathy
  • staghorn calculi
  • other kidney disorders (e.g. polycystic kidney)
  • bladder tumours
  • tuberculosis
  • chemical cystitis (e.g. cytotoxic therapy)
  • appendicitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

This is defined as the presence of a significant growth
of bacteria in the urine (concentration >10 8 colonyforming
units/L), which has not produced symptoms
requiring consultation

A

Asymptomatic bacteriuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Screening for and treatment of asymptomatic
bacteriuria is not recommended except for:

1

2

A

• pregnant women because of the risk of
pyelonephritis and pregnancy complications

• patients before urological procedures (e.g.
TURP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

This is defined as the presence of frequency, dysuria
and loin pain alone or in combination, together with
a significant growth of organisms on urine culture

A

Symptomatic bacteriuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The clinical differentiation between cystitis
or lower UTI and kidney or upper UTI cannot be
made accurately on the basis of symptoms, except
in those patients with _____ and _____

A

well-defined loin pain and/or

tenderness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Inflammation of the bladder and/or urethra is
associated with dysuria (pain or scalding with
micturition) and/or urinary frequency

A 
Acute cystitis (dysuria-frequency
syndrome)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In severe cases of acute cystitis
, _______may be present, and
the urine may have an offensive smell.

A

haematuria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F,

Constitutional symptoms are minimal or absent in pts with acute cystitis

A

T

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Other causes of dysuria and frequency include
1
2
3

A

urethritis, prostatitis and vulvovaginitis, all of

which can normally be distinguished clinically

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Acute bacterial infection of the kidney produces
loin pain and constitutional upset, with fever,
rigors, nausea and sometimes vomiting

A

Acute pyelonephritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

This is cystitis occurring in the uninstrumented nonpregnant
female without structural or neurological
abnormalities.

A

Uncomplicated urinary tract infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

This is associated with anatomical or functional
abnormalities (e.g. diabetes, urinary calculi) that
increase the risk of serious complications or
treatment failure

A

Complicated urinary tract infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

The _________ (sometimes termed abacterial
cystitis) is that where the patient presents with
dysuria and frequency but does not show a positive
urine culture

A

urethral syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

urethral syndrome

_______ of adult women with urinary symptoms
have this syndrome

A

30–40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

organisms in pts with urethral syndrome

A

The organisms may be anaerobic or fastidious in

their culture requirements

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Specific organisms in pts with urethral syndrome

A

The organisms may include Ureaplasma,

Chlamydia and viruses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

This is an uncommon but important cause of the

urethral syndrome

A

Interstitial cystitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the classic sx of Interstitial cystitis?

A

The classic symptoms are frequency day and
night and a dull suprapubic ache relieved briefly
by bladder emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

classic feature of Interstitial cystitis?

A

The feature is small haemorrhages on distension

of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the tx of Interstitial cystitis?

A

Treatment is hydrodistension ± a course of

tricyclics, for example amitriptyline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Collected urine is stored for 24 hrs in what temp?

A

4 ° C to prevent bacterial multiplication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How to get Clean catch midstream specimen of urine (MSU).

A

This is best collected from a full bladder, to allow
at least 100 mL of urine to be passed before
collection of the MSU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How to get Catheter specimen of urine (CSU)

A

a short open-ended
catheter can be inserted and a specimen collected
after 200 mL has flushed the catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

This is an extremely reliable way to detect bacteriuria in
neonates and in patients where UTI is suspected
but cannot be confirmed because of low colony
counts or contamination in an MSU

A

Suprapubic aspirate of urine (SPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How to obtain Suprapubic aspirate of urine (SPA

A

Under local anaesthetic, a needle (lumbar puncture needle in adults) is inserted into the very full bladder
about 1–2 cm above the pubic symphysis, and
20 mL is collected by a syringe. Any organisms in
an SPA specimen indicate UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Urine specimen collection in children

• Bag specimen: cannot diagnose UTI
• ________—usually by 3–4 years when cooperative
• ______—practical and reliable
• ______—reliable and the best option
• _______—for failed SPA or those unable to void on
request

A

MSU

MCC

SPA

CSU

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

_______findings of urinary leucocytes or nitrite
are suggestive of UTI and may be an indication for
empirical treatment if asymptomatic

A

Dipstick

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

__________ dipsticks
are useful in detecting pyuria and give a good guide
to infection with a specificity of 94–98% (2–6%
false positive) and 74–96% sensitivity (4–26% false
negatives). 5

A

Leucocyte esterase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

_______dipsticks give a useful guide

to the presence of bacteria

A

Positive nitrite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

How to detect pyuria using microscopy?

A

The urine is examined under a microscope to detect
pyuria (more than 10 pus cells—WBCs—per highpowered
field) but should be examined in a counting
chamber to calculate the number of WBCs/mL of urine.

41
Q

In the counting chamber pyuria is _____ WBC/mL
in phase-contrast microscopy. Pyuria is a very
sensitive sign of UTI.

A

> 8000

42
Q

Vaginal squames and debris indicate _____

A

contamination.

43
Q

The_____ and _______ of organisms present in the

urine are the most useful indicators of UTI

A

nature and number

44
Q

MC organisms seen in urine culture

A

Most common are enteric organisms

45
Q

____ and ______

are responsible for over 90% of UTI

A

Escherichia

coli (especially) and Staphylococcus saprophyticus

46
Q

Gram negative organisms responsible for UTI

A

Gram-negative organisms ( Klebsiella
sp. and Proteus sp.), enterococci sp . and Grampositive
cocci ( Streptococcus faecalis and other
staphylococci) also responsible.

47
Q

Infections due to organisms other than E. coli
(e.g. Pseudomonas sp.) are suggestive of an
underlying _______

A

kidney tract abnormality

48
Q

If _______ colony forming units (cfu) per mL of
bacteria are present in an MSU, it is highly likely
that the patient has a UTI

A

> 10 5

49
Q

On the other hand, it is most important to realise
that up to 30% of women with acute bacterial
cystitis have less than 10 5 cfu/mL in the MSU.
For this reason, it is reasonable to treat women
with ______ and ______ even if they have
<10 5 cfu/mL of organisms in an MSU.

A

dysuria and frequency

50
Q

Significant levels for UTI:
• _________ WBC >10 per m L (10 × 10 6 /L)
• ______: counts >10 5 cfu/mL (10 8 /L)

A

Microscopy:

Culture

51
Q

UTI: basic management

Urine dipstick
• Microculture (clean catch)
• First-line antibiotics—\_\_\_\_\_\_\_
• \_\_\_\_\_ for severe dysuria
• High fluid intake
• Check sensitivity—leave or change ABs
• Repeat MCU within 48 hours after AB course
A

trimethoprim or cephalexin

Alkaliniser

52
Q

Investigation of urinary tract infections

Investigations are indicated in:

All children

All males

All women with:
1
2
3
4
A
  • acute pyelonephritis
  • recurrent infections: >2 per year
  • confirmed sterile pyuria
  • other features of kidney disease, e.g. haematuria
53
Q

Basic investigations for UTI include:

1
2
3

A
  1. MCU—microscopy and culture (post-treatment)
  2. Kidney function tests: plasma urea and creatinine, eGFR
  3. Intravenous urogram (IVU) and/or ultrasound
54
Q

Special considerations for UTI:

In children: _____
In adult males: consider prostatic infection studies if IVU
normal
In severe pyelonephritis:______
In pregnant women: ultrasound to exclude obstruction

A

micturating cystogram

ultrasound or IVU (urgent) to
exclude obstruction

55
Q

Treatment (non-pregnant women) of UTI

_____ therapy is preferred to _____
therapy.

A

Multiple dose

single dose

56
Q

Treatment (non-pregnant women) of UTI

Use for _____ days in women (trimethoprim—3 days).
Use for ___ days in women with known urinary
tract abnormality

A

5

10

57
Q

Abx for Treatment (non-pregnant women) of UTI

1
2
3

A 
• trimethoprim 300 mg (o) daily for 3 days (first
choice)
or
• cephalexin 500 mg (o) daily for 5 days
or
• amoxycillin/ + clavulanate 500/125 mg (o) 12
hourly for 5 days
or
58
Q

Abx for Treatment (non-pregnant women) of UTI

4
5

A

• nitrofurantoin 50 mg (o) 6 hourly for 5 days
or
• norfloxacin 400 mg (o) 12 hourly for 3 days
(if resistance to above agents proven and if
susceptible)

59
Q

Cautions for use of norfloxacin

A

Caution about tendonopathy, including rupture

60
Q

When to do MCU after abx tx

A

Follow-up: MCU 1–2 weeks later.

61
Q

Abx for Treatment (non-pregnant women) of UTI

Avoid using important________as first-line agents

A

quinolones—norfloxacin

or ciprofloxacin—

62
Q

Abx for Treatment (non-pregnant women) of UTI

_____ is not first line because it has no
advantage over trimethoprim and has more side
effects.

A

Cotrimoxazole

63
Q

Abx for Treatment (non-pregnant women) of UTI

Treatment failures are usually due to a _______ or ______

A

resistant
organism or an underlying abnormality of the
urinary tract.

64
Q

________ should always be excluded
during early pregnancy because it tends to be blown
into a full infection

A

Asymptomatic bacteriuria

65
Q

Treatment of acute cystitis (empirical) in pregnancy:

1
2
3

A

• cephalexin 500 mg (o) 12 hourly for 5 days
or
• nitrofurantoin 100 mg (o) 12 hourly for 5 days
or
• amoxycillin + clavulanate 500/125 mg (o) 12
hourly for 5 days

66
Q

Asymptomatic bacteriuria in pregnancy should be treated with a ______ course

A

week-long

67
Q

Investigations for UTI in males

A

Investigations: MCU, U&E, ultrasound.

68
Q

Abx for UTI in males

1
2
3

A

• trimethoprim 300 mg (o) daily for 14 days
or
• cephalexin 500 mg (o) 12 hourly for 14 days
or
• amoxycillin + clavulanate 500/125 mg (o) 12
hourly for 14 days

69
Q

all males with a UTI should be investigated

to exclude an underlying______

A

abnormality, e.g. prostatitis,

obstruction.

70
Q

Mild cases can be treated with oral therapy alone
using double the dosage of drugs recommended for
uncomplicated cystitis, except for trimethoprim
when the same dosage is recommended

A

Acute pyelonephritis

71
Q

Duration of Tx of acute pyelonephritis

A

10 days

72
Q

_____ or ______ is used for 10 days if resistance to these

drugs is proven.

A

Ciprofloxacin
(500 mg (o) 12 hourly) or norfloxacin (400 mg (o)
12 hourly)

73
Q

acute pyelonephritis

For severe infection with suspected septicaemia,
admit to hospital and treat initially with parenteral
antibiotics for ______days after taking urine for
microscopy and culture and blood for culture

A

2 to 5

74
Q

IV abx for acute pyelo

1
2

A

• amoxycillin 2 g IV 6 hourly 4
plus
• gentamicin 4–6 mg/kg/day, single daily IV dose
Follow with oral therapy for a total of 14 days

75
Q

IV abx for acute pyelo

Gentamicin can be replaced with IV ___ or ____

A

cefotaxime or

ceftriaxone

76
Q

_____ indicate that the organism is resistant to the
antimicrobial agents employed or that there is an
underlying abnormality such as a kidney stone or a
chronically infected prostate in the male patient

A

Persistent (chronic) UTIs

77
Q

Abx for Recurrent or chronic urinary tract
infections:

A 10- to 14-day course of:
1
2
3
4
A 
• amoxycillin/potassium clavulanate (500/125 mg)
(o) 12 hourly
or
• trimethoprim 300 mg (o) once daily
or
• cephalexin 500 mg (o) 12 hourly
or
• norfloxacin 400 mg (o) 12 hourly (if proven
resistance to above agents)
78
Q

In some female patients with recurrent UTI a
single dose of a suitable agent within_______hours after
intercourse is adequate but, in more severe cases,
courses may be taken for____ months or on occasions
longer

A

2

3–6

79
Q

Abx for prevention of recurrent UTI

1
2
3

A 
• trimethoprim 150 mg (o) nocte
or
• cephalexin 250 mg (o) nocte
or
• norfloxacin 200–400 mg (o) nocte (if proven
resistance to others
80
Q

A recent Cochrane review on the use of _____________ for the prevention of UTI
concluded that there was evidence to recommend
for the prevention of
recurrent symptomatic UTIs in women,

A

cranberries

Vaccinium macrocarpon

81
Q

T or F

There is poor
evidence for the use Cranberry juice in the treatment of UTI, in the
management of asymptomatic bacteriuria, or in the
prevention of UTIs in children.

A

T

82
Q

The genitourinary tract is involved in _______ of cases

of tuberculosis.

A

3–5%

83
Q

The genital and urinary tracts are

often involved in TB together as a result of ____

A

miliary spread.

84
Q

MC presentation of GU TB

A

The commonest presenting complaints are

dysuria and frequency, which can be severe

85
Q

Urine culture results of GU TB

A

Routine

urine culture shows sterile pyuria.

86
Q

Xray findings of GU TB

A

typical X-ray appearance of distorted calyces

and medullary calcification

87
Q

The presence of Candida albicans in the urine is
common. Antifungal therapy is not recommended
if associated with indwelling catheters but is
recommended if associated with____ or _____

A

upper UTIs and/or

systemic candidiasis

88
Q

Tx of Candiduria

A

Use fluconazole 200 mg (o) daily for 7 days

89
Q

Consider _______in men with few urinary
symptoms (frequency, urgency and dysuria), flu-like
illness, fever, low backache and perineal pain

A

bacterial prostatitis

90
Q

Abx for mild to moderate bacterial prostatitis

A

amoxycillin + clavulanate

500/125 mg (o) bd for 4–6 weeks.

91
Q

Abx for moderate to severe bacterial prostatitis

A

If severe, use

amoxy/ampicillin 2 g IV 6 hourly plus gentamicin (

92
Q

Treat or not?

women with dysuria and frequency
merely because there are <10 5 cfu/mL in an
MCU

A

Treat

93
Q

Overtreating women with acute cystitis and
normal urinary tracts; single-dose therapy is
effective in 70–80% of cases, and overtreatment
often leads to _____ and _____

A

vaginal candidiasis or antibioticinduced

diarrhoea

94
Q

Most symptomatic UTIs are _____ occurring
in sexually active women with anatomically normal
urinary tracts

A

acute cystitis

95
Q

A 3-day course of trimethoprim 300 mg daily is a

suitable first choice for ______

A

acute uncomplicated cystitis

in women.

96
Q

The _______ examination may not detect calculi,
small tumours, clubbed calyces and papillary
necrosis.

A

ultrasound

97
Q

In males the _____ is the most common source of

recurrent UTI

A

prostate

98
Q

UTI is commonly associated with _______ (occasionally macroscopic haematuria).

A

microscopic

haematuria

99
Q

Due to the rising level of E. coli resistance,
____ is no longer recommended unless
susceptibility of the organism is proven

A

amoxycillin

MC (90 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions