Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MC > UTI > Flashcards

UTI Flashcards

(99 cards)

Start Studying
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
organisms in pts with urethral syndrome
The organisms may be anaerobic or fastidious in | their culture requirements
26
Specific organisms in pts with urethral syndrome
The organisms may include Ureaplasma, | Chlamydia and viruses
27
This is an uncommon but important cause of the | urethral syndrome
Interstitial cystitis
28
What are the classic sx of Interstitial cystitis?
The classic symptoms are frequency day and night and a dull suprapubic ache relieved briefly by bladder emptying
29
classic feature of Interstitial cystitis?
The feature is small haemorrhages on distension | of the bladder
30
What is the tx of Interstitial cystitis?
Treatment is hydrodistension ± a course of | tricyclics, for example amitriptyline
31
Collected urine is stored for 24 hrs in what temp?
4 ° C to prevent bacterial multiplication
32
How to get Clean catch midstream specimen of urine (MSU).
This is best collected from a full bladder, to allow at least 100 mL of urine to be passed before collection of the MSU
33
How to get Catheter specimen of urine (CSU)
a short open-ended catheter can be inserted and a specimen collected after 200 mL has flushed the catheter
34
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
Suprapubic aspirate of urine (SPA
35
How to obtain Suprapubic aspirate of urine (SPA
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
36
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
MSU MCC SPA CSU
37
_______findings of urinary leucocytes or nitrite are suggestive of UTI and may be an indication for empirical treatment if asymptomatic
Dipstick
38
__________ 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
Leucocyte esterase
39
_______dipsticks give a useful guide | to the presence of bacteria
Positive nitrite
40
How to detect pyuria using microscopy?
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
In the counting chamber pyuria is _____ WBC/mL in phase-contrast microscopy. Pyuria is a very sensitive sign of UTI.
>8000
42
Vaginal squames and debris indicate _____
contamination.
43
The_____ and _______ of organisms present in the | urine are the most useful indicators of UTI
nature and number
44
MC organisms seen in urine culture
Most common are enteric organisms
45
____ and ______ | are responsible for over 90% of UTI
Escherichia | coli (especially) and Staphylococcus saprophyticus
46
Gram negative organisms responsible for UTI
Gram-negative organisms ( Klebsiella sp. and Proteus sp.), enterococci sp . and Grampositive cocci ( Streptococcus faecalis and other staphylococci) also responsible.
47
Infections due to organisms other than E. coli (e.g. Pseudomonas sp.) are suggestive of an underlying _______
kidney tract abnormality
48
If _______ colony forming units (cfu) per mL of bacteria are present in an MSU, it is highly likely that the patient has a UTI
>10 5
49
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.
dysuria and frequency
50
Significant levels for UTI: • _________ WBC >10 per m L (10 × 10 6 /L) • ______: counts >10 5 cfu/mL (10 8 /L)
Microscopy: Culture
51
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 ```
trimethoprim or cephalexin Alkaliniser
52
Investigation of urinary tract infections Investigations are indicated in: All children All males ``` All women with: 1 2 3 4 ```
* acute pyelonephritis * recurrent infections: >2 per year * confirmed sterile pyuria * other features of kidney disease, e.g. haematuria
53
Basic investigations for UTI include: 1 2 3
1. MCU—microscopy and culture (post-treatment) 2. Kidney function tests: plasma urea and creatinine, eGFR 3. Intravenous urogram (IVU) and/or ultrasound
54
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
micturating cystogram ultrasound or IVU (urgent) to exclude obstruction
55
Treatment (non-pregnant women) of UTI _____ therapy is preferred to _____ therapy.
Multiple dose single dose
56
Treatment (non-pregnant women) of UTI Use for _____ days in women (trimethoprim—3 days). Use for ___ days in women with known urinary tract abnormality
5 10
57
Abx for Treatment (non-pregnant women) of UTI 1 2 3
``` • 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
Abx for Treatment (non-pregnant women) of UTI 4 5
• 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
Cautions for use of norfloxacin
Caution about tendonopathy, including rupture
60
When to do MCU after abx tx
Follow-up: MCU 1–2 weeks later.
61
Abx for Treatment (non-pregnant women) of UTI Avoid using important________as first-line agents
quinolones—norfloxacin | or ciprofloxacin—
62
Abx for Treatment (non-pregnant women) of UTI _____ is not first line because it has no advantage over trimethoprim and has more side effects.
Cotrimoxazole
63
Abx for Treatment (non-pregnant women) of UTI Treatment failures are usually due to a _______ or ______
resistant organism or an underlying abnormality of the urinary tract.
64
________ should always be excluded during early pregnancy because it tends to be blown into a full infection
Asymptomatic bacteriuria
65
Treatment of acute cystitis (empirical) in pregnancy: 1 2 3
• 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
Asymptomatic bacteriuria in pregnancy should be treated with a ______ course
week-long
67
Investigations for UTI in males
Investigations: MCU, U&E, ultrasound.
68
Abx for UTI in males 1 2 3
• 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
all males with a UTI should be investigated | to exclude an underlying______
abnormality, e.g. prostatitis, | obstruction.
70
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
Acute pyelonephritis
71
Duration of Tx of acute pyelonephritis
10 days
72
_____ or ______ is used for 10 days if resistance to these | drugs is proven.
Ciprofloxacin (500 mg (o) 12 hourly) or norfloxacin (400 mg (o) 12 hourly)
73
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
2 to 5
74
IV abx for acute pyelo 1 2
• 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
IV abx for acute pyelo Gentamicin can be replaced with IV ___ or ____
cefotaxime or | ceftriaxone
76
_____ 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
Persistent (chronic) UTIs
77
Abx for Recurrent or chronic urinary tract infections: ``` A 10- to 14-day course of: 1 2 3 4 ```
``` • 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
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
2 3–6
79
Abx for prevention of recurrent UTI 1 2 3
``` • trimethoprim 150 mg (o) nocte or • cephalexin 250 mg (o) nocte or • norfloxacin 200–400 mg (o) nocte (if proven resistance to others ```
80
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,
cranberries | Vaccinium macrocarpon
81
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.
T
82
The genitourinary tract is involved in _______ of cases | of tuberculosis.
3–5%
83
The genital and urinary tracts are | often involved in TB together as a result of ____
miliary spread.
84
MC presentation of GU TB
The commonest presenting complaints are | dysuria and frequency, which can be severe
85
Urine culture results of GU TB
Routine | urine culture shows sterile pyuria.
86
Xray findings of GU TB
typical X-ray appearance of distorted calyces | and medullary calcification
87
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 _____
upper UTIs and/or | systemic candidiasis
88
Tx of Candiduria
Use fluconazole 200 mg (o) daily for 7 days
89
Consider _______in men with few urinary symptoms (frequency, urgency and dysuria), flu-like illness, fever, low backache and perineal pain
bacterial prostatitis
90
Abx for mild to moderate bacterial prostatitis
amoxycillin + clavulanate | 500/125 mg (o) bd for 4–6 weeks.
91
Abx for moderate to severe bacterial prostatitis
If severe, use | amoxy/ampicillin 2 g IV 6 hourly plus gentamicin (
92
Treat or not? women with dysuria and frequency merely because there are <10 5 cfu/mL in an MCU
Treat
93
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 _____
vaginal candidiasis or antibioticinduced | diarrhoea
94
Most symptomatic UTIs are _____ occurring in sexually active women with anatomically normal urinary tracts
acute cystitis
95
A 3-day course of trimethoprim 300 mg daily is a | suitable first choice for ______
acute uncomplicated cystitis | in women.
96
The _______ examination may not detect calculi, small tumours, clubbed calyces and papillary necrosis.
ultrasound
97
In males the _____ is the most common source of | recurrent UTI
prostate
98
UTI is commonly associated with _______ (occasionally macroscopic haematuria).
microscopic | haematuria
99
Due to the rising level of E. coli resistance, ____ is no longer recommended unless susceptibility of the organism is proven
amoxycillin

MC (90 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions