UTI MR

Question 1

most common complication in pregnancy

Answer 1

UTI

Question 2

Predisposing factors of UTI

Answer 2

Short urethra
High levels of progestrone
Cortisol increase
Uterine enlargement
Physiological Glycosuria
Sex
Delivery
Instrementation

Question 3

How high levels of progestrone increase chance of UTI

Answer 3

cause hypertrophy of smooth muscles in ureter narrowing lumen causing urine stasis

Question 4

How high cortisol is factor of UTI

Answer 4

Suppresses immunity

Question 5

Uterine enlargement

Answer 5

compresses ureters= urine stasis

Question 6

Causative Organism

Answer 6

Most commonly E.Coli
Klebsiella
Streptococcus
Staph.aureus and saprophyticus
Proteus
Psuedomonas

Question 7

Routes of infection

Answer 7

Ascending route
Lymphatic Spread
Hematogenous Spread

Question 8

Severe type, requires hospitalization

Answer 8

Upper urinary tract infection

Question 9

Mild, home treated UTI

Answer 9

Lower UTI

Question 10

Part of urinary system that can be affected in Upper UTI

Answer 10

Kidney (Pyelonephritis)
Ureter (Ureteritis)

Question 11

Part of urinary system that can be affected in Lower UTI

Answer 11

Bladder (cystitis)
Urethra(Urethritis)

Question 12

Symptoms of Lower UTI

Answer 12

Dysuria
Burning micturation
Frequency (+6day +1 night)
Urgency
Hematuria (if there is stone)
Suprapubic or lower abdominal pain

Question 13

Symptoms of upper UTI

Answer 13

Loin pain
Fever
Palpitation
Vomiting
Chills

Question 14

Signs on examination of Upper UTI

Answer 14

Renal angle tenderness
High temp
Tachycardia
Signs of dehydration

Question 15

Why right kidney is more affected in UTI in pregnant women

Answer 15

Uterus is dextro-rotated (coz colon on left side) so more pressure on right ureter.
Ovarian vein passes over right ureter compresses it (left passes adjacent to left ureter)

Question 16

Investigation done for UTI

Answer 16

Midstream urine analysis
Culture and sensitivity
Nitrites
Ketone bodies
CBC (for WBC)
Random blood sugar
Renal function test

Question 17

Midstream urine analysis

Answer 17

Colour
Smell
+10^5 bacteria/ml
+10 pus cells (pyuria)
RBCs in urine

Question 18

Renal function test test for

Answer 18

creatinine and urea

Question 19

Presence of elevated white cells in urine (+10) but no bacteria

Answer 19

Sterile Pyuria

Question 20

Causes of Sterile Pyuria

Answer 20

Chlamydia
Gonorheaa
TB
Trichomonas Vaginalis
Herpes Virus
Renal stones
took antibiotic before sample
drank alot of water before sample
SLE
Kawasaki
Cancer

Question 21

Asymptomatic bacteruria

Answer 21

Presence of +10^5/ml of bacteria in 2 mid stream samples w/no symtoms

Question 22

Untreated Asymptomatic Bacteruria can cause

Answer 22

Progress to pyelonephritis
Preterm labour
ass. with Preclampsia and DM

Question 23

Diagnosis of Asymptomatic Bacteruria

Answer 23

Routine Analysis in 1st visit

Question 24

Treatment of Asymptomatic Bacteruria

Answer 24

Antibiotic
Ampicillin 500mg/6hrs
Cephalosporine, Nitofurantoin tablets

Question 25

Prophylaxis of UTI

Answer 25

fluid intake increase empty bladder frequently t/out day and after sex

Question 26

Treatment of Upper UTI

Answer 26

Hospital admission IV antibiotic Paracetamol Antiemetic IV fluids

Question 27

IV antibiotic given to Upper UTI

Answer 27

Penicillin (Amoxicillin, Ampicillin, Augmentin) Cephalosporin (Cefalexin, Cefazolin)

Question 28

If IV antibiotic for Upper UTI shows improvement after 48 hrs

Answer 28

Change to oral antibiotic

Question 29

If no improvement after 48 hours of IV antibiotic in Upper UTI

Answer 29

give Gentamicin

Question 30

No improvement on antibiotics for Upper UTI infections suggests

Answer 30

Renal Stone Perinephric Abcess Malformation (polycystic kidney) Diagnose via U/S

Question 31

Antiemetic given in Upper UTI

Answer 31

Metochlopramide Prochloroperazin

Question 32

Lower UTI treatment

Answer 32

Home treated Broad spectrum antibiotic for 3 days (changed if no improvement according to culture result)

Question 33

Fetal complications of UTI

Answer 33

Miscarriage IUFD IUGR Preterm Labour Childhood asthma

Question 34

Maternal Complications

Answer 34

Septicemia Perinephric abcess Anemia Renal failure Pulmonary oedema

Question 35

Safe antibiotic in pregnancy

Answer 35

Penecillins Cephalosporins

Question 36

Caution antibiotics

Answer 36

Gentamicin= ototoxicity

Question 37

Avoid in 1st trimester antibiotic

Answer 37

Trimetoprim = folate antagonist

Question 38

Avoid in 3rd trimester

Answer 38

Nitrofurantoin= Hemoplytic anemia Sulphonamides = kernicterus

Question 39

Contraindicated in Pregnancy Antibiotics

Answer 39

Tetracycline Ciprofloxacine Chloroamphenicol