UTIs

Question 1

undertreatment of UTIs can lead to

Answer 1

pyelonephritis

Question 2

pathogenesis of UTIs - 3 ways

Answer 2

1- hematogenous - s. aureus bacteremia, candida
2- virulence factors - adhesins, fimbrae
3- ascending - e coli, enterobac

Question 3

protective factors against asymptomatic bacteriuria

Answer 3

• high urea in urine
• low pH
• frequent micturition

Question 4

majority of UTIs - what is their etiology EEK

Answer 4

• E coli
  Entero bac
• Klebsiella

Question 5

voided urine with same strain of bacteria >10^5

pyuria - WBCs

Answer 5

Asymptomatic bacteriuria

Question 6

If you have bacteria in the urine without clinical symptoms or consequences, and you are not pregnant THEN

Answer 6

DO NOT TREAT

Question 7

When is screening for asymptomatic bacteriuria important

Answer 7

in pregnant women

urologic procedures

Question 8

pregnant women have —- increased risk of developing what from asymptomatic bacteruiria

Answer 8

20-30x increased risk of pyelo

Question 9

dysuria
frequency 
urgency
\+leukocyte esterase, nitrites 
bacteriuria

Answer 9

uncomplicated cystisis

Question 10

2 treatment recommendations for uncomplicated cystisis

Answer 10

1- nitrofurantoin - 5 days

2- TMP-SMX - if local resistance < 20% - 3 days

Question 11

2 alternative Abx that can be used to treat uncomplicated cystisis

Answer 11

CIPRO

AMOX-CLAV

Question 12

Abx for acute uncomplicated pyelonephritis

Answer 12

• Cipro if e coli resistance < 10%
• TMP- SMX
  7- 14 days

Question 13

inpatient Abx for uncomplicated pyelo

Answer 13

= IV Fluoroquinolone
= amp+ gentamicin 
3rd gen ceph 
pip-tazo
14 days

Question 14

signs and symptoms of catheter-associated UTI

Answer 14

• fever, rigors, chills,
• ## flank pain, acute hematuria