Urinary Tract Infections Overview
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Questions and Answers

Which of the following statements about urinary tract infections (UTIs) is correct?

  • Females have a shorter urethra, increasing their risk of UTIs. (correct)
  • Upper UTIs consist of urethritis and cystitis.
  • UTIs are caused by viruses that ascend into the bladder from the urethra.
  • Males have a higher risk of developing UTIs compared to females.

    • Which of the following is NOT considered a lower urinary tract infection?

  • Urethritis
  • Pyelonephritis (correct)
  • Prostatitis
  • Cystitis

    • Which of the following factors increases the risk of UTIs in males?

  • Use of diaphragm as a contraceptive method
  • Lack of prostatic hyperplasia
  • Uncircumcised status or prostatic hyperplasia (correct)
  • Circumcision

    • Which of the following statements about complicated UTIs is correct?

    <p>UTIs in immunocompromised patients are considered complicated.</p> Signup and view all the answers

    What is the primary reason females have a greater risk of UTIs compared to males?

    <p>Females have a shorter urethra</p> Signup and view all the answers

    Which of the following types of UTIs is considered an upper UTI?

    <p>Pyelonephritis</p> Signup and view all the answers

    Which of the following is the most common pathogen that causes UTIs?

    <p>E.Coli</p> Signup and view all the answers

    What is the most common pathogen that causes treatment failure UTIs, recurrent UTIs?

    <p>S. saprophyticus</p> Signup and view all the answers

    What is the gold standard for diagnosing acute cystitis to determine the causative organism?

    <p>Culture</p> Signup and view all the answers

    Which urinary symptom is NOT commonly associated with acute cystitis?

    <p>frothy vaginal discharge</p> Signup and view all the answers

    What is the diagnostic threshold for a complicated case of acute cystitis in terms of colony-forming units per milliliter (CFU/mL) on culture?

    <p>More than 100,000 CFU/mL</p> Signup and view all the answers

    In recurrent urinary tract infections (UTIs), how many symptomatic episodes more than 2 weeks apart in one year classify as recurrent?

    <p>2-4 episodes</p> Signup and view all the answers

    When should asymptomatic bacteriuria be treated according to the information provided?

    <p>If the patient is post renal transplant</p> Signup and view all the answers

    What is a positive finding that suggest Acute cystitis on a UA

    <p>nitrites</p> Signup and view all the answers

    Which of the following symptoms differentiates pyelonephritis from a common UTI?

    <p>Fever and CVA tenderness</p> Signup and view all the answers

    In pyelonephritis, what key diagnostic finding can be observed on a urine microscopy?

    <p>White blood cell casts</p> Signup and view all the answers

    What is a potential complication of untreated pyelonephritis involving the kidneys?

    <p>Renal abscess</p> Signup and view all the answers

    Which of the following symptoms in an elderly patient with UTI should raise suspicion for pyelonephritis?

    <p>Altered mental status</p> Signup and view all the answers

    Where should you send a very ill appearing patient with persistent fevers, unstable vitals, and the inability to tolerate oral fluids, who has a suspected UTI or pyelonephritis?

    <p>Emergency room</p> Signup and view all the answers

    What is the preferred first-line treatment for uncomplicated cystitis in pregnant women?

    <p>Nitrofurantoin (100 mg twice a day for 5 days)</p> Signup and view all the answers

    What is the recommended treatment for uncomplicated cystitis in patients with a nitrofurantoin allergy?

    <p>Bactrim (1 double strength dose twice a day for 3 days) OR Fosfomycin (3 grams single dose)</p> Signup and view all the answers

    Which of the following is a contraindication for the use of Bactrim in the treatment of UTIs?

    <p>Sulfa allergy</p> Signup and view all the answers

    What is the recommended initial empiric treatment for outpatient acute pyelonephritis?

    <p>A single dose of ceftriaxone (1 g IV), Ciprofloxacin (400 mg IV), or Gentamicin (5mg/kg IV) followed by either ciprofloxacin, levofloxacin, or Bactrim</p> Signup and view all the answers

    Which of the following is NOT a recommended option for pharmaceutical UTI treatment in pregnant patients?

    <p>Tetracyclines</p> Signup and view all the answers

    Which of the following is NOT considered a prophylactic treatment option for recurrent UTIs?

    <p>Phenazopyridine</p> Signup and view all the answers

    How long can phenazopyridine (AZO/Pyridium) be used when taken with an antibiotic for a UTI?

    <p>2 days</p> Signup and view all the answers

    What is the recommended inpatient treatment for acute pyelonephritis, that is then followed by either ciprofloxacin (twice a day for 7 days), levofloxacin (once a day for 5 days), or Bactrim (twice a day for 14 days)?

    <p>All of the above</p> Signup and view all the answers

    What is the recommendation regarding UTI screening in catheterized patients?

    <p>UTI screening is not recommended because it does not change outcomes</p> Signup and view all the answers

    Which antibiotic should be used as the first-line treatment for uncomplicated cystitis?

    <p>Nitrofurantoin (100 mg twice a day for 5 days)</p> Signup and view all the answers

    If a patient has a nitrofurantoin allergy, what is the recommended treatment for uncomplicated cystitis?

    <p>Bactrim (1 double strength dose twice a day for 3 days) or Fosfomycin (3 grams single dose)</p> Signup and view all the answers

    Which antibiotic should be avoided in patients with a history of Clostridium difficile (C. diff) infection?

    <p>Fosfomycin</p> Signup and view all the answers

    Which of the following is a potential side effect of Bactrim that patients should be cautioned about?

    <p>Avoid direct sunlight</p> Signup and view all the answers

    What is the recommended duration of treatment for UTIs in men?

    <p>14 days</p> Signup and view all the answers

    What is the 3rd most common urinary tract disorder?

    <p>Nephrolithiasis</p> Signup and view all the answers

    Which type of stones are found in women with recurrent UTIs caused by certain bacteria?

    <p>Struvite stones</p> Signup and view all the answers

    What is the most common type of stone associated with kidney stones?

    <p>Calcium oxalate</p> Signup and view all the answers

    Which stones present as hexagonal crystals on urine microscopy?

    <p>Cystine calculi</p> Signup and view all the answers

    What is the treatment focus for uric acid calculi?

    <p>Alkalinizing the urine</p> Signup and view all the answers

    Which stone type must be treated with percutaneous nephrolithotomy?

    <p>Struvite calculi</p> Signup and view all the answers

    What is the best diagnostic test for kidney stones according to the text?

    <p>CT scan</p> Signup and view all the answers

    Which of the following is NOT a risk factor for developing nephrolithiasis (kidney stones)?

    <p>Obesity</p> Signup and view all the answers

    What is the recommended initial treatment for a patient presenting with a kidney stone less than 5 mm in size?

    <p>Pain control and hydration</p> Signup and view all the answers

    What is the most appropriate diagnostic test for suspected kidney stones?

    <p>Non-contrast computed tomography (CT) scan</p> Signup and view all the answers

    What is the recommended treatment for a patient with a kidney stone who presents with a fever?

    <p>Percutaneous nephrostomy stent</p> Signup and view all the answers

    Which of the following drugs is associated with an increased risk of kidney stone formation?

    <p>Acyclovir</p> Signup and view all the answers

    What is the most common underlying cause of hypercalciuria (high levels of calcium in the urine) leading to kidney stones?

    <p>Renal tubular dysfunction</p> Signup and view all the answers

    Which type of kidney stone is associated with an increased acidity, or pH less than 5.5, in the urine?

    <p>Uric acid calculi</p> Signup and view all the answers

    What is the recommended initial treatment for a patient presenting with a kidney stone less than 5 mm in size?

    <p>Medical expulsion therapy</p> Signup and view all the answers

    What is the recommended treatment for a patient with a kidney stone who presents with a fever?

    <p>Percutaneous nephrostomy stent</p> Signup and view all the answers

    What type of kidney stones are associated with a staghorn appearance, resembling the casting of the renal collecting system?

    <p>Struvite calculi</p> Signup and view all the answers

    What appears as a "dumbbell and bipyramidally" shaped crystals on urine microscopy

    <p>calcium oxalate</p> Signup and view all the answers

    What present as pleomorphic crystals with rhombic plates or rosettes on urine microscopy?

    <p>Uric acid calculi</p> Signup and view all the answers

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