Urinary Tract Infections

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Question 1 of 10

1. Question
Which of the following are true regarding urinary tract infection (UTI) in the emergency department?
- Female patients with UTI should be advised to increase water intake, drink cranberry juice and to void promptly after intercourse, as there is a strong evidence basis for these actions
- Risk factors for UTI development in males are insertive anal intercourse and prostatic hypertrophy
- E.coli is responsible for 80-95% of uncomplicated UTIs
- The presence of a renal stone increases the likelihood of UTI in both sexes
- A common pathogen in men with prostatic hypertrophy is enterococcus
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Question 2 of 10

2. Question
A young female presents to the emergency department convinced she has a UTI. Which of the following, if present, would make it more likely to be a urethritis?
- Frequency of passage of urine
- Relatively fewer white cells in the urine
- Vaginal discharge and vaginal bleeding and no frequency
- Urgency
- Protein and nitrites in the urine
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Question 3 of 10

3. Question
Urine dipstick is often misinterpreted in the emergency department. Which of the following statements is true regarding findings from an MSU sample?
- The sensitivity of leucocyte esterase alone is 20%
- The sensitivity of nitrites is 100%
- If both leucocyte esterase and nitrites are positive, the sensitivity for UTI diagnosis is 94%
- The absence of nitrites excludes the presence of all pathogens
- If the urine dipstick definition of a UTI was positive leucocyte and nitrite, the overtreatment rate for UTI would be 90%
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Question 4 of 10

4. Question
Urinary nitrites on dipstick can be affected by various factors. Which one of the following does not affect nitrite tests?
- Inadequate dietary nitrate
- An excess of vitamin C
- Spermicidal jelly
- Low urine pH
- Very high levels of urinary urobilinogen
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Question 5 of 10

5. Question
Which one of the following conditions usually does not require a formal urine culture in the emergency department?
- A healthy young female with symptoms and signs of pyelonephritis
- A 35 year old male with symptoms of UTI and dipstick positive white cells and nitrites
- A patient with HIV and symptoms of UTI and dipstick positive white cells and nitrites
- A simple uncomplicated UTI in a fit healthy young female with normal UGT
- A 65 year old female with symptoms suggestive of a UTI
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Question 6 of 10

6. Question
The elderly commonly suffer from urinary sepsis. In the elderly with pyelonephritis, which one of the following statements is false?
- Symptoms and signs are commonly not those involving the urinary tract
- 20% of cases of pyelonephritis in the elderly can involve GI or respiratory symptoms
- Pyelonephritis in the elderly patient classically presents with fever, loin pain and chills
- Fever is absent in up to 33% of cases
- It is a common condition
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Question 7 of 10

7. Question
Which of the following would be considered a reason to treat pyelonephritis in the community?
- Pregnancy
- Urinary tract obstruction
- Dehydration
- A healthy young female with none of the above; first episode; no signs of sepsis
- Renal failure
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Question 8 of 10

8. Question
You see an elderly patient with an in-dwelling catheter and think of UTIs in this setting. Which of the following is true?
- Suprapubic catheters are associated with fewer UTIs
- Bacteruria would indicate a UTI
- Pyuria always indicates a UTI
- The diagnosis is easily established without culture
- The patient’s catheter must have become blocked
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Question 9 of 10

9. Question
Which of the following are not considered appropriate drugs to treat pyelonephritis?
- Gentamicin
- Third generation cephalosporins
- Ceftriaxone
- Trimethoprim
- Ciprofloxacin
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Question 10 of 10

10. Question
You have a patient with a history and dipstick findings suggestive of a UTI. She is eight weeks pregnant. Which of the following antibiotics should be used if she has no documented allergies?
- Ciprofloxacin
- Tetracycline
- Ceftriaxone
- Nitrofurantoin
- Trimethoprim
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Urinary Tract Infections – Post Test

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