Lower UTI

Question 1

Definition of UTI?

Answer 1

any infection of urinary tract

cystitis - infection of the bladder

Question 2

Name 4 risk factors of LUTI

Answer 2

1. Sexual intercourse
2. Female gender (shorter urethra)
3. Post menopause ( decreased oestrogen - loss of protection from vaginal flora)
4. Catheter
5. Diabetes mellitus
6. Urinary stasis

Question 3

Name 4 symptoms of LUTI

Answer 3

1. Suprapubic pain
2. Dysuria - pain/difficulty urinating
3. Frequent urination
4. Urinary stasis - problems voiding

Question 4

Symptoms of LUTI in Elderly

Answer 4

1. Fatigue
2. Incontinence
3. May develop delirium

Question 5

Ix of UTI

Answer 5

1. Urine dipstick 
# + leukocytes
# + nitrites

2. Urine culture (Gold standard)

Question 6

Further Ix

Answer 6

1. Renal ultrasound

Question 7

Gold standard Ix for UTI

Answer 7

1. Urine culture

Question 8

When should urine culture be sent?

Answer 8

1. > 65 years of age

2. visible / non visible haematuria

Question 9

Standard tx for LUTI

Answer 9

Trimethoprim / Nitrofunatoin for 3 days

Question 10

Treatment for symptomatic pregnant women

Answer 10

1. a urine culture should be sent in all cases
2. should be treated with an antibiotic for 7 days
   nitrofurantoin (should be avoided near term), amoxicillin or cefalexin

Question 11

Treatment for asymptomatic bacteriuria in pregnant women

Answer 11

1. a urine culture should be performed routinely at the first antenatal visit
2. immediate antibiotic prescription of either nitrofurantoin (should be avoided near term), amoxicillin or cefalexin.
3. This should be a 7-day course
   the rationale of treating asymptomatic bacteriuria is the significant risk of progression to acute pyelonephritis
4. a further urine culture should be sent following completion of treatment as a test of cure