Question 1

What is the cause of most uncomplicated urinary tract infections (UTIs)?

Accepted Answer

Of the Enterobacteriaceae, antibiotic-susceptible strains of E.coli that emanate from the patient's own fecal flora cause most uncomplicated UTIs.

Question 2

Bacteria gain access to the urinary tract by all of the following routes except the:

Accepted Answer

Bacteria gain access to the urinary tract by three different routes, the ascending route, the hematogenous route, and the lymphatic pathways.

Question 3

What may candiduria signify?

Accepted Answer

Candiduria may be an indication of bladder or renal parenchymal infection, a urinary tract fungus ball, or disseminated candidiasis.Predisposing factors include diabetes mellitus, antibiotic and corticosteroid therapy, female gender, instrumentations, and disturbance of urine flow.

Question 4

What characteristic of urine inhibits growth of many pathogens?

Accepted Answer

Although urine is frequently considered a good culture medium, the extremely high urine osmolarity (concentration) and low pH levels inhibit the growth of many uropathogens and almost all normal bacterial flora of the urethra.

Question 5

The criteria used to determine the presence of a urinary tract infection (UTI) include all the following except:

Accepted Answer

The criteria that determine if a UTI is present must include the presence or absence of symptoms, predisposing factors, the patient population, and the type of organism or organisms isolated.

Question 6

A young woman goes to her physician complaining of dysuria, frequency, urgency, and suprapubic pain.A urinalysis shows hematuria, positive protein, positive leukocyte esterase, and a positive nitrite.What is a probable diagnosis?

Accepted Answer

Adults with uncomplicated lower UTIs limited to the urethra or bladder present primarily with dysuria, often in combination with frequency, urgency, suprapubic pain, and hematuria.Each episode of uncomplicated UTI in women is usually associated with 1 week of symptoms.

Question 7

What group has more urinary tract infections (UTIs) caused by Staphylococcus saprophyticus?

Accepted Answer

S.saprophyticus is found predominantly in symptomatic sexually active women younger than age 40.

Question 8

Urine cultures are performed for all the following reasons except to:

Accepted Answer

Urine cultures are requested not only in connection with the symptoms of acute urinary tract infection (UTI) but also in the absence of specific symptoms, as a test of cure, to evaluate the effectiveness of antimicrobial therapy, to detect asymptomatic bacteriuria in pregnant women, and to evaluate for bacteremia, fever, or both, to name but a few instances.

Question 9

What is the most common way for the renal parenchyma to become infected with gram-positive bacteria?

Accepted Answer

Infection of the renal parenchyma by many species of gram-positive bacteria (particularly in patients with staphylococcal bacteremia or endocarditis, mycobacterial infection, Candida infection, and other fungal infections) clearly occurs by the hematogenous route.Gram-negative infections rarely occur by the hematogenous route.

Question 10

All of the following can contribute to reduced leukocyte chemotaxis in the renal medulla except:

Accepted Answer

Conditions such as high ammonia concentration, hyperosmolarity, lowered pH, and sluggish blood flow in the renal medulla can contribute to reduced leukocyte chemotaxis and bactericidal activity of white blood cells, resulting in lowered infection resistance.

Question 11

What organisms usually cause urinary tract infections (UTIs) in older men in conjunction with prostatic hypertrophy?

Accepted Answer

Enterococcal UTIs occur primarily in older men, particularly in association with urinary tract manipulation or instrumentation or prostatic hypertrophy.

Question 12

Urinary tract infection (UTI) in children is associated with significant morbidity and long-term medical problems, including all the following except:

Accepted Answer

UTI in children is associated with great morbidity and long-term medical problems, including impaired renal function, hypertension, end-stage renal disease, and complications of pregnancy as an adult.

Question 13

What is one factor that may contribute to the incidence of candiduria in hospitalized patients?

Accepted Answer

Candiduria is rare in healthy adults.However, it is commonly seen in hospitalized patients.As many as 10% of patients in tertiary care facilities have Candida in their urine.This is because of several factors, including sicker patients, increasing incidence of urinary instrumentation, and increasing use of broad-spectrum antibiotics.

Question 14

Because the urethra is shorter in women, bacteria are easily introduced into the bladder by:

Accepted Answer

Because of the shorter urethra in women, bacteria are easily introduced into the bladder by sexual intercourse.

Question 15

The atypical clinical presentation of a geriatric patient with a urinary tract infection (UTI) includes all the following except:

Accepted Answer

The diagnosis and management of UTI in the geriatric population can be challenging.These patients frequently have an atypical clinical presentation including delirium, fevers alone, or failure to thrive.

Question 16

All of the following are reasons why institutionalized patients have more urinary tract infections (UTIs) than noninstitutionalized patients except:

Accepted Answer

Hospitalized patients and those residing in long-term care facilities develop UTIs more often than outpatients.The generally ill condition of the institutionalized population, higher probability of urinary tract instrumentation, and higher incidence of genitourinary tract anatomic or functional abnormalities are major contributors to this difference.

Question 17

When a patient has an indwelling urinary catheter, what symptoms may be present indicating a urinary tract infection?

Accepted Answer

Flank pain and fever without lower urinary tract symptoms, and bacteremia without any urinary tract symptoms, can be seen in patients with indwelling urinary catheters.

Question 18

What organisms growing in a urine culture can be considered contaminants?

Accepted Answer

Isolation of Bacillus spp.can almost be considered contamination.Urinary tract infections (UTIs) truly caused by the organism are exceedingly rare.

Question 19

The symptoms of pyelonephritis include all the following except:

Accepted Answer

Patients with upper urinary tract infections (UTIs), such as pyelonephritis, have flank pain, nausea, vomiting, fevers, and costovertebral angle tenderness.These symptoms may occur in the presence or absence of symptoms of cystitis.

Question 20

What part of the urinary tract is most susceptible to infection?

Accepted Answer

Except for the urethral mucosa and the renal medulla, which appear to be relatively susceptible to infection, the normal urinary tract is resistant to colonization and subsequent infection by bacteria.

Quiz 37: Urinary Tract Infections

What is the cause of most uncomplicated urinary tract infections (UTIs) ?