Management
A 25-year-old otherwise healthy woman presents with dysuria and urinary frequency. She is afebrile and has no systemic symptoms. Which of the following is the most appropriate first-line oral antibiotic for her condition?
A. Amoxicillin
B. Nitrofurantoin
C. Ciprofloxacin
D. Gentamicin
B. Nitrofurantoin
Which of the following is the most typical symptom of cystitis?
A. Flank pain
B. Fever >38°C
C. Dysuria and frequency
D. Haemoptysis
C. Dysuria and frequency
Which investigation is most commonly used as a simple, inexpensive, and rapid first-line test in suspected UTI?
A. Urinalysis
B. Urine culture
C. Renal ultrasound
D. Blood cultures
A. Urinalysis
What is the most common reservoir for uropathogens causing urinary tract infection?
A. Skin
B. Bloodstream
C. Gastrointestinal tract
D. Respiratory tract
C. Gastrointestinal tract
A man presents with a lower UTI. How long should he typically be treated with antibiotics?
A. 1 day
B. 3 days
C. 5 days
D. 7 days
D. 7 days
A 32-year-old woman presents with urinary frequency and dysuria. She also reports fever of 38.5 °C, chills, and right-sided renal angle tenderness. Which of the following is the most likely diagnosis?
A. Acute cystitis
B. Pyelonephritis
C. Recurrent UTI
D. Uncomplicated cystitis
B. Pyelonephritis
A dipstick urinalysis shows nitrite positivity. This finding is most strongly associated with which organisms?
A.Lactobacilli
B. Staphylococcus saprophyticus
C. Candida albicans
D. Enterobacteriaceae
D. Enterobacteriaceae
More than 95% of urinary tract infections occur by which mechanism of pathogen entry?
A. Haematogenous spread from bloodstream infection
B. Reactivation of latent bacteria in the renal parenchyma
C. Direct inoculation during urological procedures
D. Ascending infection from periurethral colonisation
D. Ascending infection from periurethral colonisation
A 34-year-old woman presents with fever (38.5°C), flank pain, and dysuria. She is haemodynamically stable and suspected to have acute pyelonephritis. Which is the most appropriate initial antibiotic management while awaiting culture results?
A. Oral nitrofurantoin 100 mg BD for 3 days
B. Oral trimethoprim 200 mg BD for 5 days
C. IV cefuroxime ± stat dose fosfomycin
D. IV cefuroxime ± stat dose gentamycin
D. IV cefuroxime ± stat dose gentamycin
A 35-year-old woman presents with her third urinary tract infection in six months. She has no history of diabetes or anatomical urinary tract abnormalities. Which factor most likely explains her recurrent infections?
A. Hypertension
B. High fluid intake
C. Sexual acitivity
D. Lactobacillus colonisation
C. Sexual acitivity
Which one of the following patients with suspected UTI should definitely have a urine culture and antimicrobial susceptibility testing performed?
A. 22-year-old woman with typical cystitis symptoms
B. 30-year-old man with dysuria
C. 28-year-old woman with mild cystitis, no comorbidities
D. 25-year-old woman with suprapubic pain and nitrite-positive dipstick
B. 30-year-old man with dysuria
Which organisms are most often implicated in haematogenous seeding of the urinary tract, rather than ascending infection?
A. Staphylococcus aureus and Pseudomonas aeruginosa
B. Proteus mirabilis and Staphylococcus saprophyticus
C. Enterococcus faecalis and Candida albicans
D. E. coli and Klebsiella pneumoniae
A. Staphylococcus aureus and Pseudomonas aeruginosa