host and bugs
physiology
micturition
pharmacology
clinical cases
100

This is the most common cause of community-acquired UTIs

What is Escherichia coli?

100

This is the functional unit of the kidney.

What is the nephron?

100

This muscle contracts during urination.

What is the detrusor muscle?

100

This is now Australia's first-line antibiotic for uncomplicated cystitis.

What is nitrofurantoin?

100

A patient drinks 5 litres of water.

This hormone falls.

What is ADH?

200

Name two host defences that normally prevent UTIs.

  • Urine flow
  • Acidic urine
  • Secretory IgA
  • Tamm-Horsfall protein
  • Intact uroepithelium 
200

This nephron segment reabsorbs approximately 65% of filtered sodium and water.


What is the proximal convoluted tubule?

200

These spinal cord segments provide parasympathetic innervation to the bladder.

What are S2–S4?

200

Loop diuretics inhibit this transporter.

What is NKCC2?

200

A patient presents with:

  • Fever
  • Flank pain
  • Rigors

Most likely diagnosis?

What is pyelonephritis?

300

This bacterial virulence factor allows bacteria to ascend the ureters.

What are pili (fimbriae)?

300

This hormone inserts aquaporin-2 channels into collecting duct cells.

What is ADH?

300

This receptor relaxes the bladder during filling.

What is the β3 receptor?

300

This urinary antiseptic only works when urine pH is ≤5.5.

What is methenamine hippurate?

300

A patient has BPH.

Which phase of micturition becomes most difficult?

What is bladder emptying (voiding)?

400

Which organism produces urease and is associated with urinary stones?

What is Proteus?

400

These three stimuli increase renin release.

  • Reduced renal perfusion
  • Reduced NaCl delivery to the macula densa
  • Increased sympathetic stimulation
400

The brain centre responsible for coordinating normal urination.

What is the pontine micturition centre?

400

Why should Ural not be taken with fosfomycin?

It alkalinises urine and reduces fosfomycin effectiveness.

400

A patient receives atropine.

What urinary side effect is expected?

Urinary retention

500

A catheterised ICU patient develops a UTI. Which organism becomes much more likely?

What is Pseudomonas aeruginosa?

500

A patient loses 2 L of blood.

Predict the changes in:

  • Renin
  • ADH
  • ANP

↑ Renin

↑ ADH

↓ ANP

500

Put these in order:

  • Detrusor contracts
  • Stretch receptors activated
  • Pontine micturition centre activated
  • External sphincter relaxes

Stretch receptors

Pontine micturition centre

External sphincter relaxes

Detrusor contracts

500

Name two reasons nitrofurantoin resistance remains uncommon

  • Multi-site mechanism
  • High urinary concentration
  • Minimal gut exposure
  • Multiple simultaneous mutations required
500

A patient has severe dehydration.

Predict:

  • Urine volume
  • Urine osmolality
  • ADH

↓ Urine volume

↑ Urine osmolality

↑ ADH