Question 1

All of the following are reasons why institutionalized patients have more UTIs than noninstitutionalized patients, except

Accepted Answer

All of the other options listed (A, C, and D) are factors that can contribute to an increased risk of UTIs in institutionalized patients. However, less frequent emptying of the bladder is not a reason why institutionalized patients have more UTIs than noninstitutionalized patients. In fact, noninstitutionalized patients may also experience less frequent emptying of the bladder due to various factors such as mobility issues or lack of access to restrooms.

Question 2

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

Accepted Answer

The most common way for the renal parenchyma to become infected with gram-positive bacteria is through the hematogenous route. This means the bacteria are spread through the bloodstream from another site of infection in the body to the kidneys.

Question 3

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

Accepted Answer

The urethral mucosa is the most susceptible to infection because it is the entry point for bacteria into the urinary tract, leading to conditions like urethritis.

Question 4

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

The symptoms and positive findings on urinalysis are indicative of a urinary tract infection. Pyelonephritis may also present with similar symptoms but would likely have additional symptoms such as fever and flank pain. Bacteremia and septicemia are possible complications of a UTI, but are not the primary diagnosis.

Question 5

What group has the most UTIs caused by Staphylococcus saprophyticus?

Accepted Answer

Staphylococcus saprophyticus is a common cause of urinary tract infections (UTIs) in sexually active young women. The other options may be at risk for UTIs, but not specifically caused by this pathogen.

Question 6

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

Accepted Answer

Reduced water reabsorption would actually increase leukocyte chemotaxis in the renal medulla by creating a more concentrated gradient. A and B are true statements that can contribute to reduced leukocyte chemotaxis, and D can also contribute by reducing the distribution of chemokines or other signaling molecules.

Question 7

What characteristic of urine inhibits growth of many pathogens?

Accepted Answer

Urine is naturally slightly acidic, with a pH around 6, which inhibits the growth of many pathogens. High glucose levels or protein levels could actually provide nutrients for pathogens, while a high pH would create a more favorable environment for their growth.

Question 8

The symptoms of pyelonephritis include all the following, except

Accepted Answer

All of the other symptoms listed are commonly associated with pyelonephritis, but septicemia (a serious bloodstream infection) is not a typical symptom. However, in severe cases of pyelonephritis, septicemia can develop as a complication.

Question 9

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

Accepted Answer

The answer of When a patient has an indwelling urinary...

Question 10

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

Accepted Answer

Bacillus spp. are common environmental bacteria and are often considered contaminants in urine cultures unless isolated in significant numbers or from a sterile site.

Question 11

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

Accepted Answer

Urine cultures are not typically used to test for Chlamydia. Chlamydia testing is usually done through a separate test, such as a nucleic acid amplification test (NAAT). Urine cultures are used primarily to diagnose and confirm urinary tract infections (UTIs) by identifying and characterizing the specific bacteria causing the infection. They may also be used to monitor the effectiveness of antibiotic treatment, detect asymptomatic bacteriuria in certain populations (such as pregnant women), and evaluate for possible complications such as kidney infections. Urine cultures are not generally used to detect bacteremia, as blood cultures are more appropriate for this purpose.

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

While hemolytic-uremic syndrome has been associated with UTIs, it is not a long-term medical problem typically associated with UTIs in children. Impaired renal function, hypertension, and end-stage renal disease are all potential complications of UTIs in children.

Question 13

What might candiduria signify?

Accepted Answer

Candiduria can signify a variety of conditions including bladder or renal parenchymal infection, urinary tract fungus ball, and disseminated candidiasis. Therefore, all of the answer choices are correct.

Question 14

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

Accepted Answer

The increased use of broad-spectrum antimicrobial agents can contribute to candiduria by suppressing the normal flora in the urinary tract, allowing Candida species to overgrow and cause infection. Poor personal hygiene and contaminated instruments can both contribute to the development of urinary tract infections, but are not specific to candiduria. Multiple bacterial infections of the urinary tract are also not a known contributing factor to candiduria.

Question 15

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

Accepted Answer

Bacteria can enter the urinary tract through the ascending route (from the urethra to the bladder and then to the kidneys), the hematogenous route (from the bloodstream), and the lymphatic pathways (from lymph nodes). However, there is no known neurologic route for bacteria to enter the urinary tract.

Question 16

The atypical clinical presentation of a geriatric patient with a UTI includes all the following, except

Accepted Answer

Burning upon urination is a typical symptom of a UTI and is not considered atypical in geriatric patients. Delirium, fever, and failure to thrive are all atypical symptoms that may indicate a UTI in this population.

Question 17

The criteria used to determine the presence of a UTI include all the following, except

Accepted Answer

The answer of The criteria used to determine the presence...

Question 18

What organisms usually cause UTIs in older men in conjunction with prostatic hypertrophy?

Accepted Answer

Enterococcus spp. is the most common cause of UTIs in older men with prostatic hypertrophy.

Question 19

What is the most common cause of uncomplicated UTIs?

Accepted Answer

Escherichia coli is the most common cause of uncomplicated UTIs, accounting for approximately 80-90% of cases. Pseudomonas aeruginosa, Staphylococcus epidermidis, and Streptococcus agalactiae are less common causes of UTIs.

Question 20

While Gardnerella vaginalis can be a cause of UTIs, its presence in urine generally indicates

Accepted Answer

Gardnerella vaginalis is a bacteria commonly found in the vagina and its presence in urine usually indicates contamination from the vaginal area.

Quiz 37: Urinary Tract Infections