Pathology EMQ.

Name: Edward Wallitt

Theme: URINARY TRACT INFECTIONS

OPTION LIST

A	Urine dipstick	I	KUB film
B	IV antibiotics	J	CT scan
C	Coliforms	K	Renal Tract Imaging
D	Sterile pyuria	L	Trimethoprim
E	Bacterial infection	M	Sterile pyuria secondary to partially treated previous infection
F	Amoxicillin	N	Proteus mirabilis
G	Microscopy/Culture of urine	O	Staphylococcus epidermidis
H	Nothing	P	Streptococcus faecalis

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 25 year old secretary presents with frequency, dysuria and a fever. What is the most appropriate 1^st line investigation?

2. A 84 year old lady discharged 2 weeks ago from hospital following a fall presents with confusion. On examination she has suprapubic tenderness and is pyrexial. Urine microscopy shows <10⁵ bacteria/ml and a urine white cell count > 100. What is the probable diagnosis?

3. A 19 year old male medical student presents to his GP with fever and dysuria. A UTI is diagnosed and clears up following a course of amoxicillin. What further management/investigation is appropriate?

4. A wheel-chair bound 46 year old man suffering from multiple sclerosis is brought to A&E with fever, confusion and right sided abdominal pain radiating to his groin. His urine dipstick shows blood. What is the most appropriate anti-microbial agent?

5. The same 25 year old secretary presents 8 weeks later to A & E with fever and dysuria. Her urine is cultured. What is the most likely organism that would be grown?

ANSWERS

1. A

2. M

3. K

4. B

5. C