UTI and STD

A urinary tract infection (UTI) is an infection in any part of the urinary system. Which of the following is NOT listed as a component of the urinary system in the introduction?

• Bladder
• Ureters
• Prostate
• Kidneys

Answer explanation

The introduction defines the urinary system in the context of UTI as including the kidneys, bladder, ureters, and urethra. The prostate is not listed as part of the system in this definition, although it is mentioned later in relation to UTI terminology and risk factors.

Which term describes the presence of bacteriuria without any associated symptoms?

• Cystitis
• Urethritis
• Significant bacteriuria
• Asymptomatic bacteriuria

Answer explanation

Asymptomatic bacteriuria is defined as bacteriuria with no symptoms. Significant bacteriuria is defined as the presence of at least 105 bacteria/ml of urine. Cystitis and Urethritis are types of infections.

Which of the following is considered an Upper UTI?

• Urethritis
• Cystitis
• Chronic pyelonephritis
• Prostatitis

Answer explanation

The classification of UTI lists Chronic pyelonephritis, Acute pyelonephritis, Interstitial pyelonephritis, and Renal abscess under the category of UPPER UTI. Cystitis and Urethritis are classified as LOWER UTI. Prostatitis is a lower tract infection.

Nitrofurantoin's mechanism of action involves being activated inside bacteria by which of the following?

• Flavoprotein nitrofurantoin reductase
• Reduction via cytochrome P450 enzymes
• Competition with PABA (para-aminobenzoic acid)
• Blocking cell wall synthesis

Answer explanation

The mechanism of action for Nitrofurantoin states that it is activated inside bacteria by reduction via the flavoprotein nitrofurantoin reductase to unstable metabolites, which disrupt ribosomal RNA, DNA, and other intracellular components.

What is the listed plasma half-life (t21​) range for Nitrofurantoin?

• 0.3−1 hour
• 2−4 hours
• 6−8 hours
• 10−12 hours

Answer explanation

The pharmacokinetics section for Nitrofurantoin states that its Plasma t21​ is 0.3−1 hr.

Which condition is a risk factor for UTI specific to males, according to the document?

• Shorter urethra
• Sexual intercourse
• Prostatic hypertrophy
• Incomplete bladder emptying with age (general)

Answer explanation

The risk factors section lists prostatic hypertrophy and bacterial prostatitis as risk factors specific to males. Shorter urethra and sexual intercourse are listed as risk factors for females. Incomplete bladder emptying with age is a general factor under 'Aging'.

Which drug, used for symptomatic relief in UTI, colours the urine dark brown by its metabolites?

• Sulfisoxazole
• Phenazopyridine
• Methenamine mandelate
• Nitrofurantoin

Answer explanation

Nitrofurantoin turns the urine dark brown by its metabolites. Phenazopyridine, used for symptomatic relief, colours the urine red or orange.

Methenamine mandelate is effective because it releases which substance in acidic urine?

• Acetic acid
• Formaldehyde
• Mandelic acid
• Ascorbic acid

Answer explanation

Methenamine mandelate is a salt of mandelic acid and methenamine, and it releases formaldehyde in acidic urine below pH 5.5. Formaldehyde is the bactericidal agent.

Why should Methenamine mandelate be avoided in renal failure?

• It increases the risk of haematuria.
• It is ineffective against most urinary pathogens in this state.
• Mandelic acid contributes to acidosis.
• It causes chemical cystitis.

Answer explanation

Methenamine mandelate should be avoided in renal failure because the mandelic acid component adds to acidosis.

What is the typical treatment course duration for acute uncomplicated UTI using Cotrimoxazole (2 tablets twice a day)?

• 3 days
• 7-10 days
• 14 days
• Single dose

Answer explanation

In acute uncomplicated UTI, Cotrimoxazole is used in the dose of 2 tablets twice a day for 7-10 days. The 7 day therapy regimen also lists Cotrimoxazole 2 tab BID.