Urgent Care For UTI 3

Question 1

A 72-year-old woman with recurrent UTIs asks about prevention strategies. Which of the following has the best evidence for reducing recurrent UTIs in postmenopausal women?

Accepted Answer

Topical vaginal estrogen

Answer

Topical vaginal estrogen restores normal vaginal flora and has strong evidence for reducing recurrent UTIs in postmenopausal women.

Question 2

A male patient aged 45 presents with dysuria and frequency. Prostate exam is normal. What is the recommended duration of antibiotic therapy for uncomplicated cystitis in men?

Accepted Answer

7-day course of fluoroquinolone or TMP-SMX

Answer

Men with cystitis are treated for 7 days because short-course therapy has higher failure rates in males due to anatomical and prostatic factors.

Question 3

Which urinalysis finding is the MOST specific for a true UTI versus contamination?

Accepted Answer

Positive nitrites

Answer

Positive nitrites are highly specific for gram-negative bacteriuria because they indicate bacterial reduction of dietary nitrates.

Question 4

A hospitalized patient develops a fever and new costovertebral angle tenderness 5 days after admission. UA grows gram-negative rods. Which empiric antibiotic choice is most appropriate for hospital-acquired pyelonephritis?

Accepted Answer

Piperacillin-tazobactam IV

Answer

Hospital-acquired infections carry higher risk for resistant organisms including ESBL-producing and Pseudomonas species, warranting broader coverage with piperacillin-tazobactam.

Question 5

A 26-year-old woman presents with her third UTI in 6 months. Cultures have consistently grown E. coli sensitive to all agents. What is the most appropriate preventive strategy?

Accepted Answer

Long-term daily suppressive antibiotics with nitrofurantoin 50 mg

Answer

Low-dose continuous antibiotic prophylaxis with nitrofurantoin 50 mg nightly is evidence-based for women with recurrent UTIs (≥3/year).

Urgent Care Practice Test

Urgent Care Practice Test

Urgent Care For UTI 3