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OSCE question 4.

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OSCE question 4. See also MCQ Paper 1, question 14 & MCQ Paper 5, question 31 for a fuller discussion.

1.       What are the criteria for deeming a mssu +ve?

>100,000 bugs/ ml.  

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2.       She has no symptoms. What is the condition called?

Asymptomatic bacteruria.

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3.       What is the incidence in pregnancy?

~ 5%  

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4.       Is the incidence different to the non-pregnant population?

No.  

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5.       is the pregnant woman more prone to ascending infection? 

Yes. If so, what are the reasons?  Mainly urinary stasis. ?urine a better culture medium. ? altered immunity.

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6.       What is the main complication?

Pyelonephritis. What is the risk of it occurring? ~30%.  

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7.       What is the main risk to the baby in this condition?          

Maternal pyrexia. You might have been asked what steps to take in addition to appropriate antibiotics. These would have included tepid sponging, paracetamol to reduce the pyrexia and high fluid intake

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8.       What is the management of this patient?

Repeat MSSU. Rx if +ve. Renal scan if history of recurrent UTIs, urological surgery etc.

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