08-20-2007, 08:17 PM
The following vignette applies to the next 2 items.
You are asked to see a 63-year-old woman who is in the hospital after undergoing an operation 4 days ago for a displaced tibia-fibula fracture. The operation was uncomplicated. Preoperative chest x-ray film was normal. She has a transurethral urinary catheter, which was placed during the operation 4 days ago. Today she has a temperature of 37.9°C (100.2°F). Laboratory studies disclose mild leukocytosis. Urinalysis shows greater than 100 WBC/hpf and many bacteria. You suspect that she has a urinary tract infection.
Item 1 of 2
31. Which of the following would have been the most appropriate method of preventing a urinary tract infection in this patient?
A
) Cleaning the perineum twice daily with povidone-iodine
B
) Irrigating the bladder every 8 hours
C
) Removing the catheter immediately post-operation
D
) Treating the patient with prophylactic antibiotics
E
) Using only silver-coated urinary catheters
Item 2 of 2
32.
Incidence of Bacteruria Related to Catheter Use
Study Randomized Suprapubic Catheter Transurethral Catheter Odds Ratio +95% CI
A No 2/25 21/31 0.04(0.01-0.24)
B Yes 10/48 20/44 0.32(0.11-0.86)
C Yes 2/32 16/34 0.08(0.01-0.41)
D Yes 8/32 5/40 1.87(0.48-8.01)
*CI=confidence interval
A Colleague suggests to you that suprapubic catheters can decrease a patient's risk for bacterial colonization. You identify four studies in the medical literature that compare the incidence of bacteruria in patients with a transurethral catheter versus patients with a suprapubic catheter. The study results are shown. Which of the following is the most important criterion related to the validity of these data?
A
) Confidence interval
B
) The number of patients with bacteriuria
C
) Odds ratio
D
) Sample size
E
) Study design
You are asked to see a 63-year-old woman who is in the hospital after undergoing an operation 4 days ago for a displaced tibia-fibula fracture. The operation was uncomplicated. Preoperative chest x-ray film was normal. She has a transurethral urinary catheter, which was placed during the operation 4 days ago. Today she has a temperature of 37.9°C (100.2°F). Laboratory studies disclose mild leukocytosis. Urinalysis shows greater than 100 WBC/hpf and many bacteria. You suspect that she has a urinary tract infection.
Item 1 of 2
31. Which of the following would have been the most appropriate method of preventing a urinary tract infection in this patient?
A
) Cleaning the perineum twice daily with povidone-iodine
B
) Irrigating the bladder every 8 hours
C
) Removing the catheter immediately post-operation
D
) Treating the patient with prophylactic antibiotics
E
) Using only silver-coated urinary catheters
Item 2 of 2
32.
Incidence of Bacteruria Related to Catheter Use
Study Randomized Suprapubic Catheter Transurethral Catheter Odds Ratio +95% CI
A No 2/25 21/31 0.04(0.01-0.24)
B Yes 10/48 20/44 0.32(0.11-0.86)
C Yes 2/32 16/34 0.08(0.01-0.41)
D Yes 8/32 5/40 1.87(0.48-8.01)
*CI=confidence interval
A Colleague suggests to you that suprapubic catheters can decrease a patient's risk for bacterial colonization. You identify four studies in the medical literature that compare the incidence of bacteruria in patients with a transurethral catheter versus patients with a suprapubic catheter. The study results are shown. Which of the following is the most important criterion related to the validity of these data?
A
) Confidence interval
B
) The number of patients with bacteriuria
C
) Odds ratio
D
) Sample size
E
) Study design