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Uncomplicated Lower UTI Treatment — MRCGP AKT MCQ

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HardUrologyUncomplicated Lower UTI TreatmentMRCGP AKTUKMLAPARAPSA

A non-pregnant woman with recurrent lower UTI has no current infection and has not improved with behavioural measures or single-dose antibiotic prophylaxis. After specialist-informed review she chooses methenamine hippurate. Which counselling and follow-up are correct?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Avoid urinary alkalinisers; review at 6 months and then annually

Explanation lettering: D = shown as A · A = shown as D

D is correct. Methenamine hippurate is an alternative prophylactic strategy in selected non-pregnant patients after current UTI is treated. Alkalinising products such as potassium or sodium citrate reduce its effectiveness and should be avoided. NICE advises review within 6 months and then every 12 months. A omits the initial review, B and E continue the interacting product, and C imposes an unsupported fixed 3-month stop.

Reference: NICE NG112: recurrent UTI antimicrobial prescribing: https://www.nice.org.uk/guidance/ng112/chapter/recommendations GMC: PA registration assessment content map: https://www.gmc-uk.org/education/standards-guidance-and-curricula/standards-and-outcomes/pa-and-aa-prequalification-education-framework/pa-registration-assessment-content-map