Chapter 14 Urinary tract Power point Flashcards
Acute pyelonephritis
pyonephrosis
Renal infections
Inflammation of the kidney
Bacteria that has spread to the kidney from the lower urinary tract or less commonly, the blood
Commonly encountered by females
Treated with antibiotics
Can progress to abscess, pyonephrosis,xanthogranulomatous pyelonephritis,emphysematous pyelonephritis, and chronic pyelonephritis
Acute pyelonephritis
Flank pain Bacteriuria Pyuria Dysuria Urinary frequency leukocytosis
Clinical symptoms
Acute pyelonephritis
Normal
Renal enlargement
Focal areas of altered echotexture
Compression of renal sinus
Sonographic appearance
Acute pyelonephritis
Having pus (purulent material) within the collecting system Caused by an obstructive process or infection that leads to urinary stasis
pyonephrosis
Pyuria Bacteruria Fever Flank pain leukocytosis
Clinical symptoms
pyonephrosis
Hydronephrosis with low level,dependent layering echoes within the dilated calices and renal pelvis
Sonographic appearance
pyonephrosis
Can occur in regions of the kidney affected by pyelonephritis or be located adjacent to the kidney
Renal abscess
a collection of purelent material that has leaked through the true capsule into the tissue surrounding the kidney
Perinephric abscess
High fever
Flank pain
Leukocytosis
Clinical symptoms
Renal Abcess
Anechoic
Complex
Hypoechoic
Gas may develop which would produce dirty shadowing or reverberation artifact
Sonographic findings
renal abcess
Rare, but life threatening
May be the result of long-standing urinary obstruction, but most often found in patients with
Diabetis
Immunocompromised
Bacteria formation allows gas to accumulate in the renal parenchyma
Bacteria is Escherichia coli
Patients are extremely ill
Sonographically air is noted in the parenchyma with reverberation artifact
Emphysematous pyelonephritis
Caused by recurrent kidney infections or chronic obstruction
Leads to scarring of the calices and renal pelvis
May lead to xanthogranulomatous pyelonephritis and end-stage renal disease
Clinical findings same as acute pyelonephritis
Chronic pyelonephritis
kidneys are small and echogenic with lobulated borders
Chronic pyelonephritis
sonographically
Most common form of fungal urinary tract infection is Candida albicans
Most commonly affects patients
Immunocompromised
Diabetis mellitus
IV drug abusers
Infants with longstanding indwelling catheters
Renal fungal disease
Flank pain
Fever
Chills
Renal fungal disease
clinical findings
fungal balls will be echogenic, mobile, nonshadowing structures within the renal collecting system
Renal fungal disease
sonographically
Caused from a distant infection such as throat or an autoimmune reaction. (lupus)
Infection leads glomerular damage and the kidneys can slowly shut down secondary to diminished filtration capabilities
glomerulonephritis
Smoky urine Fever Proteinuria Hematuria Hypertension Azotemia (abnormally high levels of nitrogenous wastes in blood)
glomerulonephritis
clinical findings
Renal artery stenosis A decrease in the diameter of the renal arteries, usually caused by artherosclerosis Risk factors: Smoking Diabetes High cholesterol High blood pressure
RAR > 3.5
Renal vascular abnormalities
Renal vein thrombosis Blood clot within the renal vein Caused by Renal tumors Trauma Renal infections Post renal transplant
Renal vasular abnormalities
flank pain
hematuria
Clinical symptoms
Renal vascular abnormalities
enlarged kidneys
low level echoes within dilated renal vein
absent spectral and color doppler flow
Sonographic appearance
Renal vascular abnormalities
Intrinsic renal disease classified into 2 groups by looking at the renal parenchyma
Renal disease
Sonographically renal cortex that has increased cortical echoes which is a result of deposits of collagen and fibrous tissue Interstitial nephritis Acute tubular necrosis Amyloidosis Diabetic nephropathy Systemic lupus erythematosus myeloma
Group 1
Renal Disease
Sonographic loss of normal detail making it difficult to distinguish the cortex and medullary regions of the kidney
Chronic pyelonephritis
Renal tubular ectasia
Acute bacterial nephritis
Group 2
Renal Disease
Acute Tubular Necrosis (ATN) this condition is reversible
Kidney suffers from ischemic damage and cell destruction
Bilateral enlarged kidneys with hyperechoic pyramids, may become normal once this reverses
Most common cause of Chronic Renal Failure is diabetes
Most common medical renal disease to produce acute renal failure
decreased perfusion to the kidneys Hypotension Congestive heart failure Renal vein thrombosis Renal artery stenosis Renal infection renal mass/cyst nephrotoxicity
Renal Failure
Prerenal
Urinalysis Urine ph Specific gravity Blood- Hematocrit- Hemoglobin- Protein-
Lab tests
blood, pus, bacteria-infection
Urinalysis
excess hydrogen ions urine is acidic
in part- will increase formation of renal stones
alkaline urine can indicate CRF, and renal tubular acidosis
Urine ph
- measures the kidneys ability to concentrate urine. Especially low indicates renal failure, glomerular nephritis, and pyelonephritis
Specific gravity
hematuria, associated with early renal disease, renal trauma, neoplasm, calculi, pyelonephritis
Leukocytes- inflammation, infection
Blood-
ratio of plasma: packed cell volume in the blood
Hematocrit-
can be present in the urine whenever damage or destruction of the functioning erthrocytes occurs.
Hemoglobin-
indicates glomerular damage. Can be found with benign and malignant neoplasms, calculi, chronic infection and pyelonephritis
Protein-
A by-product of muscle energy metabolism, produced at a constant rate.
is completely filtered by the glomerulus without being reabsorbed by the renal tubules.
An increase in blood serum levels indicate renal impairment
Creatinine
Urea nitrogen is an end product of cellular metabolism
Urea is formed by the liver and carried to the kidneys through blood to be excreted in urine
If elevated, indicates decreased renal function
Blood Urea Nitrogen
