Disease of the Lower Urinary Tract Flashcards by Madeline Wing

inflammation/infection of the bladder

cystitis

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infection of the kidney and collection system

pyelonephritis

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asymptomatic infections of the lower urinary tract

bacteriuria

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urinary tract infections can spread where

to the kidney

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85% of UTI’s caused by ____

gram - bacilli

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in most patients with UTI, infecting organisms are derived from where

the patient’s own fecal flora

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2 main bugs causing UTI’s

E. coli and proteus

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2 other less common bugs that cause UTI

Klebsiella and Enterobacter

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hematogenous UTI caused by what bugs

Staph and E. coli

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ascending UTI caused by what 3 bugs

E. coli
Proteus
Enterobacter

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what is dysfunctional that causes ascending UTI

vesicoureteral junction

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suppurative inflammation of the kidney

acute pyelonephritis

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affects tubules and interstitium

acute pyelonephritis

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abscess formation and lead to papillary necrosis

acute pyelonephritis

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obstruction
instrumental vesicoureteral reflux
pregnancy
diabetes
immunosuppresion

causes of acute pyelonephritis

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presents with costovertebral angle pain and fever, malaise, chills

acute pyelonephritis

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patchy infiltrates

acute pyelonephritis

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acute pyelonephritis

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acute pyelonephritis

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inflammatory cells within parenchyma

acute pyelonephritis

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tubule seen

acute pyelonephritis

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tubulointerstitial inflammation and scarring (fibrosis seen)

chronic pyelonephritis

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reflux nephropathy
chronic obstructive

chronic pyelonephritis types

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most common chronic pyelonephritis

reflux nephropathy (ascending infection)

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example of chronic obstructive lesions

BPH (benign prostatic hypertrophy)

seen on gross morphology is corticomedullary scars

chronic pyelonephritis

scarring of calyces and renal pelvis seen

chronic pyelonephritis

deep scars in this image show what

blunted calyces

deep scars and atrophy seen

chronic pyelonephritis

tubular atrophy thyroidization interstitial inflammation

histologic findings of chronic pyelonephritis

what cells will we see with chronic pyelonephritis

lymphocytes

presence of colloid (eosinophilic color)

thyroidization (seen in chronic pyelonephritis)

collection of cells

histiocytes

type of chronic pyelonephritis with histiocytes seen with foamy appearance

Xanthogranulomatous pyelonephritis

R side more lymphocytes shown

chronic pyelonephritis

arrows

thyroidization

diagnosis

chronic pyelonephritis

chronic pyelonephritis w/ thyroidization

fibrosis

chronic pyelonephritis

duplication branching ureteropelvic junction

congenital anomalies of ureters

obstruction of ureters can lead to what

hydronephrosis, hydroureter, pyelonephritis

stones (intrinsic) and tumors (extrinsic) can cause this

obstruction of ureters

ureter duplication

ureteral duplication

dilation of renal pelvis and calyces associated with atrophy due to outflow of urine obstruction

hydronephrosis

most common causes of obstructive uropathy (4)

congenital anomolies stones tumors inflammation

main types of urolithiasis

calcium oxalate calcium phosphate struvite uric acid cystine

initiation and propagation of urolithiasis

supersaturation

fever, chills, intense pain associated with this

urolithiasis

sites of stone formation

renal calyces, pelvis, and bladder

branching structures due to progressive accretion of salts (stones in calyces)

staghorn calculus

urolithiasis

staghorn calculus

2 things seen

hydronephrosis ureteral duplication

hydroureter and hydronephrosis

stones

stones in bladder

vesicoureteral reflux diverticuli extrophy urachal anomalies

congenital anomalies of urinary bladder

infection of bladder

cystitis

main bug that can cause cystitis

E. coli

frequency of urination, dysuria (burning), lower abd pain

cystitis

SE of ifosfamide

hemorrhagic cystitis

to Rx hemorrhagic cystitis

MESNA

Acquired defect in phagocytic function; foamy macrophages + Michaelis-Gutmann bodies

malakoplakia (seen in cystitis)

exstrophy of bladder

vesicoureteral reflux

urachal sinus

urachal diverticulum

patent urachus

urachal cyst

bladder stones

urethral valves/stenosis stricture caruncle

urethra problems

dysuria, frequency and associated with STDs

urethritis

urethral caruncle

lots of inflammation and RBC's seen

caruncle

external meatus in women, red and painful

caruncle