Infections and Kidney Disease Flashcards

1
Q

What abnormalities in the urinary tract may be present?

A

Preg

Transplant kidney

Renal tract stones

Obstruction

Abnormal renal tract architecture

Indwelling catheter/ureteric stents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Discuss UTIs in children

A

Structural issues more likely

Posterior urethral valves

Duplex ureters

Repeated pyelonephritis in childhood can cause renal scarring (aka chronic pyelonephritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is vesicoureteric reflux?

A

Backward flow of urine from the bladder into the kidneys

Primary = defect in valve from birth

Secondary = obstruction in bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How does TB effect the urinary tract?

A

Come from the blood stream

Starts in kidneys – caseation, eventually cause calcification of kidneys

If untreated = can spread to ureters and bladder

Can result in end-stage renal disease

Ureteric stricture = fibrosis

Thin walled bladder = reflux = ESRD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does schistosomiasis effect the renal system?

A

Blood fluke, that can lie dormant for many years

Calcification of bladder, fibrosis/stenosis of VUJ, bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the infectious causes of GN?

A

Post-infectious glomerulonephritis

Endocarditis

Hepatitis B

Hepatitis C

HIV

Devel countries = TB, syphilis, malaria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is post-infectious GN?

A

Inflam of nephrons due to infect elsewhere in the body

Group A streptococcus

Very rare in UK

1-4 weeks throat infect

Generally children (5 – 12) and > 60 year olds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is endocarditis associated GN

A

Pts with endocarditis ending up with GN

Streptococcus viridans or Staphylococcus aureus

AKI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the risk factors that increase the risk of infection in CKD?

A

Co-morbidity = DM

Decreased immune response

Decreased vaccine responsiveness

Malnutrition

Nephrotic syndrome

Lots of hospital visits = increased exposure

Increasing age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If you have kidney disease what immune cells are defunct?

A

Neutrophils

NK

Dendritic/macrophages

Adaptive immunity = T and B cell’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why are haemodialysis pts at risk of infection?

A

Introduction of bacteria via dialysis lines

Bacteraemia common

Metastatic infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are peritoneal dialysis pts at risk of?

A

Peritonitis common

Cellulitis

Tunnel site infection

Chest infection

GI infections

UTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why are transplant patients at risk of infection?

A

Greatest immunosuppression in the first 3 months

Source = nosocomial, community-acquired, reactivated, donor-derived

UTI commonest infection

Immunosuppression can mask sign of infection = reduced inflam, temp may be normal, may not have raised WBCs, Ab response delayed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Outline the methods used to prevent infection in transplant

A

Prophylactic anti-microbials given during initial period after transplant

Co-trimoxazole (Pneumocystis pneumoniae)

Valganciclovir (CMV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What of donors screened for?

A

Evidence of CNS infection

Evidence of sepsis

HSV – herpes simplex virus

VZV

EBV – epstine barr vius

HIV

Hepatitis B, Hepatitis C

TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What vaccine should a pt with CKD/ESRD/transplant have?

A

Respectively =

Influenza
Hep B
Pneumococcal, meningococcal