Injection and Tumours Flashcards
Urinary Tract Infection (UTI)
inflammation of urinary tract usually caused by bacteria
classified according to location: cystitis - bladder
pyelonephritis - upper urinary tract
urethritis - urethra
Predisposing factors of UTI
age, pregnancy, calculi, medical procedures, diabetes, chemo, tumours, antibiotics
Cystitis
Inflammation of the bladder
features: urgency, frequency, dysuria, lower abdo pain, pyuria, baceriuria, cloudy urine
Management of cystitis
manage any underlying risk factors
BUN, creatinine, electrolyte values obtained to rule out change in renal function
interventions: antibiotics, adequate fluid intake, urinary alkaliniser
Acute pyelonephritis
bacterial infection of the upper resp tract
pathology of pyelonephritis
enlargement, scattered areas of abscess, increased neutrophils in the tubules
clinical manifestations of pyelonephritis
generally produces fever, chillds, flank proteinuria, pyuria, white cell casts, haematuria, generalised malaise
management of pyelonephritis
pain reflief, consider fluids
Chronic pyelonephritis
any chronic renal inflammation
always produces some renal scarring around the calyces and renal pelvis and among tubules
Causes of chronic pyelonephritis
renal stones
recurrent acute pyelnonephritis
drug toxicity
ischaemia, immune complex disease
Patho of chronic pyelonephritis
chronic obstruction of urinary traact prevents elimination of bacteria
Types of tumours
benign cortical adenoma of kidney
carcinoma of kidney
wilms tumour
bladder
renal adenoma
solid, encapsulated, can become malignant
renal cell carcinoma (RCC)
malignancy of renal tubular or ductal cells
can be clear cell or papillary type
Risk factors of RCC
male, age 50-60, cigarettes, analgesic use, sporadic, genetic
Patho of RCC
upper pole of one kidney
vena cava and right side of heart by direct extension
metastisises to lungs, liver, lymph nodes and bone
Manifestations of RCC
largely silent disorder
haematuria, flank pain, flank mass
Wilms tumour
mixture of embryonal tissue
large bulging tumour
occurs anywhere in the kidney
Symptoms of Wilms tumour
large abdo mass, hypertension
some children may have abdo pain and vomiting
haematuria is present
Invasive transitional cell carcinoma (TCC) risks
highest in men over 60, tobacco smokers, various genetic deficits, industrial exposure to arylamine dyes, leather rubber paint organic chemicals, radiotherapy to prostate or cervix
urothelial carcinoma
can arise anywhere in the urothelium lining the urinary trat from the urethra to the calyces
multifocal and has the tendency to recur
treat with surgery
