kidney-urinary tract infection

Question 1

what are 3 risk factors for urinary tract infection?

Answer 1

sexual intercourse
urinary stasis
catheters

Question 2

what is cystitis?

Answer 2

infection of the bladder

Question 3

how does cystitis present? systemic symptoms?

Answer 3

dysuria, urinary frequency, urgency and suprapubic pain
systemic signs (like fever) are usually ABSENT

Question 4

what will be seen in the urinanalysis in cystitis?

Answer 4

coudy urine with >10 WBC WBCs/hpf

Question 5

what will be seen in a dipstick with cystitis?

Answer 5

positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites)

Question 6

will the culture be positive or negative in cystitis? (usually)

Answer 6

positive

Question 7

what is the most likely causative agent in cystitis?

Answer 7

e coli

Question 8

what agent is seen in cystitis in young sexually active women (besides e coli)

Answer 8

staph saprophyticus

Question 9

what agent causes cystitis with..

“ alkaline urine with ammonia scent”

Answer 9

proteus mirabilis

Question 10

what are you thinking if you have sterile pyruia (>10 WBCs and leukocyte esterase but negative urine culture)

Answer 10

suggets urethritis due to chlamydia or neisseria gonorrhoeae

Question 11

what is pyelonephritis

Answer 11

infection of kidney

Question 12

what condition increases the risk for pyelonephritis?

Answer 12

vesicoureteral reflux

Question 13

how does pyelonephritis present?

Answer 13

fever, flank pain, WBC casts, leukocytosis and all the symptoms seen in cystitis

Question 14

what are the top 3 causative agents of pyelonephritis?

Answer 14

1. e coli (90%)
2. enterococcus faecalis
3. klebsiella

Question 15

what disease:

“ interstitial fibrosis and atrophy of tubules due to multiple bouts of acute pyelonephritis”

Answer 15

chronic pyelonephritis

Question 16

what is the usual underlying cause of chronic pyelonephritis in children? in adults?

Answer 16

children- vesicoureteral reflux

adults- obstruction (BPH or cervical carcinoma)

Question 17

what are you thinking if you have scarring at upper and lower poles of the cortex?

Answer 17

vesicoureteral reflux

Question 18

what can be seen in the urine of chronic pyelonephritis?

Answer 18

waxy casts

Question 19

what disease do you see “thyroidization” of the kidney? what the F does that mean?

Answer 19

chronic pyelonephritis

atrophic tubules containing eosinophilic proteinaceous material resembling thyroid follicles