L16: Renal & Urinary Diseases With Pregnancy Flashcards by Ahmed Farag

Q

Def of Asymptomatic Bacteruria

A

Presence of > 100 000 CFU (colony forming unit) / ml urine in
midstream urine sample without symptoms.

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Q

Incidence of Asymptomatic Bacteruria

A

2-7%

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Q

Complications of Asymptomatic Bacteruria

A

Maternal & Fetal

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Q

maternal Complications of Asymptomatic Bacteruria

A

Acute cystitis or pyelonephritis, PIH & abortion or preterm labor.

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Q

Fetal Complications of Asymptomatic Bacteruria

A

IUGR & IUFD

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Q

TTT of Asymptomatic Bacteruria

A

Antibiotics.
- Nitrofurantoin: 100 mg/ 12 hrs for 10 days.

Others: Ampicillin, amoxicillin or cephalosporins.

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Q

Def of Acute Pylonephritis in Pregnancy

A

Acute infection involving renal pelvis (pyelitis) & interstitial tissue (nephritis).

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Q

Predisposing Factors for Acute Pylonephritis in Pregnancy

A

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Q

Predisposing Factors for Acute Pylonephritis in Pregnancy

Asymptomatic Bacteruria

A

20-40% of cases develop symptomatic infection if not treated.

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Q

Predisposing Factors for Acute Pylonephritis in Pregnancy

Urinary Stasis

A

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Q

Predisposing Factors for Acute Pylonephritis in Pregnancy

iatrogenic

A

Repeated catheterization.

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Q

Predisposing Factors for Acute Pylonephritis in Pregnancy

Diseases

A

DM, sickle cell disease & immunosuppressive diseases.

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Q

Organisms causing Acute Pylonephritis in Pregnancy

A

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Q

Routes of Infection by Acute Pylonephritis in Pregnancy

A

Ascending (through lumen).
Lymphatic.
Hematogenous

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Q

Complications of Acute Pylonephritis in Pregnancy

A

Maternal & fetal

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Q

Maternal Complications of Acute Pylonephritis in Pregnancy

A

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Q

Fetal Complications of Acute Pylonephritis in Pregnancy

A

IUGR & IUFD

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Q

Dx of Acute Pylonephritis in Pregnancy

A

Q

Dx of Acute Pylonephritis in Pregnancy

Symptoms

A

Q

Dx of Acute Pylonephritis in Pregnancy

Onset of Symptoms

A

Abrupt

Q

Dx of Acute Pylonephritis in Pregnancy

Signs

A

Fever, tachycardia & tenderness in one or both renal angles.

Q

Dx of Acute Pylonephritis in Pregnancy

INVx

A

Q

Investigations for Acute Pyelonephritis in Pregnancy

A

Q

Investigations for Acute Pyelonephritis in Pregnancy

Urine Analysis

A

Pus cells > 10/HPF.

Investigations for **Acute Pyelonephritis in Pregnancy** - Urine Culture

On both aerobic & anaerobic media.

Investigations for **Acute Pyelonephritis in Pregnancy** - Renal US

To detect underlying lesion in resistant cases.

Investigations for **Acute Pyelonephritis in Pregnancy** - Single IVP

In resistant cases.

DDx of **Acute Pyelonephritis in Pregnancy**

From other causes of fever è rigors, vomiting & acute abdomen in pregnancy.

TTT of **Acute Pyelonephritis in Pregnancy**

TTT of **Acute Pyelonephritis in Pregnancy** - General Lines

TTT of **Acute Pyelonephritis in Pregnancy** - Antibiotics

- (nitrofurantoin, penicillin or cephalosporins) then → change according to results of culture & sensitivity testing.

TTT of **Acute Pyelonephritis in Pregnancy** - TTT of Cause

Relieve obstruction → (ureteric stent or percutaneous nephrostomy).

Degrees of **CRF in Pregnancy**

Complications of **CRF in Pregnancy**

Def of **AKI in Pregnancy**

Condition in which kidneys are temporarily unable to perform their functions.

Etiology of **AKI in Pregnancy**

CP of **AKI in Pregnancy**

Prevention of **AKI in Pregnancy**

TTT of **AKI in Pregnancy**

Risks of **Pregnancy after Renal Transplant**

Managment of **Pregnancy after Renal Transplant**

Managment of **Pregnancy after Renal Transplant** - Preconceptional Care

Managment of **Pregnancy after Renal Transplant** - Managment During Pregnancy

- Close observation & monitoring of renal function. - Treatment of bacteriuria. - Follow up of immunosuppressive therapy.