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Renal II Final > Lecture 1: UTI-Pyelonephritis-Sepsis > Flashcards

Lecture 1: UTI-Pyelonephritis-Sepsis Flashcards

1
Q

What are the 3 criteria for a UTI to be considered uncomplicated?

A
  1. Non-pregnant female
  2. No anatomic abnormalities
  3. No instrumentation of the urinary tract
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2
Q

Use of what contraceptive method increases the risk for UTI?

A

Spermicide as w/ diaphragm

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3
Q

What are 4 common predisposing factors for UTI?

A
  • Diabetes
  • Frequent sexual intercourse
  • Frequent UTI’s
  • Incontinence
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4
Q

What are 2 predisposing factors for UTI in men?

A
  • Prostatic hypertrophy
  • Non-circumcised
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5
Q

2 organisms implicated as causes of cervicitis in female w/ dysuria?

A
  1. Chlamydia
  2. Neisseria
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6
Q

2 organisms implicated as causes of vaginitis in female w/ dysuria?

A
  • Candida
  • Trichomonas
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7
Q

Most likely infectious cause of urethritis in female w/ dysuria?

A

Herpetic

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8
Q

What 2 things can a complicated UTI lead to in a pregnant female?

A
  • Premature labor
  • Low birth-weight infants
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9
Q

Untreated asymptomatic bacteriuria is likely to result in what in a pregnant patient?

Pregnant pts are at increased risk for developing what complication?

A
  • Likely to result in symptomatic pyelonephritis
  • MORE likely to develop sepsis
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10
Q

Complicated UTI can present as a symptomatic disease in a man or woman and may be due to what 4 underlying conditions?

A
  1. Anatomic variant —> i.e., PCKD
  2. Foreign body in urinary tract –> stones, catheter, stents/tubes
  3. Extrinsic compression –> tumors, profound constipation
  4. Immunosuppressive conditions –> diabetes, drug-induced, HIV
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11
Q

When making the diagnosis of a complicated UTI what is the most important piece of info?

A

HISTORY

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12
Q

Prostatitis may be chronic when associated with what?

A

Prostatic hypertrophy

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13
Q

Chronic bacterial prostatits often requires a course of therapy (Abx) for how long?

A

4-6 weeks

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14
Q

When a urine sample is obtained for a reason unrelated to GU tract (i.e., health screen or diabetes follow-up) and shows bacteria on microscopic evaluation, this is known as what?

A

Asymptomatic bactriuria (ABU)

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15
Q

Recurrence of UTI in post-menopausal females may be due to what 3 factors?

A
  1. Pre-menopausal UTI’s
  2. Anatomic factors affecting bladder emptying –> cystoceles, urinary incontinence and/or residual urine
  3. Tissue effect of estrogen depletion
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16
Q

3 major subtypes/complications of Pyelonephritis?

A
  1. Papillary Necrosis
  2. Emphysematous pyelonephritis
  3. Xanthogranulomatous pyelonephritis
17
Q

Bacteremia is a common finding associated with what type of UTI?

A

Pyelonephritis

18
Q

Papillary necrosis can occur in pts with what 4 underlying conditions?

A
  1. Obstruction
  2. Diabetes
  3. Sickle cell
  4. Analgesic nephropathy
19
Q

Emphysematous pyelonephritis occurs almost excusively in which patients?

A

Diabetics

20
Q

Xanthogranulomatous pyelonephritis occurs when what 2 pre-disposing factors lead to suppurative destruction of renal tissue?

Can lead to formation of what?

A
  • Chronic obstruction (often by staghorn calculi) + Chronic infection
  • Can lead to abscess formation
21
Q

How does bacteremia (often seen in pyelonephritis), differ from sepsis?

A
  • Bacteremia simply means blood cultures are +
  • Sepsis is suspected or documented infection and an acute increase in organ failure + dysregulated host response to infection
22
Q

Septic shock is defined as serum lactate >?

A

>2 mmol/L (18 mg/dL)

23
Q

Sepsis with hypotension that cannot be reversed with infusion of fluids or there is need for vasopressors to maintain BP, is known as?

A

Septic shock

24
Q

In acute ischemia there is decreased O2 delivery and impaired removal of cellular waste leading to the upregulation of what factors that can cause direct tubular damage?

A

Endotoxins and inflammatory cytokines

25
Q

What are the possibly harmful systemic responses to sepsis/septic shock (i.e., HR, BP, temperature…)?

A
  • Fever or Hypothermia
  • Tachypnea
  • Tachycardia
  • Leukocytosis, leukopenia, or >10% bands
26
Q

What is the FENa associated with sepsis/ischemia leading to pre-renal azotemia?

A

<1%

27
Q

What is the BUN/Cr ratio associated with sepsis/iscehmia indicating pre-renal azotemia?

A

>20:1

28
Q

What is the urine osmolality associated with pre-renal azotemia (i.e., ischemia/sepsis)?

A

>500 mOsmol/Kg H2O

29
Q

What type of casts associated with pre-renal azotemia?

A

Granular casts

Renal II Final (7 decks)

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