Lecture 10 The Kitchen Sink of Renal (Stones, UTI, Pyeloneph, RCC) Flashcards
UTI’s are more common in what gender?
why?
women;
short urethra plus close proximity to anus
what endocrine disorder has an increased risk of UTI? What hospital procedure?
diabetes;
indwelling catheter
are systemic signs (high fever, chills) typically present in cystitis? what about pyelonephritis?
no, yes
besides fever and chills, name three other symptoms of pyelonephritis
CVA tenderness, flank pain, vomiting/nausea
most common pathogen overall?
top 2 most common in sexually active women?
E. coli;
1. E. Coli, 2. Staph Saprophyticus
what bacterial infection is characterized by an ammonia scent
proteus
in men, what may perineal pain/lower back pain suggest?
prostatitis
most important diagnostic test in UTI, and most important finding
microscopic urinalysis;
greater than 5 WBC per HPF
in bacterial UTI, urine dipstick is often positive for _____. in gram negative organisms (E. coli), ___ is also positive
leukocyte esterase;
nitrites
gold standard for UTI testing is _____. what value indicates infection?
urine culture;
greater than 100,000 colony forming units (CFU/mL)
with vaginitis, there is dysuria but typically not ____ or urgency;
with urethritis, there is typically pyuria but not ____
frequency;
bacteria in urine
first line treatment for cystitis is nitrofurantoin and _____
TMX (bactrim) for 3-5 days
for pyelonephritis, typically ____ is used for mild disease, and _____ or piperacillin-tazobactam is used in severe disease
cipro or levofloxacin;
ceftriaxone
for 10-14 days
renal abscess usually arise from extension of ____. perinephric abscesses occupy the space between the renal capsule and ______
pyelonephritis;
gerota’s fascia
what is the most common type of kidney stone? what does it look like?
calcium oxalate; envelope or dumbbell
what kind of shape do cysteine stones have ?
what about magnesium ammonium phosphate ?
hexagon, coffin lid
how does FA describe the pain in kidney stones?
ulinateral flank pain tenderness with colicky pain radiating to the groin
best method of visualizing kidney stones?
CT
patients with calcium oxalate stones typically present with ____calciuruia and _____calcemia
hyper, normo
what is another name for ammonium magnesium phosphate stones? what typically causes this?
struvite; proteus (or other urease + bugs)
treatment for patients with high urine calcium
thiazides + low protein diet
treatment for patients with high uric acid excretion in urine
allopurinol (and alkalinization of urine)
renal cell carcinoma typically arises from ____ cells
PCT (in cortex)
classically, RCC presents with what 3 symptoms
flank pain, hematuria, palpable abdominal mass
RCC is classically also associated with presence of _____ symptoms
paraneoplastic
