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Abdominal Pathology > Lesson 4B (Part 1) > Flashcards

Lesson 4B (Part 1) Flashcards

1
Q

What are 8 genitourinary infections?

A
  1. Acute Pyelonephritis
  2. Renal and Perinephric abscess
  3. Pyonephrosis
  4. Emphysematous Pyelonephritis
  5. Emphysematous Pyelitis
  6. Chronic Pyelonephritis
  7. Xanthogranulomatous
  8. Pyelonephritis
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2
Q

Acute pyelonephritis

A

Acutely infected kidneys from E-coli or staphylococcus aureus

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3
Q

Where does the UTI begin?

A

In the baldder

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4
Q

Where does the UTI ascend to?

A

The kidney parenchyma

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5
Q

How is acute pyelonephritis diagnosed?

A

With lab tests

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6
Q

How is acute pyelonephritis treated?

A

With antibiotics

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7
Q

Who does acute pyelonephritis affect?

A

Women

- 15-35

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8
Q

What a re the sonographic appearance of acute pyelonephritis? (6)

A
  1. Renal enlargement
  2. Compression of sinus
    - due to parenchyma being swollen
  3. Abnormal echotexture
  4. Loss of corticomedullary differentiation
    - hard to tell the difference between the pyramids in the kidney
  5. Poorly marginated mass
  6. Gas within renal parenchyma
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9
Q

Why do you have focal or diffuse absence of colour doppler in acute pyelonephritis?

A

Due to swollen inflamed areas

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10
Q

How can focal masses appear as in acute pyelonephritis? (4)

A
  1. Poorly marginated
  2. Echogenic
  3. Hypoechoic
  4. Mixed
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11
Q

What are the most sensitive modalities for demonstrating changes due to infection? (2)

A
  1. CT

2. MRI

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12
Q

Chronic pyelonephritis

A

Interstitial nephritis (swelling between the tubules) associated with vesicoureteric reflux

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13
Q

What does reflux cause?

A

10-30% of end stage renal disease

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14
Q

Who are chronic pyelonephritis more common in?

A

Women

- begins in childhood

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15
Q

What is chronic pyelonephritis caused by?

A

Incompetent papillary duct orifice

- where pyramids empty urine into minor calyces

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16
Q

What is the sonographic appearance of chronic pyelonephritis on US? (3)

A
  1. Dilated blunt calix
  2. Cortical scar and atrophy
    - becomes thin
  3. If unilateral, compensatory hypertrophy of contralateral kidney
17
Q

What can untreated pyelonephritis lead to? (2)

A
  1. Necrosis formation

2. Abscess formation

18
Q

What types of patients are at risk with renal and peripheral abscesses? (5)

A
  1. Diabetics
  2. Compromised immunity
  3. Chronic diseases
  4. UT obstruction
  5. IV drug abuse
19
Q

Peripheral

A

Around the kidney

20
Q

What is the sonographic appearance of renal and perinephric abscesses? (6)

A
  1. Round
  2. Thick-walled
  3. Complex masses
  4. Debris and septations
  5. Gas
    - dirty shadowing
  6. Posterior enhancement
21
Q

What modality has an accurate diagnosis for renal and perinephric abscess?

A

CT

22
Q

What modality has an accurate follow up exam for renal and perinephric abscess?

A

US

23
Q

Pyonephrosis

A

Purulent material in obstructed collecting system

- ureter can be infected

24
Q

What is necessary with pyonephrosis?

A

Early diagnosis and treatment in order to prevent bacteremia and septic shock

25
Q

What is the cause of pyonephrosis in the young? (2)

A
  1. UPJ obstruction

2. Calculi

26
Q

What is the cause of pyonephrosis in the elderly?

A

Malignant ureteral obstruction

27
Q

How does pyonephrosis look on US? (3)

A
  1. Mobile collecting system debris
  2. Gas and stones
  3. Fluid/debris level
28
Q

Emphysematous pyelonephritis

A

Is a uncommon, life threatening infection

29
Q

Who does emphysematous pyelonephritis affect? (2)

A
  1. Women
    - 55 years
  2. Diabetics
30
Q

How is emphysematous pyelonephritis characterized?

A

By gas formation

- usually E-coli

31
Q

What is the emergency treatment of choice for emphysematous pyelonephritis?

A

Nephrectomy

32
Q

What is the preferred imaging modality for emphysematous pyelonephritis?

A

CT

33
Q

How do the sonographic image appear for emphysematous pyelonephritis?

A

Confusing due to gas formation

34
Q

What does emphysematous pyelonephritis refer to?

A

Gas localized within collecting system

- pelvis and calyces

Abdominal Pathology (49 decks)

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