Pathology associated with the ureter and urinary bladder

Question 1

What are the typical causes of UTI

Answer 1

e.coli
staph
klebsiella
proteus
pseudomonas
or candida

Question 2

what are risk factors for UTI

Answer 2

female
young
sexually active
pregnant
recent abx
post-menopausal
catheters
DM
neurogenic bladder

Question 3

how does urine try to kill bacteria

Answer 3

acidic
high osmolality
uromodulin - protein from tubular cells
uroepithelial secretions

Question 4

what prevents reflux of urine back into the ureter

Answer 4

ureterovesicular junction (UVJ)
- where stones get stuck

Question 5

what is the presentation of UTI

Answer 5

frequency
urgency
dysuria
suprapubic discomfort
hematuria
pyruia, odor, cloudy appearance with infection

Question 6

what is a catheter associated infection

Answer 6

Cauti

Question 7

what allows bacteria to move against flow of micturation

Answer 7

flagella

Question 8

what are asymptomatic UTI

Answer 8

bacteria in urine but no true infection
no harm to GU tract
treatment: none unless pregnant

Question 9

What is inflammation of bladder wall

Answer 9

acute cystitis

Question 9

what is the appearance of acute cystitis

Answer 9

appear hyperemic, suppurative exudates

Question 9

what is interstitial cystitis

Answer 9

painful bladder syndrome
sxs of UTI in sterile environment (no bacteria)
thought to be autoimmune

Question 9

what is the most common parasitic cause of acute cystitis

Answer 9

schistosoma haematobium

Question 9

what can interstitial cystitis progress to

Answer 9

fibrosis
hemorrhagic ulcers

Question 10

what is the clinical presentation of Interstitial cystitis

Answer 10

similar to UTI > 6 months
frequency
urgency
nocturia
chronic pain
increased rate of depression

Question 11

what is acute pyelonephritis

Answer 11

ascending UTI into the ureter, renal pelvis and or kidney interstitum

Question 12

who is most likely to get acute pyelonephritis

Answer 12

women

Question 13

how do you diagnose acute pyelonephritis

Answer 13

CVA

Question 14

what part of the kidney have contractile properties

Answer 14

renal pelvis

Question 15

what are the causes of acute pyelonephritis

Answer 15

stones
vesicoureteral reflux
pregnancy
neurogenic bladder
instrumentation
sexual trauma

Question 16

what are the risks of acute pyelonephritis

Answer 16

abscess, particularly in medulla
development of scaring, fibrosis and atrophy of tubules

Question 17

what is nephrolithiasis

Answer 17

collection of protein, crystals or other substrates
may be found in kidney, ureter or bladder
increased risk of MI

Question 18

how are nephrolithiasis classified

Answer 18

primarily mineral the composes the stone
shape and location

Question 19

what are the mineral types that compose stones

Answer 19

calcium oxalate or phosphate
uric acid
struvite (magnesium, ammonium, phosphate)

Question 20

what are Staghorn calculi

Answer 20

BIG, fill minor or major calyces

Question 21

what are nonstaghorn calculi

Answer 21

vary in size and location

Question 22

what are risk factors for nephrolithiasis

Answer 22

alkaline urine
kidney naturally contain stone inhibitors that can be altered
urine stasis
idiopathic calcium oxalate urolithiasis
hypercalciruia, hyperoxaluria associated with increased absorption in

Question 23

who are struvite nephrolithiasis most common in

Answer 23

women
alkaline environment

Question 24

what is the presentation of nephrolithiasis

Answer 24

renal colic - location of pain may indicate where obstruction is occurring
N/V
Hematuria