Pathology associated with the ureter and urinary bladder Flashcards
What are the typical causes of UTI
e.coli
staph
klebsiella
proteus
pseudomonas
or candida
what are risk factors for UTI
female
young
sexually active
pregnant
recent abx
post-menopausal
catheters
DM
neurogenic bladder
how does urine try to kill bacteria
acidic
high osmolality
uromodulin - protein from tubular cells
uroepithelial secretions
what prevents reflux of urine back into the ureter
ureterovesicular junction (UVJ)
- where stones get stuck
what is the presentation of UTI
frequency
urgency
dysuria
suprapubic discomfort
hematuria
pyruia, odor, cloudy appearance with infection
what is a catheter associated infection
Cauti
what allows bacteria to move against flow of micturation
flagella
what are asymptomatic UTI
bacteria in urine but no true infection
no harm to GU tract
treatment: none unless pregnant
What is inflammation of bladder wall
acute cystitis
what is the appearance of acute cystitis
appear hyperemic, suppurative exudates
what is interstitial cystitis
painful bladder syndrome
sxs of UTI in sterile environment (no bacteria)
thought to be autoimmune
what is the most common parasitic cause of acute cystitis
schistosoma haematobium
what can interstitial cystitis progress to
fibrosis
hemorrhagic ulcers
what is the clinical presentation of Interstitial cystitis
similar to UTI > 6 months
frequency
urgency
nocturia
chronic pain
increased rate of depression
what is acute pyelonephritis
ascending UTI into the ureter, renal pelvis and or kidney interstitum
who is most likely to get acute pyelonephritis
women
how do you diagnose acute pyelonephritis
CVA
what part of the kidney have contractile properties
renal pelvis
what are the causes of acute pyelonephritis
stones
vesicoureteral reflux
pregnancy
neurogenic bladder
instrumentation
sexual trauma
what are the risks of acute pyelonephritis
abscess, particularly in medulla
development of scaring, fibrosis and atrophy of tubules
what is nephrolithiasis
collection of protein, crystals or other substrates
may be found in kidney, ureter or bladder
increased risk of MI
how are nephrolithiasis classified
primarily mineral the composes the stone
shape and location
what are the mineral types that compose stones
calcium oxalate or phosphate
uric acid
struvite (magnesium, ammonium, phosphate)
what are Staghorn calculi
BIG, fill minor or major calyces
what are nonstaghorn calculi
vary in size and location
what are risk factors for nephrolithiasis
alkaline urine
kidney naturally contain stone inhibitors that can be altered
urine stasis
idiopathic calcium oxalate urolithiasis
hypercalciruia, hyperoxaluria associated with increased absorption in
who are struvite nephrolithiasis most common in
women
alkaline environment
what is the presentation of nephrolithiasis
renal colic - location of pain may indicate where obstruction is occurring
N/V
Hematuria
