Pyelonephritis

Question 1

pathophysiology?

Answer 1

an ascending UTI.

most common organism is E.coli

Question 2

presenting sx?

Answer 2

Acute pyelonephritis commonly presents with

flank pain, new or different myalgia or flu-like symptoms,

fever, nausea, or vomiting,

commonly in the context of the key signs and symptoms of a lower urinary tract infection (e.g., frequency, urgency, and dysuria).

Question 3

ivx

Answer 3

Urine dip

MSU

FBC, ESR, CRP - infection

Renal function - deranged

Blood culture!

Imaging;
USS KUB
CT KUB - need for referal to urology

Question 4

mx?

Answer 4

Urgent!

If no signs of sepsis:
IV antibiotics - empirical eg Cefalexin
pain relief - Diclofenac PR
drink plenty water

If sepsis;
Admit
Fluid resus
IV Abx
Stent - if stone. OR Nephrostomy - esp if out of hours

Question 5

how to manage renal colic?

Answer 5

BloodS: U&Es

Imaging; CT KUB

Pain; diclofenac pr or morphineee

Treat sepsis

refer to urology