Pyelonephritis

Question 1

What is Pyelonephritis?

Answer 1

Inflammation of the kidney and renal pelvis (bacterial infection of the kidney)

Question 2

In ages of one or less what gender is more likely to get pyelonephritis?

Answer 2

Males due to higher incidence of congenital urinary tract anatomic abnormalities.

Question 3

In patients 1-50 what gender is most affected by Pyelonephritis?

Answer 3

Females due to shorter urethral route

Question 4

In patients over 50 in what gender is the incidence highest.

Answer 4

Incidence equalizes over 50.

Question 5

What is the most common cause of acute pyelonephritis?

Answer 5

E. Coli (by far the highest)

Question 6

Where do most bacterial infections of the kidney originate?

Answer 6

Bladder (ascending)

Question 7

What is another origin of pyelonephritis?

Answer 7

Hematogenus (blood)

Question 8

What is the usual infectious agent in Hematogenus origin Pyelonephritis?

Answer 8

Staphlococcus aureus (and its usually part of multiple organs with hematogenous infection.

Question 9

How can catheters play a role in pyelonephritis?

Answer 9

Infections can develop around thrombus around long standing catheters

Question 10

What are the usual causes of ascending infections (ascending pyelonephritis) in babies?

Answer 10

Congenital malformation of valves between ureters and bladder

Question 11

What is the usual cause of ascending pyelonephritis in non babies?

Answer 11

Vesicoureteral reflux

-bladder over distended with infected urine

Question 12

What type of cellular infiltration is associated with pyelonephritis?

Answer 12

Neutrophilic infiltration

Question 13

What type of necrosis is associated with pyelonephritis?

Answer 13

Liquefactive leading to abscess formation

Question 14

What is the term used to describe infected ous filling and distending the renal calyces pelvis and ureter?

Answer 14

Pyonephrosis

Question 15

What is a perinephric abscess?

Answer 15

Necrotizing infection spreading through the renal capsule into surrounding fat.

Question 16

How does pyelonephritis affect the papillary tip?

Answer 16

Papillary necrosis especially if the is concurrent diabetes mellitus that has caused disease of sparse blood vessels in the papillary tip

Question 17

What is emphysematous pyelonephritis?

Answer 17

A gas condition caused by the infecting organism in pyelonephritis

Question 18

What are some of the symptoms associated with Acute pyelonephritis?

Answer 18

1. Dysuria
2. Urinary Frequency
3. Urinary Urgency
4. Suprapubic pain
5. Hematuria
6. Systemic symptons; fever, chills, malaise

Question 19

What may patients with pyelonephritis present with?

Answer 19

1. Flank pain
2. Costovertebral tenderness
3. Sepsis/Urosepsis
4. Pus in urine

Question 20

What is the treatment for Pyelonephritis?

Answer 20

Intravenous Antibiotics

Question 21

What is the result of Chronic pyelonephritis?

Answer 21

Scarring which may be limited to the pelvis or calyces or could extend the full thickness of the parenchyma out to the capsule causing dpressions of the cortical surface

Question 22

What are the signs of chronic pyelonephritis?

Answer 22

1. Inflammation primarily with lymphocytes and plasma cells primarily involving the interstitium.
2. Fibrosis
3. Thyrodization
   - renal tubules become atrophic and distended with inspissated urine causing them to resemble thyroid follicles