Renal 4

Question 1

What is acute infectious cystitis?

How does it present?

Answer 1

Inflammation of the bladder

suprapubic pain

dysuria

urinary urgency

urinary frequency

systemic signs (fever, chills) usually absent

Question 2

What are the risk factors for acute infectious cystitis? (3)

Answer 2

1. female gender (short urethra)
2. sexual intercourse
3. indwelling catheter

Question 3

What organisms are known to cause acute infectious cystitis?

Answer 3

E. Coli (most common)

S. saprophyticus (seen in sexually active young women)

Klebsiella (urine has ammonia scent)

Proteus mirabilis

Adenovirus (hemorrhagic cystitis)

Neisseria gonorrhea

Chlamydia trachomatis

Question 4

Lab findings for acute infectious cystitis?

What does sterile pyuria and negative urine cultures suggest?

Answer 4

positive for leukocyte esterase

Nitrates appear for gram (-) organisms (esp. E. coli)

sterile pyuria and negative urine cultures suggest urethritis by Neisseria gonorrhea or chalmydia trachomatis

Question 5

What is pyelonephritis?

Answer 5

Infection of the kidney

usually due to ascending infection; increased risk with vesicoureteral reflux

Question 6

How does pyelonephritis usually present?

Answer 6

fever

flank pain

WBC casts

leukocytosis

+ symptoms of cystitis

Question 7

What pathogens are the most common causes of pyelonephritis?

Answer 7

E. coli (90%)

Klebsiella

Enterococcus faecalis