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Nephrology > Renal ID > Flashcards

Renal ID Flashcards

1
Q

Renal Abscess

A

An abscess that is confined to the kidney and is either caused by an intrinsic infection or a septic infection

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2
Q

Renal Abscess S/S

A

Fever/chills
Abd pain
Weight loss
Dysuria/hematuria/malaise

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3
Q

Renal abscess dx

A

WBC’s, bacteria, hematuria in urine
Leukocytosis
CT scan will diagnose **

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4
Q

Renal abscess tx

A

IV Abx

Percutaneous drainage

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5
Q

Acute pyelonephritis

A

Affects renal cortex while sparing glomeruli and vessels

Usually E. coli

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6
Q

What is seen in the urine for pyelo?

A

White cell casts

Pathognomonic

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7
Q

Emphysematous Pyelonephritis

A

Life-threatening necrotizing infection of the kidneys characterized by gas formation within or around the kidneys.
Majority of pts have poorly controlled DM or are immunocompromised
High mortality rate w/o tx

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8
Q

Acute Pyelo s/s

A

Shaking chills
High fever
arthralgias / myalgias
Flank pain, CVA tenderness

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9
Q

What will CT show with acute pyelo?

A

May show hydronephrosis and attenuation.

Diagnostic procedure of choice

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10
Q

Acute pyelo tx

A

Severe cases may require admission
May need a cath
IV Ampicillan until; 24 hrs after fever drops
PO Cipro, Ofloxacin, Bactrim for 21 days

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11
Q

White cell casts are pathognomonic for?

A

Pyelonephritis

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12
Q

Chronic Pyelo

A

Caused by renal injury induced by recurrent or persistent renal infxn
Occurs in pt’s with anatomical abnormalities
Most commonly vesicoureteral reflux (VUR)]Can lead to ESRD

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13
Q

Vesicoureteral Reflux (VUR)

A

Retrograde flow of urine from the bladder to the upper urinary tract.
One of the most common pediatric urinary problems

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14
Q

VUR indicence

A

10 of kids get it.
70 of pediatric UTI’s have VUR
Female > male
Genetc predisposition

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15
Q

Primary VUR

A

Congenital deficiency in the longitudinal muscle fibers ureterovesicular junction. Greatly narrows it.

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16
Q

Secondary VUR

A

Bladder outlet obstruction at the posterior urethral valve or stenosis.
Neurogenic bladder

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17
Q

VUR presentation

A

Infant: Failure to thrive, nonspecific
Older kids: flank pain, abd pain, fever
Prenatally: abd swelling, diagnosed with U/S

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18
Q

Chronic Pyelo findings

A

Coarse, Asymmetric corticomedullary scarring
Thyroidization of kidney
Eosinophillic casts
TEA

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19
Q

TEA = ?

A

Thyridization of kidney
Eosinophillic Casts
Asymmetric Scarring
Chronic Pyelo

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20
Q

Chronic pyelo S/S

A

Fever
Lethargy
N/V
Flank pain, dysuria

21
Q

Stage 1 and 2 chronic pyelo tx

A 
Amoxacillin
Bactrim
Septra
Nitrofurantoin
Continue until puberty, when it is generally outgrown
22
Q

Stage 3 and 4 chronic pyelo tx

A

Surgery (reimplant ureters)
ACE, ARB for HTN
Eliminate UTI’s

23
Q

Xanthogranulomatous Pyelonephritis (XPN)

A

An unusual variant of pyelonephritis that is usually a complication of obstruction induced by infected renal stones.
Usually involved massive destruction of the kidney requiring nephrectomy.

24
Q

XPN displays neoplasm like properties of local tissue invasion and destruction.

A

Referred to as a pseudotumor

25
Q

XPN presentation

A 
Common in middle aged women
Females > Males 4:1
Flank pain
Fever, malaise, anorexia, weight loss
Flank mass
26
Q

In children, how does XPN present?

A

It can be local or the entire kidney.
Same S/S as adults
growth retardation

27
Q

Cystitis

A

Bladder infection most commonly due to E. Coli and occasionally from enterococci.
Typically ascends form the urethra
Rare in men

28
Q

Cystitis S/S

A

Irritative voiding (frequency, urgency, dysuria)
Suprapubic discomfort
Hematuria
May appear following intercourse in women.

29
Q

Cystitis Urinalysis

A

Pyuria, bacteriuria, hematuria

Urine culture positive for causative organism

30
Q

Cystitis Tx

A

Uncomplicated: Flouro and nitrofurantoin

Bactrim and septra can be ineffective

31
Q

Urethritis

A

Inflammation of urethra caused by STD
Gonococcal Urethritis
Non gonococcal urethritis

32
Q

Gonococcal urethritis

A

Caused by gonorrhea (80% of cases)

33
Q

Non-gonoccal urethritis

A

Caused by chlamydia, ureaplasma, mycoplasma, trich.

34
Q

Post-traumatic urethritis

A

happens in 2 - 20% of post-cath patients. 10x more likely to occur with latex than silicone.

35
Q

Urethritis S/S

A

Usually occur 4 days to 2 weeks post contact.
Urethral discharge
Dysuria, itching
Heaviness in genitals

36
Q

All patients with urethritis should be tested for?

A

Gonorrhea and Chlamydia

37
Q

Urethritis Tx

A

ALL patients must be treated, even if asymptomatic.
Zithromax, flouroquinolones, doxy
IM rocephin

38
Q

Prostatitis

A

Inflammation or infection of the prostate
Acute bacterial
Chronic bacterial
nonbacterial

39
Q

Acute bacterial prostatitis

A

Usually caused by gram- rods, E. coli, pseudomonas.

40
Q

Acute prostatitis S/S

A

Perineal, sacral, suprapubic pain
Fever
irritative voiding
Very painful prostate on exam.

41
Q

Acute prostatitis Tx

A

May require hospitalization
IV ampicillin, aminoglycosides
PO quinolones for 4-6 weeks

42
Q

Chronic prostatitis

A

May evolve form acute

gram- rods

43
Q

Chronic Prostatitis S/S

A

Irritative voiding
Low back and perineal pain
Physical exam of prostate is often unremarkable
generally have normal UA

44
Q

Chronic proatatitis Tx

A

Septra has best cure rate (6-12 weeks)

NSAIDS, hot sitz bath

45
Q

Nonbacterial Prostatitis

A

Diagnosis of exclusion
S/S identical to chronic
treat for myco, chamydia

46
Q

Epididymitis

A

Inflammation of infection of the epididymis
Younger males: STD
Older males: gram- rods

47
Q

Epididymitis S/S

A

Scrotal pain along spermatic cord
Symptoms may follow, trauma, sexual activity
Fever, scrotal swelling
Prostate may be tender

48
Q

Epididymitis Tx

A

Bed rest, scrotal elevation
Abx for 10-21 days
Treat sexual partners

Nephrology (14 decks)

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