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Nephrology > Renal Infectious Disease > Flashcards

Renal Infectious Disease Flashcards

1
Q

Symptoms of renal abscess

A

fever, abdominal pain, weight loss, dysuria, hematuria

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2
Q

Diagnostic procedure of choice for renal abscess

A

CT scan

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3
Q

Treatment for renal abcess

A

IV abx and percutaneous drainage

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4
Q

What does acute pyelonephritis affect?

A

cortex with sparing of glomeruli and vessels

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5
Q

What are white cell casts in urine pathognomonic for?

A

acute pyelonephritis

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6
Q

What bacteria are most commonly implicated in acute pyelonephritis?

A

e. coli, proteus, klebsiella, enterobacter

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7
Q

What is emphysematous pyelonephritis?

A

life-threatening necrotizing infection of the kidneys characterized by gas formation within or surrounding the kidneys

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8
Q

Risk factors for emphysematous pyelonephritis

A

DM, immunocompromised, or urinary tract obstruction due to lithiasis

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9
Q

Symptoms of acute pyelonephritis

A

high fever, arthralgias, myalgias, flank pain w/CVA tenderness

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10
Q

What might a CT scan show for acute pyelonephritis?

A

hydronephrosis and attenuation caused by inflammation/infection

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11
Q

Common abx for acute pyelonephritis

A

IV ampicillin. PO-cipro, oxfloacin, Bactrim DS for 21 days.

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12
Q

How long should IV abx be cont’d?

A

for 24hrs after fever has resolved and then you can switch to PO

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13
Q

T/F chronic pyelonephritis occurs almost exclusively in patients with normal kidneys

A

false, occurs with major anatomical anomalies

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14
Q

What is one of the most common problems encountered by pediatric urologists?

A

Vesicoureteral reflux (VUR)

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15
Q

What percent of infants presenting with UTI have VUR?

A

70%

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16
Q

Etiology of primary VUR

A

deficiency in the longitudinal muscle fibers in ureterovesical junction

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17
Q

Etiology of secondary VUR

A

Bladder outlet obstruction at the posterior uretheral valve or stenosis. Functional obstruction (Neurogenic and non neurogenic bladder dysfunction)

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18
Q

How do newborns present with VUR?

A

failure to thrive, difficult feeding, or lethargy

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19
Q

What is required for a child < 5yrs w/UTI, male childe w/UTI, or febrile UTI?

A

Standard VCUG and US

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20
Q

What percent of gr. 1 reflux spontaneously resolve before adolescence?

A

90%

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21
Q

Characteristics of chronic pyelonephritis

A

asymmetric corticomedullary scarring, thyroidization of the kidney, eosinophilic casts in tubules

22
Q

symptoms of chronic pyelonephritis

A

fever, lethargy, N/V, flank pain, dysuria

23
Q

How does IVP establish diagnosis of chronic pyelonephritis?

A

reveal caliceal dilatation and blunting with cortical scars.

24
Q

Tx of chronic pyelonephritis due to stage 1 and 2 VUR

A

ABX (Amoxicillan, Bactrim, Septra, Nitrofurantoin) until puberty or until reflux resolves

25
Q

Tx of chronic pyelonephritis due to stage 3 and 4 VUR

A

Surgery involving the reimplantation of the ureters

26
Q

What is xanthogranulamtous pyelonephritis?

A

variant of chronic pyelonephritis that, in two-thirds of cases, is a complication of obstruction induced by infected renal stones.

27
Q

What is the outcome for most patients with XPN?

A

massive destruction of the kidney requiring nephrectomy

28
Q

T/F XPN is sometimes referred to as pseudotumor

A

true

29
Q

Signs/Symptoms of XPN

A

flank pain, fever, weight lose, palpable flank mass with or without CVA tenderness

30
Q

Treatment for XPN

A

nephrectomy

31
Q

What is cystitis most commonly due to?

A

coliform bacteria (usually E. coli) and occasionally from gram-positive bacteria (enterococci)

32
Q

symptoms of cystitis

A

irritative voiding, suprpubic discomfort, hematuria

33
Q

Tx of choice for uncomplicated cystitis

A

Fluroquinolones and nitrofurantoin for 1-3 days

34
Q

What percent of urethritis is caused by n. gonorrhea?

A

80%

35
Q

symptoms of urethritis

A

discharge, dysuria, itching, heaviness in genitals (males)

36
Q

What work-up should be performed for all patients presenting with urethritis?

A

full STD work-up

37
Q

Tx for urethritis

A

Zithromax, fluroquinolones, doxycycline orally or if compliance is questionable, IM Rocephin

38
Q

what usually causes acute/chronic bacterial prostatitis?

A

gram-negative rods, esp E. coli, pseudomonas

39
Q

symptoms of acute prostatitis?

A

Perineal, sacral, or suprapubic pain

Fever, irritative voiding, urinary retention

40
Q

What do you need to be careful of with an acute prostate exam?

A

careful exam must be performed as vigorous manipulation can cause septicemia

41
Q

Tx for acute prostatitis

A

I.V. antibiotics (ampicillan and aminoglycosides). PO antibiotics (quinolones) are used for 4-6 weeks

42
Q

Difference between acute and chronic prostatitis

A

Physical exam of the prostate is often unremarkable and UA is normal in chronic prostatitis

43
Q

What is necessary to make diagnosis of chronic prostatitis?

A

Culture of post-prostatic massage urine specimen

44
Q

Tx fo chronic prostatitis

A

Septra has the best cure rate, quinolones, erythromycin, cephalexin also used
6-12 wks

45
Q

What is the most common of the prostatitis syndromes?

A

nonbacterial prostatitis

46
Q

Symptoms of nonbacterial prostatitis

A

identical to chronic but no history of UTI

47
Q

Bugs that contribute to the STD forms of epidiymitis

A

chlamydia or N. gonorrhoea

48
Q

What is non STD form of epididymitis associated with?

A

UTI’s and prostatitis and result from gram-neg rods

49
Q

What medication is associated with self-limited epidiymitis?

A

amiodarone

50
Q

symptoms of epididymitis

A

scrotal pain/swelling, fever, enlarged/tender mass, tender prostate

51
Q

Tx for epididymtitis

A

Bed rest with scrotal elevation in the acute phase

ABO therapy is directed at causative organism for 10-21 days

Nephrology (18 decks)

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