Renal pathology Flashcards
lower UTI symptoms ?
- dysuria
- frequency
- urgency
- pain/stinging
- incontinence
- confusion
but can often be asymptomatic
upper tract UTI symptoms ?
- loin pain
- fever
- rigors
- haematuria
- looks more unwell
- vomiting
- anorexia
- costovertebral pain
what counts as uncomplicated UTI ? what complicated ?
it is in a non-pregnant women, everything else is complicated
- pregnant, men, catheter, abnormal anatomy, children, immunocompromised
UTI aetiology ? most common ?
- E. coli (most common)
- staphylococcus
- candida albicans
what is is seen on urine dip in UTI ?
- nitrites (gram -ve bacteria break down nitrates => nitrites)
- leukocytes
what are casts found in urine ?
found on urine microscopy
- casts are made of RBC, WBC, kidney cells, protein, fat
- give clue to renal pathology
- should be that many
when treat asymptomatic bacteriuria? what age do you not ?
- if >65 then do not treat
- treat in pregnancy
uncomplicated UTI Mx ?
3 days Abx (nitrofuartoin)
immunocompromised women UTI Mx ?
5-10 days Abx (Nitro)
men, pregnant women, catheter UTI Mx ?
7 days Abx (nitro)
what Abx to avoid during pregnancy ?
avoid trimethoprim in 1st tri
avoid nitrofurantoin in 3rd
Mx of pyelonephritis ? duration of treatment ?
- fluid replacement
- IV Abx (co-amoxiclav)
- drain obstructed kidney
- catheter
- analgesia (paracetamol or codeine phosphate)
- 7-14 Abx days depending on Abx
what counts as recurrent UTIs ?
> 2 in 6 months
3 in 1 yr
What is pyelonephritis ?
infection of the renal parenchyma and soft tissues of renal pelvis/upper ureter
pyelonephritis complications ?
associated with significant sepsis + systemic upset
what is urethritis ?
sexually transmitted disease
- acute urethral discharge following unprotected sex
urethritis aetiology ?
usually Neisseria gonorrhoea (gonococcal)
or chlamydia trachiomatis (non-gonococcal)
urethritis RF ?
- new sexual partner
- multiple sexual partners
- <25
urethritis presentation ?
- dysuria
- urethral discharge
- pruritus at end of urethra (itch skin)
urethritis Ix ?
- urinalysis (leukocyte esterase + ve)
- sediment of first voided urine (high WBC)
- gram stain of urethral discharge (high WCC)
urethritis Mx ? depends on what ?
depends if gonorrhoea or not
- cephalosporin (gonorrhoea)
- azithromycin (not)
urethritis complication ?
- high mortality in untreated women (10-40%)
- untreated may cause: arthritis meningitis, endocarditis, infertility
What is acute prostatitis ?
painful inflammation within the prostate usually plus recent or ongoing infection
- most frequent urological diagnosis in men <50 yrs
acute prostatic aetiology ?
commonly caused by E.Coli (from UTIs)
- in rare cases can be complication of urethritis (STI)