Renal & urinary Diseases Flashcards
Def of Asymptomatic Bacteruria
- Presence of > 100 000 CFU (colony forming unit) / ml urine in
midstream urine sample without symptoms.
Incidence of Asymptomatic Bacteruria
2-7%
Complications of Asymptomatic Bacteruria
Maternal & Fetal
maternal Complications of Asymptomatic Bacteruria
Acute cystitis or pyelonephritis, PIH & abortion or preterm labor.
Fetal Complications of Asymptomatic Bacteruria
IUGR & IUFD
TTT of Asymptomatic Bacteruria
Antibiotics.
- Nitrofurantoin: 100 mg/ 12 hrs for 10 days.
- Others: Ampicillin, amoxicillin or cephalosporins.
Predisposing Factors for Acute Pylonephritis in Pregnancy
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Asymptomatic Bacteruria
20-40% of cases develop symptomatic infection if not treated.
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Urinary Stasis
Predisposing Factors for Acute Pylonephritis in Pregnancy
- iatrogenic
Repeated catheterization.
Predisposing Factors for Acute Pylonephritis in Pregnancy
- Diseases
DM, sickle cell disease & immunosuppressive diseases.
Complications of Acute Pylonephritis in Pregnancy
Maternal & fetal
Maternal Complications of Acute Pylonephritis in Pregnancy
Fetal Complications of Acute Pylonephritis in Pregnancy
IUGR & IUFD
Dx of Acute Pylonephritis in Pregnancy
Dx of Acute Pylonephritis in Pregnancy
- Symptoms
Dx of Acute Pylonephritis in Pregnancy
- Onset of Symptoms
Abrupt
Dx of Acute Pylonephritis in Pregnancy
- Signs
Fever, tachycardia & tenderness in one or both renal angles.
Dx of Acute Pylonephritis in Pregnancy
- INVx
Investigations for Acute Pyelonephritis in Pregnancy
- Urine Analysis
Pus cells > 10/HPF.
Investigations for Acute Pyelonephritis in Pregnancy
- Urine Culture
On both aerobic & anaerobic media.
Investigations for Acute Pyelonephritis in Pregnancy
- Renal US
To detect underlying lesion in resistant cases.
DDx of Acute Pyelonephritis in Pregnancy
From other causes of fever è rigors, vomiting & acute abdomen in pregnancy.
TTT of Acute Pyelonephritis in Pregnancy
TTT of Acute Pyelonephritis in Pregnancy
- General Lines
TTT of Acute Pyelonephritis in Pregnancy
- Antibiotics
- (nitrofurantoin, penicillin or cephalosporins) then → change according to results of culture & sensitivity testing.
TTT of Acute Pyelonephritis in Pregnancy
- TTT of Cause
Relieve obstruction → (ureteric stent or percutaneous nephrostomy).
Risks of Pregnancy after Renal Transplant
Managment of Pregnancy after Renal Transplant