Seminar Topics Week 8, 10, 12 Flashcards
What are the most common bacterial infections in women?
UTIs.
How are UTIs classified?
Can be classified into upper and lower UTIs, depending on which part of the system the affect.
What is pyelonephritis?
Implies inflammation in the renal parenchyma and the collecting system.
What is cystitis?
Indicates inflammatory condition in the urinary bladder,. Characterized by pain, urgency, and hematuria.
What is urethritis?
Inflammation in the urethra.
What are normal defence mechanisms that prevent UTIs?
Normal voiding w/ complete emptying, antibacterial capability of the bladder mucosa and urine, uretero-vesicle junction competence, peristaltic activity.
How do bacteria cause UTIs?
usually introduced via the urethra from intercourse, improper hygiene. May come from the blood or lymphatic system, or instrumentation.
What are some CM of LUTIs?
Dysuria, hesitancy, intermittency, pain on urination, urinary retention, weak urinary stream, incontinence, nocturia, nocturnal enuresis, urgency, urinary frequency.
What are some CM of UUTIs?
Flank pain, chills, fever as well as symptoms of lower utis.
What symptoms of UTIs may older adults experience?
Nonlocalized abdo pain, cognitive impairement, delerium, falls.
How are UTIs diagnosed?
Dipstick urinalysis- look for presence of nitrites, WBCs and leukocyte esterase.
Urine culture, imaging studies of urinary tract.
What are some treatments for an uncomplicated UTI?
Adequate fluid intake, antibiotic, counselling for risk.
What are some treatments for recurrent, uncomplicated UTIs?
Repeated urinalysis, antibiotic, adequate fluid intake, imaging study.
What is polynephritis?
Inflammation of the renal parenchyma and collecting system. Commonly caused by bacterial, infection.
What is urosepsis?
Systemic infection arising from a urological source. Can lead to septic shock.
Where does polynephritis begin?
The lower urinary tract, usually caused by visco-ureteral reflux (upflushing of the urine from the lower tract to the upper tract). Starts in the renal medula and spreads to the cortex.
What are the CM of polynephritis?
Mild fatigue, chills, fever, vomiting, malaise, flank pain, annoying LUTIs. CM subside within a few days.
What diagnostic studies are done to detect polynephritis?
Urinalysis (will show pyuria, bacteruria, and hematuria)
CBC shows leukocytosis, w/ shift to the left.
Imaging studies- IVP or CT scan, ultrasound.
How are mild symptoms of polynephritis treated?
Adequate fluid intake, NSAIDs, outpatient management, IV antibiotics.
How are severe symptoms of polynephritis treated?
Adequate fluid intake, hospitalization, NSAIDs, parenteral antibiotics, urinary analgesics.
What is actue poststreptococcal glomerulo-nephritis APSGN?
Complication of strep throat/impetigo. Pt produces antibodies to streptococcal antigen. Antigen antibodies end up in glomeruli and activate compliment system, causing inflammation. This causes a decrease in filtration of metabolic waste, and increases the nephron permeability to big proteins.
What are the CM of APSGN?
Body edema, hypertension, oliguria, hematuria, rusty looking urine, and proteinuria.
Why does fluid retention occur with APSGN?
Result of decreased glomular filtration, edema starts in low pressure tissues, then worsens to other parts of the body.
How is APSGN diagnosed?
Pt Hx, BUN serum creatinine, albumin CBC Complement levels and ASO titre Renal biopsy Urinalysis