Upper urinary tract infection

Question 1

Acute pyelonephritis

Answer 1

acute bacterial infection of the renal pelvis of the kidney

Question 2

Chronic pyelonephritis

Answer 2

When repeated bouts of acute pyelonephritis leads to irreversible kidney scarring

Question 3

Route of infection of acute pyelonephritis

Answer 3

1. Ascending infection from the lower urinary tract

2. Haematogenous - blood borne infection

Question 4

Clinical features

Answer 4

1. Fever
2. Loin pain
3. frequency, urgency and dysuria
4. chills

Question 5

Causes of Pyelonephritis

Answer 5

1. Vesicouretral reflux - urine is able to move back up the urinary tract due to the valve dysfunction
2. Bladder outflow obstruction - causes stasis of urine

Question 6

Asymptomatic bacteruria

Answer 6

• Bacteria found in urine without any symptoms

- Only treated when found in pregnant women as there is 40% chance of progression into pyelonephritis

Question 7

Urinalysis

Answer 7

1. • Nitrates - come bacteria convert into nitrates
2. Leukocyte esterase enzyme released by wbc
3. Leukocytes ( cloudy due to pyuria)
4. Blood
5. Proteins

Question 8

Invest

Answer 8

1. Mid stream urine - identifies organisms

2. Urine culture is gold standard