Urinary - Part 2 (genitourinary infections + calculi) Flashcards
UTI in bladder
acute pyelonephritis
common in diabetic women (3)
emphysematous pyelonephritis
emphysematous pyelitis,
xanthrogranulomatous pyelonephritis
emergency nephrectomy treatment
emphysematous pyelonephritis
chronic suppurative renal infection
xanthrogranulomatous pyelonephritis
loss of corticomedullary differentiation (2)
pyelonephritis
acute + xanth
untreated pyelonephritis leads to
necrosis + abscess (renal/perinephric)
sono app renal abscess
round, thick walled, debris and septations, gas, posterior enhancement
pyonephrosis
purulent material in obstructed collecting system - mobile debris
cause of pyonephrosis in elder
malignant ureteral obstruction
cause of pyonephrosis in young (2)
UPJ obstruction
calculi
xanthrogranulomatous pyelo uni or bilateral
unilateral
______ leads to papillary necrosis
ischemia
most common funcal infection
candida albicans
candida albicans sono app
small cortical abscesses
most common parasitic infection
schistosomiasis
sono app schistosomiasis
wide portal tracts
parasitic infection contracted from cow/sheep
echinococcal hydatid renal disease
sono app echinococcal hydatid
daughter cyst/lillypad
what parasitic infection is US not helpful in diagnosing?
Filiarasis
Filiarisis contracted by ____, symptoms show after how long, in what age group
mosquitoes, after 5-20 years, children
t/f HIV associated with chronic renal disease
true
who are at an increased risk for bladder infections? why?
women because short urethra
what is the most common pathogen for bladder infection?
e.coli
emphysematous cystitis
gas in lumen and wall of bladder
what is a rare granuloma infection?
malacoplakia
what is brunns epithelial nests associated with? what are they?
chronic cystitis, brunns epi nests are in the bladder wall. of central portion of brunns nest degenerations – cystitis cystica results. With chronic irritation, can become glandularis
what causes fistulas
trauma
inflammation
radiation
neoplasm
where might a fistula occur (5)
bladder to vag, gut, skin, uterus, ureter
types of fistulas related to bladder (4)
vesicovaginal (surgery/carcinoma)
vesicoenteric (diverticul/chrons)
vesicocutaneous (surgery/trauma)
vesicoureteral (hysterectomy)
bladder condition most common in men
nephrolithiasis
3 most common areas kidney stone
- UPJ
- where ureter crosses iliac vessels
- UVJ
what is the most common symptom of kidney stone
flank pain
what mm will stones pass spontaneously
<5 mm
artifact assoc with stones
twinkel
t/f intrarenal gas can mimic calculi
true
Hydroureter sono app
dilated, hypoechoic tube entering bladder obliquely. anechoic ureter on either side of stone
hydronephrosis occurs when
ureteral calculus obstructs collecting system causing backup - dilated calyces connect with dilated renal pelvis
s/s hydronephrosis
flank pain, hematuria, fever, leukocytosis
s/s of staghorn calculi (3)
flank pain
hematuria
fever
if you see extrarenal pelvis variant, what could that indicate?
calculi obstruction
medullary pyrimads surrounded by calcium deposits with acoustic shadowing
nephrocalcinosis
nephrocalcinosis may be ___ or ____
dystrophic or metastatic
causes of chronic renal failure (5)
glomerulonephritis hypertension vascular disease diabetes mellitus chronic hydronephrosis
lab findings of chronic renal failure
elevated BUN & creatinine, proteinuria
s/s chronic renal failure
polyuria headaches fatigue weakness anemia
sono findings chronic renal failure
renal atrophy
hyperechoic parenchyma or isoechoic / cannot distinguish from surrounding tissue
cortical thinning <1cm
sono app acute pyelonephritis (7)
renal enlargement compression sinus abnormal ecotexture loss corticomedull diff poorly marginated gas within renal parenchyma echo/hypo or mixed
sono app renal abscess (3+2 sometimes)
round thick walled hypo sometimes: debris/septation + gas/dirty shadow
what does pyonephrosis imply
purulent material in an obstructed collecting system
sono app chronic pyelonephritis (3)
cortical thinning/scar
dilated calix
patients at risk of necrosis/abscess formation with pyelonephritis (5)
diabetes compromised immunity chronic disease UT obstruction IV drug use
sono app pyonephrosis (3)
mobile collecting system debris
gas/stones
fluid/debris level
emphysematous pyelonephritis vs pyelitis
pyelo- gas formation in kidney parenchyma
pyelitis- gas formation in collecting system only (pelvis/calyces)
what is chronic pyelonephritis associated with
interstitial nephritis with vesicoureteric reflux - reflux can lead to end stage renal disease
is xantho pyelonephritis uni or bilateral
diffuse or focal?
unilateral
can be diffuse, focal AND segmental
what is xantho pyelonephritis
chronic suppurative renal infection causing destruction of renal parenchyma and replacement of it with lipid-laden macrophages
what does this sono description fit: swollen pyramids, clubbed calyx, hydronephrosis
papillary necrosis
patients at risk of candida albicans have history of (7)
diabetes mellitus chronic indwelling catheters malignancy hematopoeitic disorders antibiotic/steroid therapy transplant IV drug use
list 3 parasitic diseases
schistosomiasis
hydatid disease
filariasis
