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1 STEP Renal pathology > Urinary tract infection 12/21 > Flashcards

Urinary tract infection 12/21 Flashcards

1
Q

4 symptoms of cystitis?

A

Suprapubic pain, dysuria, urinary frequency, urgency. No systemic signs, e.g. high fever, chills.

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2
Q

Risk factors for cystitis?

A

Female sex (short urethra), sexual intercourse, indwelling catheter, diabeted mellitus, impaired bladder emptying.

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3
Q

Most common cause of cystiti?

A

E. coli.

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4
Q

5 m/o of cystitis?

A

E. coli, Staph. saprophyticus, Klebsiella, Proteus mirabilis, Enterococcus faecalis.

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5
Q

Which m/o is common in sexually active young women?

A

Staph. saprophyticus.

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6
Q

Which m/o is MORE common in sexually active young women?

A

E. coli.

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7
Q

What disease can cause sexual intercourse?

A

Cystitis.

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8
Q

> 10 WBC/hpf and leukocyte esterase, negative urine culture. What suggested m/o? What suggested urinary tract infection?

A

STI –> Chamydia trachomatis and Neisseria gonorrhoeae. Urethritis.

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9
Q

Cystitis 3 lab. findings? (Not culture)

A

> 10 WBC/hpf, positive leukocyte esterase, nitrites.

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10
Q

Gold standart for cystitis diagnostics?

A

Culture - greater than 100 000 colony forming units.

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11
Q

Why there is leukocyte esterase in urine in cystitis?

A

Due to pyuria.

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12
Q

Why there is nitrites in urine in cystitis? What m/o indicates?

A

Gram negative bacteria convert nitrates to nitrites.

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13
Q

Nitrites in urine in cystitis. What m/o are indicated?

A

Gram negative bacteria.

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14
Q

Acute pyelonephritis predisposing factors?

A

Urinary obstruction, vesicoureteral reflux, pregnancy, diabetes mellitus, benign prostatic hyperpasia, indwelling catheter.

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15
Q

Acute pyelonephritis symptoms?

A

Flank pain (costovertebral angle tenderness), chills, fever, dysuria, frequency and urgency.

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16
Q

Costovertebral angle tenderness is common in ……

A

Acute pyelonephritis

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17
Q

What parts of kidney are involved in acute pyelonephritis?

A

Renal pelvis, tubules, interstitium.

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18
Q

What are the most common inflammatory cells in acute pyelonephritis?

A

Neutrophils.

19
Q

What are 3 m/os, that cause acute pyelonephritis?

A

E.coli, Klebsiella, Enterococcus faecalis.

20
Q

What is the most common m/o in acute pyelonephritis?

A

E. coli.

21
Q

What are the ways that m/os reach kidney in acute pyelonephritis?

A

Ascending via urethers, hematogenous spread to kidneys.

22
Q

What changes are in kidney parts, affected by acute pyelonephritis?

A

Interstitium - neutrophils infiltration.
Tubules - neutrophil casts.
May be presented parenchymal abcesses/abcesses in cortical surface.

23
Q

Urinalysis in acute pyelonephritis?

A

Pyuria (WBC in urine) and WBC casts.

24
Q

Why occurs chronic pyelonephritis?

A

Because of reccurent or inadequately treated episodes of ACUTE PYELONEPHRITIS.

25
Q

What causes chronic pyelonephritis?

A

Vesicoureteral reflux (kids) or obstruction (BPH or cervical carcinoma.

26
Q

Scarring of CORTEX at upper and lower poles of kidney indicates ……… (what pathology?) What disease it indicates?

A

Vesicoureteral reflux. Chronic pyelonephritis.

27
Q

Corticomedullary scarring and blunted calyxes are associated with ………

A

Chronic pyelonephritis.

28
Q

What is thyroidization of kidney?

A

It’s eosinophilic casts in kidney tubules, that looks like thyroid tissue in LM (H&E).

29
Q

Diabetes mellitus can cause …….

A

Acute pyelonephritis.

30
Q

Xanthogranulomatous pyelonephritis is associated with …….(m/o)…….. infection.

A

Proteus

31
Q

Xanthogranulomatous pyelonephritis is characterised by …………………………………………….

A

widespread kideny damage due to granulomatous tissue containing foamy macrophages.

32
Q

What macrophages are found in xanthogranulomatous pyelonephritis?

A

Foamy.

33
Q

Xanthogranulomatous pyelonephritis is acute or chronic?

A

Chronic.

34
Q

What nodules are seen in xanthogranulomatous pyelonephritis?

A

Orange nodules, that can mimic tumor nodules.

35
Q

There are seen nodules in kidney. What chronic disease should be considered to differenciate from tumor?

A

Xanthogranulomatous pyelonephritis.

36
Q

Cystitis. Urinalysis?

A

cloudy urine with >10 WBC/high power field (hpf)

37
Q

Cystitis. Dipstick?

A

positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites

38
Q

Cystitis. Culture?

A

greater than 100 000 colony formin units (GOLD STANDARD)

39
Q

Cystitis. Proteus - what urine?

A

alkaline urine with ammonia scent (-> amonium magnesiu phosphate stones)

40
Q

what is dominant presenting sign of urethritis?

A

dysuria

41
Q

Chronic pyelonephritis. Definition?

A

INTERSTITIAL fibrosis and ATROPHY of tubules due to mulptiple bouts of acute pyelonephritis.

42
Q

INTERSTITIAL fibrosis and ATROPHY of tubules due to mulptiple bouts of acute pyelonephritis?

A

Chronic pyelonephritis.

43
Q

Chronic pyelonephritis. morphology due to reflux?

A

Cortical scarring with blunted calyces; scarring at the upper and lower poles

44
Q

Chronic pyelonephritis. in general what morphology?

A

atrophic tubules containing eosinophilic material (resembles thyroid follicles)
Waxy casts may be in urine

1 STEP Renal pathology (12 decks)

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