Urinary Tract Obstruction and infection

Question 1

1. What are the characteristic symptoms of Urinary tract calculi?
2. What is the gold standard diagnostic test for urinary tract calculi?
3. How is it treated if symptomatic?

Answer 1

1. Most asymptomatic, renal/ureteric colic, UTI, Urinary tract obstruction
2. CT of kidneys, ureter, bladder
3. NSAIDs such as diclofenac for pain

Question 2

1. What is dilation of the kidneys following obstruction called?
2. What are the characteristic signs and symptoms of UT obstruction?

Answer 2

1. Hydronephrosis
2. Loin pain, anuria, hesitancy, narrowing/diminished force of urinary stream, terminal dribbling, incomplete bladder emptying, enlarged hydronephrotic kidney, enlarged bladder can be felt/percussed

Question 3

1. What is the most common cause of UTI?
2. Identify some risk factors of UTI
3. What are the five most typical symptoms of a UTI
4. What findings on a urine dipstick test indicate this diagnosis?

Answer 3

1. E. coli infection
2. Female gender, new sexual activity, urinary catheter, urinary tract stones/stasis, diabetes mellitus, dementia
3. dysuria (painful voiding), frequency of micturition, suprapubic pain and tenderness, haematuria, smelly urine
4. Nitrites and leucocytes positive

Question 4

1. What are the four characteristic signs of acute pyelonephritis?
2. How does it present on CT scans?
3. How should it be treated?

Answer 4

1. Fever, tenderness, loin pain and bacteruria
2. Wedge shaped areas of inflammation on the renal cortex
3. Co-trimoxazole or Co-amoxiclav