UTI-TIDK

Question 1

UTI mostly confined where?

if UTI involves upper GU tract

Answer 1

lower GU tract (cystitis)

pyelonephritis, calculi

Question 2

chronic pyelonephritis assoc with …

Answer 2

1) obstruction
2) VU-reflux
3) Chronic renal failure
4) HTN

Question 3

highest percentage of bacteriuria in which age group

Answer 3

elderly

Question 4

what is most common route of UTI?

most common bacteria?

Answer 4

Ascending infection

E coli

Question 5

Causes of hematogenous spread? patient groups?

assoc with which diseases?

Answer 5

1) debilitated patients
2) kidney injury
3) staph aureus, group A strep

1) septicemia
2) endocarditis

Question 6

virulence factors of UTI

Answer 6

1) bacterial adhesion (pili = P)
2) “O” Antigens = certain strains more resistant
3) endotoxin (decr ureteric peristalsis)

Question 7

host defenses against UTI

Answer 7

1) hydrokinetic
2) chemical = urine
3) immunological
4) cellular

Question 8

mechanical host defenses

chemical host defenses

Answer 8

bladder emptying/urine flow
ureteric peristalsis
mucus

prostatic secretions = antibacterial
urine osmolality, pH, ammonia
P1 blood group antigens

Question 9

immunological host defense

cellular host defense

Answer 9

IgA, complement

PMN’s, shedding urothelial cells

Question 10

predisposing factors to UTI

Answer 10

1) females = shorter urethra, bacterial colonization, urethral trauma
2) instrumentation
3) decr urine flow
4) calculi, vesicoureteral reflux
5) immune compromise
6) kidney/UT disease, pregnancy

Question 11

Clinical manifestations of symptomatic UTI

Answer 11

recurrent infection in males usu = urinary tract disease

Question 12

clinical manifestations of ealry childhood

Answer 12

nonspecific sx

irritability, convulsions

Question 13

complications of UTI

Answer 13

1) recurrence
2) acute pyelo
3) renal/perinephric abscess
4) chronic pyelo/renal scarring

Question 14

complications of UTI with diabetes

Answer 14

papillary necrosis

Question 15

complications of UTI with proteus

Answer 15

staghorn calculi

Question 16

causes of chronic pyelonephritis

Answer 16

1) urinary tract obstruction

2) vesicoureteral reflux (VUR)

Question 17

Obstruction predisposes to ___

Obstruction interferes with ____

Obstruction + infection =

Answer 17

1) infection and recurrence
2) eradication

incr pressure, inflamm, ischemia, direct injury

Question 18

causes of urinary tract obstruction

Answer 18

1) intrinsic = tumors, calculi, clot
2) stricture
3) extrinsic = tumor, hemorrhage, retroperitoneal fibrosis
4) diabetes/neuro

Question 19

most common cause of kidney stone

Answer 19

calcium oxalate = phosphate

Question 20

consequences of urinary tract obstruction

Answer 20

1) hydronephrosis
2) infection = acute/recurrent
3) chronic obstructive pyelonephritis
4) renal failure
5) HTN

Question 21

primary vesicoureteral reflux

1) common in…
2) how does timing change

Answer 21

1) infants

2) decr freq/severity during childhood
mild

Question 22

secondary vesicoureteral reflux

1) causes
2) patient population

Answer 22

1) congenital, neurogenic bladder, obstruction

2) older children, adults

Question 23

reflux nephropathy = chronic non-obstructive pyelo

more extensive where?

often…

Answer 23

severe, persistent reflux + infection = organisms access renal parenchyma

poles (compound vs. simple)

unilateral or unequal bilateral

Question 24

scars of chronic pyelo are usu… assoc with…

Answer 24

polar

assoc with blunted calyces

Question 25

microscopic of reflux nephropathy

Answer 25

atrophy, “periglomerular fibrosis”

Question 26

complications of chronic non-obstructive pyelo

Answer 26

Chronic renal failure

HTN

FSGS?