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Renal & Urinary > UTIs & Nephrolithiasis > Flashcards

UTIs & Nephrolithiasis Flashcards

1
Q

What are some clinical signs of cystitis? What type of symptoms are usually absent?

A

Present: dysuria, urgency, frequency, suprapubic pain
Absent: systemic signs - fever, chills, etc.

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2
Q

In cystitis, describe lab findings on:

  1. Urinalysis
  2. Dipstick
  3. Culture
A
  1. Cloudy urine with > 10 WBCS/hpf
  2. Positive leukocyte esterase & nitrites
  3. > 100,000 CFU
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3
Q

What are the top 5 most common microorganisms causing cystitis?

A
  1. E coli
  2. Staph saprophyticus
  3. Klebsiella pneumoniae
  4. Proteus mirabilis
  5. Enterococcus faecalis
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4
Q

What is sterile pyuria?

A

Pyuria ( > 10 WBCs/hpf + leukocyte esterase positive) but negative urine culture

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5
Q

What are some causes of sterile pyuria?

A
  1. Urethritis due to Chlamydia or Neisseria gonorhoeae
  2. Stones
  3. Cancer
  4. TB
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6
Q

What do people with pyelonephritis present with?

A

Systemic signs: fever, etc + flank pain
Lab findings: WBC casts, leukocytosis
+ Symptoms of cystitis

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7
Q

What are the three most common pathogens causing pyelonephritis?

A
  1. E coli (90%)
  2. Klebsiella
  3. Enterococcus faecalis
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8
Q

What are the consequences of multiple incidences of acute pyelonephritis?

A

Interstitial fibrosis & atrophy of tubules

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9
Q

What effects does chronic pyelonephritis have on the kidney?

A
  1. Scarring in cortex (scarring specifically in upper and lower poles characteristic of VUR)
  2. Blunted calyces
  3. Waxy casts in urine
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10
Q

What is seen in the kidney tubules of an individual with chronic pyelonephritis? What does this resemble?

A

Contains eosinophilic proteinaceous material –> resembles thyroid follicles

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11
Q

Name two risk factors for the development of kidney stones.

A
  1. Increased concentration of solute in urinary filtrate

2. Low urine volume

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12
Q

What do individuals with a kidney stone present with?

A
  1. Colicky pain
  2. Hematuria
  3. Unilateral flank tenderness
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13
Q

What does one do about a kidney stone?

A

Wait. Usually passes within hours. If it doesn’t, surgery!

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14
Q

What is the most common type of kidney stone?

A

Calcium oxalate and/or calcium phosphate

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15
Q

How do you treat someone with recurrent calcium stones?

A

HCTZ –> Ca sparing diuretic (increased Ca absorption via enhanced Na Ca exchanger)
Or citrate

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16
Q

Calcium oxalate crystals are associated with what?`

A
  1. Ethylene glycol
  2. Vitamin C abuse
  3. Crohn disease
17
Q

What is the most common cause of ammonium magnesium phosphate stones?

A

Infection with urease-positive organisms (Proteus, Klebsiella)

18
Q

What type of stones do ammonium magnesium phosphate stones form?

A

Staghorn calculi in renal calyces –> increase risk of UTIs

19
Q

How are ammonium magnesium phosphate stones treated?

A

Surgical removal & eradication of pathogen to prevent recurrence

20
Q

What is the only type of stone that is radiolucent?

A

Uric acid stones

21
Q

What are risk factors for developing uric acid stones?

A
  1. Hot, arid climates
  2. Low urine volume
  3. Acidic pH
22
Q

What type of stones are commonly seen in gout patients?

A

Uric acid stones

23
Q

How do you treat someone with uric acid stones?

A
  1. Hydration
  2. Alkalinization of urine –> potassium bicarbonate
  3. Allopurinol in gout patients
24
Q

Which type of stone is commonly seen in children?

A

Cysteine stones

25
Q

What are cysteine stones associated with?

A

Cystinuria (decreased cysteine reabsorption because of tubular defects)

26
Q

What type of stones are cystein stones generally?

A

Staghorn calculi

27
Q

How do you treat someone with cysteine stones?

A

Hydration and alkalinization of urine

28
Q

What types of diseases can increase the risk for uric acid stones?

A

Diseases with increased turnover of cells –> hyperuricemia

- Leukemia, myeloproliferative disorders

Renal & Urinary (6 decks)

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