43. Pyelonephritis Flashcards Preview

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Flashcards in 43. Pyelonephritis Deck (19):
1

Acute pyelonephritis is the

neutrophil infiltration of renal interstitium

2

Acute pyelonephritis affects ...(location

cortex with relative sparing of glomeruli / vessels

3

clinical presentation

1. fever
2. flank pain ( costovertebral angle tenderness)
3. nausea/ vomiting
4. chills

4

causes of acute pyelonephritis

1. ascending UTI ( E.coli is the MC
2. hematogenous spread to kidney

5

lab

WBCs in urine +/- WBCs

6

CT

striated parenchymal enhancement

7

risk factors

1. indwlling urinary catheter
2. urinary tract obstruction
3. vesicoulateral reflux
4. DM
5. pregnancy

8

compliaction

1. chronic pyelonephritits
2. renal papilary necrosis
3. peripheric abscess
4. utosepsis

9

urosepsis

sepsis started from UTI

10

acute pyelonephritis -treatment

antibiotics

11

chronic pyelonephritis is the result of

recurrent episodes of acute pyelonephritis

12

chronic pyelonephritis is the result og recurrent episodes of acute pyelonephritis - typically requires

predisposition to nfenction such as vesicoulateral reflux or chronically obstruction kidney stones

13

chronic pyelonephritis - gross and histological apperance

coarse, assymetric corticomedullary scarring, blunted and dilated calyx. Tubules can contain esoniphilic casts resmbling thyroid tissue ( thyroidization of kidney)

14

Xanthogranulomatous pyelonephritis

a rare condition chatacterized by widespread kidney damage due to granulomatous tissue containing foamy macrophages

15

• In acute pyelonephritis, the renal cortex is ____ , glomeruli are ____, and vessels are ____ (for all choices: affected or spared).

Affected; spared; spared

16

• What urinalysis finding suggests pyelonephritis in a febrile patient with flank tenderness, nausea, and vomiting? Is this acute or chronic?

White blood cell casts; acute

17

• A patient has had chronic pyelonephritis for many years. In this patient, what substance may be filling the tubules of the renal nephrons?

Eosinophilic casts, a histopathologic biopsy finding known as thyroidization of the kidney

18

• What gross anatomic changes of the kidneys occur with chronic pyelonephritis? What is required for these recurrent infections to occur?

Coarse, asymmetric corticomedullary scarring and blunted calices; a predisposition such as vesicoureteral reflux and obstruction

19

• A nonpregnant woman chooses to forgo treatment for her pyelonephritis. Name at least one complication of her poor decision.

Chronic pyelonephritis, renal papillary necrosis, perinephric abscess, urosepsis

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