Flashcards in Lesson 4B (Part 1) Deck (34)
What are 8 genitourinary infections?
1. Acute Pyelonephritis
2. Renal and Perinephric abscess
4. Emphysematous Pyelonephritis
5. Emphysematous Pyelitis
6. Chronic Pyelonephritis
Acutely infected kidneys from E-coli or staphylococcus aureus
Where does the UTI begin?
In the baldder
Where does the UTI ascend to?
The kidney parenchyma
How is acute pyelonephritis diagnosed?
With lab tests
How is acute pyelonephritis treated?
Who does acute pyelonephritis affect?
What a re the sonographic appearance of acute pyelonephritis? (6)
1. Renal enlargement
2. Compression of sinus
- due to parenchyma being swollen
3. Abnormal echotexture
4. Loss of corticomedullary differentiation
- hard to tell the difference between the pyramids in the kidney
5. Poorly marginated mass
6. Gas within renal parenchyma
Why do you have focal or diffuse absence of colour doppler in acute pyelonephritis?
Due to swollen inflamed areas
How can focal masses appear as in acute pyelonephritis? (4)
1. Poorly marginated
What are the most sensitive modalities for demonstrating changes due to infection? (2)
Interstitial nephritis (swelling between the tubules) associated with vesicoureteric reflux
What does reflux cause?
10-30% of end stage renal disease
Who are chronic pyelonephritis more common in?
- begins in childhood
What is chronic pyelonephritis caused by?
Incompetent papillary duct orifice
- where pyramids empty urine into minor calyces
What is the sonographic appearance of chronic pyelonephritis on US? (3)
1. Dilated blunt calix
2. Cortical scar and atrophy
- becomes thin
3. If unilateral, compensatory hypertrophy of contralateral kidney
What can untreated pyelonephritis lead to? (2)
1. Necrosis formation
2. Abscess formation
What types of patients are at risk with renal and peripheral abscesses? (5)
2. Compromised immunity
3. Chronic diseases
4. UT obstruction
5. IV drug abuse
Around the kidney
What is the sonographic appearance of renal and perinephric abscesses? (6)
3. Complex masses
4. Debris and septations
- dirty shadowing
6. Posterior enhancement
What modality has an accurate diagnosis for renal and perinephric abscess?
What modality has an accurate follow up exam for renal and perinephric abscess?
Purulent material in obstructed collecting system
- ureter can be infected
What is necessary with pyonephrosis?
Early diagnosis and treatment in order to prevent bacteremia and septic shock
What is the cause of pyonephrosis in the young? (2)
1. UPJ obstruction
What is the cause of pyonephrosis in the elderly?
Malignant ureteral obstruction
How does pyonephrosis look on US? (3)
1. Mobile collecting system debris
2. Gas and stones
3. Fluid/debris level
Is a uncommon, life threatening infection
Who does emphysematous pyelonephritis affect? (2)
- 55 years
How is emphysematous pyelonephritis characterized?
By gas formation
- usually E-coli
What is the emergency treatment of choice for emphysematous pyelonephritis?
What is the preferred imaging modality for emphysematous pyelonephritis?
How do the sonographic image appear for emphysematous pyelonephritis?
Confusing due to gas formation