Lesson 4B (Part 1) Flashcards Preview

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Flashcards in Lesson 4B (Part 1) Deck (34)
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1

What are 8 genitourinary infections?

1. Acute Pyelonephritis
2. Renal and Perinephric abscess
3. Pyonephrosis
4. Emphysematous Pyelonephritis
5. Emphysematous Pyelitis
6. Chronic Pyelonephritis
7. Xanthogranulomatous
8. Pyelonephritis

2

Acute pyelonephritis

Acutely infected kidneys from E-coli or staphylococcus aureus

3

Where does the UTI begin?

In the baldder

4

Where does the UTI ascend to?

The kidney parenchyma

5

How is acute pyelonephritis diagnosed?

With lab tests

6

How is acute pyelonephritis treated?

With antibiotics

7

Who does acute pyelonephritis affect?

Women
- 15-35

8

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

9

Why do you have focal or diffuse absence of colour doppler in acute pyelonephritis?

Due to swollen inflamed areas

10

How can focal masses appear as in acute pyelonephritis? (4)

1. Poorly marginated
2. Echogenic
3. Hypoechoic
4. Mixed

11

What are the most sensitive modalities for demonstrating changes due to infection? (2)

1. CT
2. MRI

12

Chronic pyelonephritis

Interstitial nephritis (swelling between the tubules) associated with vesicoureteric reflux

13

What does reflux cause?

10-30% of end stage renal disease

14

Who are chronic pyelonephritis more common in?

Women
- begins in childhood

15

What is chronic pyelonephritis caused by?

Incompetent papillary duct orifice
- where pyramids empty urine into minor calyces

16

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

17

What can untreated pyelonephritis lead to? (2)

1. Necrosis formation
2. Abscess formation

18

What types of patients are at risk with renal and peripheral abscesses? (5)

1. Diabetics
2. Compromised immunity
3. Chronic diseases
4. UT obstruction
5. IV drug abuse

19

Peripheral

Around the kidney

20

What is the sonographic appearance of renal and perinephric abscesses? (6)

1. Round
2. Thick-walled
3. Complex masses
4. Debris and septations
5. Gas
- dirty shadowing
6. Posterior enhancement

21

What modality has an accurate diagnosis for renal and perinephric abscess?

CT

22

What modality has an accurate follow up exam for renal and perinephric abscess?

US

23

Pyonephrosis

Purulent material in obstructed collecting system
- ureter can be infected

24

What is necessary with pyonephrosis?

Early diagnosis and treatment in order to prevent bacteremia and septic shock

25

What is the cause of pyonephrosis in the young? (2)

1. UPJ obstruction
2. Calculi

26

What is the cause of pyonephrosis in the elderly?

Malignant ureteral obstruction

27

How does pyonephrosis look on US? (3)

1. Mobile collecting system debris
2. Gas and stones
3. Fluid/debris level

28

Emphysematous pyelonephritis

Is a uncommon, life threatening infection

29

Who does emphysematous pyelonephritis affect? (2)

1. Women
- 55 years
2. Diabetics

30

How is emphysematous pyelonephritis characterized?

By gas formation
- usually E-coli