Med - core topics: Nephrology Flashcards

0
Q

Acute urethral syndrome

A
  • sx of dysuria, urgency, and frequency w/out significant bacteriuria
  • not really urethral, actually a bladder infection
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1
Q

Ddx of UTI

A
  • growth of > or = 10^5 organisms per milliliter from properly collected “clean-catch” urine sample
  • but can be less too
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2
Q

Chronic pyelonephritis

A
  • chronic interstitial nephritis
  • results from bacterial infection of the kidney (this distinguishes it from the many other possible causes of chronic interstitial nephritis)
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3
Q

Most common bug to cause UTI?

A
  • gram-neg bacilli E. coli
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4
Q

Common cause of catheter-associated UTI?

A

-staph epidermis

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5
Q

3 common causes of sterile pyuria?

A
  • sexually-transmitted urethritis-producing agents:
    1. Chlamydia trachomatis
    2. N. gonorrhea
    3. Herpes simplex virus
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6
Q

What 2 features of urine of a normal healthy person protects them from UTIs?

A
  1. High urea concentration of the urine
  2. High osmolarity of the urine
    - inhibit or kill the bacteria
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7
Q

What do males have that can protect them from UTIs?

A

-prostatic secretions posses antibacterial properties

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8
Q

3 reasons why pregnant women are more susceptible to upper urinary tract infections?

A
  1. Decreased urethral tone
  2. Decreased urethral peristalsis
  3. Temporary incompetence of the vesicoureteral valves
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9
Q

3 Risks of UTIs and pregnancy?

A
  • increased incidences of:
    1. Low birth rate
    2. Premature delivery
    3. Neonatal death –> esp upper tract UTIs
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10
Q

What virus can cause a UTI? Who is it commonly seen in?

A
  • adenovirus

- kids and some young adults

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11
Q

How can immobilization lead to UTIs?

A

-immobilization –> demineralization –> hypercalciuria –> calculus formation –> obstructive uropathy –> infection

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12
Q

Virulence factors of bacteria and UTIs?

A
  • most of the E.coli strains that cause UTIs in healthy non-cath pts have to have virulence factors to be able to cause and infection
  • most contain fimbrea &/or produce cytotoxins
  • BUT in patients who have structural or functional abnormalities the bacteria do not need the virulence factors to cause infections , becuase the urinary tract is already compromised
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13
Q

Tx of asymptomatic bacteriuria in patients catheterized for >2 weeks?

A

-Dont tx unless symptomatic

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14
Q

4 most common causes of sterile pyuria?

A
  1. C. trachomatis
  2. U.urealyticum
  3. Mycobacterium tuberculosis
  4. fungi
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15
Q

Pregnancy and bacturia?

A

-all pregnant women should be screened for bacteriuria in the first trimester and should be treated if bacteriuria is detected

16
Q

What diet should stone-forming hypercalciuria patients follow?

A
  • low -sodium and low-protein diets

- low-calcium diets have NOT been found to be helpful!