Urinary tract infection 12/21

Question 1

4 symptoms of cystitis?

Answer 1

Suprapubic pain, dysuria, urinary frequency, urgency. No systemic signs, e.g. high fever, chills.

Question 2

Risk factors for cystitis?

Answer 2

Female sex (short urethra), sexual intercourse, indwelling catheter, diabeted mellitus, impaired bladder emptying.

Question 3

Most common cause of cystiti?

Answer 3

E. coli.

Question 4

5 m/o of cystitis?

Answer 4

E. coli, Staph. saprophyticus, Klebsiella, Proteus mirabilis, Enterococcus faecalis.

Question 5

Which m/o is common in sexually active young women?

Answer 5

Staph. saprophyticus.

Question 6

Which m/o is MORE common in sexually active young women?

Answer 6

E. coli.

Question 7

What disease can cause sexual intercourse?

Answer 7

Cystitis.

Question 8

> 10 WBC/hpf and leukocyte esterase, negative urine culture. What suggested m/o? What suggested urinary tract infection?

Answer 8

STI –> Chamydia trachomatis and Neisseria gonorrhoeae. Urethritis.

Question 9

Cystitis 3 lab. findings? (Not culture)

Answer 9

> 10 WBC/hpf, positive leukocyte esterase, nitrites.

Question 10

Gold standart for cystitis diagnostics?

Answer 10

Culture - greater than 100 000 colony forming units.

Question 11

Why there is leukocyte esterase in urine in cystitis?

Answer 11

Due to pyuria.

Question 12

Why there is nitrites in urine in cystitis? What m/o indicates?

Answer 12

Gram negative bacteria convert nitrates to nitrites.

Question 13

Nitrites in urine in cystitis. What m/o are indicated?

Answer 13

Gram negative bacteria.

Question 14

Acute pyelonephritis predisposing factors?

Answer 14

Urinary obstruction, vesicoureteral reflux, pregnancy, diabetes mellitus, benign prostatic hyperpasia, indwelling catheter.

Question 15

Acute pyelonephritis symptoms?

Answer 15

Flank pain (costovertebral angle tenderness), chills, fever, dysuria, frequency and urgency.

Question 16

Costovertebral angle tenderness is common in ……

Answer 16

Acute pyelonephritis

Question 17

What parts of kidney are involved in acute pyelonephritis?

Answer 17

Renal pelvis, tubules, interstitium.

Question 18

What are the most common inflammatory cells in acute pyelonephritis?

Answer 18

Neutrophils.

Question 19

What are 3 m/os, that cause acute pyelonephritis?

Answer 19

E.coli, Klebsiella, Enterococcus faecalis.

Question 20

What is the most common m/o in acute pyelonephritis?

Answer 20

E. coli.

Question 21

What are the ways that m/os reach kidney in acute pyelonephritis?

Answer 21

Ascending via urethers, hematogenous spread to kidneys.

Question 22

What changes are in kidney parts, affected by acute pyelonephritis?

Answer 22

Interstitium - neutrophils infiltration.
Tubules - neutrophil casts.
May be presented parenchymal abcesses/abcesses in cortical surface.

Question 23

Urinalysis in acute pyelonephritis?

Answer 23

Pyuria (WBC in urine) and WBC casts.

Question 24

Why occurs chronic pyelonephritis?

Answer 24

Because of reccurent or inadequately treated episodes of ACUTE PYELONEPHRITIS.

Question 25

What causes chronic pyelonephritis?

Answer 25

Vesicoureteral reflux (kids) or obstruction (BPH or cervical carcinoma.

Question 26

Scarring of CORTEX at upper and lower poles of kidney indicates ......... (what pathology?) What disease it indicates?

Answer 26

Vesicoureteral reflux. Chronic pyelonephritis.

Question 27

Corticomedullary scarring and blunted calyxes are associated with .........

Answer 27

Chronic pyelonephritis.

Question 28

What is thyroidization of kidney?

Answer 28

It's eosinophilic casts in kidney tubules, that looks like thyroid tissue in LM (H&E).

Question 29

Diabetes mellitus can cause .......

Answer 29

Acute pyelonephritis.

Question 30

Xanthogranulomatous pyelonephritis is associated with .......(m/o)........ infection.

Answer 30

Proteus

Question 31

Xanthogranulomatous pyelonephritis is characterised by ....................................................

Answer 31

widespread kideny damage due to granulomatous tissue containing foamy macrophages.

Question 32

What macrophages are found in xanthogranulomatous pyelonephritis?

Answer 32

Foamy.

Question 33

Xanthogranulomatous pyelonephritis is acute or chronic?

Answer 33

Chronic.

Question 34

What nodules are seen in xanthogranulomatous pyelonephritis?

Answer 34

Orange nodules, that can mimic tumor nodules.

Question 35

There are seen nodules in kidney. What chronic disease should be considered to differenciate from tumor?

Answer 35

Xanthogranulomatous pyelonephritis.

Question 36

Cystitis. Urinalysis?

Answer 36

cloudy urine with >10 WBC/high power field (hpf)

Question 37

Cystitis. Dipstick?

Answer 37

positive leukocyte esterase (due to pyuria) and nitrites (bacteria convert nitrates to nitrites

Question 38

Cystitis. Culture?

Answer 38

greater than 100 000 colony formin units (GOLD STANDARD)

Question 39

Cystitis. Proteus - what urine?

Answer 39

alkaline urine with ammonia scent (-> amonium magnesiu phosphate stones)

Question 40

what is dominant presenting sign of urethritis?

Answer 40

dysuria

Question 41

Chronic pyelonephritis. Definition?

Answer 41

INTERSTITIAL fibrosis and ATROPHY of tubules due to mulptiple bouts of acute pyelonephritis.

Question 42

INTERSTITIAL fibrosis and ATROPHY of tubules due to mulptiple bouts of acute pyelonephritis?

Answer 42

Chronic pyelonephritis.

Question 43

Chronic pyelonephritis. morphology due to reflux?

Answer 43

Cortical scarring with blunted calyces; scarring at the upper and lower poles

Question 44

Chronic pyelonephritis. in general what morphology?

Answer 44

atrophic tubules containing eosinophilic material (resembles thyroid follicles) Waxy casts may be in urine