Volume II Flashcards
What is pyuria, and what conditions can What is the significance of bacteriuria without pyuria?
Bacteriuria without pyuria generally indicates bacterial colonization without overt infection of the urinary tract.
What is pyuria, and what conditions can contribute to it?
Pyuria is the presence of white blood cells (WBCs) in the urine, indicative of infection or an inflammatory response of the urothelium to bacteria, stones, indwelling foreign bodies, or other conditions.
What is pyuria, and what conditions can contribute to it?
Pyuria is the presence of white blood cells (WBCs) in the urine, indicative of infection or an inflammatory response of the urothelium to bacteria, stones, indwelling foreign bodies, or other conditions.
What should be considered when encountering pyuria without bacteriuria, or sterile pyuria?
Sterile pyuria warrants further evaluation, as it may indicate underlying issues beyond bacterial infection.
What are the clinical symptoms of cystitis?
Cystitis is characterized by a clinical syndrome of dysuria, frequency, urgency, and occasionally suprapubic pain.
Describe the clinical syndrome of acute pyelonephritis and its indicative features.
Acute pyelonephritis is marked by chills, fever, and flank pain, accompanied by bacteriuria and pyuria, a combination reasonably specific for acute bacterial infection of the kidney.
What does a focal, coarse scarring in the right kidney on an excretory urogram indicate? Describe the findings in the left kidney of an 18-year-old girl who had a history of recurrent fevers between 2 months and 2 years of age. What does the blunting of all calyces in a kidney signify? In the case described, what could be the reason for the absence of infections between the ages of 6 and 15 years, followed by reinfections at the age of 15? What is the significance of a serum creatinine level of 0.9 mg/dL at the age of 18 years in this context?
Focal, coarse scarring may indicate a history of infection, inflammation, or injury to the kidney. It may be associated with recurrent fevers or infections. The left kidney was atrophic with marked reflux. Excretory urography at the age of 6 years established severe atrophy of the left kidney. Blunting of all calyces often indicates chronic damage and atrophy of the kidney, possibly due to recurrent infections or other underlying kidney disorders. The absence of infections could be due to effective management, while the reinfections might have been triggered by changes in health status, lifestyle, or cessation of previous treatment measures. A serum creatinine level of 0.9 mg/dL is within the normal range, indicating that the kidney function, despite the scarring and atrophy, is still maintaining its filtering capability.
What is pyelonephritic atrophy, and in what context can it occur? Describe the clinical presentation of a 20-year-old woman with spina bifida, neurogenic bladder, and pyelonephritic atrophy. What is the significance of uniform, regular atrophy of the renal cortex in pyelonephritic atrophy? How is pyelonephritic atrophy related to spina bifida and neurogenic bladder?
Pyelonephritic atrophy refers to the atrophy of the renal cortex, usually associated with chronic inflammation or infection of the kidney. It can occur in conditions like neurogenic bladder and obstruction, often with superimposed infections. Pyelonephritic atrophy refers to the atrophy of the renal cortex, usually associated with chronic inflammation or infection of the kidney. It can occur in conditions like neurogenic bladder and obstruction, often with superimposed infections. The uniform and regular atrophy of the renal cortex suggests the reflux of bacteria simultaneously into virtually all nephrons. This type of pyelonephritic atrophy is uncommon and is characteristic of obstruction with superimposed infection. Patients with spina bifida often suffer from neurogenic bladder, leading to urinary retention and stasis. This creates an environment prone to infections and can contribute to pyelonephritic atrophy, particularly if there have been many episodes of fever and bacteriuria in early childhood.
What factors suggest a complicated urinary tract infection related to the physical condition of the patient?
Functional or anatomic abnormality of the urinary tract, diabetes, immunosuppression, and symptoms for more than 7 days at presentation.
What demographic factors may suggest a complicated urinary tract infection?
Male gender, pregnancy, elderly patient, and childhood urinary tract infection.
How do medical interventions and environmental factors contribute to the risk of a complicated urinary tract infection?
Recent antimicrobial agent use, indwelling urinary catheter, urinary tract instrumentation, and hospital-acquired infection.
List all the factors that suggest a complicated urinary tract infection.
Functional or anatomic abnormality of urinary tract, male gender, pregnancy, elderly patient, diabetes, immunosuppression, childhood urinary tract infection, recent antimicrobial agent use, indwelling urinary catheter, urinary tract instrumentation, hospital-acquired infection, and symptoms for more than 7 days at presentation.
What was the estimated number of office visits in the United States for UTI-related complaints in 2007?
10.5 million, accounting for 0.9% of all ambulatory visits.
How many visits to the emergency room were made for UTIs in the United States in 2007?
2 to 3 million.
What percentage of women experience a UTI requiring antimicrobial therapy by age 24, and in their lifetime?
Nearly 30% by age 24, and almost half during their lifetime.
