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What is Pyelitis
- - Inflamation of the renal pelvis, the outher basin-like portion of the kidney at the attachment of the ureter
- -Common in young childern escpecially girls due to the shorter urethra that in boys
- - untreated, infection may spread to kidney tissue leading to pyelonephritis
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What are the causes of pyelitis
- - Caused by pyogenic (pus forming) Bacteria
- - bacteria may orginate from a unrinary bladder infection or blood
- - or from fecal contamination and travel up the urethra to urinary bladder then up the uretea or to the renal pelvis
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Pyelitis - Symptom
Dysuria
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Treatments of Pyelitis
Antibotics
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What is Pyelonephritis
Bacterial infection of the kidney and the renal pelvis
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What causes Pyelonephritis
- Caused by pyrogenic (pus forming) bacteria
- leads to the obstruction of the unrinary tract slows urine flow which increased risk of infection
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Causes of obstruction of Pyelonephritis
- 1 - cogenital defect
- 2- kidney stone
- 3-Enlarged prostate gland
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Consequences of Pyelonephritis include
- 1- abscesses from and rupture, draining pus into the renal pelvis and urine
- 2 - Abscesses can fuse and fill the entire kidney with pus
- 3-left untreated, may lead to renal failure and uremia
- 4-Kidneys shrink, describeed as granular contracted kidney
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Pyelonephritis
- Bacterial infection of the kidney and renal pelvis
- - Leads to obstruction of the unrinary tract slows urine flow which increase risk of infecton
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Pyelonephritis- Causes or and Cause of the obstruction
Caused by Pyogenic (pus-forming) bacteria
- Causes of obstruction include
- - Congential defect
- -kidney stone
- -enlarged prostate gland
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Pyelonephritis consequences include
- 1- abscesses form and rupture draining pus into the renal pelvis and wrine
- 2-abscesses can fuse and fille the entire kidney and wremia
- 3-kidneys shrink, descibed as granular contracted kidney
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Pyelonephritis Diagnoses
- [1] Urinalysis
- [a] Urine turbid or cloudy in appearance
- [2] Microscopy
- [a] Cells and bacteria
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Pyelonephritis Symptoms
- Chills
- high fever
- sudden back pain
- dysuria
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Pyelonephritis Treatment
Antibotics
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Kidney stones AKA urinary calculi
(1) A solid mass made up of tiny crystal
(2) One or more stones can be in kidneys or ureter at the same time
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Four different types or kidney stones
- [1] Calcium stones- most frequent (~80%)
- [2] Uric acid stones (~10%)
- [3] Struvite stones (~10%)
- [4] Cystine stones- least frequent (~1%)
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Calcium stones-
- [a] Occurs 4X more often in men that in women
- [b] Likely to reoccur
- [c] Causes include
- {1} Unexplained hypercalciuria (causes elevated urinary Ca2+)
- {2} Hyperparathyroidism (causes excess serum Ca2+)
- {3}Sarcoidosis (raises serum Ca2+ levels due to overproduction of vitamin D by sarcoid granuloma)
- {4} Cancers
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Uric acid stones
- [a] More common in men than in women
- [b] Associated with gout, chemotherapy, or high protein diet
- [c] Causes urine to become more acidic leading to excess uric acid levels and stone formation
- [d] Conditions producing acidic urine include dehydration, colon surgery, or high protein diet
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Struvite stones
- [a] Found in women who have a urinary tract
- infection
- [b] Grow very large blocking the kidney, ureter, or
- urinary bladder
- [c] Bacterial enzymes increase ammonia urinary
- concentrations so urine becomes more alkaline triggering stone precipitation
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Cystine stones
- [a] Least common
- [b] Inherited disorder involving the amino acid
- cystine (the least soluble of naturally occurring amino acids)
- [c] Formed in people who have cystinuria
- [d] Kidneys fail to reabsorb cystine which then
- crystallizes and precipitates anywhere in the urinary tract
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Kidney Stones Symptoms
Primary symptom
[1] Severe pain that begins and ends abruptly- Pain in abdomen or side of the back, may move to groin or testicles
- (c)Other symptoms
- [1]Abnormal urine color
- [2] Hematuria
- [3]Chills
- [4]Fever
- [5]Nausea (Pete class)
- [6] Vomiting
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Kidney Stone Causes
- [1] Dehydration
- [2] Urinary tract infection by blocking urinary flow permitting bacterial growth in urinary tract
- [3] Urinary stasis caused by some type of obstruction such as tumors, strictures, or anatomical abnormalities
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Kidney Stone - Diagnosis
- [1]Computed tomography (CT) scans
- [2]Intravenous pyelogram (IVP)
- [3]Renal ultrasound/scan
- [4]KUB (x-ray for examining kidneys-ureters-bladder)
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Kidney Stones Treatments
- 1- Hydration
- 2-Medications
- [a]Allopurinol (for uric acid stones)
- [b]Antibiotics (for struvite stones)
- [c]Diuretics
- {1}Thiazide diuretics plus potassium citrate
- {2}Potassium-sparing diuretics
- [d]Phosphate solutions (reduces Ca2+
- release into the bloodstream)
- [e]
- Sodium bicarbonate or sodium citrate (makes
- urine more alkaline)
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Kidney Stones Surgery
- [a] Extracorporeal shockwave lithiotripsy (ESWL)
- [b] Laser lithotripsy
- [c] Percutaneous nephrolithotomy (PNL)
- [d] Ureteroscopic stone removal
- [e] Open (incisional) surgery
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Hydronephrosis
Swelling of one (unilateral hydronephrosis) or both (bilateral hydronephrosis) kidneys due to a backup of urine
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Hydronephrosis
- (2) Considered a condition, not a disease
- (a) May result from anatomic or functional processes
- interrupting the flow of urine
- (b) Increased ureteral pressure leads to decreased
- glomerular filtration rate, tubular function, and renal blood flow
- (c) Brief disruptions in urine flow are limited and
- reversible
- (d) Chronic disruptions in urine flow can lead to
- tubular atrophy and nephron loss
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Structural abnormalities contributing to hydronephrosis include
- [1] Birth defects
- [2] Ureterocele (swelling at the base of one of the
- ureters)
- [3] Ureter prolapse
- [4] Kidney stones or blood clots in the renal pelvis
- [5] Compression of the ureter due to fibrous bands,
- an abnormally located artery or vein, or tumor
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Polycystic kidney
- Kidney cyst that is a dilated renal tubule that does not
- open into the renal pelvis
Cysts enlarge, fuse together, and may become infected
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Polycystic kidney -Although cause of cyst formation is unknown, possible factors include
- [1] Congenital defects
- [2] Autosomal dominant hereditary disease
- [a] Symptoms usually begin in middle age
- [3] Autosomal recessive hereditary disease
- [a] Symptoms appear in infancy or early childhood
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Polycystic kidney - diagnosis
- [1] Physical examination
- [2] Renal ultrasound
- [3] Computed tomography (CT) scan
- [4] Intravenous pyelogram (IVP)
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Polycystic kidney - Treatments
- [1] Antihypertensive medications
- [2] Diuretics
- [3] Low-salt diet
- [4] Antibiotics
- [5] Drainage of cysts
- [6] Surgical removal of affected kidney
- [7] Kidney transplantation
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Cystitis
Inflamation of the urinary bladder casue by bacterial infection
More common in women then men due tothe women shorter urthea
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Cystitis- Causes
- [1] In women, E. coli from colon could enter urethra
- [2] Sexual intercourse
- [3] Coughing or exertion squeezes urinary bladder pushing some urine into the urethra then urine reenters urinary bladder
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Cystitis -Diagnosis & treatment
- (c) Diagnosis
- [1] Microscopic examination reveals
- [a] Bacteria
- [b] Pus
- [c] Casts
- [d] Leukocytes
- (d) Treatment - Antibiotics
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Urinary incontinence
- Loss of urinary bladder control or the involuntary
- release of urine
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Two types of urinary incontinence
- 1 -Temporary urinary incontinence
- 2- Persistent urinary incontinence
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Temporary urinary incontinence Causes include
- [a] Alcohol
- [b] Overhydration
- [c] Dehydration
- [d] Caffeine
- [e] Urinary bladder irritation
- [f] Medications
- [g] Urinary tract infection
- [h] Constipation
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Persistent urinary incontinence - causes include
- [a] Pregnancy
- [b] Changes with aging
- [c] Hysterectomy
- [d] Painful urinary bladder syndrome (interstitial
- cystitis)
- [e] Prostatitis
- [f] Enlarged prostate
- [g] Prostate cancer
- [h] Urinary bladder cancer or urinary bladder stones
- [i] Neurological disorders
- [j] Obstruction
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Three basic forms of urinary incontinence
- 1- Overflow incontinence - urinary bladder overfills and urine leask from the urethra
- 2-Stress incontinence - urethral sphincter is either weakend or damaged allowing leakage of urine following increased abdominal preasure
- 3-Urge incontinence - Strong sudden need to urinate due to urinary bladder spasms or contractions
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urinary incontinence - treatments
- 1- Behavioral techniques
- 2- Physical Therapy
- 3-Medical devices
- 4-Inerventional therapies
- 5-Surgery
- 6-Miscellaneous
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urinary incontinence - treatments
i.e of Behavorial tech
[1] Urinary bladder training
[2] Scheduled toilet trips
[3] Fluid and diet management
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urinary incontinence - treatments
i.e Physical Therapy
[1] Pelvic floor muscle exercises
[2] Electrical stimulation
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urinary incontinence - treatments
i.e. Medications
[1] Anticholinergics
[2] Topical estrogen
[3] Antidepressant
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urinary incontinence - treatments
i.e Medical Devices
[1] Urethral inserts
[2] Pessary
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urinary incontinence - treatments
i.e Intervention Therapies
[1] Radiofrequency therapy
[2] Botulinum toxin type A
[3] Bulking material injections
[4] Sacral nerve stimulator
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urinary incontinence - treatments
i.e Surgery
[1] Artificial urinary sphincter
[2] Sling procedures
[3] Urinary bladder neck suspension
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urinary incontinence - treatments
i.e MISC
[1] Absorbent pads and protective garments
[2] Catheters
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