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UTI (CRF (BLOODS
NaCl retention
HTN
Hyperkalaemia
Metabolic…
UTI
CRF
BLOODS
- NaCl retention
- Hyperkalaemia
- Anaemia
- Hypocalcaemia
- Due to incr. in phosphate binding
CLINICAL FEATURES
- Nausea
- Anorexia
- Pericarditis
- Platelet dysfx
- Encephalopathy c asterixis
- Urea crystal depositions in skin
ETIOLOGY
- Can result from:
- Glomerular
- Tubular
- Inflammatory or Vascular insults
- Most common causes
- Uremia
- Incr. nitrogenous waste products in the bld
ANOTHER ONE OF PATHOMAS ONE TRILLION 'SUPER HIGH YIELDS'
- EPO IS PRODUCED BY THE:
- RENAL PERITUBULAR INTERSTITIAL CELLS
-
SYMPTOMS
- Dysuria
- Frequency
- Urgency
- Suprapubic pain
- Absent systemic signs
UA
- WBC
- Nitrites
- Culture >100,000
ETIOLOGY
- E.Coli 80%
- Klebsiella
- Staph saprophyticus
- Proteus Mirabilis
- Enterococcus faecalis
PY
STERILE PYURIA
- Pyuria c nve urine culture
- Suggests URETHRITIS
- Due to Chlamydia or Gonorrhea
CHRONIC PYELONEPHRITIS
PATHOPHYSIOLOGY
- Interstitial fibrosis & atrophy of tubules
- Caused by recurrent incidence of acute pyelo
- Resulting in vesicoureteral reflex (children) or obstruction
CHARACTERISTICS
- Cortical scarring c blunted calyces
- Scarring @ upper & lower poles
- Atrophic tubules, eosinophilic proteinaceous material
- Reminiscent of thyroid follicles
- 'Thyroidisation' of kidney
- Waxy casts may be seen in urine
PYELONEPHRITIS
- Infx of kidney
- Usually ascending
- Vesicoureteral reflex (assoc. risk)
PRESENTATION
- Fever
- Flank pain
- WBC casts
- Leukocytosis
- c signs of cystitis
NEPHROLITHIASIS
PRESENTATION
- Colicky pain
- Haematuria
- Unilateral flank pain
TYPES OF STONE
CALCIUM OXALATE
- Hypercalcaemia
- Hypovolaemia
- Seen in Crohn's
- Incr. absorption of oxalate
- Radiopaque
STRUVITE
- UTI
- Results in Staghorn calculi in renal calyces
- Radiopaque
-
-
Tx
- Usually passes c/in hours