CAM II Nephrology Lecture 3 Questions and Answers With
complete solution–Expert Verified
pyelonephritis: bacterial infection of kidney and renal pelvis (complicated UTI)
pyelonephritis should be suspected in pts with: flank pain and lab evidence of UTI
classic triad for pyelonephritis: fever, flank pain, N/V
most common causative agents of pyelonephritis: gram negative bacteria (E. coli)
kidneys infected with E. coli can lead to an acute inflammatory responsewhich can cause:
scarring of the renal parenchyma
pyelonephritis signs/symptoms: fever
flank pain (CVA tenderness)
maybe irritative voiding symptoms (urgency, frequency, dysuria)
nausea, vomiting, diarrhea
pyelonephritis diagnosis: clinical diagnosis
urine culture with antimicrobial susceptibility testing performed in all pts and used to direct therapy
imaging, blood cultures, serum inflammatory markers should NOT be performed in uncomplicated case
urinalysis of pyelonephritis: pyuria
bacteriuria
possible hematuria
nitrite production if E.
coliwhite blood cell casts
if you were to get CT scan w contrast for pyelonephritis: perinephric stranding (imagingstudy of choice
in complicated pts)
pyelonephritis treatment: uncomplicated:
fluoroquinolones or
1/7
, single dose long acting parenteral agent (ceftriaxone IM) + oral antibiotics
complicated:
cipro, ceftriaxone, zosyn (standard IV antibiotics)
zosyn, imipenenm, meropenem if at risk for MDR gram neg
pyelonephritis in pregnant pt treatment: admitstart on broad
spectrum beta lactams IV (zosyn or ceftriaxone)
Switch to PO antibiotics (penicillins, cephalosporins,
carbapenems)or if past second trimester bactrim
pyelonephritis complications: bacteremiasepsis
2/7
complete solution–Expert Verified
pyelonephritis: bacterial infection of kidney and renal pelvis (complicated UTI)
pyelonephritis should be suspected in pts with: flank pain and lab evidence of UTI
classic triad for pyelonephritis: fever, flank pain, N/V
most common causative agents of pyelonephritis: gram negative bacteria (E. coli)
kidneys infected with E. coli can lead to an acute inflammatory responsewhich can cause:
scarring of the renal parenchyma
pyelonephritis signs/symptoms: fever
flank pain (CVA tenderness)
maybe irritative voiding symptoms (urgency, frequency, dysuria)
nausea, vomiting, diarrhea
pyelonephritis diagnosis: clinical diagnosis
urine culture with antimicrobial susceptibility testing performed in all pts and used to direct therapy
imaging, blood cultures, serum inflammatory markers should NOT be performed in uncomplicated case
urinalysis of pyelonephritis: pyuria
bacteriuria
possible hematuria
nitrite production if E.
coliwhite blood cell casts
if you were to get CT scan w contrast for pyelonephritis: perinephric stranding (imagingstudy of choice
in complicated pts)
pyelonephritis treatment: uncomplicated:
fluoroquinolones or
1/7
, single dose long acting parenteral agent (ceftriaxone IM) + oral antibiotics
complicated:
cipro, ceftriaxone, zosyn (standard IV antibiotics)
zosyn, imipenenm, meropenem if at risk for MDR gram neg
pyelonephritis in pregnant pt treatment: admitstart on broad
spectrum beta lactams IV (zosyn or ceftriaxone)
Switch to PO antibiotics (penicillins, cephalosporins,
carbapenems)or if past second trimester bactrim
pyelonephritis complications: bacteremiasepsis
2/7
