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tville01
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Inflammation of the renal pelvis and medullary tissue
pyelonephritis
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What are some factors that contribute to the development of pyelonephritis
- pregnancy
- catheter
- cytoscope
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Describe the patho of pyelonephritis
- one or both kidneys involved
- tubules affected, not glomeruli
- purulent exudate fills renal pelvis, calyces, & medulla get inflammed
- necrosis & absecces may extend to cortex & capsule
- exudate may block urine flow
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What are the signs of pyelonephritis
- pyuria-lots of pus absecces rupture
- bacteruria, hematuria, & proteinuria
- WBC cast
- fever & chills
- flank or lower back pain-from capsule stretching
- frequent & dysuria
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What are casts
molds of the tubules
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How are casts formed
- WBC migrate to tubules due to inflammation
- endothelial cells releases gel substance
- coats WBC
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What would a cast indicate
there is a problem higher up in the urinary tract
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would you see a cast with cystitis
no
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What are the diagnostic test for pyelonephritis
- H&P-abdominal or lumbar pain during palpitation
- Urinalysis-C&S-protein,blood, pus,& bacteria
- WBC casts
- X-ray-hydronephrosis(enlarged kidneys)
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What are the complications of pyelonephritis
- severe infections
- abseccess
- acute renal failure-exudate obstruct urine flow
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What is the treatment for pyelonephritis
- Antibiotics
- Increase fluid
- surgery for obstructions
- hospitalization
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What is the prognosis for pyelonephritis
- good if treated quickly
- chronic pyelonephritis-fibrious scars-loss of tubule function
- chronic renal failure
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What is the onset of pyelonephritis
acute
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