What is (are) the prominent clinical finding(s) in the diagnosis of acute pyelonephritis?
fever, chills, abdominal pain
costovertibral angle tenderness
hypogastric and loin pain
flank pain, dysuria
Correct Answer :
B. costovertibral angle tenderness
costo-vertebral angle tenderness on fist percussion is diagnostic for acute pyelonephritis beside the suggestive symptoms.
Related Questions
What is (are) the complication(s) of sexually transmitted infections?
pelvic inflammatory disease
lymphogranuloma venereum
infertility
all of the above
Which of the following conditions is NOT associated with interstitial cystitis?
inflammatory bowel disease
rheumatoid arthritis
systemic lupus erythematosus
fibromyalgia
What is the ideal antibiotic class for self-start therapy on treating recurrent cystitis in a 32 yrs. married woman?
aminopenicillins
fluoroquinolones
aminoglycosides
nitrofurantoins
Ureteral dilation in schistosomiasis could be due to:
vesicoureteral reflux
stenosis of the lower ureter
edematous ureteral wall causing deficient peristalsis
any of the above
What is false regarding viral cystitis?
in pediatrics, adenovirus types 11 and 21 could result in hemorrhagic cystitis
immunosuppressed children are especially susceptible to Cytomegalovirus and Adenoviruses 7, 21, and 35
in pediatrics, acute viral cystitis might present as acute retention of urine
classically, treatment should be culture-specific
Which of the following has NO role in bacterial colonization in the prostate?
intra-prostatic ductal reflux
paraphimosis
specific blood groups
unprotected anal intercourse
A 60 yrs. man underwent TURP for, only, obstructive LUTS. Histology of prostate chips reveals prostatitis. What NIH type of prostatitis would it be?
type I
type II
type III
type IV
What is true concerning the definition of UTI in women, based on culture results from a suprapubic aspirate of urine?
any amount of uropathogen grown in culture indicates UTI
for cystitis, more than 1000 CFU/mL indicates UTI
for pyelonephritis, more than 10,000 CFU/mL indicates UTI
for asymptomatic bacteriuria, more than 100,000 CFU/mL indicates UTI
What could cause unresolved bacteriuria?
drug resistance
non-compliance
the presence of persistent pathology
all of the above
How should a proper routine urine specimen be collected?
early morning sample, after cleansing the perineum and meatus
by urethral catheterization under strict aseptic technique
a clean catch of midstream voided urine
by suprapubic aspiration, as urine is sterile
What are the most indicative symptoms of chronic pyelonephritis?
fever and chills
suprapubic pain and pyuria
flank pain and tenderness
none of the above
Which of the following does NOT cause unresolved bacteriuria?
giant staghorn stone
perivesical abscess with fistula to the bladder
bacterial resistance
self-inflicted infection
Screening for bacteriuria is mostly indicated for:
seniors house residents
ICU patients with indwelling urinary catheters
pregnant women
neurogenic bladder patients on CIC
What is true regarding nephrogenic adenoma of the bladder?
results from ectopic nephrogenic blastema cells in the detrusor muscle
might undergo malignant transformation in 15 40% of the cases
on cystoscopy, it appears as a bladder mucosal irregularity or large intramural mass
the preferred treatment is cystectomy and urinary diversion
What is false concerning esinophilic cystitis?
probably due to antibody/antigen reaction
has no diagnostic findings on cystoscopy
has no specific medical therapy
on histology, Von Brunn`s nests appear invaginating the urothelium into the lamina propria
What is true regarding genitourinary TB?
commonly, TB enters the urinary tract via intravesical instillation of attenuated live BCG to treat bladder cancer
CT urography may show infundibular stricture with or without hydrocalicosis
renal ultrasonography reveals calyceal erosions moth-eaten calyx
TB of the vas appears, clinically, as a thin hard strictured tube
What is false concerning acute pyelonephritis?
CBC reveals leucocytosis with predominance of neutrophils
contrast CT reveals one or more focal wedge-like swollen regions of the kidney parenchyma, sparing the cortex, and demonstrating reduced enhancement rim sign
in children, recurrent acute pyelonephritis might lead to renal scarring
in pregnancy, recurrent acute pyelonephritis might lead to preterm labor
What is true concerning granulomatous inflammation of the prostate?
is a common cause of elevated PSA level
might follow BCG treatment
is sequelae of untreated type III-b prostatitis
shows homogenous enhancement following Gd-DTPA on prostate MRI
What are the diagnostic findings on cystometrogram for BPS/IC?
discomfort on placing urethral catheter and pain on bladder filling
difficulty in zeroing the pressure and diminished response to first cough
low filling pressure but high voiding pressure
uninhibited bladder contractions with a relative bladder hypotonia
What is false concerning the presentation of prostatitis syndrome?
type I could harbor prostate abscess
type II presents as intermittent urinary tract infections
type III-a presentation might include psychological complaints
between 10-15% of men with type IV, have pus cells in their semen but no symptoms
Asymptomatic bacteriuria should be treated in the following situations:
in the elderly
in long-term catheterized patient
in pregnancy
none of the above
What kind of non-infectious cystitis, do patients with systemic lupus erythematosus (SLE), likely to develop?
cystitis glandularis
cystitis cystica
esinophilic cystitis
cystitis follicularis
During the initial 3-month period of HIV infection, what would be the best diagnostic lab test?
viral load assay
western blot analysis
southern blot analysis
HIV-1/HIV-2 serology assay
HIV infection increases the incidence of the following cancers, EXCEPT:
Kaposi sarcoma,
Hodgkin lymphoma
non-Hodgkin lymphoma
cervical cancer
What is true regarding Xanthogranulomatous Pyelonephritis?
CT shows the characteristic bear paw sign
it is an infected, obstructed, poorly functioning kidney containing stones
nephrectomy is the treatment
all of the above
What is false regarding Gonorrheal STD in women?
nucleic acid amplification tests are the preferred to diagnose Gonococcal and Chlamydial infections
shows dark yellow, purulent, thick urethral discharge
the most common site of the infection is the endocervix
the incubation period is 2 3 weeks
Irritative LUTS and dyspareunia in postmenopausal women are most likely to be due to:
giggle incontinence
estrogen deficiency
cystitis glandularis
cystitis cystica
What are the sequelae of recurrent uncomplicated UTI in young women?
minimal
chronic persistent infections
chronic relapsing infections
bouts of chronic pyelonephritis
What kind of cystitis does NOT progress to malignancy?
foreign-body cystitis due to vesical calculi
Von Brunn`s nests of cystitis cystica and cystitis glandularis
schistosomiasis cystitis
inverted papilloma of the bladder
What is false concerning antiretroviral medications?
multiple antiretroviral drugs can be combined into a single pill
might cause radiolucent renal stones
can lead to a significant rise in the serum level of PDE5 inhibitors, if taken simultaneously
have the advantage of structured treatment interruptions (drug holidays)