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Questions and Answers
Which of the following risk factors is commonly associated with acute pyelonephritis?
What is primarily indicated by acute pyelonephritis?
Which pathogen is most frequently isolated in cases of acute pyelonephritis?
What microscopic feature is characteristic of chronic pyelonephritis?
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What condition is xanthogranulomatous pyelonephritis often confused with?
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What is a major microscopic finding in acute pyelonephritis?
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What is a common gross feature of chronic pyelonephritis?
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What defines hydronephrosis?
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Study Notes
Acute Pyelonephritis
- An infection of the kidney's collecting system and surrounding tissue.
- Pus formation characterizes this condition.
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Risk factors:
- Women
- Diabetics
- Immunosuppressed individuals
- Common causative agent: E. coli bacteria
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Contributing factors:
- Urinary tract infections (UTIs)
- Medical procedures involving instrumentation
- Obstruction of the urinary tract
- Pregnancy
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Macroscopic changes:
- Focal abscesses
- Wedge-shaped areas of pus accumulation
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Microscopic features:
- Inflammation with pus formation, primarily in the outer layer (cortex) of the kidney
- Swelling (edema)
- Neutrophils (a type of white blood cell) within the interstitial space and kidney tubules
- Tubular cell death (necrosis)
- Cortical abscesses and necrosis
Chronic Pyelonephritis
- A long-term and often less noticeable inflammation of the kidney, causing scarring.
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Causes:
- Obstruction of the urinary tract
- Reflux nephropathy (urine flowing back into the kidneys)
- Recurring untreated acute pyelonephritis
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Macroscopic changes:
- Shrunken kidney with scar formation
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Microscopic features:
- Patchy inflammation in the kidney's interstitial space with lymphocytes, plasma cells, and neutrophils.
- Scarring of the renal pelvis and calyces.
- Damaged and shrunken kidney tubules with thyroidization (a specific structural change) and protein-filled casts.
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Xanthogranulomatous pyelonephritis:
- A rare, aggressive type of chronic pyelonephritis.
- Often associated with kidney stones (nephrolithiasis) and chronic infection.
- Can be difficult to distinguish from kidney cancer (renal cell carcinoma).
Hydronephrosis
- Dilation of the kidney's collecting system (renal pelvis and calyces) due to blockage of urine flow.
- Causes progressive kidney damage and shrinking.
- Can be classified by severity:
- Mild
- Moderate
- Severe
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Description
This quiz covers the essential aspects of acute and chronic pyelonephritis, focusing on risk factors, common causative agents, and characteristic changes in the kidney. Understand the differences between acute and chronic forms and their implications in renal health. Test your knowledge on their pathology and clinical relevance.
