
Goodpasture Syndrome
Glomerular Diseases (Glomerulopathies) | Nephrology | Rheumatology | Secondary Glomerulopathies | Small-vessel Vasculitis | Vasculitides
Infection of the urinary tract is common and more so in women (due to shorter urethra and hormonal changes). UTIs may be classified as either a lower (Cystitis, urethritis and Prostatitis) or upper UTI (pyelonephritis). The main causative agents are bacteria such as E-coli. A lower UTI can progress to an upper UTI causing systemic symptoms and acute loin pain.
The urinary system consists of:
The kidneys are retroperitoneal bean shaped organs thats sits between veretbral levels T11-L3, the left kidney sitting slightly higher then the right kidney.
The kidneys is divided into three sections:
Arterial Supply
Venous Drainage
Nephrons
Ureters arenarrow muscular tube that transport urine to the bladder. There are three narrowed areas of each ureter:
Bladder is a muscular organ which holds urine. The wall of the bladder comprises of four layers:
Urethra Arisis from the base of the bladder and is the passageway through which urine is discharged from the body. The female urethra is much shorter (3-4cm) than the male urethra (18+cm)
Risk Factors |
Female gender |
Sexual Intercourse |
Catheterisation |
Pregnancy |
Menopause |
Diabetes |
Genitourinary malformation |
Immunosuppression |
Urinary Tract obstruction |
Clinical Presentation – lower urinary tract infection
Clinical Presentation – upper urinary tract infection
Older people may also present with delirium, confusion, falls, immobility or anorexia.
Triad of Pyelonephritis (Upper UTI): Fever, flank/back pain and nausea/vomiting
Diagnosis
Lower UTI
Upper UTI
Refer to Urologist if patient fails to respond to medical treatment, has recurrent UTIs, Haemturia and men with symptoms of UTI as this is considered abnormal.
Complications
Prognosis
Davidson’s Principles and Practice of Medicine
Nickel, J.C. (2005) Practical management of recurrent urinary tract infections in premenopausal women. Reviews of Urology, vol 7 (1), 11-17.
Australian Doctor – renal stones
Australian Family Physician – Urinary stone disease
BMJ: http://bestpractice.bmj.com.ipacez.nd.edu.au/best-practice/monograph/225/diagnosis/history-and-examination.html
Davidson’s Principles and Practices of Medicine
Discussion