Acute uncomplicated pyelonephritis • Acute pyelonephritis is a urinary tract infection that has progressed from the lower urinary tract to the upper urinary tract. • Most episodes of acute pyelonephritis are uncomplicated but hospitalization may be required. • Acute uncomplicated pyelonephritis typically occurs in healthy, young women.
patient Acute uncomplicated pyelonephritis flank pain fever (>38 C) chills Nausea and vomiting dysuria Urinary frequency urgency hematuria cost vertebral angle tenderness • (+) flank pain • Fever T= 38.6 C • (+) chills • (+) vomiting • (-) dysuria • (+) urinary frequency • (-) urgency • (-) gross hematuria • (+) CVA tenderness
Urinary Tract Infection • Exists when pathogenic microorganisms are detected in the urine, urethra, bladder, kidney, or prostate. • Access is through ascent of bacteria from the urethra to the kidney. • Commonly caused by gram-negative bacilli.
Urinary Tract Infection • Conditions affecting Pathogenesis • Gender and Sexual activity • Pregnancy • Obstruction • Neurogenic Bladder dysfunction • Vesicoureteral Reflux • Bacterial Virulence factors • Genetic Factors
Pulmonary tuberculosis • Tuberculosis is an infectious disease caused by mycobacteria, usually Mycobacterium tuberculosis • transmitted by airborne droplet nuclei, which may contain fewer than 10 bacilli • When inhaled, droplet nuclei are deposited within the terminal airspaces of the lung.
Patient Pulmonary tuberculosis Fever Weight loss Cough (productive cough) Hemoptysis trachea midline Increased tactile fremiti Dullness on percussion Increased vocal fremiti Bronchophony, egophony, whispered pectoriloquy Subjective • (+) fever • (-) weight loss • (+) chronic cough (nonproductive) • (-) hemoptysis Objective • Trachea situated midline • Increased tactile fremiti • Dullness on percussion • Increased vocal fremiti • (+) Bronchophony, egophony, whispered pectoriloquy