P Y E L O N E P H R I T I S (

B a c k

p a i n )
    Hx of UTI UTO Female Sexually active DM Implanted contraceptive Scarring calculi

E.coli Proteus klebsiella


   

Active Bacterial Growth Bacterial Invasion to upper urinary tract Involvement of renal pelvis and kidney Cellular injury of renal pelvis and kidney

Affectation of The glomerulus Glomerular

Cell Damage Necrosis

Release of chemical mediators

Release of pyrogens Irritation of nerves(T12) Altered GFR stimulation of thermostat Release of endotoxin UO temperature Flank back pain Fever Escape of CHONs & RBCs from the filtrate Proteinuria Loss of blood Proteins Hypoalbuminemia Decrease oncotic pressure Hematuria severe anemia

Stimulation of Nerve endings(T12) Colicky pain and flank pain

blood flow to injured site

extravasations of fluids local edema

detrussor irritation

tenderness of the kidney upon palpation

detrussor spasm frequency of urination

death fluid shifting from intravascular to Interstitial space compartment edema

Sarajan, Aldilyn J ADZU SOM 3rd year July 31, 2013

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