Test Result Results (SI Units)

Hemoglobin 12.5 g/dL 125 g/L

WBC count 17.0 x 103/µL 17.0 X 109/L

Platelet count 150 x 103/µL 150 X 109/L

Basic metabolic profile:

Test Result Results (SI Units)

Sodium 137 mEq/L 137 mmol/L

Potassium 3.9 mEq/L 3.9 mmol/L

Creatinine 0.7 mg/dL 62 micromol/L

Glucose78 mg/dL 4.3 mmol/L

BUN 23 mg/dL 8.2 mmol/L

Urine:

Test Result

Leukocyte esterase Positive

Blood Positive

Ketones Positive

Bacteria Numerous

WBCs 30-50 per high power field

Nitrites Positive

Leukocyte esterase Positive

Protein Negative

STD panel Urine gonorrhea/chlamydia/trichomoniasis negative

Ultrasonography:

Renal/bladder ultrasound: No hydronephrosis noted. Incidentally noted intrauterine fetus with

heartbeat of 156 beats/minute.

Pathophysiology – UTI t/c PyelonephritisTheoreticalPredisposing Factors

•
Immunosuppression*
•
I n s t r u m e n t a t i o n   o f   t h e urinary tract*
•
Kidney stones
•
Urinary retention*Precipitating Factors
•
Diabetes mellitus*
•
Pregnancy*
•
Age
•
Gender Attachment of bacteria to the urethra
Proliferation of bacteria in the urethra
Urethritis
Urethrovesical reflux Introduction of bacteria into the bladder Proliferation of bacteria in
the bladder Inflammation of the bladder Cystitis Ureterovesical reflux

 
Introduction of  bacteria to the ureter Inflammation of theureter UreteritisInfection
ascends tothe kidneysPyelonephritisActivation of theimmune responseRelease of
pyrogensfrom bacteriaRelease of  prostaglandin E2Elevation of the bodythermostat by
thehypothalamusVasoconstrictionShiveringFever Reduced heat lossthrough the
skinChillsGeneral feeling of  being unwellMalaise Nausea/Vomiting*DysuriaFlank
pain*Decreasederythropoietin productionDecrease stimulationof the bone
marrowsDecreasederyth
ropoiesisDecreased RBC productionAnemia

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