lecture notes for medical students

1. Tips on using my ppt.
1. You can freely download, edit, modify and put your
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2. Don’t be concerned about number of slides. Half the
slides are blanks except for the title.
3. First show the blank slides (eg. Aetiology ) > Ask
students what they already know about ethology of
today's topic. > Then show next slide which enumerates
aetiologies.
4. At the end rerun the show – show blank> ask questions >
show next slide.
5. This will be an ACTIVE LEARNING SESSION x
three revisions.
6. Good for self study also. Good for self study also.
Display blank slide> Think what you already know about
this > Read next slide.

2. Format

3. Format
1. Introduction & History
2. Relevant Anatomy, Physiology
3. Aetiology
4. Pathophysiology
5. Pathology
6. Classification
7. Clinical Features
8. Investigations
9. Management
10.Prevention

4. Introduction & History.

5. Introduction & History.
• Purulent exudate (inflammatory cells,
infectious organisms, and necrotic,
sloughed urothelium) collects in the
hydronephrotic collecting system ("pus
under pressure")
• results from urinary tract obstruction in the
presence of pyelonephritis.
•

6. Introduction & History.
• The walled-oiff exudate is protected from
the body's natural immune system and from
antibiotics.
• If not recognized and treated promptly, this
infectious process may progress, often
resulting in clinical deterioration with
urosepsis, which can occur swiftly.
• Thus, early recognition and treatment of
acute infections of the kidney, especially in
patients with suspected urinary tract
obstruction, are of paramount importance.

7. Aetiology

8. Aetiology
• Idiopathic
• Congenital/ Genetic
• Nutritional Deficiency/excess
• Traumatic
• Infections /Infestation
• Autoimmune
• Neoplastic (Benign/Malignant)
• Degenerative
• Iatrogenic
• Psychosomatic

9. Aetiology
• Risk factors for pyonephrosis include the
following:
– Immunosuppression due to medications (eg,
steroids)
– Disease (eg, diabetes mellitus, acquired
immunodeficiency syndrome [AIDS])
– Anatomic urinary tract obstruction (eg, from
stones, tumors, ureteropelvic junction [UPJ]
obstruction, pelvic kidney, horseshoe kidney).

10. Pathophysiology

11. Pathophysiology
• Pyonephrosis may be caused by
1. ascending infection of the urinary tract
2. the hematogenous spread of a bacterial
pathogen.
• upper urinary tract obstruction secondary to
various causes
1. Stones
2. Tumors
3. ureteropelvic junction [UPJ] obstruction).

12. Clinical Features

13. Clinical Features
• Demography
• Symptoms
• Hiistory
• Signs
• Prognosis
• Complications

14. Epidemiology

15. Epidemiology
• may develop in any age group.
• uncommon in adults and rare in children,
• extremely rare in neonates.

16. Symptoms

17. Symptoms
• Similar to an abscess, pyonephrosis is
typically associated with fever, chills, and
flank pain,
• although some patients may be
asymptomatic.
• Triad of-
1. Anemia
2. Fever
3. Flank swelling.

18. History

19. History
• Similar complaints
• Urethral instrumentation/ operations
• UTIs

20. Investigations

21. Investigations
• Laboratory Studies
– Routine
– Special
• Imaging Studies
• Tissue diagnosis
– Cytology
• FNAC
– Histology

22. Diagnostic Studies

23. Diagnostic Studies
Imaging Studies
• X-Ray
• USG
• CT
• Angiography
• MRI
• Endoscopy
• Nuclear scan

24. Management

25. Management
• Drainage—either percutaneous or
retrograde with a ureteral stent—has
become the mainstay of treatment, in
conjunction with intravenous antibiotics.
• placement of a percutaneous nephrostomy
• In selected healthy, stable patients, consider
retrograde decompression with a stent as an
option.
• Retrograde decompression with a stent
• Nephrectomy

26. Prevention

27. Prevention
• Prompt treatment of obstructive leisons of
urinary tract.

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30. Get this ppt in mobile
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store.
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3. Open Google lens.
4. Scan qr code from
next slide.

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