DIAGNOSTICS

Lee, Lucero, Macalintal, Magallanes, Maningas, Ombao, Pacifico

Initial Laboratory Tests

CBC leukocytosis Low Hgb, low Hct – bleeding (obstructive

uropathy) ESR CRP

Urinalysis

Pyuria With bacteriuria (≥105/ml): highly sensitive indicator of

UTI Sterile pyuria

Atypical organisms: C. Trachomatis, U. Urealyticum, M. Tuberculosis

Non-infectious urologic conditions: calculi, anatomic abnormality, nephrocalcinosis, VUR, interstitial nephritis, polycystic disease

Gram-stained uncentrifuged urine (for empiric choice of antibiotic)

Leukocyte casts which form casts – characteristic of acute pyelonephritis

Hematuria – urolithiasis

Serum BUN and Creatinine

determine (reversible) renal damage

Two 24-h urine collections

calcium, sodium, phosphorus, magnesium, oxalate, uric acid, citrate, sulfate, creatinine, pH, and total volume

Comprehensive Metabolic Panel

serum calcium, uric acid, and phosphorus; parathyroid hormone level

Urine culture and sensitivity

No longer requested for uncomplicated acute cystitis

criterion standard for evaluation of a urinary tract infection (UTI) during pregnancy

results are often unavailable at the time of treatment

 

Blood culture

Severely ill patients

Imaging

The total dosage of ionizing radiation should not exceed 3-5 rads during the course of pregnancy

UTZ

cheap; no exposure to radiation or dyes stones may not be identified due to

hydronephrosis in pregnancy typical acoustic shadowing

X-ray

one-shot pyelogram (ie KUB) to identify stones obscured in renal

ultrasound can deliver 0.4-1 rad

Helical CT scan

gold standard for urolithiasis in non-pregnant patients

Other Procedures

evaluation of fetal status: FHT

Thank you!