Answer to Question 1
Correct Answer: 1
Hydronephrosis develops due to unrelieved pressure by an obstruction, and the possible results are distention of the ureter, renal pelvis, and calyces. If pressure persists, a gradual loss of renal function may occur. Hydronephrosis typically manifests with colicky pain on the affected side that may radiate to the groin. When significant, a palpable mass may be felt in the flank region. Hematuria and signs of urinary tract infection (UTI) such as fever and pyuria may occur. Other manifestations include fever, nausea, and vomiting. Infection is another complication of urinary calculi caused by stasis of urine and symptoms of either an upper or lower UTI develop. Renal colic is the term for flank pain that develops when a stone obstructs the ureter, causing ureteral spasm. Ureteral tumors manifest as painless hematuria and may cause colicky pain from obstruction but typically have few outward signs until urine flow is obstructed.
Answer to Question 2
Correct Answer: 1
Pyelonephritis usually has a rapid onset, with chills and fever, malaise, vomiting, flank pain, costovertebral tenderness, diarrhea, hematuria, pyuria, and urinary frequency. Laboratory diagnosis indicates a high bacteria count and the presence of E. coli in 85 of cases, with urine cloudy and more alkaline. Nephrolithiasis may have few symptoms until a stone blocks urine flow, and a dull flank pain may be present. Patients with hydronephrosis typically have colicky pain on the affected side that may radiate to the groin; otherwise, manifestations are few. Cystitis presents with symptoms of dysuria, urinary frequency, and urgency, and urine may have a foul odor and cloudy or bloody appearance. But symptoms are more localized to the suprapubic and lower pelvic region.