Question

1. Mr. Sanchez is experiencing pain in his abdominal area. Tests and X-rays reveal a shadow in his left ureter and bones with a moth-eaten appearance. Further testing reveals that the patient has abnormal reflexes. Outline the physiological basis for his symptoms. What is the problem? What treatment would you recommend and why?

Answer 1

Moth eaten calyx refers to the ragged, feathery calyceal outline due to irregular erosions of the calyx. It is one of the earliest excretory urographic appearance of genitourinary tuberculosis.

Pathology

This appearance is due to necrotising papillitis, which may further progress to form medullary cavities which may eventually communicate with the collecting system.

Urogenital tuberculosis (UGTB) should in general be treated as pulmonary TB with a four-drug regimen of Isoniazid, Rifampicin, Ethambutol and Pyrazinamide for a total of 6 months, Ethambutol and Pyrazinamide only the first two months