17-18

Question 1

Tubules and interstitium make up ___% of renal volume

Answer 1

80

Question 2

Tubulointerstitial nephritis is commonly associated with ___ or with the following drugs:

Answer 2

Infections

NSAIDs, PPIs, or abx

Question 3

Primary Tubulointerstitial nephritis vs secondary

Answer 3

1. Begins in interstitial compartment

2. Begins in vascular, glomerular, or collecting system THEN goes to interstitium

Question 4

The most prominent aspect of Tubulointerstitial nephritis is ___

Answer 4

Inflammatory cell infiltrate mixed with T-cells, monocytes, plasma cells, and eosinophils

Question 5

Common clinical findings in Tubulointerstitial nephritis

Answer 5

• Lack of proteinuria and hypoalbuminemia
• presence of sterile pyuria and WBC casts
• polyuria
• nocturia

Question 6

How will the pt present in Tubulointerstitial nephritis?

Answer 6

Abrupt renal dysfunction
Progressive rise in Cr
Rash, fever, eosinophilia triad (common in drug-associated TIM)

Question 7

Classical TIN occurs ____ days after drug therapy.

Answer 7

10-20

Question 8

NSAID associated TIN commonly presents with ___

Answer 8

Nephrotic range proteinuria

*usually older patients

Question 9

Tx of Tubulointerstitial nephritis

Answer 9

Biopsy before therapy
Corticosteroids
Cyclophosphamide if steroids fail

Question 10

Tubulointerstitial nephritis recovery:

2 phases

Answer 10

1. Initial rapid improvement in 6-8 w

2. Slow improvement over the next year

Question 11

When you get older, Na excretion ___

Answer 11

Decreases

Question 12

Glomerular permeability is not markedly changed in aging, therefore frank ____ does not develop. But ___ does develop

Answer 12

Proteinuria

Microalbuminuria

Question 13

____, even in the absence of hyperglycemia or diabetes and independent of HTN predisposes to CKD. What does this suggest?

Answer 13

Metabolic syndrome

-renal disease may start before diabetes or HTN

Question 14

Histopathology of renal structure and function in obesity:

Answer 14

That of glomerulmegaly without FSGS

Question 15

Pathophysiology of renal structure and function in obesity:

Answer 15

Chronic inflammation from insulin resistance
Lipotoxicity
Hyperfiltration

Question 16

Therapy for renal structure and function in obesity:

Answer 16

Weight loss
Activity
Thiazolidinediones (improve insulin sensitivity)
Block RAS (ACEI or ARB)
HMG CoA reductase inhibitors