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CPR M2T1E3 > #25 Virmani - Non Glomerular Disease > Flashcards

#25 Virmani - Non Glomerular Disease Flashcards

1
Q

Identify

A

Tubulointerstitial Nephropathy

Neutrophils in interstitia

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2
Q

Identify

A

Acute Interstitial Nephritis (AIN)

Note acute inflammatory infiltrate

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3
Q

Identify

A

Chronic Tubulointerstitial Nephropathy

No active renal inflammation with sub-nephrotic proteinuria and pyuria/WBC casts

(Inflammation has occurred, peaked and troughed. Now fibrosis)

Asbsence of RBC casts

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4
Q

Identify

A

Necrotic papilla

Analgesic Nephropathy

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5
Q

Identify

A

Lithium Nephropathy

due to long term lithium use

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6
Q

Identify picture on left

A

ADPKD on left

PKD1 and PKD2 genes

**cerebral aneurysms

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7
Q

Identify and describe

A

Simple Cyst

anechoic round mass with smooth and sharply demarcated wall

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8
Q

Identify

A

Medullary Sponge Kidney

“Bouquet of flowers”

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9
Q

A 75 year old man comes in. After taking a history you discover he is on proton pump inhibitors and has been taking NSAIDS for knee pain. You order labs and they return with hematuria, sterile pyuria and leukocytes casts. What is a probable diagnosis?

A

Acute Interstitial nephritis

TRIAD: fever, skin rash, peripheral eosinophilia (arthralgias)

PPI and NSAIDS are probable offending agents.

Tx: discontinue offending agents

short course of high-dose prednisone (1mg/kg/day) - acute

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10
Q

What syndrome features: phosphaturia, bicarbanaturia, aminoaciduria, uricosuria and glycosuria?

A

Fanconi’s syndrome

Proximal tubules fail so nothing is reabsorbed

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11
Q

UT’s recurrent urinary tract infections can cause what type of stones?

A

Triple phosphate stones

Frequent UTI’s lead to scarring as well.

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12
Q

Your patient who has been diagnosed with sickle cell disease presents with fever, flank pain and hematuria. What might lead to acute pyelonephritis?

A

papillary necrosis and infection

also can be in Analgesic nephropathy

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13
Q

Patient suffers from bi-polar disorder and has been on lithium for 20 years. What must you monitor?

A

Kidney function

Distal tubular dysfunction

Cystic disease is common

Tx: change meds

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14
Q

65 year old hunter comes in with hypertension, gout and has chronic renal disease. What is the possible etiology of his nephropathy?

A

Lead bullets

Also offenders:

Lead paint

supplements (tumeric)

Moonshine

Industrial setting

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15
Q

Your patient has chronic tubulointerstitial nephritis due to a metabolic disorder. What might you have seen on labs?

A

Hypercalcemia (sarcoidosis, 1* hyperPTH, multiple myeloma, polyuria)

Chronic hypokalemia

hyperuricemia

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16
Q

Your ADPKD patient is nearing 45. He was diagnosed 5 years earlier when he came in with chronic flank pain and intermittent hematuria. His blood pressure is starting to be elevated. What other clinical association are relavant in ADPKD?

A

Hepatic cysts

Mitral valve prolapse

diverticulosis

Cerebral aneurysm

Pancreatic cysts

17
Q

Sonographic criteria for ADPKD

29 year old patient has 3 cysts on 1 kidney.

ADPKD?

A

Yes

Less than 30Y: = or > than 2 cysts per kidney

30-60: 4 or more cysts

>60: at least 4 cysts per kidney

18
Q

You have done a renal sonogram and discovered an obstruction that you believe may be the cause of the renal failure. After removal of the obstruction what must you manage?

A

Post obstructive diuresis and electrolyte abnormalities.

19
Q

Patient comes in complaining of hematuria and flank pain. She brought you a rhubarb cobbler becuase it is rhubarb season and she wanted to share. What might have caused her kidney stone?

A

Hyperoxaluria

Calcium stones

Tx: limiting animal protein

increasing citrate

reducing oxalate containing food

increasing dietary calcium intake (?)

20
Q

What is the tissue of origin for renal cell carcinoma?

A

Proximal renal tubular epithelium

21
Q

von Hippel-Lindau syndrome is associated with what cancers?

A

Multiple-Cancer Syndrome

Renal cell carcinoma

Pheochromocytoma

Pancreatic islet cell tumors

Retinol angiomaas

CNS hemangioblastoma

Endolymphatic sac tumors

Epididymal cystadenomas

22
Q

What are a patient’s options if they have renal cell carcinoma?

A

Surgery

Radiation therapy

Chemotherapy

Hormonal therapy

Immunotherapy

CPR M2T1E3 (20 decks)

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