310 - Tubulointerstitial Diseases of the Kidneys Flashcards

1
Q

We differentiate tubulointerstitial disease into __ and __.

A

acute

chronic

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2
Q

TIN= ___

A

tubulointerstitial nephritis

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3
Q

Acute TIN is defined as aggressive ___ infiltration leading to tissue __, damage to __ cells and flow, or obstruction by __/__/__.

A

inflammatory
edema
tubular
casts/crystals/cell debris

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4
Q

Clinical symptoms of acute TIN include __ due to capsular stretching.

A

flank pain

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5
Q

Acute TIN urine will contain __ and cellular __.

A

leukocytes

casts

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6
Q

Chronic TIN will cause __ due to difficulties to __ it.

A

polyuria

concentrate

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7
Q

Chronic TIN may lead to __ syndrome: 5

A
Fanconi
glycosuria
Phosphaturia  
Amino acids in urine
hypokalemia 
RTA type II (due to HCO3 urine excretion)
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8
Q

Chronic TIN may lead to RTA type __ with non-AG __ acidosis and hyper__ due to __ production.

A

4
metabolic
kalemia
ammonia

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9
Q

Chronic TIN may present with advanced __ and __ (rarely >2 gr/day).

A

azotemia

albuminuria

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10
Q

Chronic TIN US may present increased __ and __ (IS __)

A

echogenic
scarring
fibrosis

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11
Q

Now days, acute TIN is usually caused by drug __. Other reasons may include: 3

A

allergy
infection
systemic AI disease
obstruction

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12
Q

What are the main drugs causing allergic TIN? 7

A
anti TB
fluoroquinolones
sulfonamides
Beta lactam
NSAID
diuretics
alopurinol
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13
Q

The classic presentation of allergic TIN includes:4

A

fever
rash
peripheral eosinophilia
oliguric renal insufficiency

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14
Q

Allergic TIN usually starts - days after __ Abx

A

7-10

B lactam

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15
Q

The common presentation of allergic TIN includes increased __ in serum or __ symptoms.

A

Cr

AKI

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16
Q

Allergic TIN due to NSAID will usually not include __ or __, but heavy ___ is possible.

A

fever
rash+ eosinophilia
proteinuria

17
Q

__ can cause a severe allergic TIN when resuming its treatment after a long remission.

A

rifampin

18
Q

Treating allergic TIN includes: 2

A

stopping the drug causing it

steroidal treatment- only for severe cases

19
Q

Sicca syndrome (part of Sjogren syndrome)= ___

A

dry mouth and eys

20
Q

__ syndrome is an AI disease with damage to exocrine glands (saliva/tears) that can include __ nephritis.

A

Sjogren

TIS

21
Q

TIS nephritis with uveitis is more common in young __. Treatment is with PO __.

A

women

steroids

22
Q

Beside Sjogren, name other disease involving TIS nephritis: 3

A

SLE
granulomatous
IgG4 related systemic disease

23
Q

Chronic TIS is usually due to renal __ or secondary to primary __ disease. Other reasons include: 2

A

ischemia
glomerular
reflux nephropathy
sickle cell anemia

24
Q

VUR=__

A

Vesicoureteral reflux

25
Q

VUR is a result of faulty __ or early childhood urological __.

A

valves

anomalies

26
Q

Clinical symptoms of VUR include: 4

A

recurrent UTI
late aged nocturnal enuresis
AKI/HTN/proteinuria
ESRD

27
Q

VUR should be examined by __ imaging. We usually see __ asymmetric kidneys with __ borders, thin __ and __ areas to compensate.

A
US
small
irregular
cortex
hypertrophic
28
Q

VUR treatment includes: 3

A

sterile urine to prevent scarring
operating at an early age when reflux is substantial
aggressive HTN balance (ACE/ARB)