32. Tubular Kidney Disease

Question 1

df acute renal failure?

Answer 1

sudden decrease in renal funcion

Question 2

most common cause of acute renal failure?
pathogenesis?
hw does kidney look?

Answer 2

Acute Kidney injury
destruciton of functional loss of tubules
swollen kidney

Question 3

hw does medulla look in AKI?

cortex?

Answer 3

hyperemic medulla

pale cortex

Question 4

3 microscopic features of early AKI?

Answer 4

cell swelling (desquamation)
loss of PAS+ brush border at PT
Tamm-Horsfall protein (eosinophilic casts)

Question 5

1st phase of AKI? time?

3 morphologic characteristics?

Answer 5

initiaiton (hours to days)

edema
tubular dilation (hydropic change)
leukocytes in vasa recta

Question 6

2nd phase of AKI? time?

3 clinical characteristics?

morphologic characteristic?

Answer 6

Maintenance (5-7 days)

suppressed renal function
oliguria
systemic effects

degeneration/necrosis/apoptosis

Question 7

3rd phase of AKI? time?

clinical characteristic?

morphology?

Answer 7

recovery

diuresis

tubular epithelial regeneration

Question 8

phase of AKI with most deaths?

Answer 8

maintenance

Question 9

phase of AKI most susceptible to infection?

Answer 9

recovery

Question 10

main cause of ischemic AKI?

4 specifics?

Answer 10

low perfusion

dehydration
shock
sepsis
surgical procedures

Question 11

cause of nephrotoxic AKI w eosinophilic inclusions?

Answer 11

Mercury

Question 12

cause of nephrotoxic AKI w fatty inclusions?

Answer 12

Carbon tetrachloride

Question 13

cause of nephrotoxic AKI w hydropic change and oxalate crystal?

Answer 13

ethylene glycol

Question 14

cause of nephrotoxic AKI wacidophilic inclusions?

Answer 14

Lead

Question 15

2 features that distinguish ischemic from nephrotoxic AKI?

3 features od nephrotoxic AKI?

Answer 15

ischemic is segmental and has tubulorrhexis

nephrotoxic is uniform, spares distal tubules and no tubulorrhexis

Question 16

most common cause of acute pyelonephritis?

5 associations

Answer 16

E.coli (gram negative bacilli)

UTI
Pregnancy
instrumentation
vesicoureteral reflux
DM

Question 17

3 clinical sgns of acute pyelonephritis?

Answer 17

systemic signs (fever, pain)
costovertebral angle tenderness
WBC casts in urine

Question 18

2 kidney appearance in acute pyelonephritis?

cells seen?

Answer 18

inflammaiton
abscess formation

neutrophils

Question 19

morphologic appearance of chronic pyelonephritis?

cause?

Answer 19

irregular asymmetric scars

anatomic abnormalities (chronic reflux)

Question 20

4 histo signs of chronic pyelonephritis?

Answer 20

lymphocytes
plasma cells
fibrosis
thyroidization

Question 21

wt benign inflammatory disease is confused wih renal cell carcinoma?
cause?

Answer 21

Xanthogranulomatous pyelonephritis

proteus

Question 22

4 causes of drug-induced interstitial nephritis?

wt is seen inurine

Answer 22

penicillins
rifampin
thiazides
NSAIDS

eosinophilic casts

Question 23

wt is seen grossly in analgesic nephropathy?

Answer 23

papillary necrosis

Question 24

wc cancer can cause light-chain cast nephropathy?

wt is seen in urine?

Answer 24

multiple myeloma

Bence-Jones proteins

Question 25

tubular kidney disease associate w fibrosis?

Answer 25

chronic pyelonephritis

Question 26

tubular kidney disease associate w pappilary necrosis

Answer 26

Anaglesic nephropathy

Question 27

tubular kidney disease associate w eosinophilic casts?

Answer 27

drug induced interstitial nephritis

Question 28

tubular kidney disease associate w WBC casts?

Answer 28

acute pyelonephritis

Question 29

tubular kidney disease associate w giant cells?

Answer 29

Urate nephropathy

Question 30

tubular kidney disease associate w Proteus infection?

Answer 30

Xantham pigmentosus

Question 31

tubular kidney disease associate w neutrophils?

Answer 31

acute pyelonephritis

Question 32

tubular kidney disease associate w plasma cells and leukocytes?

Answer 32

chronic pyelonephritis