Intersttial Disease

Question 1

Buzz word for chronic intersyitial disease

Answer 1

Tubular fibrosis
Tubular atrophy
Infiltrate of macrophages and lymphocytes

Question 2

Causes of chronic interstitial

Answer 2

Drugs
Heavy metals like cadmium
Balkan nephro patho
Infection chronic pyelonephritis

Question 3

Labs for chronic interstitial

Answer 3

Low GfR
Proteinuria <1g a day
Urine- WBC
Anemia - due to loss of cells that produce EPO

Question 4

proximal defects

distal defects

Answer 4

proximal - aminoacduria, phosphaturia

distal - salt wasting syndrome ( loosing to much sodium) + salt sensitive hypertension

Question 5

diagnosis of chronic interstitial disease

Answer 5

imaging- kidney loos smaller
labs - decline in renal function
definitive - biopsy

Question 6

pathophys of analgesic nephropathy

Answer 6

schema of medulla leading to papillary necrosis and secondary tubular atrophy

Question 7

features of analgesic nephropathy and labs

Answer 7

more common in women 6:1

increased risk of transitional cell carcinoma
sterile pyuria, increase sodium in urine, urine becomes more acidic, inability of kidneys to concrete urine

Question 8

what’s renal papillary necrosis often combined with

Answer 8

enal papillary necrosis often occurs with analgesic nephropathy.

Question 9

causes of renal papillary necrosis

Answer 9

analgesic nephropathy 
Diabetic nephropathy
Kidney infection (pyelonephritis)
Kidney transplant rejection
Sickle cell anemia, a common cause of renal papillary necrosis in children
Urinary tract blockage

Question 10

how don said work

Answer 10

they decrease prostaglandins, but also they construct the afferent arteriole so overtime you get decreased blood flow to kidney (decrease gfr) over time your renal tubular cells and intertidal cells get damaged .

with time the cells slow off the tubules so you get sediment in urine, consisting of protein, casts ,crystals.

Question 11

diagnosis of analgesic nephropathy

Answer 11

a history of long term use of drugs like nsaids

imaging will show smaller kidney

papillary necroiss- calcifications on ct scan

the normal smooth surface of the kidney is interrupted

Question 12

balkan disease diagnosis

Answer 12

Positive familial history

2. Symmetrically shrunken kidneys with absence of intrarenal calcifications – USS
3. Mild proteinuria <1g/24hr
4. Hypostenuria (elevated urine osmolality) and glucosuria
5. Normochromic normocytic anemia in pts with only slightly impaired renal function

Question 13

hypersthenuria causes

Answer 13

dehydration and SIADH

Question 14

hyposthenuria causes

Answer 14

diabetes insipidus and drinking too much water and DAMAGE TO RENAL TUBULAR CELLS!