Intrinsic Kidney Disorders

Question 1

2 major causes of acute tubular necrosis:

Answer 1

1. Ischemia

2. Toxins

Question 2

How does ischemia arise in the tubules?

Answer 2

Prolonged low perfusion results in tubular necrosis/apoptosis.

Occurs in prolonged hypotension or hypoxemia, such as volume depletion, shock, sepsis, major surgery.

Question 3

What are some drugs that can cause nephrotoxicity in the tubules?

Answer 3

AMINOGLYCOSIDES (Gentamicin, Tobramycin)
Amphotericin B
Vanco
IV Acyclovir
Cephalosporins
CONTRAST MEDIA

Question 4

What are some endogenous causes of nephrotoxicity in tubules?

Answer 4

Myoglobin
Hemoglobin
Uric Acid

Question 5

Muddy Brown Casts seen on microscopic eval

Answer 5

Acute Tubular Necrosis

Question 6

What diseases can cause acute tubular necrosis?

Answer 6

Multiple myeloma
Rhabdomyolysis
Hemolytic anemias

Question 7

Patient has sudden decrease in GFR and BUN:creatinine ratio is <20:1

Answer 7

Acute tubular necrosis

Question 8

Which drugs are the most common culprits in Acute Interstitial Nephritis?

Answer 8

PENS
CEPHS
SULFAS
NSAIDS

Question 9

What are the most common infectious or CT disorders that cause acute interstitial nephritis?

Answer 9

strep
staph
SLE
Sjögren

Question 10

T/F. The classic triad of fever, rash, and arthralgias are seen in most cases of Acute Interstitial Nephritis.

Answer 10

False, seen together rarely.

Question 11

What are the most common findings in a patient with acute Interstitial nephritis?

Answer 11

Fever and maculopapular rash
Sterile pyuria
eosinophilia
white cell casts