Lecture 9- Renal Disease 2 Flashcards
acute pyelonephritis is also called…
tubulointerstitial nephritis
… is suppurative inflammation of the kidney and renal pelvis caused by bacterial infection. This is a renal disease affecting tubules, interstitium, and pelvis and is most often secondary to bacterial infection
acute pyelonephritis/
tubulointerstitial nephritis
predisposing conditions of acute pyelonephritis/
tubulointerstitial nephritis
pregnancy ut obstruction uti immunosuppression DM instrumentation
what drugs can cause interstitial nephritis
antibiotics
nsaids
diuretics
in drug induced interstitial nephritis, drug may bind to … or … cells and act as … with immunologic response
tubular
interstitial
hapten
The clinical presentation of drug induced nephritis is a rapid onset of …, eosinophilia, renal dysfxn with … but little or no …
fever (2-40 days)
hematuria
proteinuria
what is the prognosis of drug induced nephritis?
good, full recovery 6-8 weeks
treatment of drug induced nephritis
withdrawal of drug and corticosteroids
… is the rapid onset of renal failure, reduced UO, electrolyte imbalances. The clinical manifestations are reversible over a period of weeks as the damaged tubular epithelium regenerates
acute tubular necrosis
etiology of acute tubular necrosis?
injury to tubular epithelial cells from ischemia (shock) or a toxin
3 pathologic features of acute tubular necrosis
dilation of tubules
edema
necrosis of tubular epithelium
treatment of acute tubular necrosis
do patients usually recover?
supportive care, dialysis
yes
… is the thickening and sclerosis of the renal arteries associated with benign htn
arterionephrosclerosis
what gene is associated with arteriosclerosis and what ethnic population is this disease common in?
apolioprotein L1
african americans
The same linkage can be seen in arterionephrosclerosis that is in…
FSGS (focal/segmental glomerulosclerosis)
4 features of arterionephrosclerosis
- grossly small kidneys, granular surface
- hyaline arteriosclerosis/ fibroelastic hyperplasia
- tubular atrophy and fibrosis
- global sclerosis of glomeruli
… can be seen with malignant htn (200/120mmHg)
arterionephrosclerosis
arterionephrosclerosis is seen in …% of patients with essential htn
5%
what are the clinical symptoms of arterionephrosclerosis
increased intracranial pressure
proteinuria
ischemia leading to acute renal injury
in the pathology of arterionephrosclerosis, the arterioles show … , reducing …. and causing…
hyperplastic arteriosclerosis (know this)
blood flow
necrosis of glomeruli
… is an acquired defect in metalloproteinase that degrades vWD (or inherited ADAMTS 13 defect)
thrombotic thrombocytopenia pupura (TTP)
… is an endothelial injury from Shiga toxin+ E. coli
and a major cause of acute kidney injury in children
Hemolytic-uremic syndrome (HUS)
Hemolytic-uremic syndrome (HUS) and … can both lead to … activation
thrombotic thrombocytopenia pupura (TTP)
platelet
HUS and TTP both cause widespread … in capillaries with RBC damage.
which one is predominately kidney involvement and which one is more widespread with organ impact including transient neurologic deficits from CNS involvement?
microthombi
HUS- kidney
TTP- CNS
by the age of 70, urolithiasis affects … % of men and …% of women
11%
6%
clinical symptoms of kidney stones
asymptomatic obstruction intense pain infection hematuria
most common form of kidney stones?
calcium (80%)
3 types of kidney stones
- calcium
- magnesium ammonium phosphate
- uric acid
what can cause magnesium ammonium phosphate kidney stones?
proteus or staph infection
… is dilation of renal pelvis/calyces with parenchymal atrophy secondary to obstruction
hydronephrosis
causes of hydronephrosis
congenital uto
enlarged prostate
neoplasms
neurogenic bladder
pregnancy
most common type of kidney cancer
renal cell carcinoma
male:female for renal cell carcinoma
2:1
5 year survival in renal cell carcinoma
stage 1:
stage 4:
81%
8%
