Pathology AKI

Question 1

Intrinsic AKI Eti

Answer 1

1. ATI/N
2. AIN
3. Acute vasculitis
4. Acute glomerulonephritis

Question 2

ATI/N Eti

Answer 2

1. Ischemia (HTN, microangiopathy, thrombosis, volume depletion)
2. Direct injury (endogenous proteins or exogenous agents; heme; chemo, radiocontrast)

Question 3

ATI/N Stages

Answer 3

Initiation: 36 Hours; mild oliguria, a slight rise in sCr + BUN

Extension: Sustained oliguria; Rapid rise in SCr + BUN; Na overload, hyperkalemia, metabolic acidosis; 2nd s/s dep on cause

Recovery: Steady increase in urine volume; Loss of water, Na, K;

Question 4

AIN Eti

Answer 4

• Infection (Pyelonephritis)
• Metabolic Disease (Urate/hypercalcemic)
• UT Obstruction
• Neoplams (MM)
• Toxins/Drug

Question 5

Drug-induced AIN Meds

Answer 5

• Abx (B-lactams, rifampin, cephs)
• NSAIDs
• Diuretics (thiazides)
• PPIs
• Other: Allopurinol, dimetidine

Question 6

Drug-induced AIN

• Pathogenesis
• S/S

Answer 6

• Path: Type IV hypersensitivity mediated by IgE + eosinophils
• S/S: arthralgia, rash, fever w/. hematuria, mild proteinura, leukocyturia

Question 7

Most common cause of AERD

Answer 7

Iatrogenic -> manipulation of aorta during Sx, angioplasty, or arteriography

Question 8

AERD Morph

Answer 8

• Cholesterol clefts
• RBCs. fibrin. + leukmocytes
• Foamy M0

Question 9

Diffuse Corticl Necrosis

• EPI
• Eti

Answer 9

• Epi: Neonates, postpartum, + pregnancy

- eti: abruptio placentae, septic shock