Tubulo-interstitial diseases

Question 1

what kind of cells in tubules?

Answer 1

specialized cuboidal, metabolically active, microvilli

Question 2

what is interstitium?

Answer 2

CT where glomeruli,tubules and vessels lie

Question 3

is there much interstitium normally?

Answer 3

normally not, just think layer, more if disease like oedema/fibrosis

Question 4

what normally causes acute tubular necrosis? 3 things

Answer 4

ischaemic injury of tubular epithelial cells
acute pyelonephritis
Acute/Chronic tubulointerstitial nephritis

Question 5

What is most common cause of acute renal failure?

Answer 5

acute tubular necrosis

Question 6

when do tubular epithelial cells suffer in acute tubular necrosis?

Answer 6

they are first to die, degenerate, detach and slough off

Question 7

is acute tubular necrosis reversible?

Answer 7

yes if caught early, put on dialysis for a few weeks and the tubular epithelial cells regenerate

Question 8

recovery of acute tubular necrosis associated with?

Answer 8

diuresis

Question 9

what’s the difference between hypoperfusion and ischaemic ATN?

Answer 9

hypoperfusion is decrease GFR, it’s not enough to kill any epithelial tubular cells

Question 10

what is toxic acute tubular necrosis? causes? mechanism?

Answer 10

heavy metals
antibiotics
chemo
disrupt mitochondrial function

Question 11

Acute interstitial nephritis usually due to?

Answer 11

drug alllergy

Question 12

Acute interstitial nephritis presentation histologically?

Answer 12

tubules and interstitium infiltrated with eosinophils/inflammatory cells

Question 13

Pyelonephritis caused by what kind of Bacteria?

Answer 13

ascending gram negatives usually

Question 14

Pyelonephritis acute or chronic?

Answer 14

can be both

Question 15

Pyelonephritis obstruct urine?

Answer 15

yes or no

Question 16

acute Pyelonephritis presentation?

Answer 16

rigors, severe acute onset, frequency, fever, chills, lumbar pain

Question 17

hypertension involved in acute Pyelonephritis?

Answer 17

Nope.

Question 18

4 common gram negatives that cause acute Pyelonephritis?

Answer 18

E.coli
Klebsiella
pseudomonas
proteus

Question 19

What results from chronic Pyelonephritis? 3 things

Answer 19

interstitial scarring
tubular atrophy
saddle shaped scars

Question 20

analgesic nephropathy is what?

Answer 20

from long term toxic analgesics less common now.

Question 21

Treatment for End Stage Kidney Disease?

Answer 21

transplantation

dialysis

Question 22

what does End Stage Kidney Disease kidneys look like

Answer 22

shrunken, pitted, scarred, rubbery pale

Question 23

End Stage Kidney Disease reversible?

Answer 23

nope

Question 24

End Stage Kidney Disease causes what to kidneys?

Answer 24

insufficient GFR, can’t eliminate waste

Question 25

causes of End Stage Kidney Disease? top 3?

Answer 25

32% diabetic nephropathy
24% glomerulonephritis
14% hypertension

Question 26

when do you start getting symptoms for End Stage Kidney Disease? at ___% renal function?

Answer 26

10%