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URN Biweekly 1 > Tubulo-interstitial Renal Disease > Flashcards

Tubulo-interstitial Renal Disease Flashcards

1
Q

normal BUN and creatinine

A

BUN: 7-21
creatinine: 1

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2
Q

> 3.5 urine protein/creatinine ratio

A

nephrotic syndrome

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3
Q

____ cardiac output goes to the kidney

A

25%

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4
Q

kidneys produce ____L of urine a day

A

1.5L

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5
Q

2 main acute tubular injury causes

A
  1. ischemia
  2. direct toxic injury
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6
Q

involvement of intrarenal blood vessels
decreased effective blood volume

A

ischemia

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7
Q

can be due to endogenous (myoglobin) or exogenous (drugs) agents

A

direct toxic injury

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8
Q

causes vasoconstriction and decreased GFR and urine output

A

ischemia

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9
Q

3 consequences of acute tubular injury:

A
  1. tubular backleak
  2. sloughed cells
  3. interstitial inflammation
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10
Q

____ causes both decreased GFR and urine output

A

obstruction

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11
Q

first thing you see clinically with acute tubular injury

A

oliguria
increased BUN

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12
Q

2nd thing you see clinically with acute tubular injury

A

oliguria
increased BUN
Na+ and H2O overload
hyperkalemia
metabolic acidosis

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13
Q

what happens during recovery of acute tubular injury

A

excessive renal output
loss of Na+ and H2O and K+

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14
Q

bacterial infections
burns
crush injuries
shock due to procedures

A

ischemic causes of acute tubular injury

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15
Q

Antibiotics
anesthetics
chemotherapy
heavy metals
radiographic agents
ethylene glycol

A

nephrotoxic causes of acute tubular injury

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16
Q

hemoglobinuria
myoglobinuria

A

combined ischemic and nephrotoxic causes of acute tubular injury

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17
Q

cell necrosis
occlusion of lumen
interstitial edema
leukocytes in vasa recta
epithelial regeneration

A

morphology of acute tubular injury

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18
Q

what 2 parts of tubular system of kidney are most affected by acute tubular injury

A

PCT and thick ascending limb

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19
Q
A

damage from acute tubular injury

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20
Q
A

nucleus degeneration seen in PCT

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21
Q
A

early acute tubular necrosis

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22
Q
A

advanced acute tubular necrosis

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23
Q
A

edema (interstitial debris)

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24
Q
A

extreme case of acute tubular necrosis

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25
Q
A

regeneration phase of acute tubular necrosis (metaphase shown)

26
Q
A

nephrotoxicity (oxalate buildup)

27
Q
A

nephrotoxicity (oxalte buildup;crystals)

28
Q

due to inflammatory injury of tubules and interstitium

A

tubulointerstitial nephritis

29
Q

defects in concentrating ability of nephron

A

tubulointerstitial nephritis

30
Q

polyuria/nocturia
azotemia; increased urine Na+ conc.

A

tubulointerstitial nephritis

31
Q

absence of nephritis or nephrotic syndrome

A

tubulointerstitial nephritis

32
Q

edema
+/- acute inflammation

A

morphology of acute TIN

33
Q

mononuclear inflammatory infiltrate
fibrosis
tubular atrophy

A

chronic TIN

34
Q

2 ways infections can cause tubulointerstitial nephritis

A
  1. acute bacterial pyelonephritis
  2. chronic pyelonephritis
35
Q

toxins that can cause tubulointerstitial nephritis

A

Ab’s
diuretics
NSAIDs

36
Q

type of hypersensitivity rxns from drugs causing tubulointerstitial nephritis

A

type I or IV

37
Q
A

kidney injury in 3 ways

38
Q

takes up to 15 days and will first have fever, rash, joint pain

A

acute drug-induced interstitial nephritis

39
Q

fever, rash, joint pain +
hematuria, mild proteinuria, leukocyturia and increased BUN/creatinine

A

acute drug-induced interstitial nephritis

40
Q

necrosis
edema
eosinophils

A

morphology of acute drug-induced interstitial nephritis

41
Q
A

acute drug-induced interstitial nephritis

42
Q
A

acute drug-induced interstitial nephritis

43
Q

injury to renal pyramid

A

papillary necrosis seen

44
Q
A

papillary necrosis

45
Q
A

papillary necrosis

46
Q

2 main causes of papillary necrosis

A

diabetes
sickle cell disease

47
Q

tumor lysis syndrome; crystals block tubules (type of urate nephropathy)

A

acute uric acid nephropathy

48
Q

gouty nephropathy (type of urate nephropathy)

A

chronic urate nephropathy

49
Q

3rd type of urate nephropathy

A

nephrolithiasis

50
Q
A

urate nephropathy (crystals)

51
Q
A

urate nephropathy (crystals)

52
Q

hypercalcemia and tubular defects

A

nephrocalcinosis

53
Q
A

Calcium phosphate deposits (nephrocalcinosis)

54
Q

50% of patients with ______ develop renal insufficiency

A

multiple myeloma (plasma cell myeloma)

55
Q

bence jones proteinuria
amyloidosis
hypercalcemia

A

myeloma kidney

56
Q

obstruction of tubules by Bence Jones-Tamm-Horsfall complexes

A

light chain cast nephropathy (myeloma kidney)

57
Q

inflammatory reaction seen and cracking of amyloid

A

myeloma kidney

58
Q
A

plasma cell (multiple myeloma)

59
Q
A

cracking of Amyloid (myeloma kidney)

60
Q
A

giant cell rxn and cracking of amyloid (myeloma kidney)

URN Biweekly 1 (21 decks)

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