Tubulointerstitial Disease

Question 1

Which Abx can cause Acute interstitial Nephritis?

Answer 1

• BEta-Lactams
• Sulfonamides
• Rifampin
• Fluoroquinolones

Question 2

Acute Interstitial Nephritis

• S/S
• LabDx

Answer 2

• Triad: Fever, Rash, eosinophilia
• Polyuria, imbalance in electrolyes, acid-base chem, + minerals; AKI, RTA
• LabDx: urine sediments, proteinuria, Hansel’s stain

Question 3

Anion Gap

• formula
• Causes of INC

Answer 3

• Na - [Cl + HCO3]
• GOLD MARK
  Glycols
  Oxyproline
  Lactic aciDosis
  Methanol
  Aspirin
  Renal failure
  Ketoacidosis

Question 4

Normal anion Gap acidosis

Answer 4

• Diahrrea
• RTA
• Early RF

Question 5

Type II RTA

• Eti
• Path
• LabDx:
• A/S

Answer 5

• Eti: Drugs, heavy metal poison Multiple Myeloma
• Path: incomplete reabsorption of the filtered HCO3 by the proximal tubule
• LabDx: Hypokalemia;
• ## A/.S: Fanconi Syndrome

Question 6

Type I RTA

• Eti
• Path
• LabDx:
• A/S

Answer 6

• Eti: Amph B, Toluene, Lithium, Autoimmune, Chronic Hepatitis
• Path: defect in the H+ ATPase pump in the cortical collecting duct
• LabDx: Basic Urine pH; High calcium/phosphate; Hypokalemia
• A/S: Sjogrens, RA, medullary sponge kidney, Rickets

Question 7

Type IV RTA

• Eti
• Path
• LabDx:
• A/S

Answer 7

• Eti: Aldosterone def/resi (ACEI, ARBs, K+-sparing Diuretics, NSDAIDS)
• Path: Hyperkalemia -> Red Ammonia production -> Reduced acid buffer
• LabDx: Low Urine pH; Hyperkalemia
• A/D: Addison’s; Diabetics, Interstitial Dx, renal transplant

Question 8

Urine Anion Gap

Answer 8

Na + K+ - Cl

UAG < 0 -> GI
UAG > 0 -> GU/RTA

Question 9

Chronic Interstitial Nephritis

• Eti
• LabDx

Answer 9

• Eti: Obstruction, Drugs, Heavy Metals, Sjogrens, Sicke Cell, Multiple Myeloma
• LabDx: Proteinuria, elevated creatinine,

Question 10

Tratment for Acute + Chronic TI Dx

Answer 10

Acute: D/C drug + corticosteroids

Chronic: D/C drug, treat cause, Rx CKD, NO corticosteroids

Question 11

PKD Ravine Criteria

Answer 11

15-29 YO: Total of 2 cysts in both kidneys
30-59 YO: 2 or more cysts in each kidney
>60 YO: 4 or more cysts in each kidney

Question 12

PKD Pei criteria

Answer 12

15-29 YO: 3 or more cysts in both kidneys
30-59 YO: 2 or more cysts in each kidney
>60 YO: 4 or more cysts in each kidney