310 - Tubulointerstitial Diseases of the Kidneys

Question 1

We differentiate tubulointerstitial disease into __ and __.

Answer 1

acute

chronic

Question 2

TIN= ___

Answer 2

tubulointerstitial nephritis

Question 3

Acute TIN is defined as aggressive ___ infiltration leading to tissue __, damage to __ cells and flow, or obstruction by __/__/__.

Answer 3

inflammatory
edema
tubular
casts/crystals/cell debris

Question 4

Clinical symptoms of acute TIN include __ due to capsular stretching.

Answer 4

flank pain

Question 5

Acute TIN urine will contain __ and cellular __.

Answer 5

leukocytes

casts

Question 6

Chronic TIN will cause __ due to difficulties to __ it.

Answer 6

polyuria

concentrate

Question 7

Chronic TIN may lead to __ syndrome: 5

Answer 7

Fanconi
glycosuria
Phosphaturia  
Amino acids in urine
hypokalemia 
RTA type II (due to HCO3 urine excretion)

Question 8

Chronic TIN may lead to RTA type __ with non-AG __ acidosis and hyper__ due to __ production.

Answer 8

4
metabolic
kalemia
ammonia

Question 9

Chronic TIN may present with advanced __ and __ (rarely >2 gr/day).

Answer 9

azotemia

albuminuria

Question 10

Chronic TIN US may present increased __ and __ (IS __)

Answer 10

echogenic
scarring
fibrosis

Question 11

Now days, acute TIN is usually caused by drug __. Other reasons may include: 3

Answer 11

allergy
infection
systemic AI disease
obstruction

Question 12

What are the main drugs causing allergic TIN? 7

Answer 12

anti TB
fluoroquinolones
sulfonamides
Beta lactam
NSAID
diuretics
alopurinol

Question 13

The classic presentation of allergic TIN includes:4

Answer 13

fever
rash
peripheral eosinophilia
oliguric renal insufficiency

Question 14

Allergic TIN usually starts - days after __ Abx

Answer 14

7-10

B lactam

Question 15

The common presentation of allergic TIN includes increased __ in serum or __ symptoms.

Answer 15

Cr

AKI

Question 16

Allergic TIN due to NSAID will usually not include __ or __, but heavy ___ is possible.

Answer 16

fever
rash+ eosinophilia
proteinuria

Question 17

__ can cause a severe allergic TIN when resuming its treatment after a long remission.

Answer 17

rifampin

Question 18

Treating allergic TIN includes: 2

Answer 18

stopping the drug causing it

steroidal treatment- only for severe cases

Question 19

Sicca syndrome (part of Sjogren syndrome)= ___

Answer 19

dry mouth and eys

Question 20

__ syndrome is an AI disease with damage to exocrine glands (saliva/tears) that can include __ nephritis.

Answer 20

Sjogren

TIS

Question 21

TIS nephritis with uveitis is more common in young __. Treatment is with PO __.

Answer 21

women

steroids

Question 22

Beside Sjogren, name other disease involving TIS nephritis: 3

Answer 22

SLE
granulomatous
IgG4 related systemic disease

Question 23

Chronic TIS is usually due to renal __ or secondary to primary __ disease. Other reasons include: 2

Answer 23

ischemia
glomerular
reflux nephropathy
sickle cell anemia

Question 24

VUR=__

Answer 24

Vesicoureteral reflux

Question 25

VUR is a result of faulty __ or early childhood urological __.

Answer 25

valves

anomalies

Question 26

Clinical symptoms of VUR include: 4

Answer 26

recurrent UTI
late aged nocturnal enuresis
AKI/HTN/proteinuria
ESRD

Question 27

VUR should be examined by __ imaging. We usually see __ asymmetric kidneys with __ borders, thin __ and __ areas to compensate.

Answer 27

US
small
irregular
cortex
hypertrophic

Question 28

VUR treatment includes: 3

Answer 28

sterile urine to prevent scarring
operating at an early age when reflux is substantial
aggressive HTN balance (ACE/ARB)