Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Senior - GU Test 1 > 8 - Tubulointesterstitial > Flashcards

8 - Tubulointesterstitial Flashcards

1
Q

The term tubulointerstitial?

A

Used to broadly refer to kidney disease that involves structures in the kidney other than the glomerulus

I.e. tubulointerstitial = kidney disease not glomerulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Types of tubulinterstitial disease?

A

ATN - acute tubular nephritis

AIN - acute interstitial nephritis

Chronic disease - insult from acute factor or progressive insult w/o any obvious acute cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

S/s of renal tubule damage?

A

Generalized disruption of

  • renal electrolyte handling,
  • water balance
  • PH maintenance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Polyuria?

A

Inability to concentrate urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Hypovolemia (urine)

A

Salt wasting due to impaired reabsorption by damaged tubules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lab findings for renal tubule damage?

A

Serum

  • H BUN
  • H creatinine
  • Hyperkalemia (>5.0)
  • Metabolic acidosis (renal tubular acidosis)

UA

  • microscopic hematuria
  • pyuria
  • altered spec grav
  • broad waxy casts
  • high U(na) - (sodium wasting)
  • glycosuria/phosphaturia
  • proteinuria (<2 g/day)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is isothenuria?

A

Kidney cannot formurine w a higher or lower spec grav than that of protein free plasma

Urine spec grav = protein-free plasma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How to treat renal tubular disease?

A

Manage the specific pathology/cause

  • relief of obstruction
  • surgery
  • withdrawl of analgesics
  • chelation therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic tubulointerstitial disease diagnostic findings?

A
  • Small kidney
  • L concentrating ability
  • Hyperchloremic metabolic acidosis
  • L GFR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Four main causes of chronic tubulointerstitial disease?

HOVA

A

HOVA

H - heavy metals
O - obstructive uropathy
V - vesicoureteral reflux
A - analgesics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Definitive diagnosis of chronic tubulointerstitial disease?

A

Renal biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MC cause of chronic tubulointerstitial disease?

A

Obstructive uropathy

Obstruction -> stasis -> infection -> renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Maj causes of obstructive uropathy?

A 
Prostate
Uteral calculi
Carcinoma
Tumor
Fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Long term obstruction can lead to?

A

Hydronephrosis

distention of:

  • renal pelvis
  • calicies

Pic on 17

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Obstructive uropathy tx?

A

2 referrals

  • Urology - relieve obstruction
  • Nephrology - management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Who gets vesicoureteral reflux?

A

D/o of childhood

- young males w freq UTIs

17
Q

What causes vesicoureteral reflux?

A

Retrograde urine flow from bladder -> kidneys during voiding

B/c incompetent vesicoureteral sphincter

18
Q

Prognosis/severity of vesicoureteral reflux?

A

5 grades

Grades I-II resolve by age 5

(The rest arent mentioned so i guess we dont care)

19
Q

What is the concern with vesicoureteral reflux?

A

Chronic UTI’s lead to permanent scarring and narrowing of ureters

20
Q

Diagnosis for vesicoureteral reflux?

A

VCUG - voiding cystourethrogram

21
Q

Tx for vesicoureteral reflux?

A

Abx
Urology referral
Surgery (maybe)

22
Q

What is analgesic nephropathy?

A

Large qtys of analgesics

- 1g/day x 3 yrs

23
Q

What is the typical culprit for analgesic nephropathy? Why?

A

NSAIDS - inhibition of renal prostaglandin synthesis

Leads to chronic lack of blood and ischemic damage

24
Q

Pathologic findings of analgesic nephropathy?

A
  • Tubulointerstitial inflammation

- Papillary necrosis

25
Q

Labs for analgesic nephropathy?

A

UA

  • sloughed papillae
  • sterile pyuria
  • hematuria
  • mild proteinuria
  • polyuria (tubular damage)

CBC
- anemia (GI bleeding)

Hyperkalemia

26
Q

Radiographs of analgesic nephropathy?

A

Non-contrast CT

  • bilateral small kidneys
  • bumpy/irregular contours
  • papillary calcifications
27
Q

Tx for analgesic nephropathy?

A

Stop the drug
Good hydration
Watch for ESRD/cancer

28
Q

What happens when you ingest heavy metals particularly lead?

A
  • Filtered by glomerulus
  • Transported across PCT
  • Accumulates and causes cell damage
29
Q

Heavy metal toxicity tx?

A

Chelation w EDTA to decrease serum levels

30
Q

If you came here for pee jokes

A

Urine luck

Senior - GU Test 1 (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions