8.6 Kidney - Interstitial, Tubules, Vasc

Question 1

tubular epithelial injury

Answer 1

acute kidney injury / acute tubular necrosis

Question 2

2 types of acute kidney injury

Answer 2

ischemic (hypotension)

nephrotic (drugs, contrast, solvents, myoglobin, radiation)

Question 3

epithelial necrosis with skip areas

Answer 3

ischemic acute kidney injury

Question 4

necrosis along proximal convoluted tubule

Answer 4

nephrotic acute kidney injury

Question 5

sloughed cells into tubular lumen, mitotic figures, edema,

Answer 5

acute kidney injury

Question 6

person ingested ethylene glycol. What do you expect in their urine

Answer 6

calcium oxalate crystals

Question 7

3 phases of acute kidney injury

Answer 7

initiation (decline in urine output, rise BUN)

maintenance (oliguria, salt and water overload, incr BUN, incr K, decr pH)

recovery (increase urine, low K, incr infection)

Question 8

can’t concentrate urine, polyuria, salt wasting, metabolic acidosis

Answer 8

tubulointerstitial nephritis

Question 9

edema, increase neutrophis and eos in interstitium and tubules, focal tubular necrosis

Answer 9

acute tubulointerstitial nephritis

Question 10

prominent interstitial fibrosis, tubular atrophy, lymphocytes and plasma cells

Answer 10

chronic tubulointerstitial nephritis

Question 11

pyelonephritis caused by

Answer 11

e. coli

proteus

klebsiella

enterobacter

Question 12

pyelonephritis in kidney transplant patient caused by

Answer 12

polyomavirus

CMV

adenovirus

Question 13

risk factors for pyelonephritis

Answer 13

pregnancy

preexisting renal lesions

diabetes mellitus

immunosuppression/deficiency

Question 14

infection of upper and lower poles from

Answer 14

intrarenal reflux (ascending route)

Question 15

most common bac that causes hematogenous pyelonephritis

Answer 15

Staphylococcus

Question 16

pyuria, leukocyte casts, neutrophils in tubules

Answer 16

acute pyelonephritis

Question 17

kidney with small yellow abscesses on cortex

Answer 17

acute pyelonephritis

Question 18

complications of acute pyelonephritis

Answer 18

papillary necrosis (DM, obstruction)

pyonephrosis (pelvis w/ pus)

perinephric abscess

renal scars

Question 19

tubulointerstitial inflammation, renal scarring, dilated/deformed calyces

Answer 19

chronic pyelonephritis

Question 20

2 types of chronic pyelonephritis

Answer 20

reflux nephropathy (more in kids)

chronic obstructive pyelonephritis

Question 21

scar in upper and lower poles and blunted calyx

Answer 21

chronic pyelonephritis

Question 22

thyroidization

Answer 22

chronic pyelonephritis

Question 23

obliterative endarteritis of vessels (results in occlusion of lumen)

Answer 23

chronic pyelonephritis

Question 24

hypertension in a child

Answer 24

chronic pyelonephritis

Question 25

poor prognosis in chronic pyelonephritis

Answer 25

significant proteinuria (causes focal segmental glomerulosclerosis)

Question 26

foamy macrophages - dx - variant of - bac

Answer 26

xanthogranulomatous pyelonephritis variant of chronic pyelonephritis proteus

Question 27

drugs that cause acute drug-induced interstitial nephritis

Answer 27

PCN sulfa diuretics NSAIDs cimetidine allopurinol

Question 28

NSAIDs cause

Answer 28

acute drug induced interstitial nephritis

Question 29

fever, eosinophilia, increased creatinine

Answer 29

acute drug induced interstitial nephritis

Question 30

drugs that cause analgesic nephropathy

Answer 30

phenacetin ASA caffeine acetaminophen (metabolite of phenacetin) codeine

Question 31

aspirin causes

Answer 31

analgesic nephropathy

Question 32

causes chronic tubulointerstitial nephritis with renal papillary necrosis

Answer 32

analgesic nephropathy

Question 33

what causes papillary necrosis in analgesic nephropathy

Answer 33

depletion of glutathione in tubular cells allows oxidative metabolites to injure cells

Question 34

2 steps of analgesic nephropathy

Answer 34

papillary necrosis tubulointerstitial nephritis

Question 35

normal or slightly small kidney with cortical depressions over necrotic papillae

Answer 35

analgesic nephropathy

Question 36

analgesic nephropathy has small risk of what cancer

Answer 36

transitional papillary carcinoma of renal pelvis

Question 37

gross hematuria, not concentrated urine, acidosis, stones, anemia

Answer 37

analgesic nephropathy

Question 38

person had chemotherapy for leukemia/lymphoma. susceptible to what? - path histo findings

Answer 38

acute urate nephropathy uric acid crystals

Question 39

following high dose of oral phosphate solutions before colonoscopy - path histo findings

Answer 39

acute phosphate nephropathy calcium phosphate

Question 40

person with gout can get

Answer 40

chronic urate nephropathy (hyperuricemia) nephrolithiasis (uric acid stones)

Question 41

person drank lots of moonshine can get

Answer 41

chronic urate nephropathy

Question 42

light chain cast nephropathy

Answer 42

plasma cell myeloma

Question 43

AL amyloidosis and lambda light chain

Answer 43

plasma cell myeloma

Question 44

sclerotic glomeruli, ischemia of tubules downstream, damaged peritubular capillaries, proteinuria

Answer 44

tubulointerstitial fibrosis

Question 45

diabetes and HTN - dx - risk factors for progression to renal failure

Answer 45

benign nephrosclerosis African, severe HTN, DM

Question 46

hyaline arteriolosclerosis, fibroelastic hyperplasia (large musclar arteries w/ media and intima thickening)

Answer 46

benign nephrosclerosis

Question 47

papilledema, encephalopathy

Answer 47

malignant nephrosclerosis

Question 48

hyperplastic arteriopathy (onion skinning)

Answer 48

malignant nephrosclerosis

Question 49

bruit unilaterally - dx - causes - how to test

Answer 49

renal artery stenosis plaque or fibromuscular dysplasia arteriography

Question 50

cholesterol clefts

Answer 50

atheroembolic renal disease

Question 51

sickle cells cause what pathological finding

Answer 51

patchy papillary necrosis

Question 52

sudden anuria, acute ischemic infarct/necrosis of cortex

Answer 52

diffuse cortical necrosis