Lecture 9- Renal Disease 2

Question 1

acute pyelonephritis is also called…

Answer 1

tubulointerstitial nephritis

Question 2

… is suppurative inflammation of the kidney and renal pelvis caused by bacterial infection. This is a renal disease affecting tubules, interstitium, and pelvis and is most often secondary to bacterial infection

Answer 2

acute pyelonephritis/

tubulointerstitial nephritis

Question 3

predisposing conditions of acute pyelonephritis/

tubulointerstitial nephritis

Answer 3

pregnancy
ut obstruction
uti
immunosuppression
DM
instrumentation

Question 4

what drugs can cause interstitial nephritis

Answer 4

antibiotics
nsaids
diuretics

Question 5

in drug induced interstitial nephritis, drug may bind to … or … cells and act as … with immunologic response

Answer 5

tubular
interstitial
hapten

Question 6

The clinical presentation of drug induced nephritis is a rapid onset of …, eosinophilia, renal dysfxn with … but little or no …

Answer 6

fever (2-40 days)

hematuria

proteinuria

Question 7

what is the prognosis of drug induced nephritis?

Answer 7

good, full recovery 6-8 weeks

Question 8

treatment of drug induced nephritis

Answer 8

withdrawal of drug and corticosteroids

Question 9

… is the rapid onset of renal failure, reduced UO, electrolyte imbalances. The clinical manifestations are reversible over a period of weeks as the damaged tubular epithelium regenerates

Answer 9

acute tubular necrosis

Question 10

etiology of acute tubular necrosis?

Answer 10

injury to tubular epithelial cells from ischemia (shock) or a toxin

Question 11

3 pathologic features of acute tubular necrosis

Answer 11

dilation of tubules

edema

necrosis of tubular epithelium

Question 12

treatment of acute tubular necrosis

do patients usually recover?

Answer 12

supportive care, dialysis

yes

Question 13

… is the thickening and sclerosis of the renal arteries associated with benign htn

Answer 13

arterionephrosclerosis

Question 14

what gene is associated with arteriosclerosis and what ethnic population is this disease common in?

Answer 14

apolioprotein L1

african americans

Question 15

The same linkage can be seen in arterionephrosclerosis that is in…

Answer 15

FSGS (focal/segmental glomerulosclerosis)

Question 16

4 features of arterionephrosclerosis

Answer 16

1. grossly small kidneys, granular surface
2. hyaline arteriosclerosis/ fibroelastic hyperplasia
3. tubular atrophy and fibrosis
4. global sclerosis of glomeruli

Question 17

… can be seen with malignant htn (200/120mmHg)

Answer 17

arterionephrosclerosis

Question 18

arterionephrosclerosis is seen in …% of patients with essential htn

Answer 18

5%

Question 19

what are the clinical symptoms of arterionephrosclerosis

Answer 19

increased intracranial pressure

proteinuria

ischemia leading to acute renal injury

Question 20

in the pathology of arterionephrosclerosis, the arterioles show … , reducing …. and causing…

Answer 20

hyperplastic arteriosclerosis (know this)

blood flow

necrosis of glomeruli

Question 21

… is an acquired defect in metalloproteinase that degrades vWD (or inherited ADAMTS 13 defect)

Answer 21

thrombotic thrombocytopenia pupura (TTP)

Question 22

… is an endothelial injury from Shiga toxin+ E. coli

and a major cause of acute kidney injury in children

Answer 22

Hemolytic-uremic syndrome (HUS)

Question 23

Hemolytic-uremic syndrome (HUS) and … can both lead to … activation

Answer 23

thrombotic thrombocytopenia pupura (TTP)

platelet

Question 24

HUS and TTP both cause widespread … in capillaries with RBC damage.

which one is predominately kidney involvement and which one is more widespread with organ impact including transient neurologic deficits from CNS involvement?

Answer 24

microthombi

HUS- kidney
TTP- CNS

Question 25

by the age of 70, urolithiasis affects ... % of men and ...% of women

Answer 25

11% 6%

Question 26

clinical symptoms of kidney stones

Answer 26

``` asymptomatic obstruction intense pain infection hematuria ```

Question 27

most common form of kidney stones?

Answer 27

calcium (80%)

Question 28

3 types of kidney stones

Answer 28

1. calcium 2. magnesium ammonium phosphate 3. uric acid

Question 29

what can cause magnesium ammonium phosphate kidney stones?

Answer 29

proteus or staph infection

Question 30

... is dilation of renal pelvis/calyces with parenchymal atrophy secondary to obstruction

Answer 30

hydronephrosis

Question 31

causes of hydronephrosis

Answer 31

congenital uto enlarged prostate neoplasms neurogenic bladder pregnancy

Question 32

most common type of kidney cancer

Answer 32

renal cell carcinoma

Question 33

male:female for renal cell carcinoma

Answer 33

2:1

Question 34

5 year survival in renal cell carcinoma stage 1: stage 4:

Answer 34

81% | 8%