Renal pathology 2

Question 1

Acute tubular necrosis

Answer 1

Most common cause of intrinsic renal failure

Self-reversible in some cases but can be fatal if untreated.

Question 2

Acute tubular necrosis:

Stages

Answer 2

Death most often occur during initial oliguric phage

1) incisting event
2) maintenance phase-oliguric; lasts 1-3 wks, risk of hyperkalemia
3) recovery-polyuric; BUN and serum creatinine fall, risk of hypokalemia

Question 3

Acute tubular necrosis:

associated with

Answer 3

Renal ischemia (shock and sepsis)
Crush injury (myoglobinuria),
drugs
toxin

Key finding: granular muddy brown casts

Question 4

Renal papillary necrosis

Answer 4

Sloughing of renal papillae
Gross hematuria and proteinuria

May be triggered b a recent infection or immune stimuli

Question 5

Renal papillary necrosis:

associated with

Answer 5

1) DM
2) acute pyelonephritis
3) chronic phenacetin use (acetaminophen is phenacetin derivative)
4) sickle cell anemia and trait