Term
| What are the major causes of Allergic Interstitial Nephritis and which is the most common |
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Definition
Drug Hypersensitivities- Most common
Infection
Idiopathic
Systemic Autoimmune
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Term
| Typical endogenous and exogenous antigens in Allergic Interstitial Nephritis |
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Definition
Endogenous:
Tubular BM
Tam-Horsfall Protein
Exogenous:
Haptens
Mimics
Planted Antigen
Immune Complex |
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Term
| Predominant immune response and cytokine in Allergic Interstitial Nephritis |
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Definition
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Term
| What are the presenting signs of Allergic Interstial Nephritis and what would be suggestive on Urinalysis? |
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Definition
Triad: Macropapular Rash, Fever, Eosinophilia
Urinalyis: Hematuria
Leukocyturia
Proteinuria(<1g per day)
Isothenuria
NSAIDS: Proteinuria >3.5g per day |
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Term
| What is the diagnosis and treatment for Acute Interstitial Nephritis, but when would the treatment be contraindicated? |
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Definition
Diagnosis:
Renal Biopsy-Interstitial Infiltrate(T and Monos), Progressive Fibrosis
Urinalysis-Eosinophils
Steroids unless one of the following:
NSAID AIN
Infectious AIN
Steroids are unaffective |
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Term
| What is an indicator of the prognosis in Allergic Interstitial Nephritis |
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Definition
| Amount of Fibrosis and Duration of Injury |
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Term
| What are the presenting forms of Sarcoidosis in renal biopsy |
|
Definition
A)Hypercalcemia from Vit D production
B)Interstitial Nephritis (Granulomas)
C)Glomerular Disease (FSGS, Membranous) |
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Term
| What is Primary Chronic Interstitial Nephritis associated with |
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Definition
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Term
| What are the pathological findings of chronic interstitial nephritis |
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Definition
Chronic Inflammation: MAC's, Lymphs
Tubular Atrophy, Dilation, BM Thickening
Intersitial Fibrosis
Glomerulosclerosis |
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Term
| What is the pathogenesis of Analgesic Nephropathy |
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Definition
Acetaminophen depletes Glutathione Stores
NSAIDs and Aspirin block Prostaglandin production-> Medullary Ischemia |
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Term
| How would you diagnose Analgesic Nephropathy if you suspected it? |
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Definition
| CT Scan: Renal Papillary Calcification (Necrosis) |
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Term
| What is the cause and pathogenesis of acute hyperuricemia |
|
Definition
Cause: Severe catabolic state leads to rapid rise in serum Uric Acid
Path: Crystal precipitation causing intra-tubular obstruction |
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Term
| What is chronic hyperuricemia nephropathy associated with and what is a treatment |
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Definition
Lead exposure, "Saturnine Goat"
EDTA |
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Term
| What types of patients present with lead nephropathy and what is the pathogenesis |
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Definition
Moonshiners or Occupational exposure
Path: Nephrotoxic to PCT
PCT damage can lead to Fanconi Syndrome in Kids |
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Term
| Why is serum Lead levels ineffective at diagnosing lead nephropathy? How is it diagnosed and treated? |
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Definition
90% resides in Bones
Dx: EDTA mobilization test
Rx: EDTA Chelation |
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Term
| What are the manifestations of chronic lithium exposure on the Kidney |
|
Definition
Chronic Tubulointerstitial Nephritis: cystic dilation of DCTs
Nephrogenic Diabetes Insipidous: Li blocks Aquaporin2 expression in cortical collecting duct
Hyperparathyroid
Incomplete Distal RTA
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Term
| What are the indications of Kaliopenic Nephropathy and when would it appear |
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Definition
Vacuolization of PCT and Medullary Cysts
1 month of persistent hypokalemia |
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Term
| What are the complications of Aristolochic Acid Nephropathy and how is it treated |
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Definition
Hypocellular Cortical Interstitial Fibrosis
Upper Urothelial Tumors
Rx: Steroids, maybe bilateral nephretomies |
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Term
| Why is Aristolochic Acid a suspected cause of Balkan Endemic Nephropathy |
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Definition
| Increased incidence of Upper Urothelial Tumors |
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Term
| What is the diagnosis and treatment of myeloma |
|
Definition
Diagnosis: Screen Urine and Serum Protein, Marrow Biopsy
Treatment: Chemotherapy |
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Term
| Diagnosis of a 14-yr old girl with elevated creatinine and ocular pain |
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Definition
| Probably Tubularinterstitial Nephritis with Uveitis |
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Term
| What are some causes of Nephrocalcinosis |
|
Definition
Hyperparathyroidism
Sarcoidosis
Milk-Alkali syndrome |
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