Causes and Prognosis of Acute Tubular Injury

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Questions and Answers

What is the most common cause of Acute Tubular Injury (ATI)?

  • Direct toxic injury: drugs, radio-contrast dyes, myoglobin, hemoglobin, and radiation
  • Overwhelming sepsis or other causes of Multi-organ failure
  • Ischemia: shock, dehydration, malignant hypertension (correct)
  • Inflammation of the tubules and interstitium (tubulointerstitial nephritis)

Which part of the nephron is most affected in ischemic ATI?

  • Distal convoluted tubule
  • Proximal tubule straight segments (PST) and thick ascending loop of Henle (HL) (correct)
  • Glomerulus
  • Collecting duct

Which of the following is a characteristic of the recovery phase of ATI?

  • Salt and water overload
  • Oliguria (40-400 mL/day)
  • Hyperkalemia
  • Rising urine volumes (up to 3 L/day) with water, sodium, and especially potassium losses (hypokalemia) (correct)

Which of the following is a poor prognostic factor for ATI?

<p>ATI secondary to overwhelming sepsis or other causes of Multi-organ failure (D)</p> Signup and view all the answers

Which of the following is a characteristic of nephrotoxic ATI?

<p>Variable degrees of tubular injury and necrosis, mostly in proximal tubules (C)</p> Signup and view all the answers

How does hypertension affect the renal vasculature?

<p>Hypertension affects renal vessels, and any renal vascular changes tend to amplify the hypertension (D)</p> Signup and view all the answers

What is the main cause of malignant nephrosclerosis?

<p>Endothelial injury, platelet deposition, and increased vascular permeability (A)</p> Signup and view all the answers

What is the main feature of benign nephrosclerosis?

<p>Rarely causes renal failure (A)</p> Signup and view all the answers

What is the main structural change seen in nephrosclerosis?

<p>Medial and intimal thickening of small renal arteries and arterioles (A)</p> Signup and view all the answers

What is the most common cause of malignant hypertension?

<p>Accelerated hypertension (A)</p> Signup and view all the answers

What is the main feature of thrombotic microangiopathies?

<p>Fibrinoid necrosis and intravascular thrombosis (D)</p> Signup and view all the answers

What is the main cause of nephrosclerosis?

<p>Medial and intimal thickening of small renal arteries and arterioles, strongly associated with hypertension (C)</p> Signup and view all the answers

What is the most common cause of acute renal failure in hospitalized patients?

<p>Drug-induced interstitial nephritis (B)</p> Signup and view all the answers

Which disorder is characterized by renal calcium deposition and can lead to renal failure through tubular obstruction?

<p>Nephrocalcinosis (C)</p> Signup and view all the answers

What percentage of multiple myeloma patients have Bence Jones proteinuria?

<p>70% (C)</p> Signup and view all the answers

Which of the following conditions has eosinophils and edema present in the interstitium?

<p>Ischemic ATI (A)</p> Signup and view all the answers

In Light Chain Cast Nephropathy, what toxic effect contributes to renal insufficiency?

<p>Bence Jones proteinuria (D)</p> Signup and view all the answers

Which condition is characterized by a T cell–mediated immune reaction to a drug causing interstitial inflammation in the kidney?

<p>Drug-induced interstitial nephritis (A)</p> Signup and view all the answers

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