Q.260. What is Fanconi syndrome(F.S.)?
KIDNEY PROTECTION
Revise please the abbreviation list on:
https://draft.blogger.com/u/0/blog/post/edit/8610857019469578230/4564412989605988372
Q.260. What is Fanconi syndrome(F.S.)?
A. A generalized disorder of
R. tub. transport [Po4.uria, a.a.uria, glucosuria+
Loss of K+, uric a., HCO3]. Transport
abnormal are mainly proximal but can also occur é distal
tub.. Partial F.S. can occur, but
if multiple transport defects occur this means multiple processes e.g.: Krebs
cycle, Na, K+-ATPase, are defective. Ultrastructural
abn. involve mitochondria & endoplasmic reticulum. C.P.: {Rickets,
osteomalacia, metabolic acidosis, stunted growth (children) & hypo-kalemia]. In “Pediatric”: Cystinosis
is ass. é F.S.. In adults,
hypoPo4 is Sm.-tc. and acquired F.S., may be ass. é M.M., Wilson’s dis. & tub.
toxins. F.S. may be
an 👉early feature of M.M.
Q.261. What is difference between renal
tubular disorder & tubulointerstitial diseases?
A. Interstitial dis. are ch.ch.by: [inflammation
or fibrosis “between“ tubules
that transport
abnormalities,
wch’r 2ndry to the inflmm. or fibrotic process]. While...
-
R. tub. defects: ch.ch. by [transport abn.+”preserved R. architecture”]. Filtered substances [Gluc., a.a., Po4, Ca, Mg.,Na, K+, uric a.] us. reabsorbed in proximal
tub., then their excretion is regulated in distal tub.. A reduction in transport of any of them inadequate
reabsorption & appearance in urine. Defects
may be genetic or acquired.
Q.262. What causes Nephrogenic
diabetes insipidus (D.I.)?
A. Inability of the collecting ducts “to respond to Vasopressin”🠞 D.I., due to:
(1) Toxic: [Amphotericin B., Li-thpy, HyperCa+, sev. hypok+, distal nephron injury].
(2) Genetic loss of function of proteins incl.: V2 vasopressin receptor & water channel, aquaporin-2.
(3) Obstructive injury.
Q.263. What is “Heymann” Nephritis?
A. Injection
of crude preparation
of (tub. brush
border extract) called (Fx1A) into allogeneic rats 🠞 [A.B. mediated response,
mimic M.N. in humans + tubulointerstitial injury]. The responsible Ag. MEGALIN.
Q.264. What are the causes
of Ac. tubulointerstitial nephritis (TIN)?
A. Aetiology of Ac.TIN :
1) A.B.: [Cephalosporins- Ciprofluxacin- Sulfonamide].
2) NSAID – Allopurinol- Aza- Acyclovir.
3) Infection: {CMV-EBV-HIV- Mumps- Leptospira- Legionella.}
4) Idiopathic:(Im/m):Anti-tub.
B.M dis.
5)
TINU: Tubulointerstitial Nephritis & Uviitis syndrome.
- All NSAID esp. [Fenoprofen
& Refocoxib (vioox)]:🠞 Risk of TIN disease.
Q.265. What is the hallmark
of Ac. tubulointerstitial nephritis?
A. The hallmark
of TIN.: { Eosinophilic & Lymphocytic inflamm. cell infiltration
é interstitium, “Sparing 👉 B.V. & Glomeruli”}.
Q.266. What is the clinical Triad of Ac. tubulointerstitial
nephritis?
A. Classic clinical Triad of Ac. TIN.: 👌
Fever.
Rash.
Arthralgia.