Mezo
Forum Guru
Topics: 11
Posts: 678
|
Hi guys,
Please I need ur help urgently .. Exam is soo soon, I've a lot fo worries one of them is that i keep mixing Acute Tubular Necrosis with Acute Interstitial Nephritis, I can't differentiate between them , could u please help me figuring out the clinical clues for each of them ???
Thanks a lot for ur help
___________________
Experience is what u get when u don't get what u want to get
|
| shock
Forum Newbie
Topics: 1
Posts: 9
|
atn -acute renal failure with reversible injury to tubular epithelium
dirty brown casts epithelial casts
ain-interstitial infilatration with lymphocytes
wbc casts +fever
|
| Melu
Forum Senior
Topics: 8
Posts: 248
|
Hi Mezo,clinical clues lies mostly in UA.
*Acute tubular necrosis (ATN) is the death of tubular cells.
*CAUSES:
1.ISCHEMIC:
- Hypotension (low blood pressure) Surgery (e.g., open heart surgery, repair of abdominal aortic aneurysm)
- Obstetric (birth-related) complications
- Obstructive jaundice (yellow-tinged skin caused by blocked flow of bile
- Prolonged prerenal state
- Sepsis (infection in the blood or tissues)
2.NEPHROTOXIC:
- Aminoglycosides (antibacterial antibiotics such as streptomycin and gentamicin)
- Amphotericin B (antibiotic used to treat some forms of meningitis and systemic fungal infections)
- Cisplatin (anticancer agent used to treat late-stage ovarian and testicular cancers)
- Radioisotopic contrast media (agent used in certain imaging studies)
*Most common cause of ARF.
*ATN does not rapidly improve following the administration of large-volume intravenous fluid.
******Urine analysis: Broad, dirty brown granular casts are typically found in ischemic or nephrotoxic ATN
*Acute interstitial nephritis (AIN) is rapidly developing inflammation of the spaces between the tubules and may include inflammation of the tubules.
*CAUSES:
- ascending infection, VUR(ACUTE)
- Drug induced
- NSAID induced,Urate myopathy,
- Chr.lead poisioning,
- Multiple myeloma-Bence Jones proteinuria(tubular casts ith foreign body giant cell reaction),Nephrocalcinosis,primary amyloidosis.
****Urine analysis: often reveals eosinophils—specialized white blood cells that are seen in allergic reactions.
Hope this helps.
Edited by Melu on 08/10/08 - 08:13 PM
___________________
"The best preparation for good work tomorrow is good work today."- Elbert Hubbard
|
| Melu
Forum Senior
Topics: 8
Posts: 248
|
Urine analysis is one of the main things which helps in diagnosis.
ATN:Dark granular and epithelial cast
CRYTALLURIC ARF: crystals
AIN:WBC and WBC casts
Proliferative /necrotizing GN:RBC and RBC casts
___________________
"The best preparation for good work tomorrow is good work today."- Elbert Hubbard
|
|
| |
| | | | |
