Tubulointerstitial, Vascular and Cystic Diseases MCQs

Ans. is 'd' i.e., Males are more affected than female o 3 basic forms of UTI - (1) Pyelonephritis (2) Cystitis (3) Asymptomatic bacteremia Chronic Pyelonephritis :- Characterised by renal inflammation & fibrosts induced by recurrent or persistent renal infection, vesicoureteric reflux or other causes of UTI. Progressive renal scarring which leads to end stage renal diseaes. In reflex nephropathy, Intrarenal reflex of infected urine induces renal injury which heals by renal scarring. Being - straight, short & wide urethra, recurrent UTI is more common in female, so CPN is also twice as common is female than male.

The characteristic histologic feature of acute pyelonephritis is liquefactive necrosis and abscess formation within the renal parenchyma. In the early stages, pus formation (suppuration) is limited to the tubular lumina, but later abscesses rupture into the interstitial tissue. Large masses of intratubular neutrophils frequently extend within involved nephrons into the collecting ducts, giving rise to characteristic white blood cell casts in the urine.Typically, the glomeruli are not affected. Reference : Robbins Basic Pathology, 10 th edition, Page- 565

Explanation: Tamm-Horsfall protein is synthesized in the ascending loop of Henle and is the most abundant protein in normal urine. It plays a role in tubular function and helps prevent urinary tract infections . It is the main constituent of hyaline casts , which are the most common type of urinary casts. Explanation of other options: Mural thrombi (Option A): Blood clots adhering to the vessel or heart walls; unrelated to Tamm-Horsfall protein. Curschmann spirals (Option B): Mucus plugs seen in sputum from asthma or other obstructive pulmonary diseases. Bence-Jones proteins (Option D): Free immunoglobulin light chains in urine, associated with multiple myeloma , not a normal renal protein.