The following medications are associated with retroperitoneal fibrosis EXCEPT for:
Answer C
Retroperitoneal fibrosis appears as a fibrous, whitish plaque that encases the aorta, inferior vena cava, and their major branches, and also the ureters and other retroperitoneal structures. An underlying malignancy should always be considered as some report to be present in 8%–10%. Other causes include primary (idiopathic), infections such as tuberculosis, drugs including beta blockers, methyldopa, methysergide, hydralazine, haloperidol, phenacetin pergolide, bromocriptine and ergotomines. Previous radiation or surgical treatment to the abdomen and pelvis has also been implicated. MRI allows superior soft tissue discrimination and can more accurately distinguish the plaque from the great vessels than unenhanced CT. If there is evidence of obstructive uropathy at presentation, therapy should be first directed at its correction. Biopsy to exclude malignancy should be performed next. This can be attempted percutaneously with CT, MRI or ultrasound guidance.
The following drugs cause acute interstitial nephritis EXCEPT for:
Answer E
The diagnosis of AKI secondary to AIN may be suggested by the urinalysis findings of sterile pyuria, white blood cell casts and eosinophiluria (using Hansel stain). The clinical presentation usually involves an abnormal urine sediment (described earlier), fever, a rising serum creatinine along with abnormal urinanalysis. While skin rash is seen in about 25% of cases, eosinophilia and eosinophiluria are present in more than 75% of cases except in AIN secondary to NSAIDs, where fever, rash and eosinophilia are typically absent. Proteinuria with most drugs is usually modest, with less than 0.5–1 g/day, while in the nephrotic range is frequently seen in selected cases on ampicillin, rifampin, ranitidine and interferon.
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