. Flashcards
1
Q
What is the primary function of the urinary system?
A
Keeps body fluids steady by filtering blood and reabsorbing useful substances.
2
Q
What are the components of the renal system?
A
- Ureters
- Bladder
- Urethra
- Urinary sphincters
3
Q
What is the function of the detrusor muscle?
A
Smooth muscle of the bladder that remains relaxed to store urine.
4
Q
What is the role of the hepatic artery?
A
Brings oxygenated, nutrient-poor blood to the liver.
5
Q
What is the function of the hepatic portal vein?
A
Brings deoxygenated, nutrient-rich blood from the GI tract to the liver.
6
Q
What are the endocrine functions of the liver?
A
- Angiotensinogen – vasoconstriction/aldosterone release
- Thrombopoietin – stimulates production of platelets
- Hepcidin – inhibits iron absorption and release
7
Q
What is bile composed of?
A
- Bile salts
- Phospholipids
- Bile pigments (bilirubin)
8
Q
What are the three main carbohydrate metabolic processes in the liver?
A
- Glycogenesis
- Glycogenolysis
- Gluconeogenesis
9
Q
What are the layers of the kidney from outer to inner?
A
- Capsule
- Renal cortex
- Renal medulla
10
Q
What structures make up a renal lobe?
A
Renal pyramid + renal cortex, separated by renal columns.
11
Q
What is the function of the renal pelvis?
A
Funnel-shaped sack that collects urine before it enters the ureter.
12
Q
What are the two types of nephrons and their characteristics?
A
- Cortical nephrons – majority, short loops, located in renal cortex
- Juxtamedullary nephrons – minority, long loops, important for water balance
13
Q
What is the function of the juxtaglomerular apparatus?
A
Regulates renin secretion, adjusts blood pressure and sodium chloride content of filtrate.
14
Q
What are the three processes of urine formation?
A
- Glomerular filtration
- Tubular reabsorption
- Tubular secretion
15
Q
What is glomerular filtration rate (GFR)?
A
Average of 125 mL/min or 180 L/day, indicates kidney function.
16
Q
What factors control GFR?
A
- Vasoconstriction/dilation of arterioles
- Autoregulation mechanisms (myogenic response, tubuloglomerular feedback)
- Sympathetic nervous system influence
17
Q
What is the main function of the loop of Henle?
A
Concentrates urine and establishes a high sodium concentration in the medulla.
18
Q
What are the layers of the urinary bladder?
A
- Inner mucous
- Submucous
- Muscular
- Outer serous
19
Q
What is micturition?
A
The process of urine expulsion from the bladder.
20
Q
What are the two types of urethral sphincters?
A
- Internal sphincter – smooth muscle (involuntary)
- External sphincter – skeletal muscle (voluntary)
21
Q
What is the composition of urine?
A
- Water
- Urea
- Electrolytes
- Urochrome
22
Q
What is the role of anti-diuretic hormone (ADH)?
A
Regulates water reabsorption in the kidneys; absent leads to dilute urine, present leads to concentrated urine.
23
Q
What is acidosis?
A
Condition due to hydrogen gain, leading to a decrease in blood pH.
24
Q
What is alkalosis?
A
Condition due to hydrogen loss, leading to an increase in blood pH.
25
What does RAAS stand for?
Renin-Angiotensin-Aldosterone System.
26
What are the treatment options for stress incontinence?
* Duloxetine
* Pelvic floor muscle training
* Tampons (not recommended)
27
What is cystitis?
Inflammation of the bladder, often caused by a bacterial infection.
28
What are some common advice for managing cystitis?
* Drink plenty of fluids
* Empty bladder completely
* Keep the area clean
29
What should be advised for a new sexual partner presenting with a rash?
Drink plenty of fluids, empty bladder completely, keep area clean, take paracetamol for pain. Usually resolves in 2-3 days.
30
What are alkalinising agents and their contraindications?
Potassium/sodium citrate mixtures relieve burning. Avoid in hypertension, renal disease, and pregnancy.
31
What is the effect of cranberry juice on urinary tract infections?
Reduces adherence of bacteria to uroepithelial cells in bladder/urethra (limited evidence).
32
What is the recommended antibacterial agent for urinary tract infections?
Trimethoprim 200mg every 12 hours for 3 days or nitrofurantoin 50mg every 6 hours for 3 days.
33
What defines a water-soluble drug?
Stays in plasma and reaches organs of elimination faster but may be highly bound to plasma proteins, extending duration of action.
34
What characterizes a lipid-soluble drug?
Widely distributed throughout tissues, takes longer to reach elimination organs, extending half-life.
35
What is the role of metabolism in drug elimination?
Transforms drugs into a form that is readily excreted, usually making them more water-soluble.
36
What factors determine filtration rate in the kidneys?
Size and protein binding of the molecules.
37
What is the significance of glomerular pressure?
High pressure in the glomerulus helps squeeze out small molecules from the blood.
38
What is a pharmacophore?
Essential parts of a drug molecule that confer pharmacological activity.
39
How is terbutaline metabolized?
Oxidative deamination by cytochrome P450, resulting in a lower log P and an inactive metabolite.
40
What occurs during phase I of drug metabolism?
Converts compounds to more hydrophilic metabolites by adding or unmasking functional groups.
41
What is the function of cytochrome P450 in drug metabolism?
It is an electron acceptor involved in oxidation reactions that increase the rate of drug metabolism.
42
What is glucuronidation?
A phase II reaction that transfers glucuronic acid to drug substrates to increase their water solubility.
43
What are the main functions of the liver?
Metabolism, excretion, detoxification, storage, and immunologic functions.
44
What is the role of bile in digestion?
Bile acids aid in digestion and absorption of fats and fat-soluble vitamins.
45
What is the exocrine function of the pancreas?
Secretes digestive enzymes (protease, lipase, amylase) into the duodenum.
46
What is the primary function of the gallbladder?
Storage, concentration, and delivery of bile to the small intestine.
47
What is the reference range in clinical testing?
Typically the mean result +/- 2 standard deviations in healthy populations.
48
What does sensitivity refer to in clinical performance?
The ability to show positive results in testing.
49
What is the definition of anaemia?
Decrease in hemoglobin/RBC count leading to reduced oxygen delivery.
50
What is the ABO blood group system?
If an individual has the antigen, they do not have the corresponding antibody.
51
What is the role of erythropoietin?
Stimulates RBC production in bone marrow in response to hypoxia.
52
What is the function of hepatocytes?
Epithelial cells in the liver responsible for metabolic functions.
53
True or False: Blood typing can be used as proof of parenthood.
False
54
What is Glisson’s capsule?
Surrounds the entire liver and contains sensory nerve endings to trigger pain.
55
What is a lobule in the liver?
The structural unit of the liver, hexagonal with a central vein in the center and portal triad at six corners.
56
What are hepatocytes?
Epithelial cells of the liver with 1-2 nuclei and multiple surfaces for blood flow and bile secretion.
57
What is the blood supply to the liver?
Hepatic portal vein brings blood to the liver, and hepatic veins carry cleansed blood to the vena cava.
58
What are sinusoids?
Spaces in the liver where blood mixes, characterized by increased permeability.
59
What is the function of Kupffer cells?
Remove bacteria from portal blood by engulfing them and are involved in the breakdown of damaged RBCs.
60
What do Ito (stellate) cells do?
Store hepatic fat and vitamin A, and can become myofibroblasts to produce collagen in response to liver injury.
61
What is the role of dendritic cells in the liver?
Play a role in immunity and maintaining homeostasis by suppressing T cells.
62
What is the biliary system?
Consists of bile ducts that run in the opposite direction to blood flow, involved in bile secretion.
63
What is a liver acinus?
The smallest functional unit of the liver, characterized by zones based on oxygen supply.
64
What are the three zones of a liver acinus?
1. Periportal (receives oxygen/toxins) 2. Intermediate 3. Perivenous (less oxygen/cells dying).
65
What is bile composed of?
Bile salts, cholesterol, organic molecules, modified by bicarbonate-rich secretion.
66
What is the primary function of bile salts?
Emulsify fat globules into smaller pieces for lipase action.
67
What does hypoalbuminemia indicate?
Low levels of albumin caused by malnutrition, renal loss, or heart failure.
68
What are liver function tests (LFTs) used to measure?
Bilirubin, ALT, AST, GGT, ALP, protein, albumin, globulins.
69
What does elevated ALT/AST indicate?
Degree of inflammation in liver cells.
70
What condition is characterized by inflammation of the liver?
Hepatitis.
71
What does cholestasis refer to?
The inability of bile to flow into the duodenum from the liver.
72
What is cirrhosis?
Scarring of the liver resulting from continuous damage.
73
What are the two types of bilirubin?
Unconjugated (in blood) and conjugated (water-soluble in bile).
74
What are common signs of jaundice?
Yellowing of skin and eyes, palmar erythema, ascites, spider naevi.
75
What does high levels of ALT indicate?
Acute liver damage.
76
What is the significance of GGT levels?
High levels indicate liver or biliary tract disease.
77
What does a low albumin level signify?
Chronic liver disease or malnutrition.
78
What does a high level of albumin indicate?
Dehydration.
79
What is the relationship between glucose intake and insulin secretion?
Increased carbs lead to increased plasma glucose, stimulating pancreatic beta cells to secrete insulin.
80
What does a brown/orange color in urine indicate?
Presence of bilirubin.
81
What does a cloudy urine sample indicate?
Possible presence of vaginal mucous, excessive uric acid, or increased lipids.
82
What does a sweet/fruity smell in urine suggest?
Diabetic ketoacidosis.
83
What does a high specific gravity in urine indicate?
Dehydration.
84
What does a positive Log D indicate about a drug?
The drug favors the oil layer and is likely reabsorbed.
85
What does a negative Log D indicate about a drug?
The drug favors the water layer and is not reabsorbed, leading to excretion.
86
What does the Child-Pugh score assess?
The severity of liver damage.
87
What is the recommended alcohol limit per week?
14 units with 2 alcohol-free days.
