Aani CP: Kidney & Liver Flashcards
Risk Factors for renal stones?
- Dehydration
- Acidic urine (because citrate inhibits its formation. We make citrate when urine pH is alkaline), therefore red meat & renal acidosis can make acidic urine)
- Certain inflamm conditions e.g. Chrons, Arthritis
What can renal stones be made up of?
- Calcium Oxalate/Phosphate
- Phosphate
- Uric Acid
- Cysteine
- Mixed calcium
+ Others
Which renal stones are radiolucent?
- Uric Acid
- Cysteine
‘Ur C thru’ - Uric Cysteine
Causes of Calcium Oxalate stones?
Increased Oxalate intake, increased calcium intake (or other causes of high calcium)
Which calcium do we measure?
Total serum calcium
How do we calculate the corrected calcium level?
It takes albumin into account. (Measured - (0.02 x (40-albumin))
Pre-renal causes of AKI?
Hypoperfusion
Volume depletion/sepsis
Renal ischaemia
Drugs affecting glomerular flow
How to measure AKI severity?
Urine output & creatinine
Painless jaundice and an enlarged gallbladder- Diagnosis?
NOT gallstones. Likely pancreatic mass
Treatment of acidosis due to CKD?
Sodium bicarbonate
Why do you get anaemia in CKD?
Less erythropoietin
Why do you get osteomalacia in CKD?
Less 1 alpha hydroxylase so less active Vit D. Vit D deficiency = osteomalacia
What is the name of the space between the hepatic sinusoid and the hepatocytes?
Space of Disse
Describe the liver cells in alcoholic hepatitis?
Swollen (ballooning)
Which cells do you often find in a swollen alcoholic hepatitis liver?
Mallory Denk Bodies
What causes portal hypertension?
Fibrosis/scarring of liver tissue
Describe the mitochondria in alcoholic hepatitis?
MEGAmitochondria
Which enzume is reduced in Gilbert’s?
UPD Glucoronyl Transferase (leading to increased unconjugated bilirubin in blood)
Which enzyme conjugates Bilirubin?
UDP glucoronyl transferase
What gives poo it’s brown colour?
Stercobilinogen is oxidised in the gut to stercobilin which is brown
What happens to billirubin after it has been conjugated?
It is transported into bile canaliculi and then released into the gut. There it is converted into stercobilinogen.
Some stercobilinogen is oxidised in the gut to stercobilin which is brown
Some stercobilinogen is converted into urobilinogen and oxidised to urobilin which is yellow and excreted in the urine
What is the name of the transporter that carried conjugated bilirubin into the bile canaliculi ?
MRP2 transporter
Which can you directly measure: conjugated or unconjugated bilirubin?
Conjugated can be directly measured (van den bergh)
Why does unconjugated bilirubin not enter the urine?
Because it is bound to albumin
Explain the symptoms of pancreatic carcinoma?
- High serum bilirubin. The bile duct is blocked so bilirubin cannot be excreted
- The bilirubin cannot be converted into stercobilinogen –> pale stool
- The urobilinogen is not made. Bilirubin leaks into urine –> dark urine
