B15 - Kidney Failure & Urine Samples Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

What are some reasons for kidney failure?

A
  • kidney infection, podocytes and tubules damaged
  • Raised blood pressure damages epithelial cells in basement membrane of Bowman’s capsule.
  • genetic conditions e.g. polycystic kidney disease. Tissues replaced by fluid-filled cysts.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What could blood in the urine indicate?

A

kidneys not filtering properly. Damaged basement membrane or podocytes not acting properly as filters . Large plasma proteins and blood gets into the filtrate.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Kidney failure can cause urea and mineral ions to build up in the body. Explain the effects of kidney failure. (3)

A

Loss of electrolyte balance:
- Na+,K+,Cl- can’t be secreted
- crates osmotic imbalance in tissues
- eventual death

Toxic urea in blood:
- poison cells

High blood pressure:
- kidneys help maintain blood pressure by maintaining water potential balance in blood.
- high BP cause strokes and heart problems.

Weakened bones:
- Calcium/phosphorus balance in blood lost.

Pain and stiffness:
- due to abnormal protein build up in blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Name the two types of dialysis.

A

Haemodialysis
Peritoneal dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does dialysis fluid contain? (3)

A
  • normal glucose and plasma levels so no net movement out of blood
  • normal mineral ion levels so excess diffuses out of blood into dialysis fluid.
  • no urea, so urea leaves blood into fluid
  • countercurrent flow between blood and fluid to maximise gas exchange.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Explain the process of haemodialysis

A
  • blood leaves body through artery and into dialysis fluid.
  • blood thinners containing herapin prevent blood clotting.
  • blood passes through dialysis machine, removing waste.
  • clean blood passes through bubble trap to remove bubbles in blood.
  • clean blood returns to vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does the dialysis machine mimic?

A
  • basement membrane
  • has partially permeable dialysis membrane.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Explain the process of peritoneal dialysis.

A
  • catheter introduces dialysis fluid into abdomen.
  • peritoneum (lining of abdomen) acts as natural basement membrane.
  • left for hours for dialysis to occur - urea and excess waste is removed from blood into tissue fluid, then across the peritoneal membrane into the dialysis fluid.
  • fluid drained and discarded.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Explaint the difference between haemodialysis and peritoneal dialysis.

A

Haemodialysis
- use artificial dialysis machine as basement membrane
- usually done in hospital.

Peritoneal dialysis
- use natural peritoneum as basement membrane
- usually done at home, so patient can continue as normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the disadvantages or haemodialysis? (3)

A
  • Takes around 8 hours and must be repeated regularly.
  • patients attached to machine several times a week for several hours.
  • carefully manage diet (eat little salt and protein)
  • monitor fluid intake to keep blood chemistry stable.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is GFR? How is it measured?

A

GFR = Glomerular filtration rate

Blood test measures creatine in blood (breakdown product of muscle)
- gives an estimate (eGFR) in cm³min-¹

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What needs to be considered when measuring GFR?

A
  • GFR decreases with age, even if the person is very healthy
  • men usually have more muscle mass and more creatine than women.
  • a GFR below 60 indicates moderate-severe kidney disease ( normal GFRs don’t drop below 70)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

In a kidney transplant, where is the new kidney usually placed?

A
  • attached to blood vessels in the groin.
  • ureter of new kidney inserted into bladder.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why are immunosuppressant drugs used in kidney transplants? And what problems do they cause?

A
  • suppress immune system and prevent rejection of new organ/recognised as ‘non-self’

Problem:
- patient doesn’t properly respond to disease/infection.
BUT this is outweighed by the advantages of a new kidney.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why is a kidney transplant more ideal than dialysis?

A
  • Dialysis = monitored diet and frequent sessions.
  • long-term dialysis more expensive and has serious damaging side effects.
  • kidney transplant free from these restrictions.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the problems with kidney transplants? (3)

A
  • Rejection - antigens from donor organ recognised by immune system as non-self
  • Only last 9-10 years, patient has to go back to dialysis.
  • donor shortage as many don’t register
  • immunosuppressant drugs
17
Q

What is the hCG hormone?

A
  • produced from placenta of pregnant women around 6 days after conception (when embryo implants in uterus)
18
Q

How are monoclonal antibodies for hCG made?

A
  • inject mouse with hCG so it produces correct antibodies
  • isolate B cells(produce antibodies) from mouse’s spleen
  • B cells fused with myeloma(tumour cells) grown in a culture.
  • forms a hybridomas
  • rapidly divide, producing desired antibody which is then collected and purified
19
Q

What is a monoclonal antibody?

A

An antibody produced from a single clone of cells

20
Q

Explain the stages of a pregnancy test. (6)

A
  • Wick soacked in urine in morning (higher hGC level)

First window is the test zone:
- has mobile monoclonal antibodies
- that bind to hCG as urine travels up the stick
- forms hCG-antibody complex IF pregnant.
- urine reaches window on test stick
- immobilised monoclonal antibodies arranged so that it binds to the hCG-antibody complex, forming a SANDWHICH ASSAY.
- if pregnant, colour appears at fist window.

Second window is the control zone:
- urine continues up stick
- line of immobilised monoclonal antibodies that only bind to excess mobile monoclonal antibodies
- coloured line forms regardless if pregnant or not
- ensures test isn’t faulty

21
Q

What is the sandwich assay in a pregnancy test?

A

hCG hormone/antigen bound between a mobile and immobile monoclonal antibody.

22
Q

What is an anabolic steroid?

A
  • Drugs that mimic the male sex hormone testosterone and stimulate muscle growth.
23
Q

What steps are taken if a sportsperson is suspected of taking anabolic drugs?

A
  • suspect provide urine sample
  • sample split into two
  • First sample tested by immonuassay (sandwich assay) using monoclonal antibodies
  • second sample ran through gas chromatogram and mass spec to confirm the drug(s) present.

Different drugs can take a while to appear e.g. cocaine 2-5 days, ethanol 6-24 hrs

24
Q

name 3 anabolic drugs

A
  • cocaine
  • ethanol
  • amphetamines
  • cannnabis
  • steroids