Block 10 Formative Flashcards
What determines the excitability of nerve and muscle cells?
Levels of K+ in the blood
Difference between afferent and efferent arteriole
Efferent arteriole has a smaller diameter
What is the effect of angiotensin 2 in kidney arterioles?
Stimulates release of NO in afferent arteriole for vasodilation.
Induces vasoconstriction in EFFERENT arteriole.
Site of bicarbonate reabsorption
Majorly: PCT
Lesser extent by intercalated cells of collecting duct and DCT
Ionised antibiotic with rapid clearance by kidneys
Gentamycin- aminoglycoside which is given for gram-negative bacterial infection. It can lead to ototoxicity and kidney damage. Clearance is dependant on kidney function.
Effect of lithium in the kidney
Free drug absorbed in the GI tract. In the kidney, it substitutes for Na+ in sodium channels. It has a low therapeutic index.
Level of renal artery
L1-L2
Where does E.Coli spread from to cause UTI?
Anus to urethra
Osmotic diuretic
Mannitol which elevate blood plasma osmolality as a treatment for increased intraocular pressure and cerebral oedema.
Most common cause of nephritic syndrome
Glomerulonephritis
Normal variant in urine
Hyaline cast found in healthy individuals who may be dehydrated or undergoing strenuous exercise.
Most reliable guide for presence of bacterial infection in urine
Nitrite which cause NO3-> N02 catalysed by nitrite reductase
When are nitrites falsely negative?
Patients taking
Vitamin C
Low bacteria levels
Bacterial in ifection caused by non-nitrate reducing bacteria
Cause of obstruction at the vesico-ureteric junction
Bladder cancer
Cause of obstruction at the bladder outflow
BPH
Imaging technique to view kidney pathology
Ultrasound
What is an important indicator for glomerular filtration rate?
Para aminohippurate clearance
What is an important indicator for renal function?
Creatinine clearance
Level of kidney
T12-L3
What prevents ascent of the kidney in development?
Inferior mesenteric artery
Common type of bladder cancer
Transitional cell carcinoma
Effect of gentamycin
Aminoglycoside antibiotic which causes apoptosis of renal epithelial cells leading to AKI
IgA nephropathy
Occurs 1-2 DAYS after infection where haematuria and mesanglial cells hyperproliferating develops
Acute proliferative glomerulonephritis
Infection with streptococcus pyogenes. Develops after WEEKS with haematuria.
Post-streptococcal glomerulonephritis
Immune complex IgG, IgM and C deposition in the glomeruli. Follows signs of haematuria + proteinuria.
CRP
C-reactive protein which is a marker of inflammation
Albumin levels in inflammation
Levels decrease due to leakage into the capillary space
Structure in the kidneys which detects changes in salt concentration
Macula densa
Baroreceptors in the kidney
Juxtaglomerular apparatus
Hypocalcaemia signs
Perioral paraesthesia, cramps, tetany and convulsions
Lobe of prostate affected in BPH
Median lobe of prostate
Cells affected in renal cell carcinoma
Proximal renal tubular epithelium
Role of GnRH agonists
Treatment of prostate cancer to suppress GnRH and LH production. Briefly causes an increase in the size of the prostate.
Horse shoe kidney
Kidneys are fused on the lower base and cross in the lower aorta
Features of minimal change disease
Fusion of podocytes
Aldosterone’s target action
DCT and collecting duct
ECG sign of hyperkalemia
Tall tented T waves
Small or absent P waves and Wide QRS complex
Sinusoidal waveform
Treatment of diabetes insipidus
Desmopressin
Action of angiotensin II
Vasoconstriction of efferent arteriole
Function of thiazide diuretics
Hypercalciuria and renal stones
Largest zone of prostate gland
Peripheral zone
Effect of heparin
Hyperkalemia
Greatest osmolarity in loop of Henle
Tip of loop of henle
Effect of muscle damage on kidneys
Rhabdomyolysis is breakdown of muscle tissue and causes renal tubular necrosis
Measure of renal function
Insulin
Bladder carcinoma linked to smoking
Transitional cell carcinoma
Membranoproliferative glomerulonephritis
Persistent activation of alternative complement pathway
Nephrotic syndrome- considerations
Loss of albumin in urine creates hypercoagulable state because anti-thrombin and heparin rely on this to prevent clotting.
Types of jaundice
Obstructive jaundice
Hepatocellular jaundice
Haemolytic jaundice
Effect of insulin on ion levels
Causes a decrease of intracellular K+ levels
Effect of loop diuretics on ions
Increased urination causes loss of Na+, K+, H20.
Majority of Na+ absorption in the nephron
Ascending limb of loop of Henle (25%)
Majority in PCT
Action of osmotic diuretics
Mannitol, urea, glycin
Act on the parts of the nephron permeable to water such as the PCT, descending loop of Henle and collectind duct. Increases solute concentration to increase water retention for urination
-> Major loss of ions such as nNa+, Mg2+, Ca2+. K+.
Action of Furosemide loop diuretics
Inhibit Na+/ K+/ Ca2+ co transporter in ascending loop of Henle
-> may induce renin release due to low volume
Thiazide diuretic
Thiazide inhibits Na+/Ca2+ transporter. Promotes urea reabsorption in PCT and may lead to uric acid increase and gout.
Location of water absorption
PCT
What interferes with PSA levels?
Vigorous exercise
Which vitamin can cause kidney stone formation?
Vitamin C promotes calcium oxolate formation
-> minorly Vitamin D because it promotes hypercalcieuria
What is the range of BP that does NOT affect renal blood flow?
80-180 mmHg
-> Beyond this, GFR is affected
Which region of the kidney do carcinomas arise?
PCT
Which medication should be stopped in AKI?
Diuretics because they worsen renal function
Type of bladder cancer in Schistosomiasis hematobomium
Squamous cell carcinoma
Features of dehydration
Metabolic acidosis
Rising haematocrit
High Na+ levels
What is a hyaline cast?
Formed of Tamms-Hormsfall protein present in urine after exercsie, fever, dehydration or use of loop diuretics
Kidney disease with high phospholipase A2
Membranous glomerulonephritis
Which ions must be monitored in AKI?
K+ and H+ in DCT and collecting duct
Affected chromosome in polycystic kidney disease
Chromosome 16 and causes berry aneurysms in the brain which rupture and subarachnoid haemorrhage
Effect of Na+ in nephrotic syndrome
Low
Lobes affected in BPH
Lateral and middle
How does venous blood affect RAAS?
Longer time for baroreceptors to respond
How does arterial blood affect RAAS?
RAAS system responds immediately to drop in BP
What affects clearance of substance in kidney nephron?
Diffusivity across basement membrane
Cells that produce renin
Juxtaglomerular cells
Which part of the kidney is affected in nephrogenic diabetes insipidus?
Vasopressin receptor
What are the common species involved in pyelonephritis infection?
Enterococci, Klebsiella, Pseudomonas, Proteus and Staphylococci
What is the cause of stress incontinence?
Weakness of pelvic muscles or urinary bladder sphicnter
