Case 3 SBA Flashcards

1
Q

Divisions of the peritoneal cavity

A

Greater and lesser sac

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2
Q

Greater sac of peritoneal cavity

A

Starts at diaphragm and descends into pelvic cavity. Is not contained by the reflections

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3
Q

Lesser sac of peritoneal cavity

A

Lies behind stomach and liver, contained by reflections

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4
Q

Lesser omentum

A

Connects liver to curvature of the stomach

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5
Q

Medial part of lesser omentum

A

Hepatogastric ligament

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6
Q

Lateral part of lesser omentum

A

Hepatoduodenal ligament

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7
Q

Greater omentum

A

Connects greater curvature of stomach to transverse colon

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8
Q

The mesentery

A

Anchors small intestine to abdominal wall

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9
Q

Other examples of mesenteries

A

Mesocolon, sigmoid mesocolon, mesoappendix

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10
Q

Lienorenal ligament

A

Connects spleen and kidney

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11
Q

Omentum definition

A

reflection between two organs

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12
Q

Mesentery definition

A

reflection between organ and posterior abdominal wall

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13
Q

Retroperitoneal organs

A

Only covered on anterior surface by peritoneum. SADPUCKER (suprarenal glands, aorta, duodenum, pancreas, ureters, colon, kidneys, oesophagus, rectum)

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14
Q

Supra-colic organs

A

Stomach, liver, gallbladder, spleen

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15
Q

Infra-colic organs

A

Small intestine, transverse colon, sigmoid colon

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16
Q

Falciform ligament of liver

A

Attaches to anterior abdominal wall. Becomes coronary ligaments.

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17
Q

Coronary ligaments of liver

A

Attach liver to diaphragm, meet and form triangular ligament

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18
Q

Main muscles of the posterior abdominal wall

A

Quadratus lumborum, psoas, ilacus

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19
Q

Sections of the male urethra

A

pre-prostatic, prostatic, membranous, and spongy

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20
Q

Male vs female urethra length

A

20cm vs 5cm

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21
Q

Kidney drainage route

A

papilla → minor calyx → major calyx → renal pelvis → ureter

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22
Q

Which kidney is the most inferior?

A

Right

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23
Q

What crosses the left renal vein anteriorly?

A

Superior mesenteric

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24
Q

What connects the supra and infra-colic compartments of the greater sac?

A

Paracolic gutters

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25
Q

Clinical implications of paracolic gutters

A

More common to have infection on right side that can spread upwards towards the right subphrenic space (between diaphragm and liver)

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26
Q

Subphrenic abscess

A

Accumulation of pus in subphrenic space

27
Q

Definition of chronic kidney disease

A

Longstanding abnormal kidney function or structure with GFR < 60 mls/min/1.73m^2

28
Q

Stage 1 CKD

A

Haematuria, proteinuria, abnormal anatomy, normal GFR > 90

29
Q

Stage 2 CKD

A

Haematuria, proteinuria, abnormal anatomy, mildly reduced GFR (60-89)

30
Q

Stage 3 CKD

A

Moderately reduced GFR (30-59)

31
Q

Stage 4 CKD

A

Severe reduction in GFR (15-29)

32
Q

Stage 5 CKD

A

Kidney failure, GFR <15

33
Q

Level A1 kidney disease

A

Albuminuria <3mg/mmol

34
Q

Level A2 kidney disease

A

Albuminuria 3-30 mg/mmol

35
Q

Level A3 kidney disease

A

Albuminuria >30 mg/mmol

36
Q

Cause of urinary tract infections

A

Bacteria enter urinary tract, adhere to bladder cells, and elicit inflammatory response

37
Q

Top two causes of UTIs

A

E-coli and staphylococcus aureus

38
Q

Lower UTI

A

infection confined to bladder and urethra

39
Q

Upper UTI

A

infection spreads to kidney and ureter. more severe

40
Q

Complicated UTI

A

Other condition (including diabetes, kidney stones, blockages, catheters, immunosuppressants, and developmental abnormalities) along with UTI. Higher risk of kidney damage and septicaemia

41
Q

Risk factors for UTIs

A

female gender, increasing age, recent antibiotic use, recent sexual activity, catheterisation, pregnancy, institutionalisation, diabetes

42
Q

Signs/symptoms of lower UTI

A

increased urinary frequency (polyuria), painful urination (dysuria), haematuria (most common cause of haematuria is UTI), foul-smelling or cloudy urine (pyuria), urgency, urinary incontinence

43
Q

Signs/symptoms of upper UTI

A

rigors, fever (pyrexia), nausea/vomiting, flank pain, confusion in elderly patients

44
Q

Bacteria in urine but no UTI symptoms

A

asymptomatic bacteriuria

45
Q

UTI epidemiology

A

UTIs uncommon in men and children. 25% of women will experience UTIs, and 25% of these will have recurrent UTIs. In men and children, usually have an underlying abnormality of the urinary tract. Presents with confusion in elderly people with an upper UTI

46
Q

Urine changes with UTI

A

pyuria, dysuria, haematuria, polyuria, incontinence, urgency, very small amounts produced.

47
Q

Urine changes in AKI

A

reduced urine output

48
Q

Urine changes in CKD

A

increased frequency

49
Q

Describe loop diuretics

A

act on thick ascending loop of Henle, are powerful diuretics. Inhibit Na-K-2Cl channels. Increase Na excretions and hyperosmolarity of filtrate

50
Q

Loop diuretic examples

A

Furosemide and bumetanide

51
Q

Thiazide-like diuretics examples

A

Chlorthalidone, indapamide, hydrochlorothiazide

52
Q

Potassium sparing diuretics mechanisms

A

mineralocorticoid receptor blockers (aldosterone antagonists) or ENaC blockers

53
Q

Aldosterone antagonist examples

A

Spironolactone and eplerenone

54
Q

ENaC blockers examples

A

Amiloride and triamterene

55
Q

Proximal tubule handling of potassium

A

Paracellular reabsorption

56
Q

Loop of Henle handling of potassium

A

Reabsorption primarily via Na/K/2Cl cotransporters

57
Q

Principal cells in DCT and CD handling of potassium

A

excrete K following Na reabsorption

58
Q

Alpha-intercalated cells in CD handling of potassium

A

reabsorb K in exchange for H

59
Q

What dictates the net effect of potassium handling?

A

Relative handling by principal and alpha-intercalated cells

60
Q

Sodium reabsorption in PCT

A

apical surface has Na/K ATPase and Na/HCO3 symporter. Basolateral surface has Na/glucose symporter and Na/H exchanger

61
Q

Sodium reabsorption in LOH

A

has channels for Na to move freely. Also includes Na/K/2Cl pump on apical surface and Na/K ATPase on basolateral surface

62
Q

Sodium reabsorption in DCT

A

Na/Cl symporter on apical surface, Na/K ATPase on basolateral surface. Has Na/H exchanger and aldosterone-controlled Na/K exchanger on both surfaces

63
Q

Sodium reabsorption in CD

A

Na/H exchanger and aldosterone-controlled Na/K exchanger on both surfaces