Extras Sessions 1-4 Flashcards
Which structure encloses the kidney and adrenal gland
Renal fascia
Which organ can be located anterior to the left kidney
Spleen
In the embryo, what is the first kidney system to develop
Pronephros
The ascent of a horseshoe kidney into the lumbar retroperitoneal area is restricted by the ___ which hooks over the fused lower poles
IMA
Which component of mesoderm gives rise to the kidney
Intermediate- urogenital ridge
which vessel crosses over the ureter at the level of the pelvic brim
Ovarian artery
The ureters descend through the abdomen along the anterior surface of the
Psoas major
What separates the adrenal glands from the kidneys
Perirenal fat
What lies anterior to the right adrenal gland
Inferior vena cava
The gastrosplenic and splenorenal ligaments are part of which structure
Greater omentum
Describe the apex of the bladder connection to umbilicus
By median umbilical ligament
Which branch of the internal iliac artery is most associated with arterial supply to the bladder
Superior vesicular
Which parr of the nephron helps to regulate serum pH
Distal convoluted tubule - responsible for reabsorbing bicarbonate
Which part of the nephron is responsible for 100% of amino acid reabsorption
Proximal convoluted tubule
Which part of the nephron is responsible for 100% of glucose reabsorption
PCT
In which part of the nephron does ADH act to increase water reabsorption
CD
What tissue is this
Perirenal fat (peri means around)
What is activated in a response to haemorrhage to cause a decrease in GFR
Sympathetic nervous system
What would happen to the GFR if the glomerular oncotic pressure decreased
Increase
Oncotic pressure in glomerulus opposes filtration
What would happen to the GFR if the tubular hydrostatic pressure increased
Decrease
Opposing force to capillary hydrostatic pressure
What does the Bowman’s capsule do
Filter blood and produce ultra filtrate which contains high sodium
Patient with renal disease has high creatinine in blood but low creatinine in urine. What condition is best indicated?
Decreased kidney function
Fluid in Bowman’s capsule in a patient with high creatinine due to Lupus nephritis would be most similar to
Plasma
Renal clearance =
Urine conc x volume
/
Plasma conc
Units for urine volume in clearance
Ml per min
What diuretic is best for a patient with heart failure, low GFR, and loop diuretic resistance
Thiazide like
Features of Spironolactone
Only K+ sparing that is not selective as mineralocorticoid receptor, can cause gynecomastia, acts in CD
Drug given for Hypertension and heart failure, causes glucose intolerance, hypokalemia and uricemia
What is it
Thiazides: act in DCT
Patient with hypertension develops hypokalaemia, metabolic acidosis and ototoxicity after treatment with what
Loop diuretic
Patient given a loop diuretic for hypertension, develops hypokalaemia
Needs K+ sparing
Where would the drug act
Collecting duct= blocks ENAC, prevents reabsorption of 3% filtered Na+
What drug has a short duration, inhibits Na/K/CC2 transporter
Decreases Na+ reabsorption by 30%
Loop diuretic
Which type of diuretic increases Calcium excretion
Loop
Potential side effects of Spironolactone
Gynecomastia, impotence, BPH
Gout and hyperuricemia are side effects of
Loop diuretics
Which drug reduces mortality for heart failure after MI
Spironolactone
What acute compensatory mechanism will occur in the nephron upon a patient with orthosteric hypotension standing up
an increase in the glomerular filtration rate of the same nephron- reduced pressure to afferent allows more blood flow into glomerulus
What is the effect of aldosterone on blood pressure, where is it produced and where does it act
Increases BP, adrenal gland, DCT
Aldosterone increases salt and water absorption, upregulates Na/K+/ATPase
What features of the ascending LOH have resulted in low osmolality
Permeable to ions but impermeable to water
More dilute in ascending LOH as ions can leave the tubule but water cannot
What adaptations in the kidney will have occured in response to hypertension
Decreased release of renin
increased Na+ and Cl- in DCT will mean less renin is released
What is the most appropriate physiological response by macula densa cells to low bp
Stimulate JG cells to secrete renin
What is the most likely cause of syncope in a patient whose been outside all day in the heat with no fluids
Hypovolaemia as lost in sweat
What is the most likely explanation for the disturbance in serum sodium concentration as a result of sucrose being put in a wound
Subcutaneous absorption of sucrose
Excreted in urine
Hypertonic hyponatremia
Dilutional drop in measured sodium due to presence of osmotically active molecules in serum, which causes water to shift from ICF compartment to ECF compartment
What is the action of ADH
v1 receptor, vasoconstriction
Loss of which renal function is most likely to be identified by the lab measurement of the urine specific gravity following deprivation
Concentration
lower water intake = higher specific gravity
What physiological response is the primary cause of Hyponatraemia in a patient with SIADH
Excess water reabsorption in collecting duct
