formative test 2 and other Flashcards
what is the resident macrophage in the liver?
Kupffer cell
a patient has alcohol-related problems. there is no physical dependency on alcoho. however, there is evidence that moderate levels of psychological and social harm caused by alcohol.
The most appropriate place for a GP to refer the patient would be:
A. Al-Anon
B. Alcohol Advice Centre
C. Alcohol Concern
D. Alcoholics Anonymous
E. Medical Council on Alcoholism
B
B
A
D
E
E
B
The lesser sac may be conceptualized as the space _______ to the lesser omentum, between the ________ wall of the stomach and the surface of the peritoneum that covers the ________ surface of the ____ kidney
- posterior
- posterior
- anterior
- left
E
E
C
E
B
D
A
D
E
B
D
D
A
B
C
E
where does glycolysis typically take place within mammalian cells?
the cytosol
H
what are oval cells?
Oval cells are a specific type of cells with oval shaped nucleus that appear in the injured liver when hepatocyte proliferation is inhibited by toxins or genetic changes.
oval cells are adult liver stem cells derived from activated hepatic progenitor cells
G
C
F
A
E
D
F
what is the best test to establish a patient’s current level of glycaemic control?
blood glucose test
what is the best test to establish a patients level of glycaemic control over the past 2-3 hours?
glycosuria test
J
A
I
what are liver sinusoidal endothelial cells?
highly specialized endothelial cells representing the interface between blood cells on the one side and hepatocytes and hepatic stellate cells on the other side. LSECs represent a permeable barrier.
what are central/neurogenic diabetes insipidus and nephrogenic diabetes insipidus? what is a water deprivation test?
central = a defect in ADH production — produce more urine after vasopressin administration
insipidus = defect in kidney’s response to ADH — urine low osmolality remains
what in the kidney filter by shape rather than charge?
podocytes and the fenestrated glomerular capillary endothelium
what makes up the glomerular basement membrane?
type IV collagen, laminin and heparin sulfate proteoglycans
the negatively charged heparin sulfate repels negatively charged substances, such as plasma proteins
what lie between the glomerular capillaries, which secrete a connective tissue substance called glomerular mesangium, acting to bind the capillaries together?
mesangial cells
They are located in the juxtaglomerular apparatus and release renin in response to low sodium chloride concentration in the distal convoluted tubule.
what is this describing?
granular cells
A 42-year-old female presents to the emergency department with severe episodes of vomiting. A venous blood gas reflects evidence of metabolic alkalosis. How might this affect potassium handling in the kidney?
Increased potassium excretion by the Beta-intercalated cells of the late distal tubule and collecting ducts
what is a draw back of using creatinine to measure GFR? (apart from it is affected by age etc)
Creatinine is slightly secreted in the kidney, which results in over-estimation of GFR
alcohol and ADH?
inhibits release of ADH
What properties does the substance inulin have which make it an accurate indirect measure of renal clearance and thus glomerular filtration rate?
Inulin is filtered and not reabsorbed or secreted by the kidney
What is the predominant stimulus for anti-diuretic hormone (ADH) release?
increased plasma osmolality
which part of the nephron is response for excess dietary K+ excretion?
principal cells of the late distal tubules and collecting ducts
NOT a-intercalated cells —these increase K+ reabsorption in hypokalaemia, to restore K+ balance
A patient is diagnosed with Nephrotic syndrome, which means they lose a large volume of protein in their urine (proteinuria). What will this result in?
Reduction in capillary colloid pressure and oedema
Due to the loss of plasma proteins in the urine, there is less protein in the capillary. This results in a reduction in the oncotic pressure in the capillary and thus less drive to draw water back into the capillary (capillary colloid pressure). This allows an increase in the net filtration out of the capillary, leading to oedema (excess accumulation of fluid in the interstitial space)
A 49-year-old female patient with chronic kidney disease is found to have elevated levels of parathyroid hormone (PTH). How does the kidney respond to elevated levels of this hormone?
Increases calcium reabsorption and decreases phosphate reabsorption
CA 19-9 vs AFP vs CEA tumour markers
CA 19-9 = pancreatic cancer
AFP = hepatocellular carcinoma
CEA = colorectal cancer
causes of low vs high ferritin
low = Fe deficiency and possibly anaemia
high = hemochromatosis, liver disease, hyperthyroidism, alcohol abuse, blood transfusions, leukaemia
what are the borders of the inguinal (hesselbach’s triangle)?
medial = lateral border of the rectus abdominis muscle
lateral = inferior epigastric vessles
inferior = inguinal ligament
borders and contents of calots triangle
medial - common hepatic duct
inferior - cystic duct
superior - inferior surface of liver
contents:
- right hepatic artery
- cystic artery (from right hepatic)
- lymph node and lymphatics
