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Urology and Renal Medicine > Genitourinary system > Flashcards

Genitourinary system Flashcards

1
Q

What is the function of the kidneys

A

Excretion of metabolic products - urea, uric acid, creatinine

Excretion of foreign substances - dugs

Homeostasis - body fluids, electrolytes and acid-base balance

Regulates blood pressure

Secretes hormones - erythropoietin, renin

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2
Q

What is the function of renal blood supply to kidneys

A

Provide oxygen and nutrients

Secretion of drugs

Reabsorption of different substances

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3
Q

Function of detrusor muscle

A

Contracts to build pressure in the urinary bladder support urination

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4
Q

Function of trigone

A

Stretching of this triangular region to its limit signals the brain about the need for urination

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5
Q

Function of internal sphincter

A

Involuntary control to prevent urination

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6
Q

Function of external sphincter

A

Voluntary control to prevent urination

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7
Q

Function of bulbourethral gland

A

Produces thick lubricant which is added to watery semen to promot sperm survival

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8
Q

What is the superficial to juxtamedullary nephron ratio

A

10:1

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9
Q

What is the difference between superficial nephron and juxtamedullary nephron

A

Superficial goes to outer medulla

Juxtamedullary goes to inner medulla

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10
Q

What is the function of juxtaglomerular apparatus

A

GFR regulation through tubulo-glomerular feedback mechanism

Renin secretion for regulating blood pressure

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11
Q

What are the different renal processes

A

Glomerular filtration

Reabsoprtion

Secretion

Excretion

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12
Q

What is the filtration barrier of the glomerulus

A

Highly permeable to fluids and small solutes

Impermeable to cells and proteins

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13
Q

What kind of process is golmerular filtration

A

Passive process - driven through semipermeabel golmerular capillaries into Bowman’s capsule

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14
Q

Hydrostatic pressure

A

Pushing

Fluid exerts this pressure

Solute and fluid molecules shoved out

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15
Q

Oncotic pressure

A

Pulling

Solutes exert this pressure

Fluid molecules drawn in

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16
Q

What is the net ultrafiltration pressure

A

Ultrafiltration pressure = Hydrostatic pressure (glomerular) - hydrostatic pressure (bowmans) - oncotic pressure of plasma proteins

17
Q

What is the Glomerular Filtration Rate

A

Amount of fluid filtered from glomeruli into Bowman’s capsule

Sum of filtration rate of all functioning nephrons

GFR = Pressure (ultrafiltration) x ultrafiltration coefficient (membrane permeability and surface area)

Fall in GFR can be renal disease, build up of excretory products in plasma

18
Q

What is the healthy GFR for male and femal

A

90-140 mL/min

80-125 mL/min

19
Q

What is the myogenic mechanism of regulation of GRF

A

Arterial pressure increases

Afferent arteriole stretches

Arteriole contracts

Vessel resistance rises

Blood flow reduces

GFR stays same

20
Q

What is the tubulo-glomerular feedback mechanism

A

Increase/Decrease in GFR

Increase/Decrease NaCl in Loop of Henle

Change detected by macula densa

Increased/Decreased ATP and adenosine discharged

Afferent arteriole constricts/dilates

GFR stabilizes

21
Q

What is renal clearance

A

The number of litres of plasma that are completely cleared of the substance per unit time

Only concerned with the excretory role played by the kidneys

22
Q

What is the renal clearance formula

A

C = (U X V) / P mL/min

U= concentration of substance in urine

V = rate of urine production

P = concentrstion of substance in plasma

23
Q

How can GFR be emasured by renal clearance

A

If a molecule is freely filtered and neither reabsrobed nor secreted

24
Q

What are molecules that are freely filtered

A

Inulin - plant polysaccharide, non toxic, not found in mammals so has to be transfsued

Creatinine - Waste product from creatien in muscle metabolism, creatinine released is fairly constant, small amount is secreted into nephron so not a perfect. molevule. Process for estimating creatinine in blood and urine can account for that

25
Q

What is renal plasma flow

A

Total amount of molecule entering kidney equals amount excreted, renal clearance of this molecule equals renal plasma flow

26
Q

What are examples of renal plasma flow

A

Para aminohippurate - all PAH is removed from the plasma passing through kidney through filtration and secretion

27
Q

What is the filtration fraction

A

Amount of plasma which is filtered which arrives via the afferent artriole

ranges from 0.15-0.20 15% of plasma

FF = GFR/RPF

28
Q

What are the different transport mechanisms of renal tubules

A

Passive Transport

Active Transport

Primary active

Secondary active/ coupled transport (movement of one solute along electrochemical gradient provides energy for other solute to move against it)

  • symport Na+ Glucose symporter
  • antiport Na+ H+ antiporter
29
Q

Reabosportion in the early proximal convoluted tubule Sodium and Bicarbonate

A

Sodium and Bicarbonate reabsorption

Using Na+ K+ ATPase Pump

Na+ H+ antiporter

Na+ HCO3- symporter

Angiotensin 2 regulates Na+ reabsorption by increasing Na+ H+ antiporters

30
Q

Reabsorption in the early proximal convoluted tubule glucose reabsorption

A

Glucose rebsorption

Na+ Glucose symporter SGLT2

Glucose transporter GLUT2

31
Q

Reabsorption in early proximal convoluted tubule substances

A

Substances reabsorbed: 67% Na+, 67% Cl-, 80% HCO3-, 100% Glucose, 67% water, 100% amino acids, 50% urea

Substances secreted: drugs, ammonia, bile salts, prostaglandins, vitamins

32
Q

Reabsorption in henle’s loop substances

A

25% Na, 25 Cl, 15 water

33
Q

Reabsorption in the early distal convoluted tubule

A

Na and Cl reabsoption

Active Ca reabsorption

Na+Ca antiporter

Ca ATPase pump

No water enter

34
Q

Reabsorption in distal DCT and Collecting duct

Principal cell

A

Na+ reabsorption and K secretion

Aldosterone regulates Na reabsorption by increase apical Na channels and basolateral NaK ATPase pumps

ADH regulates water reabsorption by increasing apical aquaporins

35
Q

Reabsorption in distal DCT and Collecting duct

Intercalated cell

A

Maintain acid-base balance

Alpha : HCO3 reabsorption and H secretion

Beta: HCO3 secretion and H reabsorption

36
Q
A

Urology and Renal Medicine (2 decks)

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