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MRCS > GU anatomy/ physiology > Flashcards

GU anatomy/ physiology Flashcards

1
Q

Function of mesangial cells

A

-remove residues/ proteins to keep filtrate free of debris

-produce interleukin 1/ platelet derive growth factor (respond to local injury)

-can contract to affect the GFR

-helps form capillary loops in the glomerulus during development

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2
Q

How do the following affect the afferent/ efferent arterioles:
-angiotensin II
-sympathetic stimulation

A

-angiotensin II= contraction of EFFERENT arterioles= increased filtration pressure= increased GFR
OR
-angiotensin II= contraction of mesangial cells= reduced surface area for filtration= reduced GFR

-sympathetic stimulation= contraction of AFFERENT arterioles= reduced GFR

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3
Q

In acute renal failure what part of the nephron is most likely to be damaged

A

proximal tubule

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4
Q

Where is renin produced/ stored/ secreted

A

Juxtaglomerular apparatus

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5
Q

Where is erythropoietin produced

A

interstitial fibroblasts

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6
Q

what are the types of shock

A

hypovolaemic
cardiogenic
distributive
obstuctive

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7
Q

What are the subtypes of distributive shock

A

neurogenic
septic
anaphylactic

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8
Q

Describe the pathophysiology of distributive shock

A

anything that causes SYSTEMIC VASODILATION –> reduced tissue perfusion –> hypoxia–> acidosis–> cell death

causes:

Infection –> pathogens release toxins–> cytokine release –> inflammation/ vasodilation/ leaky capillaries

damage to spinal cord/ brain injury/ SAH–> dysfunction between para/ sympathetic NS –> cause vasodilation

allergen–> triggers IgE–> IgE binds to mast cells + basophils–> these cells release histamines–> trigger vasodilation + leaky capillaries

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9
Q

ionotropes vs vasopressors difference?

A

ionotropes= increase cardiac contractility (dopamine/ dobutamine/ adrenaline)

vasopressors= increase vasoconstriction (norad/ vasopressin)

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10
Q

Which part of the kidney gets greater blood flow: cortex/ medulla

A

CORTEX

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11
Q

What structure ensures the testes reach the scrotum

A

The gubernaculum

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12
Q

Describe the journey of the testes from the abdomen to the scrotum

A

Starts in the abdomen [lumbar region]

1st phase=abdo–> internal inguinal ring
[gubernaculum shortens + thickens]

2nd phase= through inguinal canal–> scrotum
[triggered by androgens–> gubernaculum grows + differentiates]

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13
Q

What embryological structure forms the penis/ clitoris

A

Genital tubercle

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14
Q

Match the carcinogens/ jobs to the cancer

-painter/ printer [benzopyrene]
-peanut farmer [aflatoxin]
-miner [chromium/ asbestos/ nickel]
-dye worker [beta-naphthylamine]

A

-painter/ printer [benzopyrene]= LUNG

-peanut farmer [aflatoxin]= HCC

-miner [chromium/ asbestos/ nickel]= LUNG

-dye worker [beta-naphthylamine]= BLADDER TCC

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15
Q

What structures form from the mesonephric ducts

A

mesonephric= wolffian ducts

in men= tubular system of genito-urinary
epididymis
seminal vesicles
vas deferens
ejaculatory duct
ureters
renal pelvis
calyces
collecting ducts

in women= only tubular system of urinary
ureters
renal pelvis
calyces
collecting ducts

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16
Q

What structure does the prostate form from

A

urogenital sinus

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17
Q

How do the paramesonephric ducts regress in men

A

Sertoli cells secrete Mullerian Inhibitory substance (MIS) that causes regression of the Mullerian ducts

18
Q

What structures do the urogenital folds and labioscrotal swellings give rise to

A

urogenital folds = labia MINORA/ ventral aspect of penis

labioscrotal swellings = labia MAJORA/ scrotum

19
Q

What is difference in the effect of PTH on phosphate in the kidneys and the GI tract

A

proximal tubule= PTH INHIBITS phosphate reabsorption

GI tract= PTH enhances phosphate uptake from intestines (and bones)into blood

20
Q

Syndromes associated with RCC

A

VON-hipple-lindau
birt-hob-dube syndrome

21
Q

Syndrome associated with testicular cancer

A

klinefelters (XXY)

22
Q

What causes Klinefelters syndrome

A

They have a karyotype of XXY

hence less testosterone

hence leads to symptoms of:
-smaller penis
-undescended testes
-gynaecomastia
-testicular failure
-infertility
-osteoporosis/ penia

can also have neuro probs:
-anxiety/ depresssion
-ADHD
-autism spectrum
-behavioural prbs

23
Q

How are testicular tumours broadly classified

A

Germ cell / Non-germ cell tumours

24
Q

How are Germ cell tumours classified

A

Seminomas / Non-seminomas

25
Q

What are the types of non-germ cell tumours

A

Leydig cell tumours
Sertoli cell tumours

26
Q

What are the types on non-seminomas

A

-choriocarcinoma
-embryonal cell carcinoma
-yolk sac carcinoma
-teratoma

27
Q

Which has the better prognosis/ no mets at presentation from germ cell tumours

A

seminomas compared to non-seminoma

28
Q

Which testicular tumours have raised LDH and beta-HCG

A

SEMINOMA

29
Q

What tumours markers are raised in non-seminomas

A

beta-HCG
AFP
LDH

30
Q

What hormones do non-germ cell tumours secrete

A

leydig= androgens
sertoli= oestrogens

31
Q

What is the staging system for testicular cancers

A

Royal marsden:

1= confined to testes
2= lymph nodes below diaphragm
3= lymph nodes above diaphragm
4=extra lymph node mets

32
Q

What are the most common chromosome abnormalities related to bladder cancer

A

deletion of chromosome 9

also:
-alterations of tumour suppressor genes p53/ Rb

33
Q

testicular tumour risk factors

A

-undescended testes
-post torsion (ipsi + contralateral sides)
-FHx*
-caucasian
-prev testicular ca
-Klinefelters

*dad= 4x, brother= 9x greater risk

34
Q

what structures does the cloaca develop into in males/ females

A

forms the urogenital sinus and anal canal

urogenital sinus becomes:
males= bladder(except trigone), urethra, genital tubercle (becomes penis), prostate, bulbourethral glands

females= vestibule (receives vagina + urethra)

35
Q

What is the function of bulbourethra glands and where are the located

A

function= secrete lubrication + PSA

Location= inferior to prostate, posterolateral to membranous urethra

36
Q

Equivalent of bulbourethral glands in women

A

bartholins glands (found either side of vaginal opening)

37
Q

hyperplasia vs hypertrophy

A

hyperplasia= increase in NUMBER of cells

hypertrophy= increase in SIZE of cells

38
Q

metaplasia vs dysplasia

A

metaplasia= change from one cell type to another

dysplasia= change into an abnormal version of itself (reversible- can become neoplastic )

39
Q

Which type of renal calculi form in:

acidic
alkaline
urine

A

Acidic= urate/ cystine stones

alkaline= staghorn (struvite) calculi

40
Q

Intake of what increases risk of forming oxalate calculi

A

chocolate, spinach, tea, rhubarb= increases oxalate levels

MRCS (22 decks)

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