GU anatomy/ physiology Flashcards
Function of mesangial cells
-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
How do the following affect the afferent/ efferent arterioles:
-angiotensin II
-sympathetic stimulation
-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
In acute renal failure what part of the nephron is most likely to be damaged
proximal tubule
Where is renin produced/ stored/ secreted
Juxtaglomerular apparatus
Where is erythropoietin produced
interstitial fibroblasts
what are the types of shock
hypovolaemic
cardiogenic
distributive
obstuctive
What are the subtypes of distributive shock
neurogenic
septic
anaphylactic
Describe the pathophysiology of distributive shock
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
ionotropes vs vasopressors difference?
ionotropes= increase cardiac contractility (dopamine/ dobutamine/ adrenaline)
vasopressors= increase vasoconstriction (norad/ vasopressin)
Which part of the kidney gets greater blood flow: cortex/ medulla
CORTEX
What structure ensures the testes reach the scrotum
The gubernaculum
Describe the journey of the testes from the abdomen to the scrotum
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]
What embryological structure forms the penis/ clitoris
Genital tubercle
Match the carcinogens/ jobs to the cancer
-painter/ printer [benzopyrene]
-peanut farmer [aflatoxin]
-miner [chromium/ asbestos/ nickel]
-dye worker [beta-naphthylamine]
-painter/ printer [benzopyrene]= LUNG
-peanut farmer [aflatoxin]= HCC
-miner [chromium/ asbestos/ nickel]= LUNG
-dye worker [beta-naphthylamine]= BLADDER TCC
What structures form from the mesonephric ducts
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
What structure does the prostate form from
urogenital sinus
How do the paramesonephric ducts regress in men
Sertoli cells secrete Mullerian Inhibitory substance (MIS) that causes regression of the Mullerian ducts
What structures do the urogenital folds and labioscrotal swellings give rise to
urogenital folds = labia MINORA/ ventral aspect of penis
labioscrotal swellings = labia MAJORA/ scrotum
What is difference in the effect of PTH on phosphate in the kidneys and the GI tract
proximal tubule= PTH INHIBITS phosphate reabsorption
GI tract= PTH enhances phosphate uptake from intestines (and bones)into blood
Syndromes associated with RCC
VON-hipple-lindau
birt-hob-dube syndrome
Syndrome associated with testicular cancer
klinefelters (XXY)
What causes Klinefelters syndrome
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
How are testicular tumours broadly classified
Germ cell / Non-germ cell tumours
How are Germ cell tumours classified
Seminomas / Non-seminomas
What are the types of non-germ cell tumours
Leydig cell tumours
Sertoli cell tumours
What are the types on non-seminomas
-choriocarcinoma
-embryonal cell carcinoma
-yolk sac carcinoma
-teratoma
Which has the better prognosis/ no mets at presentation from germ cell tumours
seminomas compared to non-seminoma
Which testicular tumours have raised LDH and beta-HCG
SEMINOMA
What tumours markers are raised in non-seminomas
beta-HCG
AFP
LDH
What hormones do non-germ cell tumours secrete
leydig= androgens
sertoli= oestrogens
What is the staging system for testicular cancers
Royal marsden:
1= confined to testes
2= lymph nodes below diaphragm
3= lymph nodes above diaphragm
4=extra lymph node mets
What are the most common chromosome abnormalities related to bladder cancer
deletion of chromosome 9
also:
-alterations of tumour suppressor genes p53/ Rb
testicular tumour risk factors
-undescended testes
-post torsion (ipsi + contralateral sides)
-FHx*
-caucasian
-prev testicular ca
-Klinefelters
*dad= 4x, brother= 9x greater risk
what structures does the cloaca develop into in males/ females
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)
What is the function of bulbourethra glands and where are the located
function= secrete lubrication + PSA
Location= inferior to prostate, posterolateral to membranous urethra
Equivalent of bulbourethral glands in women
bartholins glands (found either side of vaginal opening)
hyperplasia vs hypertrophy
hyperplasia= increase in NUMBER of cells
hypertrophy= increase in SIZE of cells
metaplasia vs dysplasia
metaplasia= change from one cell type to another
dysplasia= change into an abnormal version of itself (reversible- can become neoplastic )
Which type of renal calculi form in:
acidic
alkaline
urine
Acidic= urate/ cystine stones
alkaline= staghorn (struvite) calculi
Intake of what increases risk of forming oxalate calculi
chocolate, spinach, tea, rhubarb= increases oxalate levels
