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GI cancers > hard questiosn urinary > Flashcards

hard questiosn urinary Flashcards

1
Q

units of osmolarity

A

osm/l

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2
Q

how is countercurrent multiplication achieved

A

active salt resorption in thick limb, passive water reabsorption in decending loop

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3
Q

where is uta2

A

thing descending limb

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4
Q

2 pruposes of urea recycling

A

less water wasted

allows urine concentratio n

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5
Q

stimulatory factos for vasopressin

A

neausea
osmolarity up, bp down
angiotensin 2
nicotine

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6
Q

inhibitory factors for vasopressin

A

low osmolarity, bp up
anp
ethanol

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7
Q

mechanism of adh action

A

binds to v2 on collecting duct
g protein signalling
protein kinase a
aquaporins to membrae

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8
Q

what transporters are present in the dct

A

na/cl co
na/k atpase
na/ca

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9
Q

principal cell transporters

A

enac

na/k atpase

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10
Q

effects of adh on channels

A 
increase aps 
uta1 and uta3 
triple transpoter
na/cl 
enac
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11
Q

how is siadh treated

A

vaptans

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12
Q

outline how the kidsney produces new hco3

A

glutamine - 2hco3
2 nh4
out as nh3 or as nh4 via na/h transporter

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13
Q

what is the role of phospahte in the dct

A

allows h to be neutralised without wasting hco3

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14
Q

what is the henderson hesselbach equation

A

[h+] = (24 x pCO 2)/ [HCO3]

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15
Q

What suppresses salt intake

A

glutamate and serotonin in the lateral parabrachial nucleus

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16
Q

how does the relationship betwwen rpf and gfr plateau

A

high tubular sodium, increased na/cl uptake
adenosine released from macula densa
detected by extraglomerular mesangial cells
less renin
afferent smc contact

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17
Q

role of the b1 sympathetics

A

increase na uptake
stimulate renin from juxtaglomerular cells
contract afferent arteriole

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18
Q

how is renin stimulated

A

less firing from juxtaglomerular cells

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19
Q

what is anp

A

a vasodilator

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20
Q

how does aldosterone work

A 
binds to mineralocorticoid receptor 
hsp90 dissociates 
dimeriss 
into nucleus 
transcription
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21
Q

3 effects of aldosteroen

A

h out
na/k
enac

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22
Q

symptoms oh hypoaldosteronism

A

syncope
low bp
salt cravings
palpitation

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23
Q

symptoms of hyperaldosteronism

A

hypertension
muscle weaknes
polyuria
thirst

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24
Q

3 low pressure receptors

A

atria
right ventricles
pulmoary vasculature

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25
Q

3 high pressure receptors

A

carotid sinus
aortic arch
juxtaglomerular apperatus

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26
Q

where does anp bind

A

guanalyl cyclase

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27
Q

4 effects of anp

A 
less na in 
lower renin etc 
less b1 activity 
lower bp 
vasodilates
28
Q

how does insulin cause k uptake

A

na/h stimulation

29
Q

how do cillia on dct help k leave

A 
increase flow 
stimulate pdk 1
caclium in 
turns on k channel
k out
30
Q

syndrome of hypokalaemia

A

gitelmans synrome

31
Q

symtoms of reduced sodium secretion

A

oedema
pulmonary odema
hypertension

32
Q

how does acidosis cause weakness

A

casues catabolism nad anorexia

33
Q

what causes hyperkalaemia

A

less dct secretion

acidosis (h in k out)

34
Q

symotoms of hyperkalaemia

A

diarrhoea
vomiting
weakness

35
Q

ecg changes in hyperkalaemia

A 
tented t waves 
arrythmia 
ventriculat tachycardia / fib
asystole 
o waves broaden 
qrs broadens
36
Q

how can renal failure increase risk of cvd

A

hyperparathyroidsim as less 1- alpha hydrox.
also phosphate retention
3 hyperparathyroidism

37
Q

how is hyperkalaemia treated acutely

A

nahco3
insulin dextrose
k sequesterants

38
Q

ways of tensting kidney function

A

creatinine trend with egfr

39
Q

how is ckd classified

A

proteinuria (<3, 3-30, 30)
gfr

albumin creatinine ratio

40
Q

where is access needed for dialysis

A

arteriovenouos fistula

central venous line

41
Q

what is done to match kidney

A

hla
bloods
serum match

42
Q

risk factors for kidney cancer

A

dialysis
cancer
smoking (transitional cell)
radiotherapy

43
Q

features seen with plapable kiney mass

A

wiehgt loss
polycythemia
anaemia

44
Q

tests for painless visable haematuria

A

history
renal function
flex cyst

45
Q

imaging for suspected renal cancer

A

ct renal
ct chest
bone scan

46
Q

how is kidney cance rstaged

A

t1 less than 7cm
t2 greater than 7 cm
t3 insude perinephritic fat

47
Q

if unfit for kiney surgery what si given

A

cryotherapy

48
Q

chemo for metastatic kidney cnacer

A

immunotherapy and tyrosine kinase inhibotors

49
Q

bladdeer: investigations for painless visable haematuria

A

ct urogram
renal function
flex yst

50
Q

risk factors for kiney cancer

A

smoking
schistomoniasis
catherterisation
radiotherapy

51
Q

how is kidney cnacer staged

A 
ta - papillary 
tis - in situ
t1 - subepithelial connective tidsue
t2 - muscularis propria
t3 in perivesicular fat 
t4 distal
52
Q

management for non invasive bladder cancer

A

bcg

intravesicular chemo

53
Q

what is bcg

A

i mmunological agnt preventing recurrence

54
Q

how is prostate cncer diagnosed

A

psa and mri

then cystoscopy and biopsy to stage

55
Q

how is prostate cance staged

A 
t1 a less 5%
b more 5 %
c found after raised psa 
t2
a 1/2 of 1/2
b full half 
c whole

t3a - broken capsule
b - in semenal vesicle

56
Q

surgery for stress incontinance

A

colposuspension
fascial sling
periurethral bulking

57
Q

risk factors for overactive bladder

A 
caffeine 
drugs 
bmi 
ibs 
prolapse
58
Q

when investigasitng overactive bladder what must be first ruled out

A

enlarged prostate/prolapse

59
Q

drugs for overactive bladder

A

antimuscarinics
b3 agonists
botox

60
Q

how is oveactive bladder surgically treated

A

augmentation cystoplasty

urinaet diversion

61
Q

causes of continuous incontinance

A

vesicovaginal fistulae

ectooic ureter

62
Q

what imaging is doen for bph

A

uss

63
Q

what is done in bph to rule out cance r

A

flex cyst

64
Q

why are alpoha blockers given in bph

A

relax neck of bladder

65
Q

why are 5 alpha reductase inhibitors given

A

stop dheas

GI cancers (18 decks)

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