High Yield Renal content- Passmed Flashcards
Lymphatic drainage of bladder
Internal and external lymphatic node
Abnormal collagen synthesis in the glomerulus
Alpert Syndrome. This is a nephritic condition where there is genetic mutation in collagen synthesis.
Complement activation in the glomerulus
Post-streptococcal glomerulnephritis
Membranoproliferative glmerulonephritis
What condition is caused by impairment of the glomerular filtration barrier?
Nephrotic syndrome as protein leakage occurs due to gloemrular damage.
Parasympathetic innervation to bladder
Pelvic splanchnic nerve -
Sympathetic innervation to bladder
Hypogastric plexus.
Amyloidosis
Deposition of antibody light chains which is a nephrotic syndrome.
How does post-streptococcal glomerulnephritis affect the glomerulus?
Causes enlarged and hyper cellular glomeruli and complement activation of glomerulus. Associated with IgG, IgM.
Acute tubular necrosis-cause
Typically caused by drug damage such as from gentamycin. This causes brownn granular casts to form.
What causes formation of brown granular casts?
Acute tubular necrosis.
What is the proportion of men with raised PSA with prostatic cancer?
1/3
How can renal function or GFR be determined?
Insulin > Clearance
How can renal plasma levels be determined?
Paraaminohippurate clearance.
Effect of angiotensin II
Increases bradykinin levels and vasoconstriction of efferent arteriolae.
Diclofenac
NSAID which causes kidney damage.
Sterile pyruia
Urine shows high WBC but no other abnormal findings. This is due to urethritis as a result of STI.
IgA nephropathy
Causes mesanglial hypercellularity and occurs a few days after infection. Children are most commonly affected by this in nephritic syndrome.
Effect of muscle death on potassium levels
Potassium will be released and causes hyperkalemia.
MOA of Bicalutamide
Blocks androgen receptors.
What is a horseshoe kidney?
What is the venous drainage of the bladder in females?
Vesicouterine venous plexus.
What is the venous drainage of the bladder in males?
Vesicoprostatic venous plexus.
Effect of hypocalcaeimia
Perioral parasesthesiaa (pins and needles)
Cramps
Tetanus
Convulsions
What causes loss of potassium?
Vomiting and diarrhoea
What causes increased levels of prostate specific antigen?
Urine retention
BPH
Prostate cancer
How does diabetic nephropathy affect the kidneys?
Glomerulosclerosis and glycation
What ever do the renal arteries branch from the abdominal aorta?
L2
Effect of salbutamol on ion levels
Causes hypokalemia.
What is haemolytic uraemia?
Damage to the blood vessels that lads to thrombocytopenia, acute kidney injury and haemolytic anaemia
Level of left kidney
L1
Level of right kidney
L3
How does penicillin affect the kidneys?
Acute interstitial necrosis.
Which level do the renal arteries enter?
L1.
How does oncotic pressure change in the kidneys?
Increase in oncotic pressure in efferent arteriole than afferent arteriole, due to uptake of fluid in Bowman’s capsule.
What is the lining of the ascending loop of Henle?
Simple squamous epithelia. It takes up only Na+ and K+.
What is the epithelia of descending loop of Henle?
Simple squamous,s and it is permeable only to water.
What is the epithelia of the DCT?
Simple Cuboidal epithelia
What is the epithelia of PCT?
Simple cuboidal epithelia with microvilli
What is a measure of renal plasma flow?
Para-aminohippuric acid
What measures eGFR?
Creatinine or insulin
Insulin is filtered and NOT reabsorbed.
What is the role of the kidneys in bones?
Formation of calcitriol, 1,25 dehydroxecalciferol.
What does calcitriol form from?
Calcidiol 25, hydroxycholecalciferol
What is the blood supply to the juxtamedullary nephrons?
Vasa recta, a branch of the efferent. Juxtamedullary have long loops of Henle which penetrate deep into medulla.
What are the features of cortical nephrons?
They have short or NO loop of Henle, and blood supply is from Peritubular artery, a branch of the efferent arteriole.
Which transporter allows glucose to enter cell?
SGLT transporter
Which transporter allows glucose to leave the cell?
GLUT transporter
What is responsible for increasing osmolality in kidneys?
ADH, released from paraventricular and supraoptic nucleus that increases expression of aquaporin 2.
What is the effect of alcohol on kidney?
Reduces release of ADH, so increases urination.
How does albumin change in infection?
Decreased due to increased capillary permeability.
Which antigen is important for transplant?
HLA-DR
What are causes of sterile Pyuria?
Tuberculosis
Urethritis due to STI
What is nephrogenic diabetes insipidus?
X linked mutation of the vasopressin ADH receptor
What causes increased PSA?
Vigorous exercise
Urinary retention
UTI
Where do renal carcinomas occur?
PCT
Where does ectopic testes occur?
Femoral triangle
Superficial inguinal pouch
What is a sign of hyperkalemia on ECG?
Small/absent P waves
Bizarre sinusoidal QRS complex
Tall tented T waves
What causes membranous glomerulonephritis?
Anti-phospholipase A2 antibodies.
What is the treatment for minimal change disease?
Glucocorticoids like prednisone.
