Kidney Flashcards

1
Q

Describe the first part of filtration, which happens in a ____

A

Nephron, blood moves into kidney from renal artery into the glomerulus (ball of capillaries), this forces ions , glucose, amino acids into the Bowman’s capsule, a surrounding collecting duct

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2
Q

Describe path of filtration post glomerulus

A

fluid moves through proximal convoluted tubule into renal cortex, where most solutes are re-absorbed via simple osmosis and diffusion

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3
Q

what two structures make up the loop of Henle

A

Ascending and descending, into the renal medulla

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4
Q

Fluid enters loop of Henle through ___ limb, into ___ Na+ conc, which causes __

A

Descending, into high Na+ so it looses more and more water

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5
Q

The second part of the loop of Henle, the fluid (with a ___ conc), moves up the ___ limb, where ____

A

high Na+ conc. (lost water in descending limb), ascending, Na+ in high conc. inside the ascending limb diffuses out, then is actively pumped out at the top - causing the high external Na+ in the first place

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6
Q

The name of exchange in the loop of Henle

A

Counter-current exchange

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7
Q

What hormone controls the final conc. of urine in the collecting duct, and where is it secreted

A

Antidiuretic Hormone (ADH), secreted in the posterior pituitary gland

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8
Q

What does ADH do

A

Anti-diuretic, ant-urine, helps to increase reabsorption to retain more water, raise the blood pressure

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9
Q

How does ADH work

A

increase’s the nephron’s permeability to water to allow more water to be reabsorbed

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10
Q

what condition can cause symptoms similar to another because it blocks ADH secretion?

A

Diabetes insipidus > tumour/injury to pituitary, no ADH means less water reabsorbed, more frequent urination, presents like diabetes

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11
Q

What begins the renin-angiotensin system

A

JGA (juxta-glomerular apparatus), cluster of cells around glomerulus that release renin if BP drops

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12
Q

Describe the renin-angiotensin pathway up to AT2

A

Renin converts angiotensinogen to angiotensin 1
ACE catalyses angiotensin 1 > angiotensin 2

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13
Q

What does the renin-angiotensin system do?

A

increases blood pressure through reabsorption and vasoconstriction

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14
Q

How does angiotensin 2 work

A

Stimulates adrenal gland to produce aldosterone, which acts on kidneys to reabsorb Na+ and lose K+
Direct act on vessel to vasoconstrict

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15
Q

Signs of kidney dysfunction

A

Changes in urine, dark urine, proteinuria (proteins in urine), Haematuria (blood in urine), fluid retention, sodium/potassium imbalance

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16
Q

What are the 3 classifications for acute kidney injury

A

Pre-renal
Intra-Renal
Post-renal

17
Q

What are some pre-renal causes of acute kidney injury?

A

(issue getting things to the kidney)
dehydration, low BP (trauma, shock), heart failure

18
Q

What are some intra-renal causes of acute kidney injury?

A

(issues inside the kidney)
inflammation, embolism, nephron scarring/damage

19
Q

What are some post-renal causes of acute kidney injury?

A

Obstruction, kidney stones

20
Q

How to manage acute kidney injury?

A

Blood tests to check function, measure urine output (will be around .5mL/kg/hr), manage fluid balance carefully

21
Q

Associations of chronic kidney injury

A

atherosclerosis, diabetes, hypertension, systemic lupus, rental stones, heart failure

22
Q

investigations for chronic kidney injury

A

BP checks, dipping urine for blood/glucose/proteins, testing for blood creatinine levels, imaging

23
Q

Which drugs should be avoided in chronic kidney disease

A

NSAIDs, PPIs, cholesterol medications, metformin

24
Q

What is an AV fistula and when is it used

A

Artery-Vein fistula (fuse them together), used in dialysis when a higher volume of blood is needed

25
Q

3 main complications of chronic kidney disease

A
  • Anaemia
    EPO produced by kidney stimulates proliferation of stem cells in bone marrow to mature RBCs
  • Bleeding risk
    Causes abnormal platelet function
  • Calcium and Bone metabolism
    Vit D3, needed for Ca absorption, is converted into active form in kidney
26
Q

3 main complications of chronic kidney disease

A
  • Anaemia
    EPO produced by kidney stimulates proliferation of stem cells in bone marrow to mature RBCs
  • Bleeding risk
    Causes abnormal platelet function
  • Calcium and Bone metabolism
    Vit D3, needed for Ca absorption, is converted into active form in kidney
27
Q

Name 4 types of Diuretic medications

A
  • Thiazides
  • Loop diuretics (used in heart failure, inhibits Na/K resorption in loop of Henle
  • K-sparring diuretics
  • Osmotic diuretics
28
Q

What is SIADH?

A

Syndrome of Inappropriate Antidiuretic Hormone
basically the opposite to diabetes insipidus, the body produces too much ADH and retains water