Kidney anatomy

Question 1

What is found in glomerular filtrate?

Answer 1

water, glucose, AA’s, urea

Question 2

What are symptoms of nephrotic syndromes?

Answer 2

high levels of protein

low albumin

edema

hyperlipidemia

Question 3

What are symptoms of nephritic syndromes?

Answer 3

mild levels of protein

hematuria (blood in urine)

hypertension

blurred vision

azotemia (^ N+)

Oliguria (low urine output)

Question 4

What causes post-streptococcal glomerulonephritis

Answer 4

an autoimmune reaction caused 1-2weeks after Streptococcus infection

Question 5

what does post-streptococcal glomerulonephritis do

Answer 5

damages the filtration barrier (immune complexes deposited at glomerular membrane)

• leading to loss of protein/albumin in urine (nephritic syndrome symptoms)

Question 6

how is post-streptococcal glomerulonephritis treated

Answer 6

no treatment - symptom relief

antibiotics for remaining bacteria

blood pressure medicines

limit salt intake

usually goes away on its own

Question 7

structure of glomerular capillaries

Answer 7

fenestrated - high permeability to water & electrolytes

Question 8

What does mannitol do and how does it work?

Answer 8

used to decrease pressure - is poorly reabsorbed by kidney increasing osmotic pressure in glomerular filtrate decreasing H20 reabsorption

Question 9

when is mannitol used?

Answer 9

acute glaucoma

cerebral oedema (cant cross BBB)

forced diuresis

Question 10

How is diabetes potentially being treated?

Answer 10

SGLT2 inhibitors to prevent glucose reuptake in nephron

Sodium-glucose linked transporter

Question 11

what does Acetazolamide do?

Answer 11

suppresses H+ ions preventing Na+ pumps from reabsorbing lots of Na+ and therefore water

Question 12

what are side effects of acetazolamide?

Answer 12

increased HCO3- excretion - mildly alkaline urine,

metabolic acidosis

effect is self-limiting

Question 13

how does counter current multiplication work?

Answer 13

constant pumping of sodium from ascending limb a d establishing of equilibrium in descending limb leading high osmolarity in loop of Henle and 200 difference maintained

Question 14

what does Furosemide (loop diuretic) do?

Answer 14

inhibit Na+/K+/2CL- co transporter

causes increased osmotic pressure in distal tubule filtrate (decrease H20 reabsorption

Question 15

What does hydrochlorothiazide do?

Answer 15

black Na+/Ca+ co-transporter - decreases water reabsorption

is self limiting

Question 16

how is hydrochlorothiazide self limited?

Answer 16

decrease blood volume -> renine secretion -> angiotensin and aldosterone secretion -> limited thiazide effect

Question 17

How does ADH work?

Answer 17

increases water permeability of the cortical and medullary collecting ducts - increased amount of aquaporins

Question 18

where is ADH released from and how is it regulated?

Answer 18

pituitary gland - supraoptic & paraventricular nuclei

ECF ^ osmolarity detected = increased signals to pituitary glands = increased ADH secretion

Question 19

what are the 2 types of diabetes insipidus

Answer 19

pituitary (central) - reduced ADH release of pituitary gland

Nephrogenic (peripheral) - kidney unresponsive to ADH

Question 20

How do K+ sparing diuretics work? (eg Triamterene Amiloride)

Answer 20

block epithelial Na+ channel (ENaC), collecting tubules/ducts

Question 21

How does aldosterone influence Na+ reabsorption

Answer 21

increases ENaC opening & promotes DNA transcription = ^ ENaC & Na+, K+ synthesis

Question 22

What hormones does the kidney produce?

Answer 22

EPO, Vitamin D synthesis process

Question 23

How is EPO synthesised?

Answer 23

Reduced O2 detected, Hypoxia inducible factor, increased EPO transcription

Question 24

When is EPO used medically

Answer 24

renal failure, cancer (replenish red blood cells)