Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

4th Yr - CMS 1 > Kidneys > Flashcards

Kidneys Flashcards

You may prefer our related Brainscape-certified flashcards:
Introductory Sommelier Exam (CMS) flashcards
1
Q

where do kidneys sit in the body?

A

back of the peritoneal cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

where do the kidneys get their blood supply from?

A

from renal arteries which get there blood directly from aorta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how much CO do our kidneys take?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

can we increase or decrease the blood flow to our kidneys ?

A

NO - only when kidney is diseased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

how is blood flow to kidneys maintained?

A

by reducing blood flow to certain areas eg. if you’re in shock u will get pale and clammy extremities = peripheral resistance increasing in order to keep as much BP as possible in ur central vessels ie. aorta and venal arteries to allow kidneys to be perfused with blood that contains 02 and nutrients whilst skin and peripheral muscle can go couple hrs without too much blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

how much blood do the kidneys filter out a day?

A

1500L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is a nephron?

A

small working unit of the kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

describe the journey of the blood that comes from the renal artery to the kidneys

A
  • renal artery divides into smaller arterioles
  • the smallest arterioles feed into glomerulus (filters small molecules and water out of blood and keeps bigger molecules like proteins inside the blood)
  • there’s a high vol of fluid leaving glomerulus going into proximal convoluted tubule (high vol of dilute liquid)
  • then passes thru descending limb of loupe of henle and then ascending loupe
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is the loupe of henle ?

A

-counter current multiplier
-osmotic gradient is generated here which allows the vol of water and concentration of salts to be decided an adjusted

-from acceding loupe of henle the urine goes into distal convoluted tubule and then into collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is special about the descending loop?

A
  • walls are permeable to water only
  • water diffuses out passively
  • fluid on LOH becomes more hypertonic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what blood vessel is surrounding the LOH?

A

vasa recta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is special about ascending LOH?

A
  • walls stop being permeable to water
  • walls permeable to NaCl
  • NaCl leaks out and goes back into blood
  • fluid becomes more concentrated
  • water and salt reabsorbed back into blood
    THIS IS COUNTER CURRENT MULTIPLIER
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is passively reabsorbed in the nephron?

A

water is reabsorbed down an osmotic gradient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what is passively secreted in nephron ?

A

NH4 is passively secreted from cells in the lining of the LOH into the urine down a concentration grad

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is actively secreted in nephron?

A

drugs (penicillin), h+, energy dependant process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is actively reabsoped in the nephron?

A

glucose, lactate, energy dependant process
ur body needs these

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

where does the final concentration of urine happen ?

A

collecting duct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which hormone controls the final concentration of urine?

A

ADH secreted by pituitary
cells in pituitary can detect BP and blood osmolarity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the relationship between BP and blood osmolarity?

A

When there is a large intake of NaCl in less amount of water, our body detects high osmolarity that result in a higher amount of pressure of blood flow in the arteries.
- don’t want to produce too much urine
- adh which stimulate reabsorption of water
- produces decrease urine output and increases BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is diabetes incites ?

A
  • very dilute urine has no sugar in it
  • caused by injury or tumours in pituarty therefore bale to secret ADH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is diabetes mellitus ?

A

increase thirst and dry mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is JGA?

A
  • juxta glomelular apparatus
  • cells in glomerulus
  • they can sense changes BP and changes in urine concentration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is renin?

A
  • enzyme that converts angiotensinogen (from liver) to angiotensin 1
  • both are inactive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what happens when the JGA detect drop in BP or increase in urine concentration

A

will release renin

25
Q

what happens when angiotensin 1 is in circulation and gets converted by ACE

A

gets converted to angiotensin 2 (active ) which causes vasoconstriction = ^ BP and ^ in peripheral resistance

angiotensin 2 can act on adrenal glands which produce aldosterone which increases water and Na retention so = concentrated urine to maintain BP

26
Q

what are some signs and symptoms of kidney dysfunction?

A
27
Q

what is pitting oedema ?

A

fluid retention in ankles and feet due to sitting or standing for too long
- if u press onto area indentation will stay there = can be associated with heart failure or kidney failure

28
Q

what is acute kidney injury?

A
  • common
  • can be caused by shock dehydration or blood loss or elderly or prexisitng heart or kidney disease
29
Q

what can happen if u have AKI?

A

decrease in urine output
decrease in secretory function (can’t excrete protein or urea)
impaired Na/K balance

30
Q

what are the 3 causes of AKI?

A

pre renal
intra renal
post renal

31
Q

what can pre renal be due to ?

A

dehydration, low BP (myocardial event or blood loss due to trauma) and heart failure

32
Q

what can intra renal be due to ?

A

inflammation (if there’s load of inflammatory products in blood and they get clogged in filter in glomerlours) or , embolism clots from aorta to kidney can stop perfusion causing scarring and damage to nephron

33
Q

what can post renal be due to?

A

obstruction and stones
- if flow of urine from kidneys gets blocked in urethra and bladder by stones or cancers or scarring from previous surgery can prevent kidney from working

34
Q

how do we manage AKI?

A

urine tests

35
Q

which do we see more in clinics AKI or CKD?

A

CKD

36
Q

what is CKD?

A
  • if AKI isn’t treated or managed
  • can be due to athersclorsis, diabetes (microvascular) , hypertension, SLE, scleroderma( affects everything) and renal stones
  • rest in pic
37
Q

how do we investigate CKD?

A
38
Q

how do we manage CKD

A
39
Q

why do we do renal dialysis?

A

if the ideas progresses
kidneys don’t work properly

40
Q

what is dialysis?

A
  • take blood out and do what glomerlaus can’t do ie filter blood, adjusting salt and fluid and then putting blood back in
  • this is long process (2-3 times a week) and hard for peripheral vessels so surgeons produce AV fistula = short cut of artery and vein in arm or peritoneal dialysis (pass fluid into peritoneal membrane allows passive exchange of water and salts )
41
Q

if both dialysis methods don’t work what do we do?

A
  • renal transplant only if donor found
  • transplant put near pelvis an lower abdomen not always where kidneys were as its difficult to access
  • artery vein and uretera can be connected to this transplant to produce urine
42
Q

what is tissue typing ?

A
  • when ur having a transplant from someone u need to know if its been tissue typed so there’s no rejection
43
Q

who can be a donor?

A

someone who’s died suddenly or left brain dead in intensive care

44
Q

what do pts who have had a transplant need to prevent rejection ?

A
  • immunosuppressants to prevent infections and cancers
  • they also need follow ups
45
Q

what are the complications of kidney diseases

A
  • anemia
  • bleeding risk
  • Ca and bone metabolism
46
Q

what is erythropoietin? (EPO)

A

hormone produced by kidneys
stimulates in bone marrow proliferation of stem cells and maturation into RBC

47
Q

what happens when you have less EPO due to kidney disease?

A

anemeia

48
Q

why do ppl with kidney disease have bleeding risk complications?

A

abnormal platelet formation, abnormal platelet and vessel wall interaction (virchows triad), anticoagulation for dialysis

  • increases risk of bleeding after surgery and extractions = need to be aware of this and manage
49
Q

why do ppl with kidney disease have Ca and bone metabolism complications ?

A
  • parathormone released from pituitary gland and mobilises osteoclasts
  • its normally secreted in response to low Ca levels
  • it sets off to bind to osteoclasts and tells them to moblises bone to get as much Ca as they can
  • this increases bone turnover = causes renal osteodystrophy and giant cell lesions (clumps of osteoclasts and giant cells in jaw = burry hole sin bones present as cysts and tumours and these are hormone driven so if we don’t address parathormone and ca levels these can keep on growing
50
Q

what are the drugs that act on the kidney ?

A
51
Q

how do thiazide diuretics (bendroflumethiazide) work?

A
  • used in heart failure and high BP
    -inhibits Na resorption in distal tubule therefore preventing full osmotic gradient therefore kidney is less Able to resorb water and u get increased urine vol
52
Q

what is a downside to thiazide diuretics?

A
  • increased counter transport of K
  • causes low K in blood = affects atriofibrillation
53
Q

how do loop diuretics work?

A
  • used on heart failure and high BP
  • inhibit Na/K reabsorption in ascending LOH
  • can cause hypokalemai and hypnatraimea (low sodium)
54
Q

what supplements do some pts need fro hypokalaemia ?

A

k supplements

55
Q

how do K sparing diuretics?

A

inhibit aldosterone dependent Na reabsorption in distal nephron which reduces negative potential in lumen and causes decrease secretion of K therefore we get increased K levels

56
Q

how do osmotic diuretics work?

A

large molecules which get filtered in glomerulus, too large to be reabsopred and therefore stays in LOH they cause osmotic potential in lumen which leads to reduced water reabsorption

  • used in surgery (mantatol) to manage urine
57
Q

what do we need to know about pts who take diuretics?

A
  • need to go to the loo
58
Q

what do we need to know about pts who have kidney disease

A

4th Yr - CMS 1 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions