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Renal > Mixture > Flashcards

Mixture Flashcards

1
Q

What is the role of a nephron?

A

Filtering unit

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2
Q

Which structure is damaged in nephrotic syndrome?

A

Epithelial foot process

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3
Q

In nephrotic syndrome what 3 problems occur?

A

Proteinuria
Hypoalbuminaemia
Oedema

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4
Q

How is blood pressure controlled in kidneys?

A

Renin secretion:

  • Salt/water retention
  • converts angiotensinogen to angiotensin I
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5
Q

How is urine formed?

A

Capillary hydrostatic pressure forces water/salts of plasma across to GBM (glomerular basement membrane)

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6
Q

Name 3 factors affecting filtration rate across GBM?

A

1) molecular weight
2) hudrostatic pressure in afferent arteriole
3) surface charge (GBM = -ve)

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7
Q

Which 3 things should you not find in urine of healthy person?

A

1) protein
2) glucose
3) amino acids

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8
Q

What is method to adapt urine concentration called?

Where in kidney does this occur?

A

Counter current mechanism

Medulla

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9
Q

What is the function of proximal convoluted tubule?

A

Recovers 70% glomerular filtrate

Recovers and generates bicarbonate secretion

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10
Q

What enzyme does acetazolamide inhibit?

What process is dependent on this enzyme?

A

Carbonic anhydrase

Reabsorption of bicarbonate

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11
Q

What happens at the ascending limb of henle?

A

Uptake of Na, 2Cl, K, H2O

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12
Q

Where is the site of loop diuretics?

What do they do?

A

Ascending limb of henle

Reduce Na, K, Cl, H2O

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13
Q

What happens at distal tubule?

A

Reabsorption of Na with Cl (co-transport mechanism)

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14
Q

Which type of diuretics act in distal tubule?

A

Thiazide diuretics

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15
Q

What gets reabsorbed in cortical collecting duct?

What controls this?

A

Na (with H2O and Cl) in exchange for K

Aldosterone

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16
Q

What is spironalactone?

What is the risk with this drug?

A

Aldosterone antagonist

Hyperkalaemia

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17
Q

Where is the site of urinary concentration?

What hormone acts here to control water reabsorption?

A

Medullary collecting duct

Anti diuretic hormone (ADH)

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18
Q

How does diabetes insipidus affect ADH?

A

Failure to secrete ADH

Peripheral resistance to ADH

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19
Q

What is furosemide?

A

Loop diuretic

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20
Q

What stimulates erythropoietin?

A

Hypoxia (low O2)

21
Q

What vitamin is activated by kidneys?

What does it increase absorption of?

A

Vitamin D

Calcium

22
Q

What is a secondary problem of decreased vitamin D levels in kidney?

A

Renal osteodystrophy:
decreased vit D –> decreased Ca –> stimulation of parathyroid hormone –> secondary hyperparathyroidism –> bone disease (renal osteodystrophy)

23
Q 
What is a normal range of kidney function from the following:
50-80mls/min/1.73^2
80-100mls/min/1.73^2
100-120mls/min/1.73^2
120-150mls/min/1.73^2
A

100-120mls/min/1.73^2

24
Q

Name two ways to measure kidney function exactly?

A

1) Inject radioactive tracer - Technetium (Tc^99)

2) Creatinine clearance

25
Q

What 4 variables are needed to work out eGFR?

A

1) Age
2) Sex
3) Ethnicity
4) Serum creatinine

26
Q

What is the difference in time to accquire disease between AKI and CKD?
Can they be recovered?

A

AKI acquired abruptly
- potential to recover
CKD acquired progressively
- irreversible

27
Q

What is normal range of pH of blood?

A

7.35-7.45

28
Q

What is normal range of PCO2 in arterial blood?

A

4.5-5.4kPa

29
Q

What is normal range of HCO3- in blood?

A

24-30mmol/L

30
Q

Name 2 intracellular ions?

A

Potassium

Phosphate

31
Q

Name 2 extracellular ions?

A

Sodium

Chloride

32
Q

What is aldosterone responsible for in electrolyte homestasis?

A

Reabsorbing Na in exchange for K

33
Q

What hormone controls calcium?

A

Parathyroid hormone

34
Q

What does calcitonin do to calcium?

A

Enhances renal excretion of Ca so lowers levels

35
Q

Name 2 risks of hypervolaemia?

A

1) High BP

2) Oedema

36
Q

Name a risk of hypovolaemia?

A

Low BP

37
Q

What does atrial natriutertic peptide do to renin?

What is its effect on Na excretion?

A

Inhibits it

Reduces Na excretion into urine

38
Q

What secretes antiduiretic hormone (ADH)?

Name something that blocks the action of ADH?

A

Pituitary

Alcohol

39
Q 
Here are 3 types of hameaturia:
Dipstick haematuria
Microscopic haematuria
Macroscopic haematuria
How can they be confirmed?
A

Dipstick haematuria - +ve urinalysis
Microscopic haematuria - RBCs on microscopy
Macroscopic haematuria - blood visible in urine

40
Q

Which 2 genes are responsible for Autosomal-dominant polycystic kidney disease (ADPKD)?

A

PKD1 (XX/Y 16) - polycystin 1

PKD2 (XX/Y 4) - Ca ion channel

41
Q

Advantages of peritoneal dialysis

A

Increased flexibility
Better mobility
Less fluid restriction
No anti-coagulation

42
Q

Advantages of haemodialysis

A

Less responsibility
Shorter treatment times
Small solute clearance is highly efficient

43
Q

Disadvantages of

peritoneal dialysis

A 
Large responsibility
Storage of equipment
Hyperglycaemia
Protein losses
Complications - hernias, peritonitis
44
Q

Disadvantages of haemodialysis

A

Circulatory stress
Scheduled treatment
Risk of bleeding
Complications - infection, hypotension

45
Q

What do Angiotensin AT1 Receptor Blockers (ARBs) treat?

How?

A

Hypertension

Prevent angiotensin II working

46
Q

If the site of immunoglobulin deposition is subendothelial what syndrome results?

A

Nephritic syndrome

47
Q

If the site of immunoglobulin deposition is subepithelial deposition what syndrome results?

A

Nephrotic syndrome

48
Q

4 symptoms of nephritic syndrome?

A

1) Haematuria
2) Proteinuria
3) High BP
4) Impaired renal function

Renal (9 decks)

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