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EDAIC PART II > Physiology (Renal) > Flashcards

Physiology (Renal) Flashcards

1
Q

What is the volume of renal blood flow?

A

1000 ml/min = 25% of cardiac output

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2
Q

What is the flow equation?

A

RBF = RPF /1 - Haematocrite

RBF - Renal blood flow
RPF - Renal plasma flow

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3
Q

How to calculate renal plasma flow?

A
  • Same formula as clearance
  • Using P-Aminohippuric Acid (Excreted)
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4
Q

Formula for Renal Plasma Flow?

A

RBF = RPP/RVR

RPP = Renal perfusion pressure
RVR = Renal vascular resistance

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5
Q

What is the tubulo-glomerular feedback?

A

This is when the renal tubules regulate their own blood flow and therefor the glomerular filtration rate

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6
Q

What is GFR?

A

This measures the rate at which blood is filtered by the kidney.

GFR = Clearance

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7
Q

What is clearance?

A

The volume of plasma that is cleared of substance per unit time (ml/min)

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8
Q

Formula for clearance?

A

Cx = UxV/Px

Cx = Clearance
U = Urinary concentration
V = Urine flow
Px = Plasma concentration

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9
Q

What is the substance used to measure clearance?

A
  • Insulin
  • Freely filtered
  • Not secreted, reabsorbed, metabolised or stored
  • Creatinine is a more practical surrogate
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10
Q

Draw a graph for renal auto-regulation ?

A
  • RBF regulated between MAP of 80-180mmHg
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11
Q

What are the auto-regulatory MAP ranges for different organs?

A
  • Heart - 50-150 mmHg
  • Brain - 60-160 mmHg
  • Renal - 80-180 mmHg
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12
Q

Glucose handling?

A

Glucose filtration by the kidney is directly proportional to the plasma glucose concentration

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13
Q

What is T-Max of glucose?

A

This is the maximal tubular absorption of glucose at 11 mmol/L and 300mg/min

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14
Q

What are the hormones produced by the kidney ?

A
  • Erythropoietin
  • 1,25-Di-hydroxycholecalciferol
  • Renin
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15
Q

What is Erythropoietin?

A
  • Regulates erythropoiesis
  • Secreted from glomerular apparatus in response to - Hypoperfusion & Hypoxia
  • Its receptor present on the membrane of RBCs
  • Causes increased production of RBC
  • Deficiency responsible for anaemia in chronic kidney disease
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16
Q

What is 1,25-dihydroxycholecalciferol?

A
  • It is responsible for calcium balance
  • Enhances calcium absorption from proximal bowel
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17
Q

What is Renin?

A
  • Part of the Renin-Angiotensin-Aldosterone system
  • Activated by decreased renal perfusion
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18
Q

List the acid-base buffers in the body?

A
  • Bicarbonate
  • Haemoglobin
  • Plasma protein
  • Phosphate
19
Q

Formula for calculating anion-gap?

A

AG = (Na+K) - (Cl+HCO)

20
Q

What is the Davenport diagram?

A

This shows the relationship between pH, PCO2 and HCO3

  • See page 110 of passway for explanation of diagram
  • Learn how to draw the diagram
21
Q

Correction of bicarbonate deficiency ?

A

NaHCO3 = BD x 30% x Body weight

BD = Base deficit

22
Q

Base deficit abnormalities?

A
  • Respiratory = HCO normal
  • Metabolic = PCO2 normal
23
Q

Sodium handling ?

A
  • ADH has a significant effect on final conc of urinary Na
  • Urine is hypotonic after passing through AL thick - Na 100mmol/L
  • With ADH - DCT & CD retain water + Increase urinary Na
24
Q

How to calculate serum osmolarity?

A

2Na + Glu/18 + BUN/2.8

Na - mEq/L
Glu & BUN - mg/dL

25
Q

What are the causes of hypernatraemia ?

A
  • Increased sodium concentration
  • ## water depletion
25
Q

What are the causes of hypernatraemia ?

A
  • Increased sodium concentration
  • ## water depletion
26
Q

What are the causes of hyponatraemia?

A
  • Sodium deficiency
  • Hyperaldosteronism
  • Hypotonic saline
  • TURP syndrome
  • Reduced water excretion
  • Hyperglycaemia
27
Q

How is diabetes insipidus treated ?

A

Desmopressin

28
Q

Effect of rapid correction of hyponatraemia?

A

Central demyelinating lesion

29
Q

Potassium handling in the kidney?

A
  • Usually maintained between 5-10mmol/L - Horizontal
  • Potassium secreted in the DCT-Electrochemical gradient
30
Q

Factors affecting inter-compartmental potassium shift?

A
  • Extracellular pH
  • Circulating insulin
  • Hypothermia
31
Q

What are the factors causing extracellular shift of potassium?

A
  • Acidosis
  • Decreased insulin
  • Beta-blocker
  • Increased plasma osmolality
  • Hyperthermia
32
Q

What are the factors causing intracellular shift of potassium?

A
  • Decreased plasma osmolality
  • Beta receptor activation
  • Hypothermia
  • Alkalosis
  • Insulin
33
Q

What are the effects of hyperkalaemia ?

A
  • Muscle weakness
  • Nausea & vomiting
  • Diarrhoea
  • Palpitation
  • CVS collapse
34
Q

What are the characteristic ECG changes in hyperkalaemia?

A
  • Peaked t-waves
  • Wide QRS
  • Prolonged PR interval
  • P-wave loss
  • ST depression
  • VF / Asystole
35
Q

What is the treatment of hyperkalaemia?

A
  • Treat the precipitating cause
  • Calcium chloride - 10ml / 10% - Potassium antagonist
  • Insulin/dextrose over 30 mins
  • Salbutamol
  • Dialysis
36
Q

What are the causes of hypokalaemia ?

A
  • Reduced intake
  • Increase loss (Renal, burns & GI)
  • Inter-compartmental shift
37
Q

What are the effects of hypokalaemia ?

A
  • Decreased myocardial contractility
  • Muscle weakness
  • Polyuria
  • Ileus
38
Q

What are the characteristic ECG changes of hypokalaemia ?

A
  • T-wave flattening & inversion
  • U-waves and ST depression
  • Prolonged QT interval and asystole
39
Q

Treatment of hypokalaemia ?

A
  • Treat the cause
  • Potassium replacement
40
Q

Properties of calcium ?

A
  • About 98% present in bones
  • About 40% bound to albumin
  • Range in plasma between 2-2.6mmol/L
41
Q

What are the hormones regulating calcium levels ?

A

Read about it **

42
Q

Hormones enhancing absorption of Calcium?

A
  • Calcitriol
  • 1,25-Dihydroxyvitamin D
  • PTH - Regulated
43
Q

Hypercalaemia?

A
  • Present in 98% of cancers
  • Hyper-parathyroidism
  • Paget’s disease

EDAIC PART II (15 decks)

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