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BIOM2015 > Renal > Flashcards

Renal Flashcards

1
Q

What are the three stages of making urine?

A
  1. Glomerular filtration
  2. Tubular reabsorption
  3. Tubular secretion (excretion)
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2
Q

What are the main functions of the kidneys

A
  • pH balance
  • water balance
  • maintain homeostasis of the blood
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3
Q

What 4 changes happen in aging kidneys?

A
  • decreased kidney mass
  • decreased nephron number
  • decreased kidney blood flow
  • decreased glomerular filtration rate
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4
Q

How does ADH allow kidneys to reabsorb more water?

A

-acts on distal and collecting tubule cells to promote insertion of aquaporins in apical membrane by triggering cAMP

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5
Q

How does the elderlys sense of thirst differ when dehydrated?

A
  • baseline blood osmolality is increased
  • however still feel less thirsty when dehydrated
  • sensitive to changes in plasma osmolarity, but less sensitive to changes in plasma volume
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6
Q

What appetite signalling is different in elderly?

A

-satiation signals are upregulated

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7
Q

What equation is related to acid base balance?

A

CO2 + H2O — H2CO3 — H+ + HCO3-

-first step can have carbonic anhydrase speed it up

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8
Q

What are the three mechanisms for acid base balance?

A

1) chemical buffers - rapid but limited
2) respiratory - moderate; can increase of decrease CO2 release
3) renal - slow; regulates H+ and HCO3- secretion and reabsorption

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9
Q

What two molecules balance blood pH?

A

CO2 and HCO3-

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10
Q

Describe respiratory acidosis and how body fixes it

A
  • abnormal CO2 retention from hyperventilation
  • too much CO2
  • respiratory system broken, so other end of seesaw has to increase -> more HCO3-
  • kidneys balance by conserving more HCO3-
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11
Q

Describe metabolic acidosis and how body fixes it

A
  • reduction of HCO3- or build up of acid
  • loads H+, less HCO3- bc it has been used dealing with the extra H+
  • ventilation increases to remove excess CO2 and kidneys conserve HCO3-
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12
Q

What is the criteria for CKD?

A

-glomerular filtration rate (GFR) < 60 mL/min/1.73m^2 that is present for 3 or more months
AND/OR
-evidence of kidney damage present for 3 or more months (albuminuria, haematuria, structural / images, patholoigcal / biopsy)

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13
Q

What two factors determine the stage of CKD?

A
  • GFR

- amount of albuminuria

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14
Q

How is hypertension involved in CKD?

A
  • both cause and complication

- treated by removing excess fluid in dialysis, restrict Na intake and hypertensive drugs

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15
Q

What is hyperkalaemia and how is it involved in CKD?

A
  • high blood K+ levels
  • causes: acidosis (kidneys busy with H+, so K builds up), some medications
  • drugs mess with the RAAS system -> this results in Na+ not getting reabsorbed, but also stops K+ getting excreted
  • depolarises cardiac myocytes -> cardiac mega issues
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16
Q

How can CKD cause bone disorders?

A
  • kidneys have reduced capacity to activate vit D -> reduced Ca absorption
  • PTH secreted to compensate, so more Ca is leached from bone
17
Q

Main points about haemodialysis:

A
  • outside body
  • blood cleansed in dialysis chamber (membrane in machine) and is returned
  • either fistula or graft joins vein/artery together for vascular access
  • 5ish hours a few days a week at hospital
18
Q

Main points about peritoneal dialysis:

A
  • inside body
  • dialysis fluid added to peritoneal cavity
  • peritoneal membrane acts as filtration membrane
  • works through abdominal catheter
  • each time: drain previous fluid, then refill, then leave it
19
Q

What is the muscle in bladder that pushes the urine out, and what system controls it?

A
  • detrusor muscle
  • contracts to empty, relaxes to fill
  • emptying parasympathetic, filling sympathetic
20
Q

What controls the internal sphincter and what type of muscle? (Bladder)

A
  • smooth muscle

- sympathetic NS

21
Q

What controls the external sphincter and what type of muscle?

A
  • skeletal muscle

- somatic NS

22
Q

What are the 4 types of incontinence?

A

Stress, urge, overflow and functional

SUFO

23
Q

What is stress UI?

A
  • leaks of urine due to pressure on the bladder

- anything that puts pressure on bladder, weakens urethra, or weakens pelvic floor muscles

24
Q

What is urge UI?

A
  • bladder tells you its full when it isn’t
  • muscle is overactive
  • often no known cause
25
Q

What is overflow UI?

A
  • Bladder doesnt completely empty
  • increased pressure overcomes sphincter control
  • underactive detrusor muscle or obstruction
26
Q

What is functional UI?

A
  • lack of recognition of need to urinate, or inability to get to toilet
  • nothing physically wrong with urinary system
27
Q

What are the 4 physiological factors that predispose elderly to dehydration?

A
  • decreased total body water
  • altered sense of thirst
  • decrease in urine concentrating ability
  • decrease in ADH effectiveness
28
Q

What is the bodies response to alkalosis

A
  • HCO3- is excreted in the urine

- H+ is reabsorbed into the blood

29
Q

What is the bodies response to acidosis

A
  • H+ is excreted in the urine

- HCO3- is reabsorbed into the blood

30
Q

What is micturition and describe the reflex

A

It is the contraction of the bladder and the relaxation of two sphincters

  • Filling of the bladder stimulates the stretch receptors
  • this triggers the parasympathetic nerve to contract the bladder
  • internal sphincter opens, but the micturition reflex inhibits the innovation of the external sphincter

BIOM2015 (8 decks)

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