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wrong questions/stuff i need to know > renal > Flashcards

renal Flashcards

1
Q

what is the osmolarity of body fluids?

A

300mOsmol/L

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2
Q

is the cell membrane permeable to sucrose?

A

no
permeable to urea

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3
Q

what are the components of extracellular fluid?

A

plasma
interstitial fluid
lymph
transcellular fluid

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4
Q

where does unregulated loss of fluid happen?

A

skin
lungs

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5
Q

where does regulated loss of fluid occur?

A

sweat
faeces
urine

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6
Q

is sodium concentration higher in extracellular or intracellular fluid?

A

Na is higher in the ECF

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7
Q

is the concentration of Cl higher in extracellular or intracellular fluid?

A

Cl is higher in the ECF

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8
Q

is the concentration of K higher in extracellular or intracellular fluid?

A

K is higher in the ICF

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9
Q

is the concentration of HCO3 higher in the extracellular or intracellular fluid?

A

HCO3 is higher in the ECF

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10
Q

what is mainly responsible for the osmolarity of ECF?

A

sodium

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11
Q

what is mainly responsible for the osmolarity of the ICF?

A

potassium

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12
Q

what % of cardiac output goes to the kidneys?

A

20-25%

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13
Q

what processes occur in a nephron?

A

filtration
reabsorption
secretion

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14
Q

which type of nephrons are in the long loop of henle?

A

juxtaglomerular

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15
Q

which type of nephrons are in the short loop of henle?

A

cortical

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16
Q

which nephrons produce concentrated urine?

A

juxtaglomerular nephrons

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17
Q

which cells secrete renin in the juxtaglomerular apparatus?

A

granular cells

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18
Q

is glomerular filtration a passive process?

A

yes

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19
Q

is BP in the glomerular capillaries high or low?

A

high (55mm Hg)

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20
Q

what is the normal value of net filtration pressure?

A

10 mm Hg favouring filtration

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21
Q

what is the normal glomerular filtration rate?

A

125 ml/min
mainly determined by glomerular capillary BP

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22
Q

what does a low GFR lead to?

A

decreased urine volume

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23
Q

what is the extrinsic controller of GFR?

A

sympathetic control via baroreceptor

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24
Q

what is the intrinsic control of GFR?

A

myogenic mechanism
tubuloglomerular feedback

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25
Q

what is the impact of kidney stones on GFR?

A

increased HPbc causing decreased GFR

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26
Q

does diarrhoea cause increased/decreased GFR?

A

decreased GFR

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27
Q

what can be used as a measure of GFR?

A

inulin

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28
Q

is glucose secreted?

A

no it is completely reabsorbed and should have 0 clearance

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29
Q

where abouts in the nephron does most reabsorption occur?

A

the whole length but mainly the proximal tubule

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30
Q

what is absorbed in the proximal tubule?

A

sugar
amino acid
phosphate
sulphate
lactate

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31
Q

what is secreted in the proximal tubule?

A

H+
neurotransmitter
uric acid

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32
Q

where is the Na-K pump found?

A

basolateral membrane

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33
Q

which ions are reabsorbed in the ascending loop of henle?

A

Na
Cl

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34
Q

does water reabsorption occur in the ascending loop of henle?

A

No

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35
Q

what is the most common cause of nephrotic syndrome in children?

A

minimal change disease

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36
Q

what are the possible causes of minimal change disease?

A

idiopathic
leukaemia
hodgkins lymphoma
virus

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37
Q

how does minimal change present?

A

facial/generalised oedema
heavy proteinuria
foot process fusion on EM

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38
Q

is minimal change nephritic or nephrotic?

A

nephrotic

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39
Q

how is minimal change treated?

A

steroids (prednisalone)

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40
Q

is FSGS nephrotic or nephritic?

A

nephrotic

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41
Q

what causes FSGS?

A

primary- autoimmune
secondary- HIV, obesity, sickle cell, PWID, reflux nephropathy

42
Q

what are the features of FSGS under microscope?

A

weird mesangial cells
diffuse podocyte process fusion (primary)
podocyte process fusion limited to sclerotic areas (secondary)

43
Q

where does necrosis occur in FSGS?

A

primary- everywhere
secondary- only in sclerotic areas

44
Q

how is FSGS managed?

A

60% have long term remission with prolonged steroids

45
Q

do you send urine cultures in old ladies with uncomplicated UTI?

A

not usually
except in people who have a reduced renal function

46
Q

what are the features of an epidydimal cyst?

A

scrotal swelling and on palpitation is felt separate to testes

47
Q

what is the most accurate way to measure GFR?

A

measuring inulin

48
Q

how does hydrogen reach the tubular lumen?

A

hydrogen ATPase secretes it at the distal convoluted tubule

49
Q

where do thiazides act?

A

in the Na/Cl channels in the distal convoluted tubule to prevent sodium reabsorption

50
Q

where is the micturition centre located?

A

in the pons

51
Q

what are the indications for dialysis?

A

acidosis
electrolyte
intoxication
overdose
uraemia

52
Q

which condition can be caused after an ACEi is introduced to young females?

A

AKI- fibromuscular dysplasia

53
Q

which pumps are at the apical membrane of the proximal tubule?

A

co transport= Na/glucose and Na/amino acids
counter transport= Na/H

54
Q

which pumps are at the basolateral membrane of the proximal tubule?

A

diffusion (100% reabsorbed)= glucose and
amino acids
counter transport= Na/K

55
Q

what increases water reabsorption in the distal tubule?

A

ADH (vasopressin)

56
Q

what increases sodium reabsorption and H/K secretion from the distal tubule?

A

Aldosterone

57
Q

what reduces sodium reabsorption in the distal tubule?

A

ANP

58
Q

what increases calcium reabsorption and reduces phosphate reabsorption?

A

PTH

59
Q

what effect does increased Na delivery to the kidney have on the macula densa?

A

macula densa constricts the afferent arteriole and increases renal blood flow

60
Q

what affect does kidney have on vit D production

A

activates calcidiol and converts it to calcitriol

61
Q

what is used to measure effective renal plasma flow?

A

paraamino hippurate

62
Q

what filters by negative charge?

A

the glomerular basement membrane

63
Q

why is GFR slightly over estimated?

A

because creatinine is slightly secreted in the kidney

64
Q

do prostaglandins dilate the efferent arteriole?

A

no
they dilate the afferent arteriole which increases GFR

65
Q

what is a sign of ESKD?

A

decreased calcium and anaemia

66
Q

what is the affect of ANP on the arterioles?

A

vasodilation of the afferent arterioles and vasoconstriction of the efferent arterioles

67
Q

does metabolic alkalosis result in increased K secretion?

A

yes

68
Q

what does nephrotic syndrome result in?

A

reduction of capillary colloid pressure and oedema

69
Q

where is the majority of filtered potassium absorbed?

A

the proximal convoluted tubules

70
Q

what is the consequence of an increase in hydrostatic pressure in bowmans capsule?

A

reduced GFR

71
Q

how does ADH allow for water reabsorption?

A

via the insertion of aquaporin II channels on the luminal membrane

72
Q

where does AHD act?

A

the collecting ducts

73
Q

what kind of vasculitis is HSP?

A

small vessel IgA mediated vasculitis

74
Q

how does CKD lead to anaemia?

A

due to reduced levels of erythropoietin

75
Q

what bacteria is most likely to cause peritonitis in peritoneal dialysis?

A

staph epidermis
coag negative

76
Q

can Wegener’s granulomatosis (GPA) cause rapidly progressive glomerulonephritis?

A

yes

77
Q

how does amyloidosis present?

A

middle aged
muscle weakness
breathlessness
reduced kidney function

78
Q

what is the first line investigation in peritonitis?

A

pd fluid microscopy with cell count, culture and sensitivity

79
Q

what does foot processes indicate?

A

minimal change

80
Q

what can interact with immunosuppressants and cause nephrotoxicity?

A

trimethoprim

81
Q

Which nephron structure is especially important in the kidney’s ability to produce urine of varying concentration?

A

loop of henle

82
Q

what is the glomerular filtration rate?

A

is a protein-free plasma and is formed as a result of passive forces acting across the glomerular membrane

83
Q

what has a large impact on the reduction of net filtration pressure?

A

a large increase in blood colloid osmotic pressure

84
Q

what is the renal threshhold?

A

plasma concentration of a particular substance at which its Tm is reached and the substance first appears in the urine

85
Q

why is angiotensin I formed?

A

as a result of activation of angiotensinogen by renin, and is transformed into angiotensin II as a result of converting enzyme action in the lungs

86
Q

where does water reabsorption occur?

A

to the greatest extent in the proximal convoluted tubule and is under vasopressin control in the distal and collecting tubules

87
Q

what is plasma clearance?

A

volume of plasma that is completely cleared of a substance by the kidneys in one minute of time

88
Q

what does vasopressin do?

A

activates the cyclic AMP second-messenger system within the tubular cells

89
Q

which segment of the nephron is not permeable to H2O even in the presence of vasopressin?

A

ascending limb of the loop of henle

90
Q

how does urine move from the kidneys to the urinary bladder?

A

peristaltic contraction of the smooth muscle of the ureters

91
Q

what structures do somatic motor muscles supply?

A

the distal urethra, external urethral sphincter and levator ani

92
Q

what affect do 5-alpha reductase inhibitors have on the prostate?

A

shrinks it

93
Q

what is the blood supply to the scrotum?

A

Internal pudendal and branches from external iliac artery

94
Q

what is used to visualise kidney stones?

A

non contrast CT

95
Q

what causes bleeding at the start of urination?

A

prostate or urethra

96
Q

what causes bleeding at the end of urination?

A

bladder neck

97
Q

how much creatinine is reabsorbed by the kidneys?

A

0%

98
Q

which abx are used in pregnant women with a UTI?

A

nitrofuratoin= 1st and 2nd trimester
trimethoprim=3rd semester

99
Q

what is the first line imaging in suspected renal malignancy?

A

USS

100
Q

what are the features of parasympathetic nerve outflow?

A

craniocaudal and includes CN III, VII, IX, X. Also S2, 3, 4

wrong questions/stuff i need to know (19 decks)

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