Renal Flashcards

1
Q

What three muscles are posterior to the kidneys?

A

Psoas major
Quadratus lumborum
Transversus abdominis

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2
Q

What three layers surround the kidney? (deep to superficial)

A

Renal capsule
Adipose capsule
Renal fascia

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3
Q

Where do the renal arteries arise?

A

From abdominal aorta, just inferior to the SMA

Between L1 and L2

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4
Q

What three arteries supply the adrenal glands?

A

Superior suprarenal artery
Middle suprarenal artery
Inferior suprarenal artery

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5
Q

Where do the superior suprarenal arteries branch from?

A

Inferior phrenic arteries

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6
Q

Where do the middle suprarenal arteries arise from?

A

Directly from abdominal aorta

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7
Q

Where do the inferior suprarenal arteries branch from?

A

Branches off renal arteries which pass upward to the adrenal glands

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8
Q

What hormones does the adrenal medulla release?

A

Adrenaline

Noradrenaline

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9
Q

What are the three zones of the adrenal cortex?

A

Zona glomerulosa
Zona fasciculata
Zona reticularis

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10
Q

Which zone secretes aldosterone?

A

Zona glomerulosa

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11
Q

What type of hormones, and name them, does the zone fasciculata secrete?

A

Glucocorticoids:
Cortisol
Corticosterone

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12
Q

What does the zone reticularis produce?

A

Testosterone

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13
Q

What haematopoietic growth factor do the kidneys produce?

A

Erythropoietin

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14
Q

Where is the juxtaglomerular apparatus?

A

Juxtaposition of distal convoluted tubule, squeezed between afferent and efferent arterioles

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15
Q

What do macula densa do?

A

Sense sodium concentration and tubular fluid flow in the tubular filtrate and feed back to the juxtaglomerular cells accordingly

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16
Q

What is the definition of haematuria?

A

Excretion of 3 or more RBCs per high powered field in freshly voided urine

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17
Q

What are the two types of haematuria?

A

Macroscopic (frank)

Microscopic

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18
Q

Name medical renal causes of haematuria.

A
Glomerulonephritis
Autoimmune/vasculitis (SLE, Wegners)
Genetic (sickle cell, polycystic kidneys)
Infections (TB)
Diabetes
Amyloidosis
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19
Q

Name surgical renal and lower urinary tract causes of haematuria.

A
Tumours
Calculi
Trauma
Benign prostatic hyperplasia
Urethral stricture
20
Q

What are the main risk factors associated with development of renal cell carcinomas?

A
Smoking
Obesity
Asbestos
Unopposed oestrogen
Chronic renal failure
Some heavy metals
21
Q

Name the main signs and symptoms of renal cell carcinoma.

A
Haematuria
Costovertebral pain
Palpable mass
Weight loss
Weakness
Malaise
22
Q

Where do transitional cell carcinomas arise from?

A

Anywhere between the renal pelvis and urethra, including ureter and bladder

23
Q

What is the most common site of a TCC?

A

Bladder

24
Q

In which group of people do TCCs usually arise?

A

Over 50s who smoke

25
Q

What are the signs and symptoms of transitional cell carcinoma?

A

Painless haematuria

Irritating bladder symptoms, including frequency, urgency and dysuria

26
Q

What is urolithiasis?

A

A calculi (kidney stone)

27
Q

What is the first and second most common type of calculus?

A

Calcium oxalate and phosphate

Struvite

28
Q

What is the most common infection that causes haematuria?

A

E. coli

29
Q

What other infections can cause haematuria?

A

Enterococcus faecalis
Pseudomonas
Klebsiella species

30
Q

What happens to water if you add an isotonic solution into the body?

A

Water remains in the extracellular spaces

31
Q

Give an example of an isotonic solution.

A

Saline solution

32
Q

What happens to water if you add a hypotonic solution to the body?

A

Water will move into the intracellular spaces

33
Q

What happens to water if you add a hypertonic solution to the body?

A

Water will be drawn out of the intracellular spaces into the extracellular spaces

34
Q

What is the difference in concentration of potassium ions between the intracellular and extracellular spaces?

A

Higher in intracellular spaces
Intracellular levels: 140mOsm
Extracellular levels: 4mOsm

35
Q

What is the difference in concentration of sodium ions between the intracellular and extracellular spaces?

A

Relatively low concentration intracellularly
Intracellular levels: 10mOsm
Extracellular levels: 145mOsm

36
Q

What controls renin secretion?

A

Intrarenal baroreceptors
Sympathetic input
Macula densa feedback

37
Q

What does aldosterone do in the kidneys?

A

Promotes Na+ reabsorption and K+ excretion in the proximal tubule

38
Q

What types of cells line the proximal convoluted tubule?

A

Simple cuboidal epithelial cells with prominent brush borders or microvilli

39
Q

What type of cells line the descending limb and the thin ascending limb of the Loop of Henle?

A

Simple squamous epithelial cells

40
Q

What type of cells line the thick ascending limb of the Loop of Henle?

A

Simple cuboidal to low columnar epithelial cells

41
Q

What type of cells line the distal convoluted tubule?

A

Simple cuboidal epithelial cells

42
Q

What type of cells line the last part of the distal convoluted tubule and the collecting duct?

A

Simple cuboidal epithelium consisting of principal cells and intercalated cells

43
Q

What hormone determines the expression of sodium channels on the surface of principal cells in the collection duct?

A

Aldosterone

44
Q

What hormone determines the expression of aquaporins on the surface of principal cells in the collecting duct?

A

Vasopressin (ADH)

45
Q

What does parathyroid hormone stimulate in the early distal convoluted tubule?

A

Reabsorption of calcium ions