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2 > Renal > Flashcards

Renal Flashcards

1
Q

give 4 points for a ideal GFR marker

A

appear at a constant state
be freely absorbed at glomerulus
not be absorbed at by the renal tubule and not secreted by the renal tubule
not undergo extra renal elimination

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2
Q

how is urea produced

A

as a result of protein breakdown in the liver

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3
Q

restrictions of creatinine

A

steep fall in GFR may only lead to a small rise in Cr
overestimates if muscle mass is low
underestimates if muscle mass is high

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4
Q

what are the two types of proteinuria and describe them

A

overflow - protein being produced elsewhere (myeloma)

glomerular - produced in kidneys (albuminuria)

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5
Q

urine sodium levels in intrinsic renal failure compared to pre renal failure

A

higher in intrinsic than pre renal

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6
Q

how long and wide are kidneys

A

10-12cm

5-6cm wide

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7
Q

what are kidneys covered with

A

thin but strong capsule of dense collagen fibres

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8
Q

what are the thin loops of henle lined with
what is the thick ascending limb lined with
what are the collecting ducts lined with

A

squamous
simple cuboidal cells with abundant mitochondria
simple cubiodal/columnar epithelium

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9
Q

difference between proximal tubule and distal convolution tubule

A

PCT has a brush border

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10
Q

what is the distal convoluted tubule lined with

A

simple cuboidal

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11
Q

what are medullary rays

A

lines of CDs heading from cortex down to the medulla

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12
Q

What are the ducts of bellini

A

part of the CDs seen in longitudinal sections

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13
Q

What does uroepithlium line - what kind of epithelium and how many layers

A

the urinary tract
stratified
3-6 layers

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14
Q

uroepthelial cells at the luminal surface - describe them

A

umbrella cells - domed
thick and impermeable
inflexible
variable in thickness

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15
Q

what is under the uroepithelium and how does this differ between the distal and proximal ureter

A 
lamina propria (connective tissue)
smooth muscle - distal ureter has more smooth muscle compared to the proximal ureter
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16
Q

how long is the female urethra and how does its lining change

A

3-5 cm

TE to squamous stratified

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17
Q

how long is the male urethra and how does its lining change

A

prostatic urethra 3-4cm TE
membranous 1cm stratified columnar
penile 15cm stratified columnar to stratified squamous

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18
Q

what are tubuloalveolar glands lined with in the prostate and what do they secrete

A

simple columnar secreting epithelium with fibromusclular storm secrete half of seminal fluid volume

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19
Q

what are penile concretions

A

increase with age

20
Q

what micro organism does not give a positive nitrite test

A

enterococcus sp.

21
Q

how does trimethoprim (PO) work

is it safe in pregnancy

A

inhibit folic acid synthesis

safe but avoid in first trimester

22
Q

why is nitrofurantoin (PO) only used in lower UTIs

is it safe in pregnancy

A

only reaches effective concentrations in the bladder

avoid in late pregnancy (causes neonatal haemolysis), breast feeding and children under 3 months

23
Q

what does Gentamicin not treat and what are its risks

A

enterococci

renal failure, CN8 nerve damage

24
Q

what is pivmecillinam (PO)

what does this have activity against

A

esterified version of mecillinam

ESBLs

25
Q

Tenvocilin (IV) has activity against what

what can this be used instead of

A

ESBLs
used instead of gent in patients with poor renal function
not as good as gent

26
Q

should a biopsy be done on small scarred kidneys and why

A

no

only show scarred tissue

27
Q

what acid base problem can be caused by fucked up kidneys and why
how compensate?

A

met acidosis
kidneys secrete acid
resp compensation - blow off co2

28
Q

causes of large kidneys

causes of palpable kidneys

A

PCK, myeloma, DM

PCK

29
Q

what can uraemia lead to

A

pericarditis - saddle shape ST elevation on ECG

30
Q

give the pathogenesis of GN

A

humeral (AB mediated)
T cell mediated
inflam cells, complement

over all immune mediated

31
Q

cause of minimal change GN
FCS GN
membranous GN
IgA GN

A

idiopathic. NSAIDs, IL-13
idiopathic. HIV
idiopathic. hep B. SLE. gold/penicillamine
idiopathic. HSP

32
Q

process behind FCS GN

A

defect in CD2AP slit pore proteins

increase in SUPAR

33
Q

treatment of membranous GN

A

steroids/alkylating agents/B cell monoclonal ABs

34
Q

what are raised red/blue lesions on the skin and what disease are they associated with

A

angiokeratomas

anderson fabrys

35
Q

give 3 features of medullary cystic kidney

A

abnormal renal tubules
autosomal dom
cortex and medulla shrink

36
Q

give 2 features of medullary sponge kidney

A

sporadic inheritance

cysts have calculi

37
Q

common medullary origin. white nodules

A

fibroma

38
Q

hello nodules

A

adenoma

39
Q

can become large and have an affect on renal function.

A

angiofibrolipoma

40
Q

produce rennin leading to secondary hypertension

A

JGT

41
Q

central scar on XR. dx only after nephrectomy

A

oncocytoma

42
Q

the 3 HLAs in transplantation

A

HLAA, HLAB, HLADR

43
Q

two types of amyloid and which is deposited first

A

AL first

AA second

44
Q

what leads to fertile cervical mucous

A

estrogen

45
Q

what does oestrogen do in terms of LH, prolactin and FSH

A

inhibits FSH and prolactin

stimulates secretion of LH

46
Q

where does progesterone come from
what does it do in terms of LH
what does it lead to
what kind of an affect does it have on temp and muscles

A

CL
inhibits
infertile cervical mucous
thermogenic, relaxes smooth muscles

47
Q

give the peaks of the hormones in ovulation

A

oestrogen, lh and fsh - ovulation

oestrogen and progesterone

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