Renal Flashcards by Aisha Mujahid

give 4 points for a ideal GFR marker

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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how is urea produced

as a result of protein breakdown in the liver

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restrictions of creatinine

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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what are the two types of proteinuria and describe them

overflow - protein being produced elsewhere (myeloma)

glomerular - produced in kidneys (albuminuria)

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

higher in intrinsic than pre renal

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how long and wide are kidneys

10-12cm

5-6cm wide

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what are kidneys covered with

thin but strong capsule of dense collagen fibres

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

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

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difference between proximal tubule and distal convolution tubule

PCT has a brush border

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what is the distal convoluted tubule lined with

simple cuboidal

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what are medullary rays

lines of CDs heading from cortex down to the medulla

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What are the ducts of bellini

part of the CDs seen in longitudinal sections

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

the urinary tract
stratified
3-6 layers

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uroepthelial cells at the luminal surface - describe them

umbrella cells - domed
thick and impermeable
inflexible
variable in thickness

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

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

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

3-5 cm

TE to squamous stratified

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

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

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

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

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what are penile concretions

increase with age

what micro organism does not give a positive nitrite test

enterococcus sp.

how does trimethoprim (PO) work

is it safe in pregnancy

inhibit folic acid synthesis

safe but avoid in first trimester

why is nitrofurantoin (PO) only used in lower UTIs

is it safe in pregnancy

only reaches effective concentrations in the bladder

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

what does Gentamicin not treat and what are its risks

enterococci

renal failure, CN8 nerve damage

what is pivmecillinam (PO)

what does this have activity against

esterified version of mecillinam

ESBLs

Tenvocilin (IV) has activity against what | what can this be used instead of

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

should a biopsy be done on small scarred kidneys and why

no | only show scarred tissue

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

met acidosis kidneys secrete acid resp compensation - blow off co2

causes of large kidneys | causes of palpable kidneys

PCK, myeloma, DM | PCK

what can uraemia lead to

pericarditis - saddle shape ST elevation on ECG

give the pathogenesis of GN

humeral (AB mediated) T cell mediated inflam cells, complement over all immune mediated

cause of minimal change GN FCS GN membranous GN IgA GN

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

process behind FCS GN

defect in CD2AP slit pore proteins | increase in SUPAR

treatment of membranous GN

steroids/alkylating agents/B cell monoclonal ABs

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

angiokeratomas | anderson fabrys

give 3 features of medullary cystic kidney

abnormal renal tubules autosomal dom cortex and medulla shrink

give 2 features of medullary sponge kidney

sporadic inheritance | cysts have calculi

common medullary origin. white nodules

fibroma

hello nodules

adenoma

can become large and have an affect on renal function.

angiofibrolipoma

produce rennin leading to secondary hypertension

JGT

central scar on XR. dx only after nephrectomy

oncocytoma

the 3 HLAs in transplantation

HLAA, HLAB, HLADR

two types of amyloid and which is deposited first

AL first | AA second

what leads to fertile cervical mucous

estrogen

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

inhibits FSH and prolactin | stimulates secretion of LH

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

CL inhibits infertile cervical mucous thermogenic, relaxes smooth muscles

give the peaks of the hormones in ovulation

oestrogen, lh and fsh - ovulation | oestrogen and progesterone