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NMF: Year 2 > Renal > Flashcards

Renal Flashcards

1
Q

What happens in the proximal tubule?

A

regulation of pH

100% of filtered glucose and amino acids are reabsorbed.

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2
Q

Which part of the loop of Henle is water-impearmeable?

A

ascending

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3
Q

What is secreted in the distal tubule?

A

Potassium

Hydrogen

Urea

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4
Q

Which cells make up the juxtaglomerular apparatus?

A

granular

macula densa

mesangial cells

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5
Q

Where are macula densa cells found?

A

distal convoluted tubule

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6
Q

Which cell detects NaCl?

A

macula densa

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7
Q

Which cells secrete renin?

A

granular cells

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8
Q

What do potassium-sparing diuretics do?

A

inhibit na reabsorption and K excretion

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9
Q

What do loop diuretics do?

A

NKCC2 transporter

(na, k, cl)

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10
Q

What do thiazide diuretics do?

A

Inhibit NaCl co-transporter in the distal convoluted tubule

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11
Q

What is GFR?

A

rate at which protein-free plasma is filtered into the bowmans capsule per unit of time

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12
Q

Normal GFR

A

125ml

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13
Q

which factors are taken into account when looking at GFR

A

CAGE - serum creatinine - age - gender - ethnicity

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14
Q

If muscle mass is high, is GFR over or underestimated?

A

underestimates

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15
Q

What is the main determinant of GFR?

A

glomerular capillary blood pressure

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16
Q

GFR is equal to

A

Kf x NFP (filtration coeffienct x net filtration pressure)

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17
Q

What does filtration coefficient mean?

A

how holey the membrane is

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18
Q

Net filtration pressure equation

A

BPgc + COPbc opposition: HPbc + COPgc

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19
Q

Formation of interstitial fluid

A

(Pc-Pi) - (Piep - piel) (capillary pressure - interstitial fluid pressure) - (capillary oncotic pressure - interstitial fluid oncotic pressure) inc oedema if inc pc or decrease piep

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20
Q

Constriction of which arteriole causes an increase in glomerular filtration?

A

efferent

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21
Q

How does vasoconstriction at afferent arteriole affect GFR?

A

decrease

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22
Q

Plasma clearance

A

([x]urine x Vu) / [X]plasma

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23
Q

Rate of filtration

A

conc in plasma x GFR

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24
Q

Rate of excretion

A

conc in urine x urine vol

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25
Q

Rate of reabsorption

A

rate of filtration - rate of excretion

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26
Q

Rate of secretion

A

rate of excretion - rate of filtration

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27
Q

Reabsorbed substance

A

GFR> clearance

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28
Q

Secreted substance

A

clearance> GFR

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29
Q

Neither absorbed nor secreted substance

A

clearance = GFR

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30
Q

Where does the bulk of solute and water reabsorption occur?

A

proximal tubules

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31
Q

Calculate anion gap

A

(Na+ + K+) - (Cl- + HCO-3)

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32
Q

normal anion gap

A

10-18

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33
Q

action of spirinolactone

A

aldosterone antagonist

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34
Q

Diagnose BPH

A

TRUS (transrectal ultra sound guided) biopsy

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35
Q

Treat BPH

A

alpha blocker eg tamsulosin 5 alpha reductase eg finestride

36
Q

Treat proteinuria and hypertension

A

ACE-inhibitor (-prils)

37
Q

Investigate polycystic kidney disease

A

renal ultrasound

38
Q

Nephrotic syndrome

A

proteinuria>3g/day Hypoalbuminaemia Oedema (periorbital) hypercholesterolaemia normal renal function

39
Q

How is nephrotic syndrome treated?

A

steroids

40
Q

Nephritic syndrome

A

AKI oliguria oedema/fluid retention hypertension haematuria (+/- proteinuria)

41
Q

How is nephritic syndrome treated?

A

ACEi

42
Q

What imaging is used in lower renal tract?

A

cystography

43
Q

What imaging is used in upper renal tract?

A

renal US( <50) CT urography (>50)

44
Q

What imaging is used for renal colic?

A

non-contrast CT KUB

45
Q

What investigations are done in scrotal swelling?

A

ultrasound

46
Q

What investigations are done in renal or urinary tract trauma?

A

CT: renal, ureteric contrast cystography: bladder

47
Q

most common renal cancer in a) children b) adults

A

a) nephroblastoma b) renal cell carcinoma

48
Q

What mets are seen with renal cell carcinoma?

A

canon ball mets in the lungs - also liver, brain and bones

49
Q

Investigate and treat renal cell carcinoma

A

triple phase contrast CT radical nephrectomy or radioablation - mets are radioand chemo resistant

50
Q

What tumour is associated with tuberous sclerosis?

A

angiomyolipoma

51
Q

Which type of HPV is associated with mouth ulcers?

A

1-4

52
Q

Which type of HPV is associated with genital cancer?

A

16-18

53
Q

Which benign renal tumour can cause secondary hypertension?

A

juxta glomerular cell tumour - secretes renin

54
Q

Where do most transitional cell carcinomas occur in the bladder?

A

trigone —> ureteric obstruction

55
Q

How is TCC of the bladder investigated?

A

cystoscopy with biopsy (diagnose) CT urogram (staging)

56
Q

How is TCC of the bladder treated?

A

stage 1 –> transurethral resection invasive –> radical cystectomy

57
Q

What do prostate cancers tend to be ?

A

multifocal adenomas

58
Q

What type of mets are seen with prostate cancer?

A

osteosclerotic

59
Q

How do you treat prostate cancer?

A

if old + low risk –> active surveillance if young –> radical prostatectomy or radiotherapy hormonal drugs eg LRHR agonists, anti-androgens

60
Q

What is the most common type of testicular tumour?

A

seminoma

61
Q

Give testicular tumour markers: a) seminomas b) teratomas with yolk sac elements c) highly malignant teratomas with trophoblastic tissue

A

a) placental ALP b)AFP c)bhCG

62
Q

Describe a seminoma

A

potato looking - very radiosensitive

63
Q

Which UTI bacteria a) forms calculi? b) is resistant to most antibiotics? c) is seen with women of child bearing age? d) catheterised? e) no +ve nitrates

A

a) proteus sp. b) enterococcus faecium c) staph. saphrophyticus d) pseudomonas e) enterococcus spp.

64
Q

Kass’ criteria for UTI in women of child-bearing age

A

10^4 organisms/ml = possible, needs repeat more than 10^5 = probable

65
Q

Give examples of non-proliferative GN

A

minimal change focal segemental membranous

66
Q

Give examples of proliferative GN

A

IgA nephropathy Membranous proliferative Rapid progressive (vasculitis or goodpasture’s) Post-infection

67
Q

renal failure after a fall

A

myoglobulinuria causing acute tubular necrosis

68
Q

what is trousseau’s sign?

A

spasm of fingers during BP due to hypocalcaemia

69
Q

What happens to a) phosphate b) vitamin D in CKD?

A

a) rises (sometimes need phosphate binders as not removed effectively by dialysis) b) activation is reduced

70
Q

In which disease are anti-GBM antibodies seen?

A

Goodpasture’s disease

71
Q

haemoptysis + renal failure

A

Goodpasture’s

72
Q

When do you see a) p-ANCA b) c-ANCA

A

a) microscopic polyangitis b) GPA

73
Q

How is Alport’s disease inherited?

A

x-linked

74
Q

deafness + renal failure

A

Alport’s

75
Q

Which drug stabilises the cardiac membrane in hyperkalaemia?

A

calcium gluconate

76
Q

In hyperkalaemia what does combined insulin/dextrose infusion do?

A

shifts potassium from extracellular to intracellular fluid compartment in the short-term

77
Q

How does IgA nephropathy present?

A

young male

macroscopic haematuria

overlap with times of infection

78
Q

What triad is seen in haemolytic uraemic syndrome?

A
  • acute renal failure
  • microangiopathic haemolytic anaemia
  • thrombocytopenia
79
Q

What does nebulised salbutamol do in hyperkalaemia?

A

Shifts potassium from extracellular to intracellular fluid compartment in the short-term

80
Q

how does renal cell carcinoma present?

A

haematuria, loin pain, abdominal mass

81
Q

Older patient with painless, visible haematuria

A

transitional cell carcinoma of the bladder

82
Q

rash after diarrhoea

A

Haemolytic uraemic syndrome

83
Q

Markers of nephritic syndrome

A

proteinuria

haematuria

oliguria

hypertension.

84
Q

renal screening in diabetic patients

A

albumin:creatinine ratio (ACR) in an early morning specimen

85
Q

What are muddy brown casts suggestive of ?

A

acute tubular necrosis

86
Q

Which renal disease is caused by hypertension?

A

renal artery stenosis

NMF: Year 2 (12 decks)

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