Renal Anatomy & Disease

Question 1

total body water

Answer 1

50-70% body weight = water
intracellular fluid = 25-30L
extracellualr fluid = plasma, interstitial, transcellular e.g. CSF and urine in bladder

Question 2

[intra/extra cellular ion]

Answer 2

ICF = more K, less Na. ECF = less K, more Na
ICF = less Cl, more protein. ECF = more Cl, less protein
more proteins in plasma, as too big to pass through capillary endothelium
total amount of Na in plasma sets ‘effective circulating volume’

Question 3

daily balances of H2O

Answer 3

inputs - 150mM/day Na - diet

output - 10mM - stool and sweat and 140mM in urine

Question 4

kidney

Answer 4

major role in excretion
sits between 12 thoracic vertebrae and 3rd lumbar vertebrae
150g
from renal pelvis —-> into ureta —–> into bladder

Question 5

capsule of kidney

Answer 5

fibrous layer for structural integrity

Question 6

congenital abnormalities

Answer 6

renal agenesis = 1/2500, fatal
ectopic kidney = 1/800, damage and stones
horhsoe kidney = 1/1000, fused across midline, renal stones

Question 7

nephron

Answer 7

functional unit, 1-1.5 million per kidney
fluid moves from bowmanns capsule along different sections and reaches collecting ducts = urine
ultrafiltration = bowmanns capsule - proximal tubule - loop of henle - distal tubule - collecting ducts

Question 8

types of nephron

Answer 8

superficial - 85%, glomerular in cortex, loop of henle in outer medulla
juxtamedullary - 15%, golmerular just in outer medulla, deep loops of henle into inner medulla - plays biggest role in helping concentrate urine

Question 9

renal failure

Answer 9

fall in glomerular filtration rate = inc serum urea, inc creatinine
acute = reversible
chronic = irreversible, dialysis or transplant needed

Question 10

acute renal failure

Answer 10

history - short
haem level - no change
renal size - no change
peripheral neuropathy - absent
(nerve damage leading to problems with sensation and movement)

Question 11

chronic renal failure

Answer 11

history - long
haem level - decreases
renal size - decreases
peripheral neuropathy - present

Question 12

progression of renal failure

Answer 12

uraemia = describes group of symptoms: thickening of glomerular membranes, damage to glomeruli (capillary beds), progressive scarring of glomeruli, and tubular atrophy (nephron death), interstitial inflammation and fibrosis, reduction in renal size

Question 13

failure to excrete water and salt

Answer 13

hypertension
hyperkalemia
mild acidosis

Question 14

poor excretion of urea/creatinine

Answer 14

anorexia
nausea
neuropathy

Question 15

failure to produce erythropetin

Answer 15

anemia

lethargy

Question 16

leak of protein into urine

Answer 16

how doctors test for kidney issues

Question 17

failure to excrete phosphates

Answer 17

lowers serum Ca
metastatic calcification
bone disease

Question 18

stages on renal failure

acute mild

Answer 18

GFR = >75ml/min (125 = normal)
uraemic symptoms - no
serum biochemistry - normal
comment - not progressive

Question 19

stages on renal failure

mild

Answer 19

GFR - 50-75
symptoms - no
serum - subtle
comment - early bone disease

Question 20

stages on renal failure

moderate

Answer 20

GFR = 25-50
symptoms - mild
serum - mild
comment - anemia

Question 21

stages on renal failure

severe

Answer 21

GFR = 10-25
symptoms = moderate
serum = moderate
comment = salt and water retention

Question 22

stages on renal failure

end stage

Answer 22

GFR - <5-10
symptoms - severe
serum - severe
comment - dialysis/transplant

Question 23

causes of renal disease

Answer 23

kidney infection 
diabetes mellitus
hypertension
polycystic kidneys 
other
unknown

Question 24

treatment of renal disease

Answer 24

1 - aetiology and severity = treating cause
2 - treat reversible factors and complications = diet - restrict protein, salt and water, take phosphate binders
3 - slow progression, reduce symptoms = acidosis, diuretics
4 - plan dialysis and transplant