Renal anatomy + disease 2 Flashcards

1
Q

Describe renal failure

A

A fall in GFR leading to an increase in serum urea and creatinine

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2
Q

What is GFR?

A

Glomerular filtration rate - the rate at which filtration occurs

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3
Q

Describe acute renal failure

A

Reversible

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4
Q

Describe chronic renal failure

A

Irreversible
Slow gradual fall in failure
Too late once symptoms have arisen

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5
Q

How do haemoglobin levels change in chronic renal failure?

A

Haemoglobin levels decrease

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6
Q

How does renal size change in chronic renal failure?

A

Renal size decreases

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7
Q

What is peripheral neuropathy?

A

Peripheral nerve damage leading to problems with sensation or movement

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8
Q

Describe uraemia

A

Glomerular membrane (endothelium and collagen layers) and podocyte cells thicken ->
Can lead to glomerulosclerosis, fibrosis, tubular atrophy and interstitial inflammation
->
Reduction in renal size

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9
Q

How does renal failure lead to hypertension, hyperkalemia and mild acidosis?

A

The kidney fails to excrete water and salt so the glomerular doesn’t filter properly ->
Sodium remains ->
Water and salt are retained causing hypertension ->
Plasma potassium levels remain high causing hyperkalaemia ->
H+ ions aren’t secreted so pH of body fluids decrease leading to mild acidosis

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10
Q

What symptoms does poor urea and creatinine excretion lead to?

A

Anorexia
Nausea
Vomiting

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11
Q

What symptoms does protein leaking into urine cause?

A

Neuropathy
Pericarditis (inflamed pericardium)

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12
Q

What does production failure of erythropoietin lead to?

A

Anaemia
Lethargy

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13
Q

What does erythropoietin do?

A

Regulates the production of red blood cells

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14
Q

What symptoms does failure to excrete phosphates cause?

A

Phosphate binds to plasma calcium leading to calcification (osteoporosis and osteomalacia)
Pruritus (itching)

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15
Q

What is a risk associated with dialysis?

A

Increased risk of death due to infection

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16
Q

What stage does uraemic syndrome set in?

A

At the moderate stage

17
Q

What is the ‘normal’ GFR?

A

125ml/min

18
Q

What are the most common causes of renal failure?

A

Glomerulonephritis
Diabetes mellitus

19
Q

What is the mechanism for polycystic kidney disease?

A

Tubular structures are replaced by fluid filled cysts
Reduces the number of functional glomeruli

20
Q

What are the 5 steps for prescribing treatment?

A
  1. Chronic vs acute
  2. Aetiology and severity (treat the cause)
  3. Treat reversible factors (diet, restricting protein, salt and water)
  4. Reduce symptoms (Phosphate binders/ Na bicarbonate/ Diuretics)
  5. Plan dialysis/ transplantation