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JG Year 1 > Renal colic and hypovolaemia > Flashcards

Renal colic and hypovolaemia Flashcards

1
Q

What is the 20 40 60 rule with regards to fluid and body weight?

A
  • 20% of body weight vol = ECF
  • 40% = ICF
  • 60% = total body water
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2
Q

Give 3 examples of transcellular fluid in the body

A
  • CSF
  • vireous humour
  • synovial fluid
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3
Q

What is transcellular fluid?

A

Fluid seperated from the plasma by the capillary endothelium which has specialised functions

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4
Q

What is osmotic pressure?

A

Pressure at which water is drawn into solution over a semipermeable membrane

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5
Q

What is osmolarity?

A

Total solute concentration in a solution - measured in mOsm/L

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6
Q

What is osmolality?

A

Molar concentration of solute particles per kg of solvent - measured in mOsm/kg

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7
Q

What happens to cells in a hypertonic solution?

A

Cells shrink as water moves across the plasma membrane to the to the more concentrated solution in the ECF

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8
Q

What happens to cells in a hypotonic solution?

A

Cells swell as the water moves intracellularly to a more concentrated environment

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9
Q

What is the main cation found intracellularly?

A

K+

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10
Q

What is the main cation found extracellularly?

A

Na+

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11
Q

How many sodium ions are exchanged for potassium ions by the Na/K pump?

A

3Na+’s for every 2K+

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12
Q

Where are osmoreceptors found?

A

In the hypothalamus

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13
Q

What is unusual about the capillaries adjacent to the osmoreceptors of the hypothalamus?

A

They are pearmeable unlike the rest of the BBB

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14
Q

What effect does ADH have on the distal collecting tubules in the kidney?

A

Makes them more permeable so that further resorption of water can happen

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15
Q

What effect does ADH have on the osmolality of blood?

A

Increases

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16
Q

Which electrolyte concentration in the blood determines the extracellular fluid volume?

A

Sodium

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17
Q

What is a colloid?

(give 2 e.g’s)

A

Solutions containing small solutes given IV which remain in the circulation for under an hour.

  • 5% dextrose
  • Hartmann’s
  • 0.9%NaCl
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18
Q

What are colloids?

(give 2 e.g’s)

A

Fluid containing a substance microscopically dispersed throughout. Remains in the circulation for hours/days.

  • gelatin polymers
  • hyoxywthyl starch
  • human albumin
  • blood
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19
Q

What is the range of normal serum levels of sodium?

A

135-145mol/L

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20
Q

What is the normal range for serum potassium?

A

3.5-5mol/L

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21
Q

What is the normal range for serum creatinine?

A

70-150 μmol/L

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22
Q

What is the normal range for serum urea?

A

2.5-6.7 mmol/L

23
Q

What could high creatinine and high urea signify?

A

Possible dehydration

24
Q

What are nuclear medicine studies useful for when looking at the kidneys?

A

To check function e.g. pre transplant

25
Q

Which part of the adrenal gland secretes:

  • mineralocorticoids
  • glucocorticoids
  • sex hormones
A

Cortex

26
Q

Which part of the adrenals secrete chatecholamines?

A

Medulla

27
Q

Name 4 types of shock

A
  • cardiogenic
  • hypovolaemic
  • obstructive
  • maldistributive
28
Q

Why does the skin feel cold and clammy in shock?

A

Increased resistance to blood flow to restore arterial pressure - redistribution of CO to the brain and heart and away from the peripheries

29
Q

What is the definition of DIC?

A

Pathological widespread activation of blood coagulation coupled with inappropriate haemorrhage due to the release of procoagulants

30
Q

Where are the 3 constrictions of the ureters?

A
  1. uteropelvic junction = anatomical constriction
  2. pelvic inlet = crossing the common iliac vessels
  3. entrance to the bladder
31
Q

What is the median umbilical ligament?

A

Remnant of the allantois - connects the apex of the bladder with the umbilicus

32
Q

What does the internal urethral sphincter prevent in men?

A

Retrograde flow of semen into the bladder during ejaculation

33
Q

Where do the parasympathetic preganglionic fibers come from to innervate the bladder?

A

Pelvic splanchnic nerves = S2 S3 S4

34
Q

What are the pubovesicle and puboprostatic ligaments?

A

Fibromuscular bands which suspend the neck of the bladder in women.

FIbers blend into the prostate in men

35
Q

Why isn’t ascites associated with kidney injury?

A

Kidneys are retroperitoneal

36
Q

What is the trigone?

A

Smooth triangular portion of the internal part of the bladder connecting the ureters and the urethra

37
Q

Which adrenal is crescent shaped?

A

Left

38
Q

Name a type of benign kidney tumour

A

Oncocytoma

39
Q

Which type of haematuria is most commonly seen in renal colic?

A

Microscopic

40
Q

Which tissue does renal cell carcinoma derive from?

A

Proximal tubular epithelium in the upper poles of the kidneys

41
Q

What is Von Hippel Lindau syndrome?

Which chromosome is it associated with?

A
  • AD condition which pre-disposes individuals to benign and malignant tumours (RCC)
  • Chromosome 3
42
Q

Which condition is associated with mutations in the proto-oncogene on chromosome 7?

A

Hereditory papillary RCC

43
Q

What makes up the most common type of kindey stone?

A

Calcium oxylate

44
Q

Where are the most common sites for stones to become lodged?

A

Wherever there is constriction of the ureters:

  • pelviureteric junction
  • arch over the iliac vessels
  • vesicoureteric junction
  • opening of the bladder
45
Q

What is desmopressin used for?

A

When treating urolithiasis - also reduces urine production

46
Q

When is nifedipine used in kidney conditions?

A

When helping the passage of stones

47
Q

Where is ADH secreted from?

A

Pituitary gland

48
Q

What kind of fluid loss is diarrhoea?

  1. hyperosmotic contraction
  2. hypoosmotic contraction
  3. isosmotic contraction
A
    • isosmotic contraction.

There is a decrease in ECF but not in its osmolarity

49
Q

What kind of fluid loss is seen in SIADH?

  1. isosmotic expansion
  2. hyposmotic expansion
  3. hyposmotic contraction
A
    • hyposmotic expansion

Hyponatraemia leading to excess water retention. Water–> into cells which increases the intracellular volume

50
Q

The loop of Henle is permeable to H2O but not to…?

A

Na+ - meaning resorption of H2O back into the circulation

51
Q

Describe how the SNS regulates blood volume

A
  • SNS innervated the juxtaglomerular cells which sense stretch of the afferent arterioles
  • less stretch when there’s decreased ECF volume + decreased mean arterial pressure
  • this is picked up in the carotid baroreceptors
  • they initiate renin secretion
52
Q

What are the mechanism for resolution of non-progressive stages of shock?

A
  1. fast = reflex controlled (baroreceptors and chemoreceptors)
  2. Intermediate = hormonal control (ADH, RAAS, Glucagon)
  3. Long-term recovery i.e. increased of blood volume, plasma proteins and red cell mass over time (6/52)
53
Q

What is ‘sick cell syndrome’?

A
  • Na+/K+ pump not working
  • cells swell due to uptake of water
  • dangerous in the CNS

JG Year 1 (27 decks)

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