renal key notes Flashcards
16 y/o low grade fever started a week ago, feeling fatigued, indicates pain in joints. visiting toilet more.
Urine dipstick shows trace proteins. Blood test shows raised eosinophils.
Likely diagnosis is:
Acute tubulointerstitial nephritis.
- –> fever
- –> skin rashes
- –> raised eospinophils
Dysuria
Elevated white cell count
Raised leukocutes
Raised nitrites in urine
charactersitic of:
UTI
33 y/o female, A&E severe RHS flank pain/ pain started 3hrs ago, not constant. moving towards right iliac fossa. nauseas and has low grade fever.
most likley has?
Suspected renal stone.
Thus appropriate action would be abdominal USS.
Diabetic nephropathy always presents with:
increased proteinuria.
21 y/o female complains of urinary frequency, nocturia, constipation and polydipsia. symptoms started 2 weeks ago.
genreal malaise, some pain in her left flank.
most appropriate investigation is:
Patient has symptoms of hypercalcaemia.
measure calcium/
renal carcinoma characterised by what triad
- haematuria
- flank pain
- abdominal or flank mass
alongside malignancy symptoms
- weight loss
- malaise
67 y/o diabetic female, collapsed while going to toilet. did not lose consciousness, appears well.
Urine dipstick positive for glucose nitrates, leukocytes and haematuria
UTI
66 y/o poorly controlled T2DM, 2 day history of severe pain in RHS flank, nausea and fevers that come and go/
on examination patient appears unwell, sweaty and has visible rigors with temp of 38 degrees.
Urine dipstick positive for protein, blood, leukocytes and nitrates/
CT of abdomen reveals gas in renal parenchyma
likely diagnosis?
Pyelonephritis.
- GRAM NEGATIVE
describe the action of NSAIDs on glomerular filtration pressure?
vasoconstriction of afferent arteriole.
bladder’s lymphatic drainage is predominantly by:
- external and internal iliac nodes
para-aoritc lymph nodes predominantly drain:
- the ovaries and testes
ADH key facts
- released from posterior pituitary
- acts on aquaporin 2 channels in apical membranes
- of DCT and collecting ducts
left testicular vein drains into…
left renal vein
in patients complaining of abdominal discomfort and nausea, with frequent epsiodes of kidney stones and UTIs. what anatomical abnormality may be found on imaging?
- horse shoe kidney
- fused kidneys crossing anterior to aorta
18 month baby boy with recurrent urinary tract infections.
he is noted to have abnormal renal function.
USS performed showing bilateral hydronephrosis.
most likely underlying diagnosis
patient may have posterior urethral valves
46 yo female, acute intermittent sharp pain in RHS flank, haematuria, slight nausea, history of hyperparathyroidism. BMI of 28. restless and right flank tenderness.
What substance is most likely causing the pain in this patient?
- renal colic caused by renal stones
- most renal stones are made up of calcium oxalate
Rampiril
ACE inhibitor
chancre
painless genital ulcer.
most commonly formed during primary stage of syphillis.
majority of renal phosphate reabsorption occurs in the ….
PROXIMAL CONVOLUTED TUBULE
which cells detect changes in salt concentrations and adapts the glomerular filtration rate accordingly?
- macula densa
Describe where principal cells are located and their role?
- located in DCT
- have ADH and aldosterone receptors
which cells are located in DCT and have aldosterone and ADH receptors?
- principal cells
Role of juxtaglomerular cells?
- smooth muscle cells
- mainly lcoated in afferent arteriole walls
- baroreceptors
- detect BP changes
- secrete RENIN
mechanisms a patient in hypovolemic shock may use to maintain BP
- increase heart rate
- peripheral vasoconstriction
- arterioles are sites of highest resistance in CV system
29 y/o male, polyuria, polydipsia, in hospital previously for a head injury.
water deprivation test was done.
pituitary MRI showed thickened pituitary stalk.
patient most likely has?
- diabetes insipidus
y wave on JVP
ventricular filling
emptying of right atrium
arterial baroreceptors located
carotid sinus and aortic arch
bladder recieves parasympathetic innervation from
- pelvic splanchnic nerves
what recieves venous drainage from the bladder and prostate?
- vesicoprostatic venous plexus
A 25-year-old man is injured in a road traffic accident. His right tibia is fractured and is managed by fasciotomies and application of an external fixator. Over the next 48 hours his serum creatinine rises and urine is sent for microscopy, muddy brown casts are identified. What is the most likely underlying diagnosis?
acute tubular necrosis.
acute interstitial nephritis
- usually occurs aar of drug toxicity
- no muddy brown casts
A 63-year-old male presents with several episodes of haematuria. He suffers from COPD secondary to long term smoking. What is the most likely underlying cause?
transitional cell carcinoma of bladder strongly linked to smoking/
Alport syndrome
- X linked dominant
- defect in type 4 collagen gene
- abnormal glomerular basement membrane
42 y/o female with diabetes. has been started on metformin. worried about how diabetes will affect kidneys longterm.
by which mechanism does the most damage to kidneys occur?
- non-enzymatic glycosylation of vascular membrane
- in large and medium vessels leads to atherosclerosis
- NEG in small vessels —-> hyaline arteriosclerosis
- sclerosis of renal efferent arteriole of glomerulus
- leads to nephropathy
bladder receives sympathetic innervation from the?
superior and inferior hypogastric plexuses
horseshoe kidneys become trapped under what which prevents their anterior ascent
inferior mesenteric artery
in females the bladder is drained by
- vesicouterine venous plexus
40 y/p RUQ pain, radiates to RHS shoulder, nausea and vomiting. palpable abdominal mass, Murphy’s sign positive.
- cholecystitis
- leads to post hepatic jaundice aar of biliary obstruction
A 56-year-old male presents to rheumatology clinic with ongoing pain from his rheumatoid arthritis, he is initiated on a NSAID for pain control, what affect does this have on the kidneys?
- afferent arteriole constriction
