Renal pathology Flashcards
Why are the kidneys so sensitive to drug toxicity?
receive a large amount of blood
Concentration at the hair pin loops means the medulla can get very concentrated with the drug
The concentration can greatly build up in the tubules and be reabsorbed.
What is Autonomic dysreflexia?
A massive sympathetic reaction in spinal injured patient in response to distented bladder and full rectum.
High BP
Low heart rate
Define the Bulbocavernosa reflex
pulling the catheter or pinching glan of penis/ clitoris which triggers constriction of the anus
what can Neuropathic Detrusor hyperreflexia lead to? and what is its main treatment?
Hydronephrosis
M3 Antagonists
What is the process called where damage occurs to the arterioles within the glomerulus due to excessive glucose (diabetes)?
hyaline arteriole sclerosis
Definition of CKD?
Renal impairment for >3 months
Define hydronephrosis .
The build up of fluid in the pelvis of the kidney leading to dilation of the pelvis and calcyes - eventually leading to atrophy of the kidney.
What can low Mg+ cause?
Low K+
Low Ca2+
What is the diagnostic criteria for oliguria?
<0.5ml/kg of body weight per hour
What are the most common Kidney stones?
Calcium Phosphate
Calcium Oxalate
Stuviate - Mg, Ammonia, PO4
What are the treatments for kidney stones?
<0.5mm will pass itself
> 0.6mm - tamsulosin
<2cm - Extracorapeal shockwave lithotripsy therapy
> 2cm - Percutaneous shockwave lithotripsy therapy
What is the syndrome which affects the NCC transporters in the early DCT?
Gitelman syndrome
What genetic disorder causes defects in the NK2C transporters in the thick ascending loop?
Barter Syndrome
What is the defect that renders the PCT functionally useless?
and what drug can cause it?
Fanconi Syndrome
Tetracycline
What syndrome causes defects in the ENac cells?
Liddle Syndrome
When would you see a euvolaemic and what is it?
Normal Na2+ due to increased water retention. Seen in SIADH
if a person has a eGFR of 60-89 what is there stage of kidney disease?
2: decrease in GFR without notable changes to kidney symptoms
If a person’s eGFR is 15-29, what stage are they?
Stage 4. with or without other symptoms
What is end stage kidney failure eGFR?
<15
What is the definition of renal injury/ disease?
Defined by reduced eGFR and detection of blood/ protein in urine.
Acute tubular necrosis causes? and what are they more vulnerable to and what is a pre-sign?
Reduced GFR - resulting hypoxia occuring to renal tubules.
More vulnerable to drugs and toxins.
Oligourea is a sign of this
Outline treatments used for renal disease
Reduce renal damage.
Reduce blood pressure which may occur due to fluid overload.
Reduce anaemia - EPO
Bisphosphonates - as hyperparathyroidism can come about
Why might a person develop hypocalcaemia from reduced GFR?
Reduction in 1 alpha hydroxylase enzyme activity
Reduction in phosphate excretion - Ca2+ and phosphate have to be kept in narrow parameters, so a rise in PO4- leads to a reduction in Ca2+
Reduced Reabsorption of Ca2+
What is oestodystrophy?
Secondary bone disease due to kidney disease:
- reduced vit D
- increased PTH
