Renal Physiology

Question 1

what is the associated cause to chronic renal failure?

Answer 1

diabetes

hypertension

vascular disorders

Question 2

what is glomerulosclerosis

Answer 2

continuing damage to kidney function

Question 3

what are the 2 main drivers of CKD?

Answer 3

Proteinuria

Angiotensin II

Question 4

what does glomerular hyperfiltration lead to ?

Answer 4

increase in glomerular capillary permeability

increase in protein level in interstitial fluid

accumulating protein levels lead to tubulointestilital injury

Question 5

what effect goes angiotensin II does to CKD

Answer 5

promotes glomerular hypertension

Question 6

What are the CKD manifestations?

Answer 6

Azotemia
- decrease kidney function leads to a buildup of urea and creatinine

Uremia
pathological build-up of nitrogenous waste

Question 7

what is uremic syndrome and what could it be the impact

Answer 7

an inflammatory state associated with high levels of nitrogenous compounds

lead to:
glucose tolerance
abnormal lipid metabolism
hyperparathyroidism

Question 8

what is acute kidney injury

Answer 8

abrupt loss within 7 days of renal function

Question 9

what cause AKD

Answer 9

ischaemia

drugs

hypotension

Question 10

how can the AKD be classified as?

Answer 10

Prerenal

Intrarenal

posternal

Question 11

what is prerenal AKI

Answer 11

reduced renal blood flow –> renal hypoperfusion

Question 12

what is intrarenal AKI

Answer 12

a disorder involving the tissue of the kidney

could lead to acute tubular necrosis

Question 13

what is postrenal AKI

Answer 13

blockages cause an increase in pressure within the kidney

Hypertension leads to a loss of filtrtion

Question 14

What 3 phases does AKI have?

Answer 14

initiation phase

Oliguirc phase

repair phase

Question 15

what can AKI lead to

Answer 15

metabolic acidosis

hyperkalaemia

uremia

Question 16

How do we know if patient have AKI?

Answer 16

increase in serum creatinine b >0.3mg/dl within 48 hours

Increase in serium to >1.5times in 7 days

Urine volume < 0.5ml/kg/h for 6 hours

Question 17

what is glomerulonephritis and what does it cause by?

Answer 17

is the damage to your tiny filters (the glomeruli)

its cause by immune system attacking its own body

Question 18

what are the form of acute glomerulonephritis

Answer 18

Post-infective

Rapidly progessive

Goodpasture’s syndrome

sytemic auto-immune conditions (i.e. SLE - Systemic lupus erythematosus)

Question 19

post-infective glomerulonoephritis

Answer 19

infaction with group A haemolytic strptococci

it is a deposition of complement and immune cell infiltration result in loss of kidney function

Question 20

symptoms of Post-infective glomerulonephritis

Answer 20

oliguria - initial stage
haematuria
proteinuria
Oedema - due to sodium retention

Question 21

what kind of stain can reveal the immune complex deposition in the capillaries

Answer 21

Anti-C3 antibody

Question 22

streptococcus pyogenes

Answer 22

gram positive organism

could cause:

• strep throat
• scarlet fever

can produce toxin as well !!

Question 23

Goodpasture’s syndrome

Answer 23

high aggressive form of glomerulonephritis

cause by antibodies like anti-GBM & form of IgG

HLA-DRB1 predisposition

Question 24

nephrotic syndrome

Answer 24

cause by gross proteinuria
could also lead to hypoalbuminaemia

damage the glomerular membrane

IgA nephropathy is the cause of it

Question 25

what is Berger’s disease

Answer 25

when IgA deposits builds up in the kidney, causing inflammation in the membrane and damage the kidney

Question 26

oncogenes

Answer 26

mutated formas of normal genes which can drive to malignant change

Question 27

tumour suppressor genes

Answer 27

inhibit cell growth and promotes apoptosis

Question 28

DNA repair genes

Answer 28

fix any errors which may have occured in the genome

Question 29

where can renal cancer arise from

Answer 29

adenomas (noncancerous tumors)
renal cells
renal pelvis
transitional cell carcinoma

Question 30

Wilm tumour

Answer 30

most common kidney cancer in children

strongly associated with congenital abnormalities (WT1 gene)

Question 31

what diagnosis can be used for wilm’s tumour?

Answer 31

renal biopsy

Question 32

renal clear cell carcinoma

Answer 32

arise from proximal tubular epithlial cells –> high concentrations of epithelial cells

Question 33

what kind of treatment is used in renal carcinoma?

Answer 33

surgery

targeted chemotherapeutic

cytokine infusion are used
–> inerleukin-2

Question 34

what does nivolumab do?

Answer 34

prevents the binding of ligand and receptor

Question 35

what does axitinib do?

Answer 35

small molecule tyrosine kinase inhibitor
Binds to VEFGR 1-3.
Prevents angiogenesis.
Prevents vasculogenesis.
May also promote autophagy.