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renal > rev > Flashcards

rev Flashcards

1
Q

which artery is associated with horse shoe kidneys?

A

inferior mesenteric artery - gets caught on ascent

commonest congenital abnormality

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2
Q

lymphatics for testes

A

lumbar lymph nodes around aorta

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3
Q

histological difference between PCT + DCT epithelium

A

both cuboidal epithelium BUT

PCT = thick brush border = microvilli (large surface area)

DCT = no microvillia

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4
Q

what do juxtaglomerular cells secrete?

A

renin

juxtaglomerular cells = granular

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5
Q

3 components of juxtaglomerular apparatus

A

mucula densa = sense NaCl conc
juxtaglomerulat cells
mesangial cells

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6
Q

where actually is the juxtaglomerular apparatus?

A

specialised region where DCT passes adjacent to vascular pole of the SAME renal corpuscle

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7
Q

histology of collecting ducts

A

simpler columnar

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8
Q

histology of collecting ducts

A

simpler columnar

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9
Q

histology of urine conducting system

A

transitional epithelium - urothelium

cells on luminal suface = umbrella cell (facet) - thick, provides IMpermeable barrier

below is lamina propria = smooth muscle

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10
Q

how much of cardiac volume does the kidneys receive?

A

20% = 1 litre

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11
Q

gain of NaCl effect on fluid compartments

A

gain NaCl = increase ECF + decrease ICF
(GID)

loss = opposite

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12
Q

how much of the plasma entering glomerulus is filtered/leaves through efferent arteriole?

A

20% entering glomerulus is filtered

80% enters then leaves via efferent arteriole

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13
Q

what is the charge of the basement membrane?

A

negatively charged

endothelium -> basement membrane -> podocytes
RBC barrier -> plasma protein barrier (PPB) -> PPB

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14
Q

which forces act against net filtration pressure?

A

bowmans capsule HYDROstatic = 15mmHg

capillary ONCOTIC = 30

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15
Q

net filtration pressure

A

10mmhg

(55+0)-(15+30) = 10

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16
Q

affect of nictotine + alcohol on ADH release

A

nicotine stimulates ADH release

alcohol inhibits ADH release

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17
Q

what conditions may present with resp acidosis?

A

(CO2 retention)

COPD, asthma, airway restriction

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18
Q

what conditions may present with metabolic acidosis?

A

excess H+

sepsis, lactic acidosis, DKA

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19
Q

what conditions may present with metabolic alkalosis?

A

(net loss of H or gain in HCO3)

vomiting, diuretics, hyperaldosteronism, hypokalaemia

20
Q

target saturations in COPD patient

A

88-92%

monitor ABG closely

21
Q

reduced anion gap causes

A

myeloma

hypoalbuminaemia

22
Q

raised anion gap causes

A

alcohol, kentones, Uraemia, DKA**

Isoniazid, Lactic acidosis
Ethylene glycol, Salicylate poisoning

23
Q

how does CKD cause secondary hyperparathyroidism? management ?

A

vit D os hydroxylated in kidney (impaired in CKD)
–> leads to reduced calcium absorption + 2nd hyperpara

in advanced CKD - serum phosphate rises, also increased PTH

Mx = alfacalcidiol, phosphate + phosphate binders

24
Q

foot process fusion on electromicroscopy

A

minimal change GN

complete remission with steroids

25
Q

glomerular crescents on biopsy

A

rapidly progressive GN

26
Q

positive congo red staining showing apple green befringence under polarised light

A

amyloidosis

27
Q

proteus UTIs

A

associated with formation of stones, foul smelling, burnt chocolate?

28
Q

pseudomonas aeruginosatreatment

A

ciprofloxacin - resistant to most others
–> is a Cdiff risk drug

gram neg bacillus - not a coliform

29
Q

which causative organisms of UTIs do NOT give a positive test?

A

enterococcus

30
Q

where does spironolactone act? side effects?

A

aldosterone antagonist that acts on CORTICAL COLLECTING DUCTS

SE = hyperkalaemia + gynacomastia

31
Q

what brain abnormality can acute severe hyponatraemia cause?

A

cerebral oedema

thiazides inhibit dilution in DCT

32
Q

What is measured to obtain renal plasma flow?

A

para-amino hipuric acid (PAH)

Renal plasma flow = (amount of PAH in urine per unit time) / (difference in PAH concentration in the renal artery or vein)

Normal value = 660ml/min

33
Q

where is the greatest amount of sodium reabsorbed?

A

proximal CT - due to Na/k ATPase action

-> msot filtered water is absorbed here too (osmosis)

34
Q

activity of zona glomerulosa in dehydrated state

A

increased (release aldosterone)

increased activation of RAAS

35
Q

secretion levels of ADH in dehydrated state

A

increased secretion - increase water reabsorption in collecting duct

36
Q

drugs which can cause hypokalaemia

A

thiazide diuretics
loop diuretics
acetazolamide

salbutamol (treatment of hyperkal)

37
Q

drugs which can cause hyperkalaemia

A 
ACEi, ARBs
spironolactone
heparin
ciclosporin
amiloride
K supplements
38
Q

Excessive production of which hormone in the adrenal can lead to hyper-androgenic effects such as hirsutism, deepening of the voice and increased libido? where is it produced?

A

dehydroepiandrosterone (DHEA)
–> zona reticularis

(androgen hormone that can be converted into the more biologically active testosterone)

39
Q

losartan drug type

A

ARB - stop in AKI

40
Q

what are the complication of diabetes neuropathy due to?

A

enzymatic glycosylation of the basement membrane

41
Q

AFP + HCG levels in seminomas

A

normal

usually raised in teratomas + yolk sac tumours

42
Q

most common renal carcinoma in kids

A

Wilms tumour

43
Q

acetazolamide prescribed for glucoma has what affect on the kidney?

A

mild diuretic effect through inhibition of carbonic anyhydrase
-> reduces reabsorption of sodium + therfore water in PCT

44
Q

staghorn calculi

A

composed of struvite

urease producing bacteria - proteus

(assoc with recurrent/chronic infections)

45
Q

where in the GI tract is the majority of water absorbed?

A

jejunum

46
Q

difference between loop + thiazide diuretics

A

both SE of hypokalaemia + hyponatraemia(diuretic excess)

loop = increases Ca EXCRETION, may precipitate renal calculi formation

thiazide = increases Ca resorption, used to control calculi formation

renal (15 decks)

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