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Block 1- Kim > Revision > Flashcards

Revision Flashcards

1
Q

What do intercalated and principle cells do in the DCT?

A

Intercalated:

  • H+ secretion
  • K+ resorption

Principle cells:

  • Na resorption
  • K+ secretion
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2
Q

Acid- Base Balance: In the Kidneys how is HCO3 reabsorpbed and where?

A

PCT:

  • Carbonic anhydrase
  • Na reabsoprbed & H+ excretion

DCT:

  • Intercalated cell: (both on tubular membrane)
    • H+ ATPase
    • K/H ATPase (H out, K in)
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3
Q

Acid Base Balance: How is H+ secreted in the Kidneys

A

Late DCT:

Intercalated cell A:

  • H+ ATPase
  • K/H ATPase

However this is not sufficient on its own so you need: URINARY BUFFERS- as both below processes occur HCO3- is made and being added to blood

Phospahte:

(I think anywhere this can happen)

  • Na/ H exchanger (Na in and H out)
  • NaHPO4- combines with H+

Ammonia:

  • In PCT Glutamine synthesied to form NH4+
  • In CCT: NH3 secreted. H+ATPase secretes H+ which combine to make NH4+
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4
Q

a) Where does Gluconeogenesis occur?
b) Where do glycogenolysis occur?

A

a) Liver & Kidneys
b) Liver & Skeletal muscle

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5
Q

What transports Iodide into the follicular cell?

A

Na/ I symporter

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6
Q

What converts iodide into iodine?

A

Thryoid peroxidase

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7
Q

What take iodine from the follicular cells –> Colloid?

A

Pendrin

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8
Q

Where is thyroglobulin synthesised?

A

In the follicular cell

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9
Q

Why type of hormone is the thyroid hormone?

Therefore how does it travel in blood?

A

Steroid hormone

70% Thyroid Binding Globulin

30% Albumin

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10
Q

What does thyroid binding globulin have a higher affinity for?

A

T4

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11
Q

How does T3 have an action on target cells?

A

T3/ T4 enters cell via: Diffuse/ Transported MCT 8(10)

T4 –> T3 via deiodinases

T3 binds to intracellular receptors (alpha or beta)

Interacts and binds w/ DNA and changes protein synthesis

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12
Q

Describe the types of deiodinases- where are they found?

A

Type 1: T4 –> T3 Activates inner and outter ring. Found on most cells- liver, kidney, brain, thryoid

Type 2: T4 –> T3 Activates outter ring. Intracellular raise- CNS, brown fat, placenta, MSK, SK/ Cardiac muscle

Type 3: T3–> T2 or T4 –> rT3. Remove T2- placenta/ CNS

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13
Q

What are the physiological actions of T3?

A
  • Metabolism (increase BMR)
  • Maturation & Differentiation- Bone, lungs & Brain
  • Neurological Function- Synapse formation, myelinogenesis, Neuronal outgrowth
  • Growth: CNS/ Skeletal development
    • Regulated by GH but T3/T4 needed
    • By 12 week of gestation gland makes/ secretes t3/t4 so need suficient iodine from mother
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14
Q

Beyond insulin and glucagon give some hormonal examples of glucose control

A
  • Adrenaline- increase glucose production and lipolysis
  • Cortisol- increase glucose production and lipolysis
  • Growth Hormone- increase glucose production and lipolysis
  • FFA- increase glucose production
  • Incretins eg: GLP-1
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15
Q

Describe how insulin is secreted

A

1) Extracellular glucose is transported into B cells via GLUT 2
2) Metabolised to ATP which increases the ATP: ADP ratio in cell
3) Cause closure of ATP dependant K+ channels
4) –> Depolarisation of cell membrane
5) –> Influx of caclium via voltage gated calcium channels
6) –> Exocytosis of insulin from stored vesicles

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16
Q

Talk about the stages of biphasic insulin secretion:

A

Stage I: Rapid onset and lasts 10 mins

Release of pre-docked & primed vesicles

Stage II: Prolonged plateau. As long as hyperglycaemia exists

Transport –> Dock –> Prime –> Fusion

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17
Q

Talk about how insulin promotes glucose –> Cell

A

Anabolic (Promote Glycogen synthase, Lipogenesis, Protein synthesis & Mitogenesis. Prevent Protein and lipid breakdown)

Bind to GLUT 4 receptor on cell membrane

GLUT 4 stored in IC vesicles. Insulin promotes vesicular fusion & transportation and insertion into the wall. Causing glucose –> cell

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18
Q

Fed State: Entero-Insular Axis:

What are the two hormones produced?

Where are the produced from?

What are they produced in response to?

What are they degraded by?

A

Gastrointestinal Insulinotropic Peptides: Gastric Inhibitory Peptide, Glucagon Like Peptide

Produced by L cells of SI

Produced in response to oral glucose load to augment insulin secretions

Degraded by: Dipeptidyl-peptidase 4

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19
Q

What causes DMT1?

What are the 4 Cardinal symptoms?

What is DKA caused by? Symptoms? Causes?

A

AI disease, selective destruction on pancreatic B cells –> complete insulin deficiency

Symptoms: Weight loss (unopposed proteolysis & lipolysis), Polydyspia, Polyuria, Hyperglycaemia

DKA: Production of KB (from b oxidation of FA) as alternative energy source. Symptoms: High RR, Abdo pain. Causes: Preceed illness/ missed insulin dose

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20
Q

What are the complications (bar hyperglycaemia) of DM. Split into Macrovascular and Microvascular

A

Macrovascular:

  • Nephropathy
  • Retinopathy
  • Neuropathy

Microvascular:

  • IHD
  • PVD
  • Cerebrovascular disease
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21
Q

What type of hormone is insulin?

A

Peptide hormone

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22
Q

GLUT 1:

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 1.5mM

Specificity: Glucose, Galactose, Mannose

Tissue Distribution: Ubiqutos, RBC, Brain

Notes: low affinity increase basal uptake

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23
Q

GLUT 2:

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 15mM

Specificity: Glucose, Fructose

Tissue Distribution: Pancreatic B cells, Liver

Notes: high affinity therfore low basal uptake

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24
Q

GLUT 3:

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 1.8mM

Specificity: Glucose

Tissue Distribution: Brain, intestine, placenta

Notes:

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25
Q

GLUT 4

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 5mM

Specificity: Glucose

Tissue Distribution: Muscle, Adipose

Notes: INSULIN SENSITIVE

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26
Q

GLUT 5:

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 10mM

Specificity: Fructose

Tissue Distribution: Intestine

Notes:

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27
Q

SGLT 1

Affinity

Specificity

Tissue Distribution

Notes:

A

Affinity: 0.3

Specificity: 2 Glucose: 1 Sodium (and galactose)

Tissue Distribution: Intestine & Kidney

Notes:

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28
Q

SGLT 2:

A

Affinity: 1.5mM

Specificity: 2 Glucose: 1Sodium

Tissue Distribution: Kidney

Notes:

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29
Q

Rectus Abdominus:

Attachments

Nerve supply

Function

A

Pubic bone –> Xiphoid process & CC of ribs 5-7

Nerve: T7-T11

Functions: Compress abdominal viscera, stabilse pelvis during walking, Depress ribs

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30
Q

What is the rectus abdominus covered in? And what is this structure called?

What does it contain? Why is this important?

Arcuate line- talk about the what happens to the strucutre ^?

A

Aponeurosis of the flat abdo muscles forming the rectus sheath

Rectus sheath contains the inferior epigastric artery & vein. THe superior & inferior epigastric artery unite in the rectus sheath blood flow via subclavian to external iliac

At arcuate line the rectus sheath only surrounds the RA anterirly so posteriorly RA are in direct contact with the transversalis fascia

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31
Q

External obliques:

Attachment

Nerves

Functions

A

Attachment: Ribs 5-12 –> Iliac crest & Pubic tubercle

Nerves: T7-T12 (Subcostal)

Functions: Contralateral rotation of torso

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32
Q

Internal obliques:

Attachment

Nerves

Functions

A

Attachment: Inguinal ligament, Inguinal canal & Lumbodorsal fascia –> Ribs 10-12

Nerves: T7-T12 plus ilioinguinal & iliohypogastric

Functions: Bilateral contraction compresses abdo, Ipsilateral contraction –> Ipsilateral rotation of torso

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33
Q

Transverse Abdominus

Attachment

Nerves

Functions

A

Attachment: Inguinal ligament lateral 1/3, Costal Cartilages 7-12 –> Aponeurosis linea alba, pubic crest and pectinate line

Nerves: T7-L1

Functions: Compress abdominal contents

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34
Q

What are the collective functions of the Anterior Abdominal muscles?

A
  1. Keep abdo viscera in abdo cavity
  2. Assist viscera in maintaing position
  3. Protect abdo viscera from injury
  4. Assist in forcefull expiration- push abdo viscera upwards
  5. Increase intra abdo pressure: coughing, vomiting, defecation
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35
Q

Name the 5 abdominal incisions

A

Median

Paramedian

Subcostal

Pfannestiel (suprapubic)

Gridiron @ McBurney’s Point

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36
Q

Why is the rectus muscle displaced laterally in an paramedian scar?

A

So you go towards the nerve supply

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37
Q

Why is a Gridion incision made?

Which nerve is at risk?

A

@ McBurney point 1/3 way from ASIS to umbilicus

Damage to the iliinguinal / iliohypogastric nerve

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38
Q

Where is a Pfannestil scar?

What nerve is ar risk of damage?

A

Suprapubic

Ilioinguinal nerve @ risk

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39
Q

Where is a subcostal incision made?

What must you preserve?

A

2 finger bredth below the costal margin & lateral to the linea alba

Preserve T9, superior epigastric artery and thoracoabdominal nerves

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40
Q

Which part of the pancreas is NOT retroperitoneal?

A

Tail of Pancreas

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41
Q

Where is the lesser omentum? What is it made of?

What does it contain?

A

Between the liver & stomach

From Ventral mesentary

Portal triad- Portal vein, Hepatic Artery & Common Bile duct

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42
Q

What are the 3 main branches of the Coeliac Trunk?

A

Common hepatic

Left gastric

Splenich vein

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43
Q

Where is the root of the mesentery?

What does it divide?

A

Origin of the mesentry from the SI (Jejunum and Ilium)

Divies the Infracolic sac into Left & Right

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44
Q

What is the greater oemntum made of?

A

Dorsal mesentary

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45
Q

What cells are found in gastric glands?

A

Parietal cells (IF & HCL)

Chief cells (Pepsinogen)

G Cells (Gastrin)

Mucus surface/ neck cells

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46
Q

What cells make somatostain?

A

D cells

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47
Q

Where are parietal cells found (Aside from gastric glands)?

A

Oxyntic Gland area- proximal 80% stomach

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48
Q

Where are G cells found (aside from gastric glands)?

A

Pyloric Gland area- Antrum region

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49
Q

What are the hormones released by the enteric plexus during receptive relaxation?

A

NO

Seratonin

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50
Q

Give an example of Cocci

a) -ve
b) +ve

A

a) Neisseria menigitidis, Haemophiulus influenzae
b) Strep/ Staph species

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51
Q

Give an example of a Bacillus

a) -ve
b) +ve

A

a) Samlonella, Escherichia Coli
b) Lactobacilli species or Bacillus Anthracis

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52
Q

Give some differences between bacteria & human cells

A
  • Bacteria has Pilli/ Flagella
  • Bacteria x10 bigger
  • Bacteria is prokaryote
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53
Q

Give some differences between virus and bacteria

A
  • Virus have envelope stolen from host cell
  • Virus only have RNA (bacteria = DNA in single strand)
  • Bacteria: Flagella, Pilli, Chromosome, Cell Wall
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54
Q

Define GORD

A

Reflux of acid contents through LOS

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55
Q

Define Reflux Oesophagitis

A

Caused by persistant reflux episodes

Damage of oesophageal mucosa/ inflammation

56
Q

What are the types of incontinence?

A
  • Stress
  • Functional
  • Overflow
  • Urgency
57
Q
A
58
Q

What planes and what way does the stomach rotate?

A

Stomach rotates to the right around longitudinal axis and clockwise around saggital axis

59
Q

What structures in the abdomen become secondarily retroperitoneal during development?

A

Pancreas and duodenum

60
Q

What does greater and lesser omentum develop from?

A

Greater omentum from Ventral Mesentry

Lesser omentrum from Dorsal Mesentry (is the periotneum between the stomach & liver)

61
Q

Explain the divisions of the greater sac?

A

Supracolic: Superior to TC and Anterior to Greater Omentum

Infracolic: Inferior to TC and Posterior to Greater Omentum

62
Q

Where does the liver grow out from?

What holds it in the adult position? What is the exception?

A

Ventral mesentary

Peritoneum holds it in position but there is a bare area where the top of the liver touches the diaphragm

63
Q

What does the Falciform Ligament contain? What was it embryologially?

A

Ligamentum Teres- remnent of umbilical vein

64
Q

What are the 4 lobes of the liver from the posterior view?

A

Right, Left, Caudate, Quadrate

65
Q

What is the Caudate lobe bound by?

One of the features is an embryological remanent of something- name it

A

IVC and Ligamentum Venosum- embryological remnant of Ductus Venosum

66
Q

Label

What is the function of these?

A

Right and Left Triangular ligament and Coronary ligaments attach the liver to diaphragm

67
Q

Describe the blood supply to the liver

Where does this run?

A

In the free edge of the lesser omentum

68
Q

What does the free edge of the lesser omentum contain?

A

Portal triad- Common bile duct, Hepatic artery, Portal Vein

69
Q

What is the pringle manoeuvre?

A

Pinch the free edge to cut off blood supply to the liver

70
Q

Describe the regions of the gall bladder and any surface anatomy

A

Fundus (at top) 9th CC which is L1

Body

Neck (at bottom)

71
Q

Describe the duct system of the gall bladder

A

CD= Cystic Duct

72
Q

What can refer pain to the Right shoulder?

A

Gall bladder/ Liver via phrenic nerve

73
Q

Describe the surface anatomy of the pancreas

A

Epigastric region- head nestles in the C of the duodenum (L1-L3) and extends into left hypochondrium.

Pancreatic neck sits on transpyloric plane

Pancreatic tail sits near splenic hilum

74
Q

What organs are foregut derivates?

A

Liver and Pancreas

75
Q

What is the sphincter that guards the entrace into the duodenum from the Ampulla of Vata?

A

Hepato-pancreatic sphincter

76
Q

Where can pancreatitis cause pain?

Where can fluid accumulate?

A

Epigastric/ Back pain

Fluid accumulation in lesser sac

77
Q

What is the blood supply of the pancreas?

A

CT- Superior pancreaticoduodenal artery

SMA: Inferior pancreaticoduodenal artery

Splenic Artery Branches

78
Q

What is the lymph drainage of the pancreas?

A

Coeliac nodes –> Thoracic Duct –> Supraclavicular

79
Q

What is the surface anatomy of the spleen?

A

Ribs 9-11 or Ribs 10-12

80
Q

Describe antigen detection testing?

A

Monoclonal antibodies produced against antigen

81
Q

Describe and define PCR Testing

A

Exponential replication of specific DNA or RNA sequence

Prime produced against a DNA/ RNA sequence

  • Denaturation
  • Annealing
  • Extension
82
Q

Define Serology

A

Detection of an antibody against a speific pathogen

83
Q

Describe ELISA

(Enzyme Linked Immuno-sorbent Assay)

A

(Specific antigens are produced from pathogens and used to detect antibodies)

1) Antigen specific for ____
2) Serum mixed with fixed antigen and patient’s antibodies- these will bind if present
3) An antibody with an enzyme attached if used to bind the patient’s antibody
3) Unbound antigens are washed off
5) Colourless substrates are added and converted to coloured products by enzymes
6) Coloured product indicated postive test result

84
Q

What are the sympathetic exceptions of receptor type?

A
  • Chromaffin cells of Adrenal Medulla
  • Sweat Glands

Ach Muscarinic receptors

85
Q

Describe how the sympathetic chain communicates with spinal nerves

A

White Ramus Communicans:

  • Only leaving T1-L2 spinal nerves
  • Pre-ganglionic sympathetic neurones go into sympathetic chain

Grey Ramus Communicans:

  • At all spinal levels
  • Post-ganglionic sympathetic neurones pass into spinal nerves

Splanchinic

  • Take sympathetic nerves to organs of the body
86
Q

What can cause Horner’s Syndrome?

A
  • Pancoast tumour
  • Iatrogenic
  • IJV canulation
  • Cervical cord damage (Reticulospinal neurones innervate preganglionic sympathetic fibres in the lateral grey horn) (Medullary tract)
87
Q

Name the sympathetic Ganglia in the neck

A
  • Stallate (near lung apex)
  • Middle cervical
  • Superior cervical (near skull base)
88
Q

When may you conduct a sympathectomy?

A
  • Raynauds
  • Hyperhidrosis
89
Q

Name the pre-aortic ganglia

A
  • Coeliac (T5-T9)
  • Aorticorenal
  • Superior mesenteric (T10-T11)
  • Inferior mesenteric (T12-L1)

They supply the gut tube

90
Q

Draw out how parasympathetics travel with CNX to an organ

A

Dorsal Nuclei of Vagus, travel with CNX and synapse at organ specific ganglia

(Forgut and Midgut supplied by this, Hindgut supplied by S2-S4)

91
Q

How do the other parasympathetics (not CNX) travel to organs?

A

CN 3,7,9

  • Preganglion parasympathetics travel with CN 3,7,9
  • Synapse @ peripheral ganglia
  • Then post-ganglionic travel with branches of CN V
92
Q

What is Frey Baillarger Syndrome?

A
  • Gustatory sweating of face post parotid surgery/ injury
  • PS nerve regrow to innervate muscarininc receptors of sweat glands (normally sympathetic innervated)
93
Q

Coeliac Disease

Where is the site of Pathology?

What is the Defect in Absorption/ Digestion?

A

a) Duodenum & Jejunum- damage to mucosa
b) Fats and Lactose Hydrolysis

94
Q

Pancreatitis

Where is the site of Pathology?

What is the Defect in Absorption/ Digestion?

A

a) Pancrease
b) Fat digestion

95
Q

Surgical resection Ilium/ Chron’s

Where is the site of Pathology?

What is the Defect in Absorption/ Digestion?

A

a) Terminal Ilium
b) B12 deficiency, Bile salts/ Bile acid absorption

96
Q

Lactase Deficiency

Where is the site of Pathology?

What is the Defect in Absorption/ Digestion?

A

a) Small intestine
b) Lactase hydrolysis

(Lactose passes into LI where its broken down by gut bacteria then fermented. Gases, Organic acids, other osmotically active particles are made –> Bloating and Increased Motility)

97
Q

Describe how B12 is absorbed

A

Stomach: Binds to R protein

Duodenum/ Jejunum: Bind to IF

Terminal Ilium: Absorbed by receptor mediated endocytosis

Mucosal Cell Ilium: B12 released from IF

B12 released into blood & carried by B12 binding protein

98
Q

Describe the Gastrocolic reflex

A

Mediated by Gastrin & Autonomic nerves

Initiate Colonic Mass movements (peristalsis)

Colonic contents –> Rectum –> Defeacation (via defeacation reflex)

99
Q

Describe the Defecation reflex

A
  1. Contraction of the rectum.
  2. Relaxation of the internal anal sphincter.
  3. An initial contraction of the external anal sphincter.
  4. Increased peristaltic activity in the sigmoid colon.
  5. Relaxation of the external anal sphincter.
  6. Expulsion of faeces.
100
Q

Describe the valsalva manouvre

A
  1. Full inspiration followed by forced expiration against a closed glottis causes the diaphragm to move downwards.
  2. The abdominal and thoracic muscles are contracted.
  3. Increased pressure in the abdomen forces faecal contents into the rectum.
  4. The defaecation reflex is initiated.
101
Q

What does the posterior RAMUS supply?

How may it be injured?

A

Adjacent uscles of the back and overylying dermatome

Injury via: Facet Joint Pathology

102
Q

Describe IV disc degeneration stages

A
  • Degenration
  • Prolapse
  • Extrusion
  • Sequestration
103
Q

What nerves are included in cauda equina?

A

L3-S5

104
Q

Where are the sacral spinal nerves in the cauda equina?

A

S1-S5 are centrally

105
Q

Where does the Filum Terminale begin and end?

A

L4-Terminates @ Coccyx

106
Q

Define cauda equina syndrome

A

Compression of the sacral spinal nerves

107
Q

Causes of cauda equina syndrome?

A
  • IV disc herniation
  • Tumour
  • Spinal stenosis
  • Spondylolithesis
  • Vertebral canal stenosis
108
Q

Symptoms/ signs of cauda equina

A
  • Cannot feel self going to toilet
  • Loss of Ankle Jerk Reflex
  • Lower limb sensory change
109
Q

What are the red flags for cauda equina syndrome?

A
  • Saddle anaesthesia
  • Incontinence/ Urinary retention
  • Reduced anal tone
  • Loss of sensation/ Paralysis
110
Q

Lumbar Puncture:

a) Where do you perform it
b) What layers do you go through?
c) How should the patient be positioned?
d) Where do you put the needle?
e) How do you angle the needle?

A

Want to access CSF in the subarachnoid space

a) Adults: L3/4. Children L4/5. L4= Highest point of Iliac crest
b) Skin, Supraspinous ligaments, Infraspinous ligament, Ligamentum Flavum
c) Flexed- opens up the spaces between spinous processes
d) In between the spinous processes
e) Antero-superiorly so you don’t hit the lamina

111
Q

What technique do you use for an epidural?

A

Same route as LP

ONLY into Epidural space

112
Q

What does the ligamentum flavum bind?

A

Lamina of adjacent Verberae

113
Q

What do the supraspinous and infraspinous ligaments bind?

A

Spinous processes of the adjacent vertebrae

114
Q

Spinal anaesthesia

A

Access Subarachnoid Space (remember this finished at S2)

Children: L5/S1 and Adults L3/L4

Bathes the spinal nerves of cauda equina

Levels of anaesthesia can be adjusted by: density/ volume and position

115
Q

Caudal Anaesthesia

A

Via Sacral Hiatus (Equilateral triangle between PSIS which is just above S2 spinous process) and Upper Part of Natal Cleft where Sacral Hiatus sits

Insert needle at oblique angle through ligament & advanced towards the head

Targets sacral spinal nerves

eg: Below Pelvic Pain Line S2-S4

116
Q

Describe the arterial supply of the spinal cord

A

Anterior (Vertebral artery) and x2 Posterior Spinal arteries (PICA and Vertebral)

Give rise to Intervertebral arteries

Gives rise to Radicular arteries supply roots and rootlets

117
Q

Venous drainage of spinal cord, meninges and vertberal bodies

A

Spinal veins –> Intervertebral veins

Radicular veins

Intervertebral veins –> Venous Plexus (valveless and can spread cancer from prostate –> vertebral bodies) which is in Epidural space

118
Q

What is the femoral artery felt?

What is this a marker of?

A

Midinguinal Point +/-1cm

Marks entrance to deep inguinal ring

119
Q

Describe the location of an inferior lumbar triangle hernia

Who is this most common in?

A

Males aged 50-70yrs

External Obliques (T7-T12), Iliac Crest, Latismus Dorsi (Thoracodorsal nerve)

120
Q

Superior Lumbar Triangle Herniation

A

Rib 12, Internal Oblique, Quadratus Lumborum

121
Q

Surface anatomy of the superficial inguinal ring

A

Superolateral to the pubic tubercle in the External Oblique Aponeurosis

122
Q

Femal contents of the inguinal canal

A
  • Ilioinguinal nerve
  • Genital Branch of the Genitofemoral nerve
  • Round Ligament of Uterus
  • Lymphatics from Uterus
123
Q

Inguinal Canal Contents Male

A
  • Spermatic cord
  • Ilioinguinal nerve
  • Genital branch of the Genitofemoral nerve
124
Q

Describe the walls of the inguinal canal

A

Anterior: EO muscle

Roof: IO muscle and Aponeurosis of IO and TA

Aponeurosis of IO and TA form the Conjoint tendon which sits behind superficial ring

Posterior: Transversalis Fascia

Floor: Inguinal ligament

125
Q

What causes a direct inguinal hernia?

A

Weakness of conjoint tendon/ abdo wall muscles

126
Q

Direct and Indirect Hernia in relation to INFERIOR Epigastric artery

A

Direct: Medial

Indirect: Lateral

127
Q

Describe the boarders of Hesselbach’s Triangle

A

Medial: RA

Lateral: Inferior Epigastric

Inferior: Inguinal ligament

128
Q

Nerves at risk of damage during inguinal canal region surgery

A

Iliohypogastric

Ilioinguinal (sensory to anterior scrotum and root penis)

129
Q

Define AKI

A

A significant deterioration in renal function, which is potentially reversible, over a period of hours or days.

130
Q

Define CKD

A

Abnormalities of kidney function or structure present for more than 3 months, with implications for health.

131
Q

Define ESKD

A

The stage of chronic kidney disease where renal replacement therapy (RRT) is required to safely sustain life

132
Q

Complications of CKD

A
  • Cardiovascular disease
  • Hypertension
  • Anaemia
  • Bone-mineral metabolism

•Poor nutritional and functional status

  • Progression of CKD
  • AKI
133
Q

AKI Management

A

1) Keep the patient alive
2) Generic management of AKI

  • -Review medication: dose reduction, toxic drugs to the kidney
  • -Close observation: Fluid balance and GFR monitor
  • -Fluid management/ Electrolyte management

3) Diagnose cause of AKI & treat; often requires specialist input . Know your limitations.

134
Q

Angiotensin II- What are the effects?

A
  • Vasoconstriction
  • Increase Na absorption on renal tubule cells (PCT, Thick AOL, DCT/CCT)

Indirectly:

  • Thirst
  • Alsoterone
  • ADH
135
Q

Vasodilation of Efferent Arteriole

A

Angiotensin II Blocker

136
Q

Vasoconstriction of Afferent Arterioles

A
  • Endothelin
  • Noradrenaline
  • Adrenaline​
  • Adenosine
137
Q

Vasodilation of Afferent Arterioles

A
  • Prostaglandins
  • ANP

Block 1- Kim (17 decks)

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