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BRS > Urology > Flashcards

Urology Flashcards

1
Q

What is the role of the peritubular arteries

A

Exchange and reabsorption

And supply the nephron with O2 and nutrients

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2
Q

Difference between internal and external sphincter

A 
Internal = involuntary control to prevent urination, smooth muscle
External = voluntary control to prevent urination, striated muscle
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3
Q

What is the trigone

A

Area on destructor muscle

When the trigone is stretched, a signal is sent to the brain that you need to urinate

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4
Q

What does the bulbourethral gland do

A

Secretes lubricant which promotes sperm survival

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5
Q

Why does the cortex have a granular appearance and the medulla have a striated appearance

A

The loops of henle and collecting ducts extend into the medulla, giving it a striated appareance
But the bowman’s capsules are in the cortex, giving it a granular appearance

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6
Q

Describe the difference between the superficial nephrons and the juxtamedullary nephrons

A

Superficial nephrons
- bowman’s capsule is towards outer part of cortex
- loop of henle extends into outer medulla
Juxtamedullary nephrons
- bowman’s capsule is near the border of cortex and outer medulla
- loop of henle extends into inner medulla

There are approx 10 times more superficial nephrons than juxtamedullary

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7
Q

Constituents of the juxta glomerular apparatus

A 
Macula densa (cells on distal convulsed tubule)
Juxta glomerular cells (secrete renin into afferent arteriole)
Extra glomerular mesangial cells
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8
Q

Functions of the juxta glomerular apparatus

A

GFR regulation through the tubulo glomerular feedback mechanism
Blood pressure regulation through renin secretion

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9
Q

How is fluid driven through the semi permeable membrane in the passive process of filtration in bowman’s capsule

A

By the hydrostatic pressure of the heart

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10
Q

Doscrube the filtration apparatus of the bowman’s capsule

A

Capillary walls have fenestrae which allow small molecules and water to pass through
Bowman’s capsule wall have epithelial podocytes. Between each podocyte is a slit with a slit diaphragm which has holes in to allow small molecules and water to filter through into the nephron

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11
Q

Difference between hydrostatic and oncotic pressure

A

Hydrostatic
- Exerted by fluid molecules
- fluid molecules and small solutes are pushed out
Oncotic
- exerted by proteins and large solutes
- fluid molecules are pulled in across semi permeable membrane

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12
Q

How to calculate net ultrafiltration pressure

A

Hydrostatic pressure in glomerular capillaries - oncotic pressure in glomerular capillaries - hydrostatic pressure in bowman’s capsule

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13
Q

What is the cardinal feature of renal disease

A

Gall in GFR (indicates excretory products in the plasma)

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14
Q

How to calculate GFR

A

GFR = net ultrafiltration pressure x ultrafiltration coefficient

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15
Q

What does ultrafiltration coefficient depend on

A

Membrane permeability

SA for exchange

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16
Q

Healthy GFR ranges for adults

A 
Male = 90-140 ml/min
Female = 80-125 ml/min
17
Q

What is GFR

A

The amount of fluid filtered from the glomeruli into the bowman’s capsule, across both kidneys, per unit time (ml/min)

18
Q

2 feedback mechanisms for regulating GFR

A

1) myogenic feedback mechanism
- afferent arteriole bp increases so it stretches
- smooth muscle in afferent arteriole contracts to constrict the vessel and increase resistance
- decreases blood flow and stabilises GFR
2) tubulo glomerular feeedback mechanism
- GFR increase
- NaCl in loop of henle increases and this is detected by the macula densa
- macula densa increases ATP and adenosine discharge which causes the afferent arteriole to constrict
- reduces blood flow and stabilises GFR
(Opposite actions for decreased GFR)

19
Q

What is renal clearance

A

The number of litres of plasma that are completely cleared of a substance per unit time (ml/min)
Renal clearance x conc of substance in plasma = rate of urine production x conc of substance in urine

20
Q

What about creatinine can indicate renal failure

A

Low renal clearance of creatinine or high plasma conc

21
Q

What about creatinine levels could indicate renal failure

A

High plasma levels

Or low renal clearance

22
Q

What is filtration fraction

A

FF = GFR/RPF

23
Q

Which molecule can be used to determine RPF

A

PAH (para amino hippurate)
The amount of PAH that enters the kidneys is equal to the amount that is excreted - all the PAH in the blood that enters the kidneys is excreted
There is no PAH left in the blood after the kidneys
So the GFR of PAH = the RPF
(Renal plasma flow is the volume of blood that enters the kidneys per unit time)

24
Q

How does coupled transport work

A

The movement of one substance down its electrochemical gradient provides energy for the second substance to move against its electrochemical gradient

25
Q

What can blood in the urine indicate

A

Nephritic syndrome
Kidney stones
UTI

26
Q

What does bilirubin in blood indicate

A

Liver disease or gall stones

27
Q

What does urobiligen in urine indicate

A

Liver disease or haemolysis

28
Q

What is infection of the kidney called

A

Pyelonephritis

29
Q

What is infection of the bladder called

A

Cystitis

30
Q

What are the most common causative agents for UTI

A

Bacteria

Virus and fungi are more for immunocompromised patients

31
Q

Risk factors for diabetic nephropathy

A

Smoking
Hypertension
Poor diabetes control

32
Q

What could frothy urine, periorbital odoema and pitting oedema in ankles be signs of

A

Nephrotic syndrome

33
Q

What do you see on an electron microscope with nephrotic syndrome and what is the risk that comes with this

A

Podocyte effacement - abnormal flattening of the podocytes

Risk of thrombosis

34
Q

Treatments of nephrotic syndrome

A

Immunosuppressants
Diuretics to reduce oedema
Anticoagulants to prevent thrombosis

35
Q

3 treatments for kidney stones

A

Shockwave lithotripsy
Ureteroscopy
Percutaneous nephrolithotomy

BRS (8 decks)

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