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BRS Revision Cards > Urology > Flashcards

Urology Flashcards

1
Q

Functions of the kidney?

A

Excretion
Homeostasis
Blood pressure regulation
Hormone secretion

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2
Q

From interlobular artery to interlobular vein?

A

IL artery to afferent arteriolar to glomerular capillaries to efferent arteriolar to peritubular capillaries to IL vein

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3
Q

Detrusor muscle?

A

Contracts to build pressure in urinary bladder to support urination

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4
Q

Trigone?

A

Stretching of this triangular region to its limit signals to the brain for need to urinate.

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5
Q

Internal sphincter?

A

Involuntary control to prevent urination

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6
Q

External sphincter?

A

Voluntary control to prevent urination

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7
Q

Bulbourethral gland?

A

Produces thick lubricant which is added to watery semen to promote sperm survival

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8
Q

From glomerulus to collecting duct?

A

Glomerulus to bowman’s capsule, to proximal convoluted tubule, to thin descending then thin ascending LOH, to thick LOH, to distal convoluted tubule, to collecting duct.

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9
Q

Superficial vs juxtamedullary nephrons?

A

Superficial glomeruli in outer cortex, shorter LOH
juxtamedullary have glomeruli near corticomedullary border, longer LOH and larger glomeruli so higher GFR

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10
Q

Juxtaglomerullar apparatus constituents?

A

Macula densa, extra glomerular mesangial cells, juxtaglomerular cells

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11
Q

Juxtaglomerullar apparatus function?

A

GFR regulation and renin secretion

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12
Q

Why is glomerular filtration a passive process?

A

Fluid driven through semipermeable glomerular capillaries into Bowman’s capsule space by hydrostatic pressure of the heart

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13
Q

Filtration barrier in glomerular filtration?

A

Highly permeable to fluids and small solutes, impermeable to cells and proteins.

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14
Q

Hydrostatic vs oncotic pressure?

A

Hydrostatic - fluid exerts this pressure, solute and fluid shoved out.
Oncotic - pulling, solute exerts this, fluid drawn in.

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15
Q

Net ultrafiltration pressure?

A

Puf = HPgc - HPbw - Pigc

Net ultrafiltration pressure = hydrostatic pressure in glomerular capillaries - hydrostatic pressure in bowman’s capsule - oncotic pressure of plasma proteins in glomerular capillaries.

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16
Q

Glomerular filtration rate?

A

GFR = Puf x Kf

GFR = net ultrafiltration pressure x ultrafiltration coefficient

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17
Q

Ultrafiltration coefficient?

A

Membrane permeability and SA available for filtration. Changes = GFR imbalances.

18
Q

Myotonic mechanism for GFR regulation?

A

Arterial pressure increases
Afferent arteriole stretches
Arteriole contracts
Vessel resistance rises
Blood flow reduces
GFR stays same

19
Q

Tubulo-glomerular feedback mechanism?

A

Increase/decrease in GFR
Increase/decrease NaCl in LOH
Change detected by macula densa
Increased/decreased ATP + adenosine discharged
Afferent arteriole contracts/dilates
GFR stabalises

20
Q

Renal clearance?

A

C = U x V / P (mL/min)

U is concentration of substance in urine, V is rate of urine production, P is concentration of substance in plasma.

21
Q

Most commonly and ideal molecule used to calculate renal clearance?

A

Ideal = insulin (freely filtered and neither absorbed nor reabsorbed, so filtered = amount secreted.

Commonly used = creatinine - decrease clearance = increased plasma creatinine = renal failure.
Not perfect, some secreted so overestimates GFR.

22
Q

PAH?

A

Para aminohippurate - all removed from plasma passing through kidney through filtration and secretion. Renal clearance of PAH = renal plasma flow.

23
Q

RPF?

A

Renal plasma flow - volume of blood reaching the kidney per unit of time.

24
Q

Filtration fraction?

A

FF = GFR/RPF
ratio of amount of plasma filtered and plasma which reaches afferent arteriole.

25
Q

Reabsorption in early proximal convoluted tubule?

A

100% glucose and amino acids, 80% HCO3, 67% Na, Cl and H2O, 50% urea.

Na-H antiporter, Na-K ATPase, Na-HCO3 symporter.
Na-glucose symporter (SGLT2), GLUT2.

26
Q

Reabsorption in LOH?

A

25% Na + Cl, 15% H2O.
passive reabsorption in thin, active in thick

27
Q

Reabsorption in early distal convoluted tubule?

A

Na, Cl and Ca reabsorbed.

28
Q

Late distal convoluted tubule and collecting duct reabsorption?

A

Aldosterone regulates Na, AVP regulates water reabsorption.

29
Q

Intercalated cells?

A

Alpha - pumps H+ into tubular fluid, reabsorbes bicarbonate.
Beta - secretes bicarbonate into tubular lumen, reabsorbes H+.

30
Q

Kidney dysfunction consequences?

A

Filtration failure
Hypertension, water retention
Metabolic acidosis
Anaemia
Vitamin D deficiency

31
Q

Different types of urinary disorders?

A

Inflammatory
Obstructive
Developmental/genetic

32
Q

Examples of inflammatory?

A

Infection - cystitis
Non-infective:
- metabolic - diabetic nephropathy
- immunological - nephritic syndrome and nephrotic syndrome

33
Q

Examples of obstructive disorders?

A

Stones
Benign prostatic hypertrophy

34
Q

Examples of developmental/genetic disorders?

A

Polycystic kidneys, horseshoe kidney.

35
Q

UTI

A

Urine dipstick test, cloudy urine, blood in urine, increase leukocytes.
Antibiotics, hydration, pain control.

Usually e.coli

36
Q

Nephritic syndrome presentation?

A

Haematuria, proteinuria, hypertension, reduced urine output, increased urea and creatinine.
Caused by IgA nephropathy (most common cause of glomerulonephritis)

37
Q

Diabetic nephropathy?

A

Metabolic cause, microalbuminuria, proteinuria, associated with diabetic retinopathy and neuropathy.
Thickened glomerular.basement membrane.

38
Q

Nephrotic syndrome?

A

Immunological cause, peripheral and periorbital oedema, severe proteinuria, low serum albumin, hyperlipidaemia.
Corticosteroids, diuretics and anti coagulation.

39
Q

Stones presentation?

A

Pain, haematuria, UTI, tenderness of loin and lower abdomen.
Supportive or specific treatment

40
Q

Specific treatments for stones?

A

Shockwave lithotripsy
Ureteroscopy
Percutaneous nephrolithotomy

41
Q

Polycystic kidney disease?

A

Neonatal - autosomal recessive, vs adult onset - autosomal dominant.
Loss of kidney function, pain, bleeding into renal cysts, infection of renal cysts.
Replacement therapy, Tolvaptan (vasopressin receptor 2 agonist), treat hypertension or infection.

42
Q

Horseshoe kidney?

A

Increased risk of obstruction, stones and infection. Imaging of abdomen/pelvis.

BRS Revision Cards (11 decks)

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