urology Flashcards

1
Q

parts of kidney

A

cortex
minor + major calyx => ureter
medulla
renal artery + vein

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2
Q

renal blood supply

A

renal artery => segmental arteries => interlobar => arcuate => interlobular => afferent arteriole => glomerulus

efferent arteriole => peritubular capillaries => interlobular vein => arcuate => interlobar => renal

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3
Q

Detrusor

A

contracts to build pressure in the urinary bladder to support urination

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4
Q

Trigone

A

stretching => signals brain about need for urination

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5
Q

internal vs external sphincter of bladder

A

int = involuntary => SM

ext = voluntary => striated

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6
Q

PCT cells

A

lots of mito => transport of water, salts, glucose, ions, bicarbonates

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7
Q

loop of henle - thick vs thin

A

thin (desc+asc) => low mito => passive absorption of h20 + nacl

thick (asc only) => mito rich => active salt absorption

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8
Q

DCT

A

mito rich
active reabsorption of salt and ions

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9
Q

CD cells

A

intercalated = mito rich
principal cells = not

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10
Q

superficial vs juxtamedullary nephron

A

superficial => BC towards outer cortex + short LOH (til outer medulla) => more

JM => BC towards cortex/medulla border + long LOH (til inner medulla) => less

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11
Q

macula densa

A

in dct

GFR regulation via tubulo-glomerular feedback mechanism

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12
Q

jxtaglomerular cells

A

afferent arteriole

renin secretion for regulating BP

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13
Q

how is glomerular filtration passive

A

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

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14
Q

g-filtration barrier

A

size and charge dependent

highly permeable to fluids + small solutes
impermeable to cells + proteins

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15
Q

what can pass through fenestrae

A

water, ions and small proteins

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16
Q

why very few proteins cross GMB

A

lined with negatively charged proteins that repel negative substances in blood => can’t enter BC

17
Q

slit diaphragm

A

between epithelial podocytes of BC
finger-like projections with small spaces in between
water and small solutes pass through

18
Q

net ultrafiltration pressure (Puf)

A

HPgc - HPbw - OPgc

(hydrostatic/oncotic pressures of glomeurlar capillaries/bowmans capsule)

19
Q

why is oncotic pressure in bowman’s capsule ignored in Puf calc

A

only small molecules present in BC → exert negligible pressure

20
Q

GFR

A

amount of fluid filtered from the glomeruli into BC per unit time (mL/min)

sum of filtration rate of all nephrons

21
Q

Kf

A

ultrafiltration coefficient

(dependent on membrane permeability and surface area available for filtration)

22
Q

GFR using Kf

A

GFR = Kf x Puf

23
Q

GFR regulation via myogenic mechanism

A

arterial pressure increases = afferent arteriole stretches
contracts => resistance rises
blood flow reduces = GFR stays same

24
Q

GFR regulation via tubulo-glomerular feedback mechanism

A

increased GFR = increased NaCl in Loop of Henle
detected by macula densa = increased ATP & adenosine discharging
afferent arteriole constricts => GFR stabilises (and vice versa)

25
Q

renal clearance

A

no:litres of plasma that are completely cleared of the substance per unit time

26
Q

renal clearance calculation

A

(conc of substance in urine x rate of urine production) / conc of substance in plasma

27
Q

calculate GFR using clearance

A

both equal when substance is freely filtered + no resorption/seceretion

amount filtered at BC = amount excreted

e.g inulin/creatinine

28
Q

renal plasma flow

A

amount of blood arriving at kidney per unit time => same for all

29
Q

calculate RPF usine renal clearance

A

both equal when amount of substance entering kidney = amount excreted

all filtered + secreted (none left in plasma)

e.g PAH - para amini hippurate

30
Q

filtration fraction (+calc)

A

ratio of amount of plasma filtered + amount arriving at afferent arteriole

GFR/RPF

31
Q

substances reabsorbed throughout kidney (main)

A

early PCT => Na + HCO3-
late PCT => glucose

desc LOH => H2O passively
thin asc LOH => NaCl passively
thick asc LOH => NaCl actively

early DCT => NaCl + Ca2+

late DCT + CD:
principal cell => Na+ (maintain BP)
alpha intercalated => HCO3- (increases alkalinity)
beta intercalated => H+ (increases acidity)

32
Q

issues with using inulin in GFR calc

A

must be transfused
time consuming
tedious
short duration to measure means bladder catheterisation is necessary

33
Q

51 CrEDTA

A

same properties as inulin but emits radiation

inject => measure plasma activity + monitor disappearance

34
Q

why creatinine is used in GFR calculations

A

endogenous - from creatine metabolism

released into blood at constant rate so plasma concentration = stable

35
Q

diabetes mellitus vs insipidous in urinanalysis

A

M: glucose
I: low specific gravity

36
Q

nephrotic vs nephritic syndrome in urinanalysis

A

nephrotic => protein
nephritic => blood

37
Q

liver disease urinanalysis

A

billirubin/urobillinogen

gallstones for B/haemolysis for U also