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Stage 4: CSIM 2 > Week 11: General kidney anatomy and dz > Flashcards

Week 11: General kidney anatomy and dz Flashcards

1
Q

3 layers of the kidney, from outside to inside

A
  1. Capsule
  2. Cortex
  3. Medulla
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2
Q

Describe where, within the kidney, waste travels to get to the bladder

A
  1. Nephrons
  2. Pyramids
  3. Minor calyces
  4. Major calyces
  5. Renal pelvis
  6. Ureters
  7. Bladder
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3
Q

During inspiration, what direction do kidneys move towards

A

Kidneys move downwards

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4
Q

Around what spine level are the kidneys located

A

T12-L3

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5
Q

In what 2 ways might pharyngitis affect the kidneys

A
  1. IgA nephropathy

2. Post-strep glomerulonephritis

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6
Q

Symptoms of hyper-phosphataemia

A
  1. Itch

2. Lethargy

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7
Q

Symptoms of uraemia (aka azotemia)

A
  1. N n V
  2. Pericarditis (chest pain)
  3. Confusion (uraemic encephalopathy)
  4. Uraemic flap
  5. Uremic frost (deposition of urea crystals in skin)
  6. Tendency to bleed
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8
Q

What does frothy urine indicate?

What sort of conditions is this associated with?

A

Frothy = heavy proteinuria

eg amyloidosis, nephrotic syndrome

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9
Q

What kidney conditions may cause loin pain

A
  1. Kidney stones
  2. Infection
  3. Haematuria
  4. Polycystic kidney disease
  5. IgA nephropathy
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10
Q

What kidney condition may cause oedema

A

Nephrotic syndrome (heavy proteinuria causes decrease in oncotic pressure)

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11
Q

Why does uraemia (aka azotemia) cause a tendency to bleed

A

Urea makes platelets less likely to stick together, so less clot formation

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12
Q

Describe the anatomy of the nephron, starting with the glomerulus and subsequent pathway of filtrate

A
  1. Glomerulus
  2. Proximal convoluted tubule
  3. Loop of Henle
  4. Distal convoluted tubule
  5. Collecting duct
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13
Q

How goes the glomerular basement membrane normally prevent blood proteins from leaking out

A

Type 4 collagen has a negatively charged coat which repels negatively charged albumin

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14
Q

Which part of the nephron do loop diuretics act on

A

Ascending loop of Henle

inhibit NaK2Cl co-transporter

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15
Q

Which part of the nephron do thiazide diuretics act on

A

Distal tubule

inhibit NaCl co-transporter

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16
Q

Where in nephron are glucose and amino acids reabsorbed

A

Proximal tubule

17
Q

Where in nephron is water reabsorbed

A

60-80% in proximal tubule

Remainder in collecting duct

18
Q

Where in nephron is sodium reabsorbed

A

60-70% in proximal tubule (Na/K ATPase)

5% in distal tubule (Na/Cl co-transporter)

Some in loop of Henle (Na/K/Cl co-transporter, Na/K ATPase)

2% in collecting duct (aldosterone sensitive Na channels)

19
Q

Urine dipstick:

Specific gravity increases/ decreases with dehydration

A

Specific gravity increases with dehydration

20
Q

Urine dipstick:
Describe the significance of the following types of casts

  1. Red cell casts
  2. White cell casts
  3. Granular casts
  4. Hyaline casts
A
  1. Red cell casts: Glomerulonephritis
  2. White cell casts: Acute Pyelonephritis
  3. Granular casts: glomerular/ tubular disease (distintegration of cell debris)
  4. Hyaline casts: NORMAL (from mycoprotein precipitated in renal tubules)
21
Q

What drug can cause a false positive for raised creatinine

A

Trimethoprim

22
Q

Physiological cause for low serum creatinine

A
  1. Pregnancy

2. Elderly with lower muscle mass

23
Q

What investigation is done when haematuria found on urine dipstick

A

Do urine culture and microscopy (may be myoglobulin, need to confirm it’s RBC)

24
Q

2w cancer referral for haematuria

A

> 45yo +
unexplained visible haematuria (no UTI) OR
visible haematuria that persists after successful treatment of UTI

> 60yo +
unexplained visible haematuria + increased WBC

25
Q

Who should get a non-urgent cancer referral for haematuria

A

> 60yo + recurrent/ persistent unexplained UTI

26
Q

How many dipstick tests needed to confirm persistent invisible haematuria

A

2 out of 3 positive dipsticks

27
Q

Who should be referred to urology for asymptomatic microscopic haematuria

A
  • Age >35yo

- Smokers/ ex smokers

28
Q

Gadolidium studies should not be done in people with eGFR below what?

A

eGFR <30

29
Q

In a healthy individual how much blood is lost in the urine each day

A

<1 microLitre

Stage 4: CSIM 2 (47 decks)

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