week 4 Flashcards
daily potassium req
60-80 mmol/day or about 1mmol/kg
unsafe prescribing of KCl
20mmol /hour
40mmol/litre of fluid
140mmol/day
why is upper gut almost sterile?
gastric acidity, propulsive motility, pancreatic enzymes
pH of colon
5.5-7, so slightly acidic but is buffered by bicarbonate
beneficial metabolic activites of the gut
produces vitamins, bioactive molecule production, short chain fatty acid production. These help drive water absorption, can act as a fuel for colonic cells, promote healing and inhibit growth of pathogenic bacteria
pronephros
formed in the cervical region. regresses by week 4. is rudimentary and non-functioning. Formed of 7-10 solid cell groups. Appears at third week (day 20)
mesonephros
Unsegmented. Forms from week 4 and see appearance of the excretory tubules. Mesonephric duct is only structure which will remain. Contributes cells to the genital ridge
metanephros
the definitive kidney, forms from week 5 and is functional by week 11. Excretory units develop from the metanephric mesoderm
Two parts: ureteric bud - outgrowth of the metanephric duct which will form the collecting duct
metanephric cap - spherical shape, will go onto form each kidney’s excretory units
allantois
vessels contained in this will go onto form important parts of the umbilical cord. Important in nutrition and secretion. The urachus will from from this in weeks 5-7. Duct between the bladder and yolk sac
division of cloaca into urogenital and anal/rectal sinus happens?
weeks 4-7. The urorectal septum fuses with the cloaca membrane
where does the trigone form from?
the mesonephric ducts
when do the genital ducts develop?
weeks 5-6
gonads, when does initial development begin
week 5
what do leydig cells secrete?
testosterone
what do sertoli cells secrete ?
AMH
when do external genitalia begin to form?
week 3
klinefelter’s syndrome
genetic disorder which affects 1 in 5000 males.
Boys who are born with one or more extra X chromosomes
1/5000 males affected
Causes - infertility, gynaecomastia, impaired sexual maturation.
Low sperm production as leydig cells do not produce enough
testicular feminising syndrome
genetic males with female external phenotype. Can produce testosterone, just have mutation on their X chromosome which means they cannot respond to it (deficient in receptors)
uterus and vagina are absent
Turner’s syndrome
Only have an X chromosome. Partly or completely missing one X chromosome.
Primordial germ cells degenerate shortly after they arrive at the gonadal ridge- failure of gonadal development.
Infantile genitalia
location of production of steroid hormones
adrenal gland, gonads, and placenta
examples of conditions with hormone excess
PCS, granulosa cell tumour, teratoma
examples of conditions with hormone deficiency
hypogoinadism
turner’s
klinefelter’s
hypopituitarism
hormone resistance
testicular feminisation syndrome
5 alpha-reductase type 2 deficiency
endocrine disruptor
exogenous chemicals which disrupt normal endocrine function. Have a similar structure to endogenous hormones and either block or mimic the effect of the normal hormone
primary follicle
the primary oocyte and the granulosa cells surrounding it
Granulosa cells produce
aromotase
Theca cells produce
androgens
what develops from the urethral folds
labia minora in females, lateral walls of the urethral groove on the penis - will form the penile urethra etc.
what develops from the genital swellings
(located on lateral side of the urethral folds) form scrotal swellings in male, labia majora in females
what are the three types of gallstone?
cholesterol stone - usually solitary, large and oval
bile pigment stone - multiple, irregular and hard. Are associated with chronic haemolysis
mixed stone - most common. They are multiple and multi-faceted. Have a laminated surface with layers of cholesterol, bile pigment and calcium salts
biliary colic
stone impacted in the gallbladder, usually in the neck (hartmann’s pouch).
Pain in the epigastrium/right quadrant. This is provoked by eating, with vomiting being common. Usually no jaundice, fever or abnormal LFTS.
Often the stone will move back to the base of the gallbladder settling the condition.
acute cholecystitis
impacte stone in gall bladder leading to inflammation and oedema of the gall bladder wall, with development of a bacterial infection.
Occurs within hours and leads to vomiting, nausea, fever and abdominal tenderness.
Give antibiotics and analgaesia.
choledocholithiasis
migration of one or more stones from the gall bladder to the bile duct, usually settle just above the ampulla of vater. Patients presents with obstructive jaundice, cholangitis, acute pancreatitis, or a combination of the above.
average number of insensible losses per day
800ml
Would be increased in a ventilated patient
minimum daily potassium loss
60-80 mmol/day
reasons the upper gut is almost sterile
gastric acidity, propulsive motility and the pancreatic enzymes
therapeutic range
difference between concentration that achieves therapeutic response and the concentration that has adverse effects
