Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine 2 > Week 4 - Kidney Failure > Flashcards

Week 4 - Kidney Failure Flashcards

1
Q

What are the 2 types of nephrons?

A

Cortical nephrons

Juxtamedullary nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the funciton of the renal corpuscle and tubular system of nephron?

A

Renal corpuscle = site of initial blood filtration

Tubular system = controls concentration and content of urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the blood supplies to the nephron?

A

Glomerulus capillary bed - in Bowman’s capsule - high hydrostatic pressure - FILTRATION

Peritubular capillary bed - aroudn tubular system - low hydrostatic pressure - REABSORPTION AND SECRETION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is GFR?

A

Volume of fluid entering Bowman’s capsule per unit time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What does the glomerular filter look like?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the organisatino of golumerular capillary membrane?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the effects of afferent arteriole constriction, efferent arteriole constriction and hypoproteinaemia on GFR?

A

Afferent constriction = - GFR

Efferent constriction = + GFR

Hypoproteinaemia = + GFR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the benefits of using inulin to estimate GFR?

A
  • Freely filtered
  • Not reabsorbed, secreted or metabolised by kidney
  • No effect on renal function
  • Easily measured in urine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is RPF?

A

Renal plasma flow = amount of plasma that perufses kidney per unit time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How do you derive renal bloodflow using RPF?

A

RBF = RPF / 1 - haematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the filtration fraction?

What does high FF indicate?

A

The proportion of plasma that forms filtrate

+ FF = + colloid osmotic pressure in peritubular capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the ways autoregulation alters GFR?

A

Myogenic - afferent arteriole contraction

Tubuloglomerular feedback - NaCl concentration in filtrate sensed by macula densa of JGA and singal produced, contractin afferent arterioles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the juxtaglomerular apparatus?

What is its role?

A

Macula densa + granular cells

Autoregulation and renin release

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What effect do vasodilators and NSAIDs have on RBF and GFR?

A

Vasodilators = increase RBF and GFR (prostaglandins)

NSAIDs = block prostaglandin synthesis = + vasoconstriction and ischaemia = actue renal tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is glycosuria?

What causes it?

A

When renal glucose threshold (RTG) is exceeded, glucose excreted in urine

  • Untreated diabetes
  • Hyperthyroidism
  • Pregnancy
  • Familial
  • Drugs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What happens in the proximal tubule?

A
  • Bulk reabsorption of filtered ions and solutes
  • Reabsorption of organic solutes, ions and water is coupled with sodium reabsorption
    • water permeability means so significant osmotic gradient
  • Tubular fluid = isosmotic with plasma
17
Q

How is sodium trnasported in proximal tube?

A

Readily enters epithelial cells across apical membrane

18
Q

How is bicarbonate transported in proximal tube?

A

Indirectly reabsorbed via carbonic anhydrase as apical membrane impermeable to bicarbonate

19
Q

How is water transported and reabsorbed in proximal tubes?

A

+ permeability

Occurs paracellularly across tight junctions and transcellularly via water channels on apical and basolateral membranes

Reabsorption:

  • Osmotic pressure gradient + low hydrostatic pressure = water passively moves down gradient
20
Q

How is sodium, chloride, potassium and water processed in thick ascending limb of loop of Henle?

A
  • Is impermeable to water
  • 1 Na+, 1 K+ and 2 Cl- enter cell via symporter protein in apical membrane
  • Cl- leaves via passive diffusion
  • Most K+ leaks back into lumen
  • Tubular lumen becomes + charged
  • Sodium enters cell via Na+/H+ antiporter
  • Sodium pumped out by sodium pump
  • Low sodium = electrochemical gradient = drives Na movement into cell
21
Q

What is the role of the thick ascending limb?

A
  • Reduces tubular fluid osmolality
  • Is diluting segment
  • Makes interstitial fluid of medulla hyperosmotic
    • role in creating medullary interstitium and regulating urine osmolality
22
Q

What are the effects of aldosterone in the late distal tube?

A
  • Enhances sodium reabsorption in principal cells
  • Enhances K+ secretion in principal cells
  • Enhances H+ secretion in intercalated cells
23
Q

What happens in hyperaldosteronism and hypoaldosteronism?

A

Hyper = + aldosterone, metabolic alkalosis, hypokalaemia, hypertension, oedema

  • DUE TO SODIUM AND WATER RETENTION

Hypo = type 4 renal tubular acidosis = hyperkalaemia

24
Q

What are the effects of ADH on inner medullary collecting duct?

A
    • urea permeability
  • Water diffuses out of tubule lumen, into medullary interstitium
  • Urea recycling occurs –> urea diffuses into ascending and descending limbs of loop of Henle
25
Q

What happens to body during excess sodium and sodium defecit?

A

Excess:

    • Weight gain
    • Oedema
    • Hypertension
    • Nocturia

Defecit:

    • Weight loss
    • Change in skin tugour
    • Syncope
    • Orthostatic hypotension
26
Q

What happens during chronic kidney disease?

A
  • Slow function loss overtime
  • Decreased ability to remove waste products
  • Treat with dialysis, transplant or supportive care
  • Clinically = < 60 ml/min
27
Q

How does chronic kidney failure present?

A
  • Asymptomatic serum biochemical abnormaility
  • Asymptomatic proteinuria or haematuria
  • Hypertension
  • Oedema
  • Primary renal disease symptoms
  • Uraemia symptoms
  • Complications of CKD
  • Tiredness
  • Salt and water retention
  • Itching
28
Q

How can you treat CKD?

A
  • ACE inhibitors
  • Lifestyle change
  • Monitor BP, creatinine and GFR
  • Haemodialysis
  • Peritoneal dialysis
29
Q

What is acute kidney injury?

A
  • Rapid decline in kidney function
    • serum creatinine conc.
  • Fall in urine output
  • Uraemia
  • Due to haemodynamic, septic, immunological, nephrotoxic or obstructive insults
30
Q

What are causes of pre-renal AKI?

A

Intravascular volume depletion

  • cardiac output

Systemic vasodilatation

31
Q

What are the causes of intrinsic AKI?

A

Diseases or toxins damaging small renal vessels and glomeruli

Acute tubular necrosis

Miscallaneous renal diseases

Toxins

32
Q

What causes post-renal AKI?

A

Acute obstruction of urine flow

Medicine 2 (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions