hard questiosn urinary

Question 1

units of osmolarity

Answer 1

osm/l

Question 2

how is countercurrent multiplication achieved

Answer 2

active salt resorption in thick limb, passive water reabsorption in decending loop

Question 3

where is uta2

Answer 3

thing descending limb

Question 4

2 pruposes of urea recycling

Answer 4

less water wasted

allows urine concentratio n

Question 5

stimulatory factos for vasopressin

Answer 5

neausea
osmolarity up, bp down
angiotensin 2
nicotine

Question 6

inhibitory factors for vasopressin

Answer 6

low osmolarity, bp up
anp
ethanol

Question 7

mechanism of adh action

Answer 7

binds to v2 on collecting duct
g protein signalling
protein kinase a
aquaporins to membrae

Question 8

what transporters are present in the dct

Answer 8

na/cl co
na/k atpase
na/ca

Question 9

principal cell transporters

Answer 9

enac

na/k atpase

Question 10

effects of adh on channels

Answer 10

increase aps 
uta1 and uta3 
triple transpoter
na/cl 
enac

Question 11

how is siadh treated

Answer 11

vaptans

Question 12

outline how the kidsney produces new hco3

Answer 12

glutamine - 2hco3
2 nh4
out as nh3 or as nh4 via na/h transporter

Question 13

what is the role of phospahte in the dct

Answer 13

allows h to be neutralised without wasting hco3

Question 14

what is the henderson hesselbach equation

Answer 14

[h+] = (24 x pCO 2)/ [HCO3]

Question 15

What suppresses salt intake

Answer 15

glutamate and serotonin in the lateral parabrachial nucleus

Question 16

how does the relationship betwwen rpf and gfr plateau

Answer 16

high tubular sodium, increased na/cl uptake
adenosine released from macula densa
detected by extraglomerular mesangial cells
less renin
afferent smc contact

Question 17

role of the b1 sympathetics

Answer 17

increase na uptake
stimulate renin from juxtaglomerular cells
contract afferent arteriole

Question 18

how is renin stimulated

Answer 18

less firing from juxtaglomerular cells

Question 19

what is anp

Answer 19

a vasodilator

Question 20

how does aldosterone work

Answer 20

binds to mineralocorticoid receptor 
hsp90 dissociates 
dimeriss 
into nucleus 
transcription

Question 21

3 effects of aldosteroen

Answer 21

h out
na/k
enac

Question 22

symptoms oh hypoaldosteronism

Answer 22

syncope
low bp
salt cravings
palpitation

Question 23

symptoms of hyperaldosteronism

Answer 23

hypertension
muscle weaknes
polyuria
thirst

Question 24

3 low pressure receptors

Answer 24

atria
right ventricles
pulmoary vasculature

Question 25

3 high pressure receptors

Answer 25

carotid sinus aortic arch juxtaglomerular apperatus

Question 26

where does anp bind

Answer 26

guanalyl cyclase

Question 27

4 effects of anp

Answer 27

``` less na in lower renin etc less b1 activity lower bp vasodilates ```

Question 28

how does insulin cause k uptake

Answer 28

na/h stimulation

Question 29

how do cillia on dct help k leave

Answer 29

``` increase flow stimulate pdk 1 caclium in turns on k channel k out ```

Question 30

syndrome of hypokalaemia

Answer 30

gitelmans synrome

Question 31

symtoms of reduced sodium secretion

Answer 31

oedema pulmonary odema hypertension

Question 32

how does acidosis cause weakness

Answer 32

casues catabolism nad anorexia

Question 33

what causes hyperkalaemia

Answer 33

less dct secretion | acidosis (h in k out)

Question 34

symotoms of hyperkalaemia

Answer 34

diarrhoea vomiting weakness

Question 35

ecg changes in hyperkalaemia

Answer 35

``` tented t waves arrythmia ventriculat tachycardia / fib asystole o waves broaden qrs broadens ```

Question 36

how can renal failure increase risk of cvd

Answer 36

hyperparathyroidsim as less 1- alpha hydrox. also phosphate retention 3 hyperparathyroidism

Question 37

how is hyperkalaemia treated acutely

Answer 37

nahco3 insulin dextrose k sequesterants

Question 38

ways of tensting kidney function

Answer 38

creatinine trend with egfr

Question 39

how is ckd classified

Answer 39

proteinuria (<3, 3-30, 30) gfr albumin creatinine ratio

Question 40

where is access needed for dialysis

Answer 40

arteriovenouos fistula | central venous line

Question 41

what is done to match kidney

Answer 41

hla bloods serum match

Question 42

risk factors for kidney cancer

Answer 42

dialysis cancer smoking (transitional cell) radiotherapy

Question 43

features seen with plapable kiney mass

Answer 43

wiehgt loss polycythemia anaemia

Question 44

tests for painless visable haematuria

Answer 44

history renal function flex cyst

Question 45

imaging for suspected renal cancer

Answer 45

ct renal ct chest bone scan

Question 46

how is kidney cance rstaged

Answer 46

t1 less than 7cm t2 greater than 7 cm t3 insude perinephritic fat

Question 47

if unfit for kiney surgery what si given

Answer 47

cryotherapy

Question 48

chemo for metastatic kidney cnacer

Answer 48

immunotherapy and tyrosine kinase inhibotors

Question 49

bladdeer: investigations for painless visable haematuria

Answer 49

ct urogram renal function flex yst

Question 50

risk factors for kiney cancer

Answer 50

smoking schistomoniasis catherterisation radiotherapy

Question 51

how is kidney cnacer staged

Answer 51

``` ta - papillary tis - in situ t1 - subepithelial connective tidsue t2 - muscularis propria t3 in perivesicular fat t4 distal ```

Question 52

management for non invasive bladder cancer

Answer 52

bcg | intravesicular chemo

Question 53

what is bcg

Answer 53

i mmunological agnt preventing recurrence

Question 54

how is prostate cncer diagnosed

Answer 54

psa and mri | then cystoscopy and biopsy to stage

Question 55

how is prostate cance staged

Answer 55

``` t1 a less 5% b more 5 % c found after raised psa t2 a 1/2 of 1/2 b full half c whole ``` t3a - broken capsule b - in semenal vesicle

Question 56

surgery for stress incontinance

Answer 56

colposuspension fascial sling periurethral bulking

Question 57

risk factors for overactive bladder

Answer 57

``` caffeine drugs bmi ibs prolapse ```

Question 58

when investigasitng overactive bladder what must be first ruled out

Answer 58

enlarged prostate/prolapse

Question 59

drugs for overactive bladder

Answer 59

antimuscarinics b3 agonists botox

Question 60

how is oveactive bladder surgically treated

Answer 60

augmentation cystoplasty | urinaet diversion

Question 61

causes of continuous incontinance

Answer 61

vesicovaginal fistulae | ectooic ureter

Question 62

what imaging is doen for bph

Answer 62

uss

Question 63

what is done in bph to rule out cance r

Answer 63

flex cyst

Question 64

why are alpoha blockers given in bph

Answer 64

relax neck of bladder

Question 65

why are 5 alpha reductase inhibitors given

Answer 65

stop dheas