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1

classify types of haematuria

Glomerular
-Often associated with proteinuria
-Urine dip stick to test

Collecting system
-microscopic
-Little/no proteinuria
-Symptoms = lion to groin pain, clots, vomiting, anuria

Focal lesion
-Often asymptomatic
-Back-pain
-palpable mass e.g. malignancy

2

describe the differing symptoms between nephrotic syndrome and nephritic

nephrotic
- oedema, weight gain
- frothy urine
- loss of albumin
- hyerlipidema, malnutrition, infection, thromboembolism

nephritic
- loss of RBC
- haematuria and proteinuria
- raised BP and JVP
- inflammation
- oliguria

3

define acute tubular necrosis

Persistent oliguria and renal failure after correction of pre-renal condition

4

state the major transporters in each aspect of the nephron

proximal tubule
- Na+/K+/ATPase
- glutamine = HCO3- & NH4+

TAL
- Na/2Cl/K
- ROMK

early distal
- Na/Cl

late distal/CD
- principal = ENaC & ROMK
- intercalated = H/ATPase & H/K/ATPase

5

name the transport channel blockers

Na/2Cl/K = furosemide

Na/Cl = thiazide

aldosterone = spirolactone

CA = acetazolamide

6

what determines the volume of the ECF and why?

renal Na+ handling
because the osmolality of the ECF is kept ~constant, the amount of Na+ in the body determines ECF volume. To maintain a constant ECF volume the amount of Na+ excreted needs to match the input, from diet.

7

Describe the tissue organisation of the ureter and bladder

- transitional epithelium - means that the ureter can expand in size when required and the epithelium can "flatten" to make more space (becomes stratified columnar to stratified squamous) --> stratified columnar --> stratified squamous

- mucous membrane for lubrication and protection of bacteria

- elastic lamina - allows stretch and recoil when lots of fluid is inside

- inner circular, outer longitudinal muscle

- adventitia (contains blood vessels and nerves)

8

Describe the tissue and cellular organisation of the different tubular segments of the nephron as a basis for understanding their function

PCT
- brush border = increase surface area
- pinocytosis = move large molecules
- lateral processes & infoldings

Thin descending
- simple squamous
- nuclei bulge into lumen

DCT
- no brush border or pinocytosis
- lateral processes & infoldings
- cuboidal cells

CD
- cuboidal to columnar

9

how is bone health affected in chronic kidney failure

there is a build-up of phosphate as it is not being excreted, this stimulates the PTH. Causing calcium to get leached out of the bones and increase the risk of fracture as a result of decreased calcium present within the bones.

10

what stimulates ADH release

- increase in osmolality sensed by osmoreceptors

- decrease in BP sensed by baroreceptos

11

describe the different prostatic zones

transitional zone
- BHP
- around urethra

peripheral
- where most carcinomas occur
- atrophy

12

treatment for tumours of the bladder

- superficial = BCG
- into detrusor muscle = cystectomy

13

define engagement

refers to how deep the presenting part is engaged in the bony pelvis

14

endometrial tumour types

non-neoplastic = endometriosis

pre-malignant = hyperplasia

benign = endometrial polyps

malignant = endometrial adenocarcinoma

15

fallopian tube tumour types

non-neoplastic = salphagitis

pre-malignant = tubular intraepitheial carcinoma

benign = adenotamoid tumour

malignant = carcinoma

16

myometrium tumour types

non-neoplastic = adenomyosis

benign = leiomyomas

malignant = leiomyosarcoma

17

cervix tumour types

non-neoplastic = cervitis

pre-malignant = squamous intraepithelial lesion (SIL)

benign = endocervical polyps

malignant = SqCC

18

describe the differences and origins of seminoma and non-seminoma GCT

seminoma = gonadal germ cell

NSGCT
- Embryonal carcinoma
- Teratoma (ectoderm, mesoderm, endoderm)
- Choriocarcinoma (trophoblast)
- Yolk sac tumour (extra-embryonic, endoderm)

19

describe the normal sexual response cycle for females

arousal = vagina lubricates, clitoris swells, nipples erect

plateau = vulva swells, vagina lengthens

orgasm = Muscular contractions of outer 1/3 of vagina, uterus and anal area. Pleasant sensation felt

resolution = Return to baseline or unaroused state

refractory period = time delay before plateau stage can be re-entered

20

describe the normal sexual response cycle for males

arousal = erect penis, testes draw into body, nipples erect

plateau = Deepening vasodilation of genitalia. Pre-ejaculatory fluid

orgasm = Muscular contractions involving penis and perineum. Contraction of prostate gland and seminal vesicles (ejaculation)

resolution = return to baseline or unaroused state

refractory period = Penile erection may obtain but orgasm cant reoccur. Period lengthens with age and fatigue

21

name the perineal musculature

ischiocavernosus
bulbospongiosus

22

describe the deep perineal pouch

deep pouch of perineal membrane, more muscles in females as the path of the urethra is shorter

23

describe the superficial perineal pouch

everything from the perineal membrane to the skin
- e.g. nerves, vessels, erectile tissue, perineal muscles, Bartholin glands in females

24

differences in female and male pouches

males
-'membranous urethra'
- bulbourethral glands
- dorsal nerve of penis

females
- vagina
- urethrovaginalis muscle
- dorsal nerve of clitoris