Renal

Question 1

What three muscles are posterior to the kidneys?

Answer 1

Psoas major
Quadratus lumborum
Transversus abdominis

Question 2

What three layers surround the kidney? (deep to superficial)

Answer 2

Renal capsule
Adipose capsule
Renal fascia

Question 3

Where do the renal arteries arise?

Answer 3

From abdominal aorta, just inferior to the SMA

Between L1 and L2

Question 4

What three arteries supply the adrenal glands?

Answer 4

Superior suprarenal artery
Middle suprarenal artery
Inferior suprarenal artery

Question 5

Where do the superior suprarenal arteries branch from?

Answer 5

Inferior phrenic arteries

Question 6

Where do the middle suprarenal arteries arise from?

Answer 6

Directly from abdominal aorta

Question 7

Where do the inferior suprarenal arteries branch from?

Answer 7

Branches off renal arteries which pass upward to the adrenal glands

Question 8

What hormones does the adrenal medulla release?

Answer 8

Adrenaline

Noradrenaline

Question 9

What are the three zones of the adrenal cortex?

Answer 9

Zona glomerulosa
Zona fasciculata
Zona reticularis

Question 10

Which zone secretes aldosterone?

Answer 10

Zona glomerulosa

Question 11

What type of hormones, and name them, does the zone fasciculata secrete?

Answer 11

Glucocorticoids:
Cortisol
Corticosterone

Question 12

What does the zone reticularis produce?

Answer 12

Testosterone

Question 13

What haematopoietic growth factor do the kidneys produce?

Answer 13

Erythropoietin

Question 14

Where is the juxtaglomerular apparatus?

Answer 14

Juxtaposition of distal convoluted tubule, squeezed between afferent and efferent arterioles

Question 15

What do macula densa do?

Answer 15

Sense sodium concentration and tubular fluid flow in the tubular filtrate and feed back to the juxtaglomerular cells accordingly

Question 16

What is the definition of haematuria?

Answer 16

Excretion of 3 or more RBCs per high powered field in freshly voided urine

Question 17

What are the two types of haematuria?

Answer 17

Macroscopic (frank)

Microscopic

Question 18

Name medical renal causes of haematuria.

Answer 18

Glomerulonephritis
Autoimmune/vasculitis (SLE, Wegners)
Genetic (sickle cell, polycystic kidneys)
Infections (TB)
Diabetes
Amyloidosis

Question 19

Name surgical renal and lower urinary tract causes of haematuria.

Answer 19

Tumours
Calculi
Trauma
Benign prostatic hyperplasia
Urethral stricture

Question 20

What are the main risk factors associated with development of renal cell carcinomas?

Answer 20

Smoking
Obesity
Asbestos
Unopposed oestrogen
Chronic renal failure
Some heavy metals

Question 21

Name the main signs and symptoms of renal cell carcinoma.

Answer 21

Haematuria
Costovertebral pain
Palpable mass
Weight loss
Weakness
Malaise

Question 22

Where do transitional cell carcinomas arise from?

Answer 22

Anywhere between the renal pelvis and urethra, including ureter and bladder

Question 23

What is the most common site of a TCC?

Answer 23

Bladder

Question 24

In which group of people do TCCs usually arise?

Answer 24

Over 50s who smoke

Question 25

What are the signs and symptoms of transitional cell carcinoma?

Answer 25

Painless haematuria | Irritating bladder symptoms, including frequency, urgency and dysuria

Question 26

What is urolithiasis?

Answer 26

A calculi (kidney stone)

Question 27

What is the first and second most common type of calculus?

Answer 27

Calcium oxalate and phosphate | Struvite

Question 28

What is the most common infection that causes haematuria?

Answer 28

E. coli

Question 29

What other infections can cause haematuria?

Answer 29

Enterococcus faecalis Pseudomonas Klebsiella species

Question 30

What happens to water if you add an isotonic solution into the body?

Answer 30

Water remains in the extracellular spaces

Question 31

Give an example of an isotonic solution.

Answer 31

Saline solution

Question 32

What happens to water if you add a hypotonic solution to the body?

Answer 32

Water will move into the intracellular spaces

Question 33

What happens to water if you add a hypertonic solution to the body?

Answer 33

Water will be drawn out of the intracellular spaces into the extracellular spaces

Question 34

What is the difference in concentration of potassium ions between the intracellular and extracellular spaces?

Answer 34

Higher in intracellular spaces Intracellular levels: 140mOsm Extracellular levels: 4mOsm

Question 35

What is the difference in concentration of sodium ions between the intracellular and extracellular spaces?

Answer 35

Relatively low concentration intracellularly Intracellular levels: 10mOsm Extracellular levels: 145mOsm

Question 36

What controls renin secretion?

Answer 36

Intrarenal baroreceptors Sympathetic input Macula densa feedback

Question 37

What does aldosterone do in the kidneys?

Answer 37

Promotes Na+ reabsorption and K+ excretion in the proximal tubule

Question 38

What types of cells line the proximal convoluted tubule?

Answer 38

Simple cuboidal epithelial cells with prominent brush borders or microvilli

Question 39

What type of cells line the descending limb and the thin ascending limb of the Loop of Henle?

Answer 39

Simple squamous epithelial cells

Question 40

What type of cells line the thick ascending limb of the Loop of Henle?

Answer 40

Simple cuboidal to low columnar epithelial cells

Question 41

What type of cells line the distal convoluted tubule?

Answer 41

Simple cuboidal epithelial cells

Question 42

What type of cells line the last part of the distal convoluted tubule and the collecting duct?

Answer 42

Simple cuboidal epithelium consisting of principal cells and intercalated cells

Question 43

What hormone determines the expression of sodium channels on the surface of principal cells in the collection duct?

Answer 43

Aldosterone

Question 44

What hormone determines the expression of aquaporins on the surface of principal cells in the collecting duct?

Answer 44

Vasopressin (ADH)

Question 45

What does parathyroid hormone stimulate in the early distal convoluted tubule?

Answer 45

Reabsorption of calcium ions