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Year 1 Body Systems > Renal > Flashcards

Flashcards in Renal Deck (216)
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31

What is another name for an epithelial foot process?

Podocytes

32

What is pyelonephritis?

Pus in the kidney

33

What is reflux nephropathy and why does it occur and what can it lead to?

Occurs in childhood when the kidneys are growing
Have an incompetent vesicoureteric junction
On voiding urine passes back up ureter then back into bladder, there is risk of stagnation and infection
On voiding infected urine passes back up to the kidneys - pyelonephritis - injury and scarring
Can lead to CKD

34

What is the clinical presentation of reflux nephropathy and what is the treatment?

Child with fever of unknown origin
Fails to meet developmental mile stones - bedwetting at 5-7 years
Family history of reflux nephropathy
Treatment is prophylactic Abx

35

If haematuria was found in a patient over 45 what would you suspect and who would you refer them to?

Suspect a lesion somewhere in the renal tract
Refer to a urologist

36

If haematuria was found in a patient under 45 what would you suspect and who would you refer them to?

Suspect Glomerulonephritis
refer to the renal physician

37

What is glomerulonephritis?

Inflammation in the glomerulus

38

What 4 things make up nephrotic syndrome?

1) Proteinuria
2) Hypoalbuminaemia
3) Oedema
4) Hypercholesterolaemia

39

What happens in nephrotic syndrome to the glomerulus?

Injury to the foot processes of the nephron

40

What 4 things can cause injury to the foot processes of the nephron and therefore nephrotic syndrome?

1) Minimal change disease (children)
2) Membranous nephropathy
3) Focal segmented glomerulosclerosis
4) Amyloid (caused by myeloma, malignancy of the bone marrow)

41

What is the most important way by which foot processes in health prevent the filtration of albumin from the blood?

Repel them by being negatively charged

42

What 4 important substances are freely filtered into the nephron?

1) Electrolytes
2) Sugars
3) Amino acids
4) Vitamins

43

What 3 things affect the filtration of a molecule across the glomerular basement membrane?

1) Molecular weight
2) Surface charge - glomerular basement membrane is negatively charged
3) Hydrostatic pressure in the afferent arteriole

44

What is a normal glomerular filtration rate?

100-120mls/min/1.73m2

45

What does accurate glomerular filtration rate measurement require the injection of and when is this carried out?

The injection of a radioactive tracer such as Technetium Tc99
Performed rarely except in the case of live kidney donors to determine accurate kidney function prior to donation

46

What is performed as an alternative to glomerular filtration rate but is not used often clinically? Is this more or less accurate?

Creatinine clearance
Not as accurate
Requires a blood test and 24 hour urine collection

47

What is the routinely used measurement of kidney function?

Serum creatinine
Simple blood test
Normal range is 64-104 umol/L

48

What 4 things are required to calculate eGFR?

1) Serum creatinine
2) Age
3) Sex
4) Ethnicity

49

What does eGFR correlate with?

Percentage kidney function

50

At what eGFR do patients need to commence dialysis?

51

At what level is plasma osmolality maintained at to maintain normal cellular function?

285 mOsm/L

52

What is a normal urine osmolality?

50-1400mOsm/L

53

What mechanism is responsible for the kidneys ability to produce concentrated urine during periods of decreased fluid intake?

Counter current mechanism
Establishes a high conc gradient in the medulla and enables water resorption in the proximal tubule and the collecting duct

54

What are the 3 methods of insensible loss of fluid?

1) Sweat
2) respiration
3) Faeces

55

How does antidiuretic hormone increase fluid retention?

Inserts channels into the medullary collecting duct to allow reabsorption of water

56

What 2 things can uraemia (accumulation of waste products) lead to?

1) Pericarditis
2) Encephalopathy

57

Where is the Na+/K+ATPase in the nephron?

In all sections of the nephron
Located on the apical (blood) side
Pumps 3Na+ out for 2 K+ in

58

What percentage of glomerular filtrate is recovered at the proximal convoluted tubule?

70% (water and electrolytes)

59

At what point in the nephron is bicarbonate regenerated?

Proximal convoluted tubule

60

What channels are present in the proximal convoluted tubule to enable reabsorption of large amounts of water?

Aquaporins