Renal

Question 1

Cannon balls on CXR

Answer 1

renal mets

Question 2

Loin to groin pain

Answer 2

renal colic

Question 3

Sea anemone on cytoscopy

Answer 3

transitional cell carcinoma

Question 4

UTI plus travel to India

Answer 4

Carbapenase-producing Klebsiella (resistant to all abx)

Question 5

UTI with foul smelling urine and renal calculi

Answer 5

Proteus

Question 6

Beading of the renal artery

Answer 6

fibromuscular dysplasia

Question 7

RBC casts in urine

Answer 7

proves haematuria is from glomerulus

Question 8

Muddy brown casts of epithelial cells

Answer 8

acute tubular necrosis

Question 9

Potato appearance

Answer 9

testicular seminoma

Question 10

Apple-green birefringence on congo red stain

Answer 10

amyloidosis

Question 11

What is osmolarity?

Answer 11

number of solute particles (osmoles) per litre

Question 12

What are the effects of a hypotonic, hypertonic and isotonic solution on a cell volume?

Answer 12

hypotonic: bursts
hypertonic: shrinks
isotonic: neutral

Question 13

Why is a urea solution hypertonic and sucrose solution isotonic?

Answer 13

urea can cross cell membrane

sucrose is too large to cross membrane

Question 14

What are the two major volume compartments in the body?

Answer 14

intracellular volume (66%) and extracellular volume (33%)

Question 15

How is an isotonic saline (0.9% NaCl) distributed?

Answer 15

majorly in the extracellular fluid compartment

Question 16

How is a glucose 5% solution distributed?

Answer 16

glucose is metabolised and fluid distributed throughout both compartments

Question 17

How are balanced crystalloid solutions distributed?

Answer 17

majorly throughout the extracellular fluid

Question 18

What makes up the upper urinary tract?

Answer 18

kidneys, ureters

Question 19

What makes up the lower urinary tract?

Answer 19

bladder, urethra

Question 20

Where do the renal veins lie in relation to renal arteries?

Answer 20

anterior

Question 21

Where do the common illiac arteries lie in relation to common iliac veins?

Answer 21

anterior

Question 22

Where does lymph from the kidneys drain?

Answer 22

lumbar nodes

Question 23

Where does the abdominal aorta bifurcate?

Answer 23

at level of umbilicus

Question 24

Where are adrenal glands situated?

Answer 24

on superior kidney

Question 25

What is the outer and inner portion of the kidney called?

Answer 25

outer renal capsule outer cortex inner medulla (27 renal pyramids with striped appearance due to each containing 50000 nephrons)

Question 26

What are the different parts of a nephron

Answer 26

``` glomerulus proximal convoluted tubule loop of henle distal convoluted tubule collecting duct ```

Question 27

How doe urine drain from the kidney?

Answer 27

collecting ducts meet into widening calyces and flow into the wide renal pelvis before into ureter at pelviureteric junction

Question 28

Where are the anatomical sites of ureteric constriction?

Answer 28

pelviureteric junction ureter crossing anterior to common iliac artery (often at the bifurcation) ureteric oriface (opening into bladder floor)

Question 29

What are staghorn calculi?

Answer 29

branched stones filling/partially filling the renal pelvis and calyces

Question 30

Where does the ureter run in relation to the uterine tubes and uterine artery?

Answer 30

inferiorly

Question 31

What forms the internal urethral sphincter in males and why?

Answer 31

detrusor muscle at internal urethral oriface contracts during ejaculation to prevent retrogade flow of semen (involuntary)

Question 32

What is normal position for uterus?

Answer 32

anteflexed

Question 33

What are the two pouches in a female and one pouch in male?

Answer 33

uterovesicle rectouterine (pouch of douglas) rectovesicle in males

Question 34

What sphincters are under voluntary control when peeing?

Answer 34

external urethral sphincter (men just before spongy urethra, females near external urethral oriface @ level of levator ani)

Question 35

What is the name of the sac that testis sit in the scrotum?

Answer 35

tunica vaginalis

Question 36

What layers separate blood from glomerular filtrate?

Answer 36

2 cell layers | capillary endothelium with thicker than usual basal lamina and surrounded by specialised epithelium (podocytes)

Question 37

What are mesangial cells?

Answer 37

specialised cells of the kidney that produce and maintain the mesangium/ connective tissue core in the glomerulus.

Question 38

What part of the nephron is in the medulla?

Answer 38

loop of henle

Question 39

What is the juxtaglomerular apparatus?

Answer 39

specialised region formed at the site where the distal convolutedd tubule passes adjacent to the vascular pole of its glomerulus

Question 40

What are the conducting parts of the urinary tract lined by?

Answer 40

transitional epithelium that changes to stratified squamous near termination

Question 41

What is AKI?

Answer 41

abrupt (<48hr) reduction in kidney function

Question 42

Diagnostic criteria for AKI?

Answer 42

rise in serum creatinine >26micromol Increase in creatinine by 50% Reduction in urine output <0.5ml/kg/hr for >6hours

Question 43

What is acute tubular necrosis?

Answer 43

death of epithelial cells in tubules

Question 44

What is a normal urine output?

Answer 44

0.5mls/kg/hour