Uni Week 2 Workshop and Case

Question 1

[cite_start]What is the location and composition of the Juxtaglomerular Apparatus (JGA)?

Answer 1

The JGA is located where the distal tubule meets the afferent arteriole and is made of macula densa (senses NaCl)

Question 2

[cite_start]What is the function of the Juxtaglomerular Apparatus (JGA)?

Answer 2

It controls blood pressure and filtration rate. [cite: 34]

Question 3

[cite_start]How is the RAAS System triggered?

Answer 3

It is triggered by low BP or low Na+. [cite: 34]

Question 4

Explain the process of the RAAS System.

Answer 4

JG cells release renin

Question 5

[cite_start]How are Na+

Answer 5

K+

Question 6

[cite_start]What is the permeability of the thick ascending limb of the loop of Henle to water?

Answer 6

It is impermeable to water

Question 7

[cite_start]What is the etiology of Bartter Syndrome?

Answer 7

It is caused by a genetic defect in ion transporters (e.g.

Question 8

Describe the pathophysiology of Bartter Syndrome.

Answer 8

It involves defective NaCl reabsorption

Question 9

What are the clinical features and complications of Bartter Syndrome?

Answer 9

Clinical features include polyuria

Question 10

[cite_start]What is the function of the Proximal Convoluted Tubule (PCT)?

Answer 10

It reabsorbs approximately 65% of filtered Na+

Question 11

[cite_start]What are the causes of Fanconi Syndrome?

Answer 11

Causes can be inherited (e.g.

Question 12

What are the clinical features of Fanconi Syndrome?

Answer 12

Clinical features include polyuria

Question 13

What are the clinical consequences of a compromised glomerular filtration barrier?

Answer 13

A compromised glomerular filtration barrier leads to proteinuria (protein in urine) due to increased permeability to macromolecules like albumin. It is associated with nephrotic syndrome

Question 14

What are the clinical implications of impaired autoregulatory processes in maintaining renal blood flow and GFR?

Answer 14

Impaired autoregulation (via myogenic reflex and tubuloglomerular feedback) leads to fluctuations in GFR with blood pressure changes. [cite_start]This can cause acute kidney injury (AKI) during hypotension or shock and contributes to the progression of chronic kidney disease (CKD) in hypertension and diabetes. [cite: 66]

Question 15

How does hypernatremia impact renal function and sodium balance?

Answer 15

Hypernatremia reflects a water deficit

Question 16

Explain how the Na+/H+ antiporter utilizes the bicarbonate buffer system to maintain balance of H+ ions.

Answer 16

The Na+/H+ antiporter is located in the proximal tubule and exchanges intracellular H+ for luminal Na+. Secreted H+ combines with filtered HCO3- to form H2CO3

Question 17

[cite_start]How is diluted urine formed?

Answer 17

Dilute urine is formed when there is low ADH

Question 18

[cite_start]How is concentrated urine formed?

Answer 18

Concentrated urine is formed when there is high ADH

Question 19

[cite_start]Where does ADH act to increase water reabsorption?

Answer 19

ADH acts on the Distal Convoluted Tubule (DCT) and Collecting Duct (CD) to increase water reabsorption. [cite: 68]

Question 20

[cite_start]How does ADH affect urea reabsorption?

Answer 20

ADH promotes urea reabsorption in the inner medullary collecting duct to enhance medullary osmolarity. [cite: 68]

Question 21

What are the differences in reabsorption in Diabetes Insipidus (DI) compared to a typically functioning nephron?

Answer 21

In Diabetes Insipidus

Question 22

Why is the condition called Diabetes Insipidus?

Answer 22

The term “Diabetes” means “siphon” (Greek)

Question 23

What are the causes of Diabetes Insipidus?

Answer 23

Central DI can be caused by damage to the hypothalamus or pituitary (trauma

Question 24

[cite_start]Are the following urinalysis results consistent with Diabetes Insipidus: Volume = 3000 ml (normal 1200-2000)

Answer 24

Urine Specific Gravity (USG) = 1.006 (normal 1.010-1.030)

Question 25

[cite_start]How can Central Diabetes Insipidus be treated?

Answer 25

Central DI can be treated with Desmopressin (DDAVP) and fluid monitoring. [cite: 73]

Question 26

[cite_start]How can Nephrogenic Diabetes Insipidus be treated?

Answer 26

Nephrogenic DI can be treated with a low-sodium diet

Question 27

[cite_start]How can Gestational Diabetes Insipidus be treated?

Answer 27

Gestational DI can be treated with Desmopressin

Question 28

What is the definition of "urgency" as a Lower Urinary Tract Symptom (LUTS) and what questions should be asked to a patient about it?

Answer 28

Urgency is a sudden

Question 29

What is the definition of "frequency" as a Lower Urinary Tract Symptom (LUTS) and what questions should be asked to a patient about it?

Answer 29

Frequency is voiding (urinating) too often during the day. [cite_start]Appropriate questions to ask are: "How many times do you typically urinate during the day?" and "Do you feel you urinate more often than usual?" [cite: 75]

Question 30

What is the definition of "nocturia" as a Lower Urinary Tract Symptom (LUTS) and what questions should be asked to a patient about it?

Answer 30

Nocturia is waking up one or more times during the night to void. [cite_start]Appropriate questions to ask are: "How many times do you wake up at night specifically to urinate?" and "Does waking up to urinate disturb your sleep?" [cite: 75]

Question 31

What is the definition of "dysuria" as a Lower Urinary Tract Symptom (LUTS) and what questions should be asked to a patient about it?

Answer 31

Dysuria is pain or discomfort (e.g.