Notes in WEEK 109 LOs: Urinary system - Renal colic

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Published	12/01/2024	The glomerular membrane is made up of three layers: the {{c1::capillary endothelial cells}}, the {{c1::glomerular basement membrane}} (GBM) and the {{…
Published	12/01/2024	Glomerular capillary pores are {{c1::100nm}} in diameter.
Published	12/01/2024	Inner podocyte filtration slits are {{c1::8nm}} in diameter.
Published	12/01/2024	The basement membrane is {{c1::negatively}} charged (by glycoproteins and collagen) to prevent the filtration of proteins that are {{c1::negatively}} …
Published	12/01/2024	The glomerular capillary wall is made up of {{c1::endothelial cells}} with pores, allowing all solutes to pass.
Published	12/01/2024	The narrow filtration slits allow fluid to leave the {{c1::glomerular capillaries}} and enter the lumen of the {{c1::Bowman’s capsule}} as glomerular …
Published	12/01/2024	The glomerular filtration rate (GFR) is influenced by three physical forces; the {{c1::glomerular capillary}} blood pressure, the {{c1::plasma-colloid…
Published	12/01/2024	Glomerular hydrostatic pressure (blood) ıs approximately {{c1::55}} mm/Hg, which is influenced by the {{c1::arterial blood}} pressure and {{c1::vascul…
Published	12/01/2024	Blood colloid osmotic pressure is approximately {{c1::30}} mm/Hg. As plasma proteins cannot cross glomerular membrane, they remain in capillaries.&nbs…
Published	12/01/2024	Bowman’s capsule hydrostatic pressure is approximately {{c1::15}} mm/Hg, which is the force exerted by the fluid in the capsule.
Published	12/01/2024	The hydrostatic pressure is {{c1::higher}} than other capillaries due to the afferent arteriole having a {{c1::larger}} diameter of compared to the ef…
Published	12/01/2024	As the afferent arteriole has a {{c1::larger}} diameter of compared to the efferent arteriole, more blood can enter through the afferent arteriole tha…
Published	12/01/2024	Solute osmolarity in the capillary and filtrate is {{c1::290}} mosmol/L.
Published	12/01/2024	Net filtration pressure (NFP): Hydrostatic pressure (55mmHg) - Blood oncotic pressure (30mmHg) - Bowman’s capsule pressure (15mmHg) = Net NFP {{c1::10…
Published	12/01/2024	Glomerular capillary hydrostatic pressure is be regulated to maintain a constant GFR of approximately {{c1::120}} ml/min
Published	12/01/2024	Glomerular capillary hydrostatic pressure of ~120 ml/min can be regulated by {{c1::autoregulation}}, hormonal regulation by the {{c1::kidneys}} and au…
Published	12/01/2024	Mean arterial pressure (MAP) of {{c1::60}} mmHg or greater is required to maintain adequate tissue perfusion.
Published	12/01/2024	Mean arterial pressure (MAP) is the {{c1::diastolic pressure}} (DP) + 1/3 {{c1::pulse pressure}} (PP).
Published	12/01/2024	Glomerular filtration rate (GFR) autoregulation includes the granular cells that secrete {{c1::renin}}, the macular densa cells that detect {{c1::sodi…
Published	12/01/2024	In GFR autoregulation, a decreased mean arterial pressure (MAP) results in decreased GFR. Decreased GFR is detected by {{c1::macula densa}} cells, tha…
Published	12/01/2024	GFR is hormonally regulated by the renin-{{c1::angiotensin}}-aldosterone system (RAAS)
Published	12/01/2024	in GFR Hormal regulation, a decreased mean arterial pressure (MAP) decreases glomerular capillary pressure, resulting in decreased GFR. This is detect…
Published	12/01/2024	Creatinine is the breakdown product of {{c1::creatine}}, which is used as an energy supply by muscles and the brain.
Published	12/01/2024	Creatinine Clearance is calculated by {{c1::multiplying}} the concentration of creatinine in the urine and urine flow rate, {{c1::divided}} by the pla…
Published	12/01/2024	Normal GFR is found between {{c1::90 – 120}} ml/min.
Published	12/01/2024	Those with chronic renal impairment are expected to have a GFR between {{c1::30 – 60}} ml/min.
Published	12/01/2024	Those with chronic kidney disease (CKD) are classified with GFR of {{c1::10 - 30}} ml/min.
Published	12/01/2024	Those with end-stage renal failure (ESRF) have an GFR of {{c1::< 10}} ml/min.
Published	12/01/2024	Plasma [creatinine] and [{{c1::urea}}] are used as indicators of renal function.
Published	12/01/2024	Urine is considered to be {{c1::sterile}}.
Published	12/01/2024	Urine contains waste products and other molecules not required by the body. The component that makes urine yellow in colour is {{c1::urobilin}}, a pro…
Published	12/01/2024	Approximately how much urine is produced by an individual per day?
Published	12/01/2024	Of the 120 ml/min filtrate formed, {{c1::119}} ml/min is reabsorbed, which shows that the urine flow rate is {{c1::1}} ml/min.
Published	12/01/2024	Normal urine should have a pH of {{c1::6.2 (4.5-8)}}. An osmolarity of {{c2::500-1200}} mosmols/L. A protein level of {{c3::< 25}} mg/24hr. NO GLUC…
Published	12/01/2024	A plasma pH of 7.6 is maintained by the removal of {{c1::hydrogen ions (H+)}} by the kidneys.
Published	12/01/2024	As kidneys cannot produce urine with pH < 4.5, the H+ excreted is buffered with {{c1::hydrogen phosphate (HPO4)}}.
Published	12/01/2024	Proteinuria is the presence of {{c1::protein}} in the urine.
Published	12/01/2024	Microalbuminuria is the excretion of {{c1::albumin}} into the urine at a rate of {{c2::25 – 300}} mg/24 hrs.
Published	12/01/2024	Albumin excretion in the urine of {{c1::> 300}} mg/24 hrs indicates significant damage to the glomerular membrane.
Published	12/01/2024	Nephrotic syndrome, whereby significant damage to the kidney blood vessels resulting in protein excretion in the urine will demonstrate an albumin exc…
Published	12/01/2024	Urine is transported by the {{c1::ureters}}, stored in the {{c1::bladder}}, and eliminated through the {{c1::urethra}}.
Published	12/01/2024	Mechanoreceptors are activated in the bladder to indicate micturition. The {{c1::parasympathetic}} nervous system forces {{c1::internal}} urethral sph…
Published	12/01/2024	Urinary tract infections (UTIs) cause inflammation of the urinary {{c1::epithelium}}, often by bacteria from gut flora.
Published	12/01/2024	Cystitis is {{c1::inflammation}} of the bladder due to {{c1::retrograde}} movement of bacteria such as E.coli into urethra and bladder. Occurs more of…
Published	12/01/2024	What are the body’s natural defences against UTIs?
Published	12/01/2024	Acute cystitis often presents with urgency and frequency. The inflammatory response results in the bladder swelling, activating the {{c1::stretch rece…
Published	12/01/2024	As we age, we lose {{c1::muscle tone}} of our sphincters, which may lead to incontinence and slow urine leakage.
Published	12/01/2024	As we age, the number of function kidney nephrons {{c1::decrease}}, thus {{c1::decreasing}} kidney function. GFR reduces due to {{c1::fewer}} glomerul…
Published	12/01/2024	Define Hematuria and the two different ways it can present
Published	12/01/2024	Two causes of non-persistent (transient) visible haematuria?
Published	12/01/2024	Causes of persistent visible haematuria?
Published	12/01/2024	If a patient presents with unexplainable visible hematuria (no UTI), or with visible hematuria that persists after UTI treatment, an urgent cancer ref…
Published	12/01/2024	If a patient presents with unexplainable non-visible hematuria and dysuria or raised white cell count, an urgent cancer referral should be placed if t…
Published	12/01/2024	If a 65 y/o patient presents with recurrent UTIs, should their cancer referral be urgent or non-urgent?
Published	12/01/2024	An unwell patient presents with severe hematuria. What other symptom, if present, would be indicative for hospital admission?
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