Renal system worksheet 1. Is the diameter of the afferent arteriole larger or smaller than the diameter of the efferent arteriole? State how this affects glomerular pressure. Larger. Creates...

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Renal system worksheet 1. Is the diameter of the afferent arteriole larger or smaller than the diameter of the efferent arteriole? State how this affects glomerular pressure. Larger. Creates filtration pressure of 55mmHg in glomerulus. 2. Explain the three forces that contribute to the net glomerular filtration pressure, including the direction of movement of fluid (inwards to the blood capillaries, or outwards the filtrate) for each of the forces. ANSWER SHOULD INCLUDE: Explanation of what each of the following is: Glomerular hydrostatic pressure Blood colloid hydrostatic pressure Capsular hydrostatic pressure Glomerular hydrostatic pressure - outwards to the filtrate Blood colloid hydrostatic pressure – inwards to the blood Capsular hydrostatic pressure – inwards to the blood 3. Explain why the kidney needs to maintain a consistent filtration pressure. GFR has influence on amount/composition of urine, and therefore volume/composition of blood (so what happens if these change?). 4. Name the two main types of diuretics, and briefly explain how these diuretics exert their actions. ANSWER SHOULD INCLUDE: Identify main types – loop and thiazide (Loop diuretics e.g. furosemide, bumetanide and torasemide. Thiazide diuretics e.g. bendroflumethiazide, indapamide and metolazone). Actions – discuss effect of inhibition of sodium reabsorption (e.g. effect on urine output, blood volume and blood pressure) Specify which parts of nephron the 2 types of diuretic act on. 5. What is pyelonephritis? Explain the causes and describe the signs/symptoms of pyelonephritis. Name the bacterium that is most often associated with urinary tract infections and explain the usual treatment of the infection. Outline the possible consequences of untreated pyelonephritis. ANSWER SHOULD INCLUDE: Definition of ‘pyelonephritis’. Type of infection (i.e. causative agent) and how it gets into the body. Description of symptoms i.e. usual UTI symptoms (e.g. frequency, urgency, painful urination etc), But also describe additional serious signs/symptoms or complications when upper urinary tract infected. Identify drug treatment and route of administration. Explain possible serious consequences of untreated pyelonephritis. 6. Explain the role of the renin-angiotensin–aldosterone pathway in restoring blood pressure and fluid balance. Include the stimulus for release, the pathway that is involved, and the physiological effects of angiotensin II and aldosterone. ANSWER SHOULD INCLUDE: Identify stimulus/change that starts the pathway (i.e. identify the direction of change in BP or circulating fluid status). What happens in Juxtaglomerular cells? Clue: what stimulus causes release of renin? Explain action of renin – what protein does it act on? What is this converted to? Which enzyme converts angiotensin 1 to angiotensin 2? What are the actions of angiotensin 2? Clue: stimulates adrenal cortex to produce what? And what effect does angiotensin 2 have on blood vessels? What causes increased reabsorption of Na into blood? What effect does this have on blood volume? How is BP restored? Explain how this relates to equation for BP (BP= CO x TPR). 7. Explain what ACE stands for, and how ACE inhibitors affect blood pressure. ANSWER SHOULD INCLUDE: Explanation of what ACE is. Explanation of how angiotensin 2 causes BP to increase. As a consequence of this, explanation of how ACE inhibitors reduce blood pressure. 8. Describe the roles of antidiuretic hormone and aldosterone in the regulation of fluid excretion. ANSWER SHOULD INCLUDE: What triggers release of ADH (i.e. stimulus). What ADH does (i.e. actions of ADH and location of receptors for ADH). Identify the effectors that respond to ADH and explain what happens when they are activated. What effect this has on fluid excretion and fluid retention. What triggers release of aldosterone (i.e. stimulus). What aldosterone does (i.e. actions of aldosterone and location of receptors for aldosterone). Identify the effectors that respond to aldosterone and explain what happens when they are activated. What effect this has on fluid excretion and fluid retention. 9. What is chronic kidney disease? Explain the causes and describe the signs/symptoms of chronic kidney disease. Outline the management of chronic kidney disease. Review PowerPoint slides on ‘Chronic kidney disease and prostate cancer’ ANSWER SHOULD INCLUDE: Explanation of CKD pathophysiology (see slide no.4, 9) Causes (see slide no. 6, 7) Signs & symptoms (see slide no.11,13,17) Management (see slide no. 18-22) 10. What is cystitis? Describe i) the causes of ii) signs and symptoms of urinary tract infections. Why does if tend to affect women more than men? Give the name of the drug that is most commonly used to treat cystitis. ANSWER SHOULD INCLUDE: Give definition of ‘cystitis’. Type of infection (i.e. causative agent) and how it gets into the body. Description of symptoms i.e. usual UTI symptoms Women more risk of cystitis – i.e. explain position and length of urethras. Identify drug treatment and route of administration.