medine and surgery notes

Apr 24th, 2015
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THE KIDNEYDr James Swao, FRACPNEPHROLOGY TOPICSA) UTI1.UTI2.PYELONEPHRITISB) AGN1.AGN2.RPGN3.CGNC) NEPHROTIC SYNDROME1.NEPHROTIC SYNDROME2.MCD3.DN4.DISORDERED OF TUBULAR FUNCTIONNEPHROLOGY TOPICSD) HEREDITARY1.POLYCYSTIC KIDNEY DISEASESE) OBSTRUCTIVE UROPATHY (UTO)E)IMMUNOPATHOGENESIS IN RENAL INJURYF) ACUTE KIDNEY INJURYG) Asymptomatic urinary abnormalitiesThe KidneyTHE KIDNEYCONSISTS OF:1. Blood vessels (many and various levels)2. Glomerulus3. Renal tubules4. Renal interstitiumTHE GLOMERULUSTHE GLOMERULAR BASEMENT MEMBRANE(GBM)LARGE AMOUNT OF WATER BEINGFILTERED.ABILITY TO RETAIN PROTEINS WITHINTHE PLASMA. THIS IS ACHIEVED BY:A) THE GBMB) SLIT-LIKE DIAPHRAMThe Glomerular Basement MembraneStructureDEFINITIONS1. Diseases of the glomerulus is likely to involvethe whole nephron (Glomerulonephritis)2. Tubular disease may restrict it self within thetubule (renal tubular acidosis) but notalways.3. Involvement of both renal tubule andinterstitial areas is very common as in renaltubular interstitial diseasesTHE KIDNEY FUNCTIONS(SUMMARY) CONSERVATION OF WATER ACID BASE BALANCE ELECTROLYTE CONTROL ENDOCRINE FUNCTIONS BLOOD PRESSURE CONTROLGLOMERULAR FITRATIONA)ULTRAFILTRATION OF 180L AND REABSORPTION OF>90%/day1. This is favoured by:a) Hydrostatic pressure within the glomerular capillary.b) Oncotic pressure at the Bowmans space.But impeded by:a) Oncotic pressure i

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