Renal Phys
What are the two principle actions of Angiotensin II
Vasoconstriction and increasing blood volume (via aldosterone and ADH release)
What is the management for AKI?
Treat underlying cause
Supportive care
Dialysis
The pterion overlies what structure?
(the anterior branch of) the middle meningeal artery
Where does the spinal cord end?
L1
What two drugs should you give TOGETHER to manage hypertension
ACE or ARB + CCB or TD
What factors determine the glomerular filtration rate (GFR)?
Hydrostatic and osmotic (oncotic) pressures across the glomerular filtration barrier.
What are the four major risk factors for atherosclerosis (modifiable)
High LDL cholesterol
Hypertension
Smoking
Diabetes mellitus
The maxillary sinuses are clinically the most commonly infected of the paranasal sinuses. What anatomical feature contributes most to this susceptibility?
Their openings are located high on the superomedial wall
Name what these cranial nerves are:
1, 7, 9, 10, 11
You need 4/5 to get the points
1 - olfactory
7 - facial
9 - glossopharyngeal
10 - Vagus
11 - accessory
What % of patients on ACEI will get a cough?
20%
In what order do these mechanisms act - from fastest to slowest?
ADH, Chemoreceptor Reflex, RAAS, ADH, Baroreceptor Reflex, Kidney/pressure naturesis
Short term: baroreceptors → autonomic nervous system
Intermediate: RAAS, ADH, vascular stress-relaxation
Long term: kidneys → Na⁺/water balance → blood volume
why might taking anti-hypertensive medication at night be more beneficial than in the morning?
lower risk of cardiovascular events
What four bones merge at the pterion?
Parietal, frontal, temporal, sphenoid
What is the muscle around the eye that is responsible for closing/blinking, and what is its' innervation?
Ocularis oculi - CN VII facial nerve
How does Aldosterone specifically affect electrolyte levels in the distal convoluted tubule and collecting duct?
Reabsorption of Na + H2O into plasma, excretion of K
What would be expected in laboratory findings for an AKI? (5)
High serum creatinine, elevated BUN, hyperkalemia, metabolic acidosis, abnormal urine analysis
What is required to ensure you get an accurate BP reading?
When does the anterior fontanelle & posterior fontanelle close respectively?
18 months / 1 year
Where do the three trigeminal nerves enter exit the skull?
V1 - superior orbital fissure
V2 - foramen rotundum
V3 - foramen ovale
Name a non-dihydropyridine calcium channel blocker, explain its mechanism and 1 side effect?
Diltiazem, verpamil
Inhibits calcium entry into the vascular smooth muscle cells of a blood vessel, as well as cells in teh heart and GI tract
Side effects: hypotension, headache, flushes, reflux, ankle oedema, bradycardia, constipation
What does a juxtaglomerular apparatus include? Location and function of each?
Juxtaglomerular cell: in wall of afferent arteriole (mechanoreceptors sensing BP, renin synthesis)
Macula densa: in wall of DCT where it passes between afferent and efferent (sense NaCl)
Mesangial cells: between afferent arteriole, efferent arteriole and macula densa (structural support)
Name 3 complications of chronic hypertension and how it happens
1. Congestive Heart Failure - increased after load -> LV hypertrophy/fibrosis -> impaired BF from heart -> decreased perfusion & blood backs up into lungs
2. Injury to endothelium -> atherosclerosis
Will also accept CAD and stroke as subsequent answers of atherosclerosis
3. Retinopathy - damage to microvasculature
Three muscles that are responsible for closing the mouth (elevating)?
Masseter + temporalis + medial pterygoid
What are the three neural tube defects and describe them.
1. Spina bifida - spinal column does not close
2. Meningocele - neural tube lies in the normal position with a cyst formed by the protruding subarachnoid space
3. Meningomyelocele - neural tube lies ectopically in the cystic space
OR will accept anencephaly - failure of cephalic end to close or microcephaly - failure of normal size development fo the neural tube.
Calcium channel blocking agents primarily lower blood pressure by binding to which specific site?
alpha-1 subunit of L type calcium channels