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Urology Notes

Medicine Notes > Medicine and Surgery Notes

This is an extract of our Urology document, which we sell as part of our Medicine and Surgery Notes collection written by the top tier of Bristol University students.

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Medicine & Surgery Urology Pathophysiology of Glomerular Filtration GFR = KS [(PGC - PT) - ( p GC - pT)]
K = permeability of glomerular membrane
| in nephrotic syndrome. Leads to | GFR S = surface area of glomerular membrane
| when a kidney is removed; effective surface area falls if there is reduced renal blood flow (e.g. through partial blockage of a renal artery). Both situations lead to |GFR PGC = hydrostatic pressure in glomerular capillaries
| when systemic blood pressure falls or when blood is diverted away from kidney. Leads to |
GFR (and vice versa)

PT = hydrostatic pressure in tubule (i.e. Bowman's capsule)
| if a blockage exists in renal tubules; e.g. kidney stone; tumour in, or close to, kidney. Leads to | GFR because of 'back pressure'
pGC = colloid osmotic pressure (C.O.P.) in glomerular capillaries
| in nephrotic syndrome, liver disease, malnutrition. All lead to | GFR
p T = C.O.P. in tubular fluid

| in nephrotic syndrome. Leads to | GFR Type of Diuretic

Example

Site of Action

Mechanism of Action

Route of Administration

Indications

Contraindications

Adverse Effects

Loop

Furosemide Bumetanide Torasemide

Thick ascending segment of loop of Henle

Oral IV Intramuscular

Acute pulmonary oedema Oliguria due to acute renal failure Hypertension

Severe renal impairment Cardiac glycosides

Hypokalaemia Hyponatraemia Hyperuricaemia Hypotension Hypovolaemia

Thiazide

Chlorothiazide Bendroflumethazide Metolazone

DCT

Inhibits Na+/K+/2Cl+ cotransporter Increasing the amount of sodium reaching the collecting duct Increases K+ and H+ secretion Inhibits Na+/Cltransport Increases K+ and H+ secretion and decreases Ca2+
excretion

Oral 1-2 hours

Hypertension Oedema secondary to CHF Liver disease Nephrotic syndrome

Hypokalaemia Hyponatraemia Hypocalcaemia Cardiac glycosides Diabetes mellitus, may cause hyperglycaemia

Hypokalaemia Hyponatraemia Hyperuricaemia Hypercalcaemia

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