• Position, surface anatomy and coverings of the kidneys in the retroperitoneum.
• Internal renal architecture: cortex, medulla, pyramids, calyces and the collecting system.
• The renal arterial tree, venous drainage and the lymphatic and autonomic supply.
• Anatomy of the ureters, bladder and urethra, with the clinically important constrictions and sphincters.

2. Development of the Urinary System

• Understand urinary system embryology from intermediate mesoderm: pronephros, mesonephros, metanephros progression
• Describe ureteric bud-metanephric mesenchyme interactions driving nephron and collecting system formation
• Explain ascent and rotation of kidneys and blood supply changes during development
• Outline partitioning of cloaca into urogenital sinus and anorectal canal
• Recognise congenital anomalies: renal agenesis, horseshoe kidney, duplex ureter, vesicoureteral reflux
• Correlate embryological defects with clinical presentations and neonatal imaging findings

3. The Nephron

• Understand the role of the nephron within the kidney
• Be aware of the anatomical segments of the nephron and each of their basic functions within the filtering process of the kidney

• The three-layer glomerular filtration barrier and the Starling forces that drive filtration.
• Filtration fraction and the role of afferent vs efferent arteriolar tone in setting glomerular pressure.
• Segment-by-segment tubular reabsorption: PCT, loop of Henle, DCT and collecting duct.
• Tubular secretion via the organic anion and cation transporters and its role in drug clearance.

5. Control of Plasma Volume

• Understand the components of extracellular fluid and their effect on plasma concentrations and diffusion
• Understand some of the mechanisms by which the kidneys help to regulate blood pressure
• Be aware of the transporters within each section of the kidney nephron and their roles within homeostasis
• Be aware of how these transporters can be targeted by drugs such as diuretics and how these can be used therapeutically

6. Control of Plasma Osmolarity

• Understand how the body controls plasma osmolarity
• Understand the role of the hypothalamus, pituitary gland and ADH in the control of plasma osmolarity
• Understand the effect of ADH on the collecting ducts of the kidney
• Understand the medullary counter-current mechanism for sensitively controlling the reabsorption of water
• Understand some of the things that can go wrong with controlling plasma osmolarity

7. Control of Potassium

• Understand potassium’s essential cellular roles: volume, pH, enzymes, excitability, cardiac function.
• Explain internal balance: rapid shifts of K⁺ between intracellular and extracellular compartments.
• Describe external (renal) balance: long-term potassium control via nephron reabsorption and secretion.
• Identify factors influencing cellular K⁺ uptake: insulin, aldosterone, catecholamines, acid-base status.
• Outline mechanisms regulating renal K⁺ secretion in distal nephron regions.
  Recognise clinical features and management strategies of hypo- and hyperkalaemia.

8. Micturition

• Understand the phases of micturition (urination)
• Understand the neural mechanisms that regulate these phases
• Understand some of the pathophysiology that can affect micturition and why certain neurological conditions can present with urinary symptoms

9. Diuretics

• Understand the mechanisms by which different diuretics reduce sodium and water reabsorption.
• Identify uses and side effects of loop, thiazide, potassium-sparing, osmotic, and carbonic anhydrase diuretics.
• Recognise which diuretics cause hypokalaemia (loops, thiazides) versus hyperkalaemia (amiloride, spironolactone).
• Understand clinical indications like hypertension, oedema, heart failure, hypercalcaemia, glaucoma, and cerebral oedema.

10. Glomerular Filtration Rate and the Measurement of Kidney Function

• Understand what a Glomerular Filtratation Rate (GFR) is
• Understand how this can be calculated for patients and its relevance
• Understand the prupose of urinalysis
• Be aware of urodynamic studies and what they involve

• Definition, severity grading, and the importance of acute vs chronic timing.
• The two-step diagnostic approach: plasma tonicity first, then volume status.
• Major aetiologies including SIADH, heart failure, cirrhosis and adrenal insufficiency.
• Principles of safe correction and the rationale for the 10 mmol/L per 24-hour ceiling.

12. Urinary Incontinence

• Define urinary incontinence and distinguish types (stress, urge, mixed).
• Identify key risk factors contributing to urinary incontinence.
• Understand pathophysiology behind stress and urge incontinence.
• Describe conservative management strategies (lifestyle, pelvic floor exercises).
• Explain when and why surgical or pharmacological treatments are appropriate.

13. Glomerular Disease

• Define glomerular disease and differentiate nephritic versus nephrotic syndromes.
• Recognise underlying pathophysiology of key glomerulopathies (e.g., IgA nephropathy, Goodpasture’s).
• Describe major clinical features: haematuria, proteinuria, oedema, hypertension.
• Explain diagnostic approach: urine tests, renal biopsy, serology and complement levels.
• Understand basic management principles including immunosuppression and supportive care strategies.

14. Diabetic Nephropathy

• Understand the pathophysiology of Diabetic Nephropathy
• Understand how Diabetes can cause a nephrotic syndrome
• Be aware of the signs and symptoms of Diabetic Nephropathy
• Know the risk factors for developing Diabetic Nephropathy as a Diabetic

15. Acute Kidney Injury

• Define AKI and identify prerenal, intrinsic, and postrenal categories.
• Recognise key risk factors and early clinical indicators of AKI.
• Use KDIGO/RIFLE criteria to diagnose and stage AKI.
• Interpret lab findings, including serum creatinine, urine output, FeNa, for AKI assessment.
• Apply a structured differential diagnosis and diagnostic approach (urine, imaging, biopsy).
• Understand management principles: treat cause, fluid balance, nephrotoxins, and renal replacement therapy.

16. Chronic Kidney Disease

• Define CKD using GFR and proteinuria criteria for at least three months.
• Recognise main causes, such as diabetes, hypertension, glomerulonephritis, tubular injury, idiopathic and infection.
• Understand CKD staging and histological changes like fibrosis, sclerotic glomeruli, inflammation, arterial thickening.
• Learn diagnostic investigations to assess cause, severity, and complications of CKD.
• Explore management strategies: slow progression, control hypertension, proteinuria, diabetes, and treat key complications.

17. Urinary Tract Obstruction

• Understand the causes of urinary tract obstruction
• Be aware of specific conditions and their pathophysiology that can cause urinary tract obstruction
• Understand the different types of urinary retention and their presentations
• Be aware of the complications of urinary retention and the surrounding syndromes

• Definitions and classification of UTI: lower vs upper, uncomplicated vs complicated.
• Microbiology and pathogenesis, including the dominance of uropathogenic <em>E. coli</em>.
• Investigation principles, including dipstick and MSU and when each is useful.
• Antibiotic management of uncomplicated cystitis, pyelonephritis, and special groups (pregnancy, children, catheter, recurrent).

19. Prostate Pathology

• Understand prostate zones and their relevance to disease localisation.
• Recognise histological differences between benign prostatic hyperplasia and prostate adenocarcinoma.
• Describe Gleason grading and its prognostic implications for prostate cancer.
• Identify prostatic intraepithelial neoplasia (PIN) as a premalignant lesion.
• Appreciate inflammation types like granulomatous prostatitis and their cancer mimicry.

20. Male Urological Conditions

• Describe the causes and management of phimosis and paraphimosis.
• Recognise key features of epididymo-orchitis and differentiate it from testicular torsion.
• Understand the urgency and treatment of testicular torsion.
• Identify the clinical presentation of a varicocele and its potential impact on fertility.
• Know when urgent urological referral is required.
• Understand the typical age and presentation pattern of each condition.

21. Urological Malignancy

• Define urological malignancies and recognise renal cell and transitional cell carcinomas.
• Identify key risk factors and classic presentation signs such as haematuria.
• Understand investigations and management approaches for renal cell carcinoma.
• Describe transitional (bladder) carcinoma, including risk factors, symptoms, investigations, and treatment.
• Appreciate the overall importance of haematuria as a diagnostic clue in urological cancer.