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Test your basic knowledge |
Renal
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can
study here
.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.
This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.
1. What is amyloidosis associated with
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Chronic conditions - multiple myeloma - TB - RA
Inc in concentration - not amout - due to water reabsorption
2. How does RCC spread
Needs to be bilateral
Amyloidosis
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Invades IVC and spreads hematogenously
3. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
Hyperkalemia
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
Inc - dec - dec
4. What is the most frequent kind of kidney stone and What are causes that lead to it
Inc Ca/Na exchange to inc Ca reabsoprtion
Advanced renal dz - CRF
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
5. In addition to glucose and amino acids - what other components of the filtrate are reabsorbed in the proximal tubule
Poor - days to weeks
Renal tubular cells - polygonal clear cells
Most of the bicarb - sodium - chloride - and water
Stimulates thirst
6. What does LM - EM - IF show in diffuse proliferative GN
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Diabetic glomerulonephropathy
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
7. RBC casts - ddx
Passively reabsorbs water via medullary hypertonicity
Hypovent - immediate
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
Size and charge
8. In who is RCC most comon
Na reabsorption drives H20 reabsorption
Freely filtered and neither absorbed or secreted
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
Men 50 to 70 - inc incidence with smoking and obesity
9. Bergers' disease - which antibody and What do you see on LM and IF
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Staghorn calculi - worsened by alkaluria
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Liver
10. What does US show with medullary cystic disease
Small kidney - poor prognosis
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Renal in origin
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
11. how does this present in adults and What is the pattern of inheritence
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
Macula densa
Renal tubular cells - polygonal clear cells
Acts on V2 receptors leading to insertion of aquaporins on luminal side
12. Which cells sense decreases in Na delivery
Macula densa
Anion gap = na - (Cl + bicarb)
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
13. What is the compensatory response in metabolic alkalosis
Dec - dec - dec
Hypovent - immediate
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
14. What is the effect of aldosterone in principal cells
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
White cell casts
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
15. when polycystic kidney disease presents in an infant - What is the pattern of inheritance - What are the associations - What are concernse post neonatal period
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
16. In renal failure What are the consquence sof Na/H20 retention
Liver
Inc - dec - dec
CHF - pulmonary edema - HTN
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
17. Subendothelial immune complexes with granular IF
Membranoproliferative glomerulonephritis
Involves glomeruli and other organs
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
18. What do macula densa cells sense
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
Na
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
19. What dyslipidemia is most common in renal failure
Renal artery - interlobar a - interlobular a
NC - dec - dec
Triglycerides
Acts on V2 receptors leading to insertion of aquaporins on luminal side
20. What is the least common kidney stone - What causes it and How do you treat it
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Cx<GFR
Cystine - 2ndary to cystinuria - hexagonal - treat with alkalization of urine
21. What happens in the collecting tubules
RTA type 2 (proximal)
Reabsorb Na in exchange for secreting K and H
NC - dec - dec
Podocytes foot processes
22. What are the associations with RTA type 4
Membranoproliferative glomerulonephritis
PH = pKa + log bicarb/0.03PCO2
Cx = GFR
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
23. an inflammatory process leading to hematuria and RBC casts - associated with azotemia - oliguria - HTN and proteinuria
Nephritic syndrome
Renal tubular cells - polygonal clear cells
Dec renal bicarb reabsorption - delayed
Solute is reabsorbed more quickly than water
24. massive proteinuria (>3.5g/day) frothy urine - hyperlipidemia - fatty casts - edema
Na
Type II - C3 nephritic factor
Nephrotic syndrome
Huge palpable flank mass and hematuria
25. What circumstances causes ADH secretion
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Inc plasma osm - dec blood volume
Staghorn calculi - worsened by alkaluria
Converts 25- OH vitamin D to 1 -25 -(OH)2 vitamin D which inc intestinal reabsorption of both calcium and phosphate
26. In a metabolic acidosis What additional calculation is necessary and How do you make it
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Anion gap = na - (Cl + bicarb)
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
27. what happens to pH - PCO2 - and bicarb in respiratory alkalosis
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Most of the bicarb - sodium - chloride - and water
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
Inc - dec - dec
28. tram track appearance on EM - typ - path - and associated dz
Ectopic EPO - ACTH - PTHrP - prolactin
Renal artery - interlobar a - interlobular a
Inc renal calcium reabsorption and dec renal phosphate reabsoprtion - BUT also stimulates the prox tub cells to make 1 -25 (OH)2 vit D which inc intestinal absorption of both Ca and PO4
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
29. What is ADPKD also associated with
Modified smooth muscle of afferent arteriole - secrete renin
No
Polycystic liver disease - berry aneurysms - mitral valve prolapse
Amyloidosis
30. What is the effect of AT II on the posterior pituitary
Hypervent - immediate
Fibrin and plasma proteins (C3b) with glomerular function parietal cells - monocytes and MACS
Diarrhea - glue - RTA - hyperchloremia
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
31. Why is the left kidney taken during living donor transplantation
Huge palpable flank mass and hematuria
Needs to be bilateral
It has a longer renal vein
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
32. net tubular reabsorption of x
NC - dec - dec
Wilms tumor (ages 2-4)
Cx<GFR
Membranoproliferative glomerulonephritis
33. What are the effects of PTH hormone on the kidney
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Acute tubular necrosis
Inc renal calcium reabsorption and dec renal phosphate reabsoprtion - BUT also stimulates the prox tub cells to make 1 -25 (OH)2 vit D which inc intestinal absorption of both Ca and PO4
34. What are the associations with RTA type 1
Liver
Type II - C3 nephritic factor
Hyperkalemia
Hypokalemia - risk for Ca containing kidney stones
35. Where is angiotensinogen made
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Involves glomeruli and other organs
Liver
Medullary cystic disease
36. What is the compensatory response in respiratory alkalosis
60% total body water - 40% ICF - 20% ECF
Radiopaque
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Dec renal bicarb reabsorption - delayed
37. What can cause oxalate crystals
Hypovent - immediate
Dec - dec - dec
Antifreeze - ethyelene glycol or vit C abuse
Hypokalemia and hypophosphatemic rickets
38. What are JG cells and what substance do they secrete
UTI or acute gastroenteritis
Wilms tumor (ages 2-4)
Modified smooth muscle of afferent arteriole - secrete renin
Acute - ATN - or chronic - HTN - DM
39. When is TF/P = 1
Solute and water are reabsorbed at the same rate
Carbonic anhydrase
Anion gap = na - (Cl + bicarb)
Macula densa
40. Why can inulin be used to calculate GFR?
White cell casts
Men 50 to 70 - inc incidence with smoking and obesity
Freely filtered and neither absorbed or secreted
Von hippel laundau and gene deletion in chromosome 3
41. What needs to happen for postrenal obstruction to creat ARF
ADPKD
Acute renal failure
Metabolic acidosis
Needs to be bilateral
42. Focal
Diabetic glomerulonephropathy
Acute renal failure
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Few glomeruli
43. do you see casts in bladder cancer - kidney stones with hematuria
Phenacetin - smoking - aniline dyes - cyclophosphamide
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
No
V x Urine concentration
44. most common tumor of urinary tract system (can occur in renal calyces - renal pelvis - ureters - bladder)
NKCC
Transitional cell carcinoma
HIV
Rxn from angiotensinogen to angiontensin I
45. no net secretion or reabsorption of x
Cx = GFR
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Dec renal bicarb reabsorption - delayed
Solute is reabsorbed less quickly than water or net secretion of substance
46. What is the second most common kidney stone
Inhibits Na/phosphate cotransport leading to phosphate excretion
Inc in Ca and PO4 absoprtion from the gut
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
47. How do struvite stones appear on xray
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Radiopaque
ANP
48. When is TF/P <1
Freely filtered and neither absorbed or secreted
Solute is reabsorbed more quickly than water
Macula densa
RPF/(1- Hct)
49. What enzyme allows for conversion of 25- OH vit D to 1 -25 (OH)2 vit D
Stimulates thirst
1alpha hydroxylase - PTH stimulates it
To defend GFR
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
50. What happens to the urine in the descending limb
Inc
Dec - dec - NC
Becomes concentrated and hypertonic
Acute - ATN - or chronic - HTN - DM