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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. nonenzymatic glycosylation of GBM - inc permeability and thickening
Acute - ATN - or chronic - HTN - DM
Diabetic glomerulonephropathy
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Diuretics - vomiting - antacid - hyperaldosteronism
2. Under what circumstances is aldosterone secreted
Solute and water are reabsorbed at the same rate
Wilms tumor (ages 2-4)
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Under and under
3. What does aldosterone do in the collecting tubule
Carbonic anhydrase
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
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
Insertion of Na channel on luminal side
4. medullary cysts sometimes lead to fibrosis and progressive renal insuff with urinary concentrating defects
Eosinphilic casts in tubules
Passively reabsorbs water via medullary hypertonicity
Medullary cystic disease
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
5. What is winter's formula and when do you use it
RTA type 1 (distal)
Na
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
6. Defect in proximal tubule HCO3 reabsorption
Stimulates thirst
RTA type 2 (proximal)
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
Actively reabsorbs NaCl - diluting - makes urine hypotonic
7. What is generated and secreted in the proximal tubule
Ammonia - buffer for secreted H+
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
RTA type 2 (proximal)
Dec - inc - dec
8. What does US show with medullary cystic disease
Vasa recta - interlobular v - interlobar v - renal v
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
Small kidney - poor prognosis
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
9. What two cells make up the JGA
Vasa recta - interlobular v - interlobar v - renal v
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Hypokalemia - risk for Ca containing kidney stones
Macula densa and JG cells
10. The fenestrated capillary endothelium constitutes what portion of the barrier
JG cells
UTI or acute gastroenteritis
Size
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
11. What effect does ANP have on GFR
Acute renal failure
Metabolic acidosis
Inc
Insertion of Na channel on luminal side
12. in acute cystitis with pyuria - do you see casts
No
Crescent - moon shape
Corticosteroids
Solute is reabsorbed more quickly than water
13. What is the LM for diabetic glomerulonephropathy
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Thickening of glomerular BM
Reabsorb Na in exchange for secreting K and H
Invades IVC and spreads hematogenously
14. What is transporter in the thick ascneding loop of Henle indirectly induces the paracellular reabsorption of Mg and Ca
NC - dec - dec
NKCC
Radiolabelled albumin
Dec - inc - dec
15. The fused basement membrane with heparan sulfate constitutes what portion of the charge
It has a longer renal vein
Inulin
Chronic pyelonephritis
Negative charge
16. What is the BUN/Cr ratio in instrinsic renal ARF and why
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
GFR/RPF
Freely filtered and neither absorbed or secreted
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
17. What is the most common renal malignancy of early childhood
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
60% total body water - 40% ICF - 20% ECF
Wilms tumor (ages 2-4)
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
18. What are the effects of PTH hormone on the kidney
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
Renal artery - interlobar a - interlobular a
Solute and water are reabsorbed at the same rate
Stimulates thirst
19. In what clinical context does Berger's disease often present
Cx>GFR
Makes urine less concentrated - impermeable to H20
UTI or acute gastroenteritis
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
20. What do you see on LM and IF with rapidly progressive GN
Vasa recta - interlobular v - interlobar v - renal v
Crescent - moon shape
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
21. Which cells sense decreases in Na delivery
Diabetic glomerulonephropathy
Macula densa
RTA type 2 (proximal)
60% total body water - 40% ICF - 20% ECF
22. What is renal osteodystrophy
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
Inulin
Insertion of Na channel on luminal side
23. RBC casts - ddx
LM - nl glomeruli - EM - foot process effacement
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
24. When is TF/P = 1
Polycystic liver disease - berry aneurysms - mitral valve prolapse
Solute and water are reabsorbed at the same rate
Staghorn calculi - worsened by alkaluria
Radiopaque
25. Why is the left kidney taken during living donor transplantation
It has a longer renal vein
Inc renal bicarb resabsoprtion - delayed
ADPKD
Radiolabelled albumin
26. hypoaldosteronism or lack of collecting tubule response to aldosteron
Filtered - secreted
Radiolabelled albumin
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
RTA type 4 (hyperkalemic)
27. Bergers' disease - which antibody and What do you see on LM and IF
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Poor - days to weeks
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Inulin
28. What is the henderson hasselbalch equation
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Angio I to angio II and inhibits bradykinin
Hyperceullular glomeruli
PH = pKa + log bicarb/0.03PCO2
29. What do you see on LM for focal segmental glomerulosclerosis
No
Segmental sclerosis and hylanosis
LM - nl glomeruli - EM - foot process effacement
Advanced renal dz - CRF
30. What circumstances causes ADH secretion
Inc plasma osm - dec blood volume
Anion gap = na - (Cl + bicarb)
NKCC
Size and charge
31. What is is Alport's syndrome and what else do you see with it other than renal path
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Excreted - filtered
GFR x plasma concentration
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
32. What is the effect of PTH on the proximal tubule
Needs to be bilateral
UTI or acute gastroenteritis
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Inhibits Na/phosphate cotransport leading to phosphate excretion
33. Where is potassium conc. Highest? Intra or extra
Intra = HIKIN!
Corticosteroids
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Rxn from angiotensinogen to angiontensin I
34. What is the 60-40-20 rule of body weight
RPF/(1- Hct)
Liver
Medullary cystic disease
60% total body water - 40% ICF - 20% ECF
35. What enzyme allows for conversion of 25- OH vit D to 1 -25 (OH)2 vit D
1alpha hydroxylase - PTH stimulates it
Cx<GFR
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
EPO - endothelial cells of peritubular capillaries
36. Where is angiotensinogen made
Na and volume loss
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
1alpha hydroxylase - PTH stimulates it
Liver
37. What effect does afferent arteriole cxn have on RPF - GFR and FF
Excreted - filtered
Involves glomeruli and other organs
Staghorn calculi - worsened by alkaluria
Dec - dec - NC
38. What is the compensatory response in metabolic alkalosis
Hypovent - immediate
Simple cysts
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Dialysis cysts
39. TCC is associated with problems in your Pee SAC - ??
Phenacetin - smoking - aniline dyes - cyclophosphamide
Corticosteroids
Thickening of glomerular BM
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
40. What is the compensatory response in respiratory alkalosis
Dec renal bicarb reabsorption - delayed
It has a longer renal vein
Dec - dec - NC
Acute renal failure
41. How do calcium stones appear on x ray
ADPKD
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Radiopaque
Rxn from angiotensinogen to angiontensin I
42. membranous
Thickening of glomerular BM
Few glomeruli
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
Negative charge
43. What cells create the epithelial layer of the glomerular filtration barrier
CHF - pulmonary edema - HTN
Solute and water are reabsorbed at the same rate
160-200 - 350
Podocytes foot processes
44. no net secretion or reabsorption of x
Inc in concentration - not amout - due to water reabsorption
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Cx = GFR
NKCC
45. What are the features of membranous GN (diffuse membranous glomerulopathy) on LM - EM and IF
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
Cx>GFR
White cell casts
46. What is the ddx for a respiratory alkalosis
Dec - inc - inc
Hypervent - early high altitude - aspirin ingestion early
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
JG cells
47. Congo - red stain - apple green birefringence
Amyloidosis
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
Renal in origin
Hyperceullular glomeruli
48. What are the associations with RTA type 2
Small kidney - poor prognosis
Inc renal bicarb resabsoprtion - delayed
Acute renal failure
Hypokalemia and hypophosphatemic rickets
49. what happens to pH - PCO2 - and bicarb in respiratory alkalosis
Inc - dec - dec
Diarrhea - glue - RTA - hyperchloremia
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Acts on V2 receptors leading to insertion of aquaporins on luminal side
50. diffuse
Ectopic EPO - ACTH - PTHrP - prolactin
All glomeruli
Inc
Amyloidosis