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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 effect does cxn of the ureter have on RPF - GFR and FF
UTI or acute gastroenteritis
JG cells
NC - dec - dec
Carbonic anhydrase
2. What 3 things stimulate the release of renin - and Where is it released from
Cx>GFR
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
Solute and water are reabsorbed at the same rate
Small kidney - poor prognosis
3. What is a normal filtration fraction
Failure of EPO
20 percent
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
Bladder cancer
4. With what genetic tumor syndrome is RCC associated
To defend GFR
No
Von hippel laundau and gene deletion in chromosome 3
Inc - inc - inc
5. What is the prognosis of RPGN
NC - dec - dec
Poor - days to weeks
Rxn from angiotensinogen to angiontensin I
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
6. How do struvite stones appear on xray
Radiopaque
Type II - C3 nephritic factor
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
LM - nl glomeruli - EM - foot process effacement
7. secondary glomerular dz
Men 50 to 70 - inc incidence with smoking and obesity
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Involves glomeruli and other organs
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
8. What are the associations with RTA type 2
Hypokalemia and hypophosphatemic rickets
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
Segmental sclerosis and hylanosis
9. Where is ACE made and What are 2 of its fxns
60% total body water - 40% ICF - 20% ECF
All glomeruli
Angio I to angio II and inhibits bradykinin
Solute is reabsorbed more quickly than water
10. What is the ddx for respiratory acidosis
Kids - peripheral and periorbital edema - resolves spontaneously
Radiolabelled albumin
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
NC - dec - dec
11. What is lost in nephrotic syndrome resulting what urine and serum changes
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
NKCC
12. At what level of plasma glucose does glucosuria begin and what serum glucose is the transporter fully saturated
160-200 - 350
Na and volume loss
Amyloidosis
60% total body water - 40% ICF - 20% ECF
13. What is the 3rd most common kidney stone and What causes it
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
CHF - pulmonary edema - HTN
Kids - peripheral and periorbital edema - resolves spontaneously
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
14. What effect does afferent arteriole cxn have on RPF - GFR and FF
Dec - dec - NC
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Solute is reabsorbed less quickly than water or net secretion of substance
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
15. RBC casts - ddx
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
White cell casts
Inhibits Na/phosphate cotransport leading to phosphate excretion
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
16. What is is Alport's syndrome and what else do you see with it other than renal path
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
No
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
Thickening of glomerular BM
17. What change (lack of) is common in children with renal failure
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Growth retardation and developmental delay
Makes urine less concentrated - impermeable to H20
Dec - dec - NC
18. Which cells sense decreases in BP
PH = pKa + log bicarb/0.03PCO2
JG cells
Diabetic glomerulonephropathy
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
19. primary glomerular dz
Involves only glomeruli
CHF - pulmonary edema - HTN
All glomeruli
Renal artery - interlobar a - interlobular a
20. What is the effect of AT II on efferent arterioles
Inc in Ca and PO4 absoprtion from the gut
Actively reabsorbs NaCl - diluting - makes urine hypotonic
Fibrin and plasma proteins (C3b) with glomerular function parietal cells - monocytes and MACS
Contrict leading to inc FF - preserver renal GFR in low volume states
21. What are the associations with nephrotic syndrome
Thromboembolism and inc risk of infection
Radiopaque
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Nonspecific
22. What effect does dec plasma protein concentration have on RPF - GFR - and FF
Complications of chronic kidney disease or HTN
Hypokalemia - risk for Ca containing kidney stones
NC - inc - inc
Inc in Ca and PO4 absoprtion from the gut
23. medullary cysts sometimes lead to fibrosis and progressive renal insuff with urinary concentrating defects
Crescent - moon shape
Antifreeze - ethyelene glycol or vit C abuse
Medullary cystic disease
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
24. in TCC - What does painelss hematuria suggest
Filtered - secreted
Cx<GFR
NC - inc - inc
Bladder cancer
25. What does ADH do in the collecting tubule
Excreted - filtered
Acts on V2 receptors leading to insertion of aquaporins on luminal side
Under and under
CHF - pulmonary edema - HTN
26. 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
Dec - inc - inc
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Hypokalemia - risk for Ca containing kidney stones
27. What receptor responds to inc sympathetic discharge leading to renin secretion from JG cells
Inc - dec - dec
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Beta 1
1/4 plasma - and 3/4 interstitial volume
28. What happens to urine in the ascending limb
GFR x plasma concentration
EPO - endothelial cells of peritubular capillaries
Makes urine less concentrated - impermeable to H20
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
29. What does LM - EM - IF show in diffuse proliferative GN
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
EPO - endothelial cells of peritubular capillaries
30. in acute post strep GN - What do you see on LM - EM and IF
31. What are the two forms of renal failure and What are examples of each
Acute - ATN - or chronic - HTN - DM
Filtered - secreted
Antifreeze - ethyelene glycol or vit C abuse
Inc renal bicarb resabsoprtion - delayed
32. gross hematuria and proteinuria possibly triggered by infxn or immune stimulus - dz - path associated conditions
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
Bladder cancer
Inc in Ca and PO4 absoprtion from the gut
33. What effect does efferent arteriole cxn have on RPF - GFR and FF
Na and volume loss
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
Dec - inc - inc
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
34. membranous
Macula densa and JG cells
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Acute renal failure
Thickening of glomerular BM
35. tram track appearance on EM - typ - path - and associated dz
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
To defend GFR
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
36. granular - muddy brown casts - ddx
Acute tubular necrosis
Inc renal bicarb resabsoprtion - delayed
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
Na
37. net tubular secretion of x
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Thromboembolism and inc risk of infection
Solute and water are reabsorbed at the same rate
Cx>GFR
38. What is the least common kidney stone - What causes it and How do you treat it
Solute is reabsorbed more quickly than water
Nephritic syndrome
Cystine - 2ndary to cystinuria - hexagonal - treat with alkalization of urine
Chronic conditions - multiple myeloma - TB - RA
39. Why can PAH be used to measure ERPF
Hypokalemia - risk for Ca containing kidney stones
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Dec - inc - dec
1/4 plasma - and 3/4 interstitial volume
40. How are amino acids reabsorbed
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
41. TCC is associated with problems in your Pee SAC - ??
Phenacetin - smoking - aniline dyes - cyclophosphamide
Inc in concentration - not amout - due to water reabsorption
Nephrotic syndrome
Freely filtered and neither absorbed or secreted
42. Why is there anemia in renal failure
Solute is reabsorbed less quickly than water or net secretion of substance
Failure of EPO
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Ammonia - buffer for secreted H+
43. What does NEG lead to in the efferent arterioles
Principal cells and intercalated cells
It has a longer renal vein
HIV
Inc GFR and mesangial expansion
44. What are the main causes of membranous GN
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
EPO - endothelial cells of peritubular capillaries
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
45. What is the effect of PTH on the proximal tubule
Ammonia - buffer for secreted H+
Inhibits Na/phosphate cotransport leading to phosphate excretion
Ectopic EPO - ACTH - PTHrP - prolactin
Triglycerides
46. what happens to pH - PCO2 - and bicarb in respiratory alkalosis
Cx>GFR
Nephrotic syndrome
Inc GFR and mesangial expansion
Inc - dec - dec
47. What do you see in the urine with acute pyelonephritis
Size and charge
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
White cell casts
Hypervent - immediate
48. How does Wilms tumor present
Vasa recta - interlobular v - interlobar v - renal v
Huge palpable flank mass and hematuria
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
Needs to be bilateral
49. acute interstitial renal inflammation with pyuria with eosinphils - associated with fever - rash - hematuria and CVA tenderness - dz and causative agents
Medullary cystic disease
Solute and water are reabsorbed at the same rate
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
Transitional cell carcinoma
50. In renal failure What acid - base disturbance is most likely
Modified smooth muscle of afferent arteriole - secrete renin
Small kidney - poor prognosis
Inc renal bicarb resabsoprtion - delayed
Metabolic acidosis