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Test your basic knowledge |
Renal
Start Test
Study First
Subject
:
health-sciences
Instructions:
Answer 50 questions in 15 minutes.
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study here
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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 are the associations with nephrotic syndrome
PH - then PC02
Thromboembolism and inc risk of infection
Failure of EPO
Advanced renal dz - CRF
2. What effect does cxn of the ureter have on RPF - GFR and FF
Phenacetin - smoking - aniline dyes - cyclophosphamide
Segmental sclerosis and hylanosis
NC - dec - dec
It has a longer renal vein
3. Where is ACE made and What are 2 of its fxns
Angio I to angio II and inhibits bradykinin
Hypervent - early high altitude - aspirin ingestion early
Hyperkalemia
ADPKD
4. What is the BUN/Cr ratio in prerenal azotemia and why?
Dec renal bicarb reabsorption - delayed
NC - dec - dec
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
5. massive proteinuria (>3.5g/day) frothy urine - hyperlipidemia - fatty casts - edema
Diarrhea - glue - RTA - hyperchloremia
Macula densa
Nephrotic syndrome
Involves only glomeruli
6. How do the ureters course in relation to the uterine artery and ductus deferens
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
White cell casts
Men 50 to 70 - inc incidence with smoking and obesity
Under and under
7. What is is Alport's syndrome and what else do you see with it other than renal path
Crescent - moon shape
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Size
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
8. most common tumor of urinary tract system (can occur in renal calyces - renal pelvis - ureters - bladder)
Inc in Ca and PO4 absoprtion from the gut
Transitional cell carcinoma
Renal in origin
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
9. What are the effects of PTH hormone on the kidney
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Reabsorb Na in exchange for secreting K and H
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
Cx<GFR
10. in TCC - What does painelss hematuria suggest
NC - dec - dec
Stimulates thirst
Bladder cancer
Macula densa and JG cells
11. What is the genetic etiology of wilms tumor and What is WAGR complex
Wilms tumor (ages 2-4)
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
12. What are the two forms of renal failure and What are examples of each
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
Proximal tubule - na/glucose co transporter
Growth retardation and developmental delay
Acute - ATN - or chronic - HTN - DM
13. What happens when PTH is secreted
Insertion of Na channel on luminal side
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Eosinphilic casts in tubules
Thromboembolism and inc risk of infection
14. TCC is associated with problems in your Pee SAC - ??
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Hypokalemia and hypophosphatemic rickets
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
Phenacetin - smoking - aniline dyes - cyclophosphamide
15. What serum changes cause a secretion in PTH
Dec - inc - inc
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
16. What are the effects of AT II on the adrenal gland
Nephrotic syndrome
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Acts on V2 receptors leading to insertion of aquaporins on luminal side
Cx>GFR
17. cortical and medullary cysts resulting from long standing dialysis
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Dialysis cysts
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Podocytes foot processes
18. What is the net effect of PTH
Radiopaque
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
RTA type 1 (distal)
Inc in Ca and PO4 absoprtion from the gut
19. Why can PAH be used to measure ERPF
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Liver
Involves only glomeruli
Inc plasma osm - dec blood volume
20. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
RTA type 4 (hyperkalemic)
Cx = GFR
GFR x plasma concentration
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
21. What effect does ANP have on GFR
All glomeruli
Inc
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
Transitional cell carcinoma
22. In renal failure with uremia - What are the 5 aspects of uremia
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
By 10%
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
1alpha hydroxylase - PTH stimulates it
23. Why is the left kidney taken during living donor transplantation
LM - nl glomeruli - EM - foot process effacement
It has a longer renal vein
Segmental sclerosis and hylanosis
Dialysis cysts
24. What is the compensatory response in metabolic acidosis
PH = pKa + log bicarb/0.03PCO2
Most of the bicarb - sodium - chloride - and water
Hypervent - immediate
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
25. How What does the glomerular filtration barrier distinguish by
Inc renal bicarb resabsoprtion - delayed
Antifreeze - ethyelene glycol or vit C abuse
Diabetic glomerulonephropathy
Size and charge
26. proliferative
Hyperceullular glomeruli
Inc renal bicarb resabsoprtion - delayed
To defend GFR
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
27. What is the algorithim for acidosis/alkalosis
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
PH - then PC02
Renal in origin
28. In who is RCC most comon
Acute - ATN - or chronic - HTN - DM
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
NC - dec - dec
Men 50 to 70 - inc incidence with smoking and obesity
29. Why is there anemia in renal failure
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Failure of EPO
RTA type 4 (hyperkalemic)
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
30. How is extracellular volume measured
Inulin
Dec - inc - dec
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
Bladder cancer
31. What is the effect of AT II on GFR - FF and Na
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
Size and charge
32. What is the BUN/Cr ratio in instrinsic renal ARF and why
Cystine - 2ndary to cystinuria - hexagonal - treat with alkalization of urine
Solute and water are reabsorbed at the same rate
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Von hippel laundau and gene deletion in chromosome 3
33. What is the compensatory response in metabolic alkalosis
Negative charge
Hypovent - immediate
Solute and water are reabsorbed at the same rate
Contrict leading to inc FF - preserver renal GFR in low volume states
34. Defect in proximal tubule HCO3 reabsorption
RTA type 1 (distal)
RTA type 2 (proximal)
NC - dec - dec
Deficiency in neutral amino acid (tryptophan) transporter - resulting in pellagra
35. Where is potassium conc. Highest? Intra or extra
Amyloidosis
Metabolic acidosis
Intra = HIKIN!
Actively reabsorbs NaCl - diluting - makes urine hypotonic
36. What are the effects of AT II on vascular smooth muscle
PH - then PC02
Hyperkalemia
Vasocxn - inc BP
Inc in concentration - not amout - due to water reabsorption
37. fever - CVA tenderness - N/V - affects cortex with relative sparing of glomeruli/vessels
Acute pyelonephritis
Hypovent - immediate
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
38. What is lost in nephrotic syndrome resulting what urine and serum changes
RTA type 1 (distal)
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
39. What do casts indicated about hematuria/pyuria
Staghorn calculi - worsened by alkaluria
Renal in origin
Dec - dec - NC
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
40. Defect in collecting ducts ability to excrete H+
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
Acute pyelonephritis
Hypokalemia and hypophosphatemic rickets
RTA type 1 (distal)
41. What is the purpose of the JGA
Inc
To defend GFR
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Solute is reabsorbed more quickly than water
42. RBC casts - ddx
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Hypokalemia and hypophosphatemic rickets
Small kidney - poor prognosis
43. In a metabolic acidosis What additional calculation is necessary and How do you make it
Stimulates thirst
Anion gap = na - (Cl + bicarb)
Na and volume loss
Inc renal bicarb resabsoprtion - delayed
44. What are the associations with RTA type 4
PH - then PC02
Contrict leading to inc FF - preserver renal GFR in low volume states
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
45. What change (lack of) is common in children with renal failure
Growth retardation and developmental delay
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
Thromboembolism and inc risk of infection
Reabsorb Na in exchange for secreting K and H
46. Where is angiotensinogen made
Liver
Principal cells and intercalated cells
Crescent - moon shape
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
47. tram track appearance on EM - typ - path - and associated dz
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Inc
Medullary cystic disease
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
48. What effect does afferent arteriole cxn have on RPF - GFR and FF
Inc
Dec - inc - dec
Dec - dec - NC
Crescent - moon shape
49. What is the formula for reabsorption
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Dec renal bicarb reabsorption - delayed
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Filtered - secreted
50. What are the main complications of kidney stones
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
Dec - dec - NC
UTI or acute gastroenteritis
Hydronephrosis and pyelonephritis
Sorry!:) No result found.
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