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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 enzyme allows for conversion of 25- OH vit D to 1 -25 (OH)2 vit D
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
Dec - inc - dec
Inc plasma osm - dec blood volume
1alpha hydroxylase - PTH stimulates it
2. In what disease in FSGS the most common glomerular disease
Diarrhea - glue - RTA - hyperchloremia
Renal artery - interlobar a - interlobular a
Intra = HIKIN!
HIV
3. What does aldosterone do in the collecting tubule
Needs to be bilateral
Acute - ATN - or chronic - HTN - DM
Ammonia - buffer for secreted H+
Insertion of Na channel on luminal side
4. What is the formula for reabsorption
Becomes concentrated and hypertonic
Intra = HIKIN!
Filtered - secreted
NC - dec - dec
5. Why can inulin be used to calculate GFR?
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
Freely filtered and neither absorbed or secreted
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
Acute tubular necrosis
6. What substance is secreted in response increase atrial pressure
Nephrotic syndrome
Chronic pyelonephritis
ANP
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
7. Where is ACE made and What are 2 of its fxns
RPF/(1- Hct)
Angio I to angio II and inhibits bradykinin
White cell casts
CHF - pulmonary edema - HTN
8. What effect does ANP have on Na in the kidney
Failure of EPO
NC - dec - dec
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
9. Why does Na conc nearly match Osm
Filtered - secreted
Na reabsorption drives H20 reabsorption
Phenacetin - smoking - aniline dyes - cyclophosphamide
CHF - pulmonary edema - HTN
10. What do patients die from ADPKD
Contrict leading to inc FF - preserver renal GFR in low volume states
Complications of chronic kidney disease or HTN
Huge palpable flank mass and hematuria
Nephrotic syndrome
11. What do you see in the urine with acute pyelonephritis
Needs to be bilateral
White cell casts
Hypokalemia and hypophosphatemic rickets
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
12. Why is the left kidney taken during living donor transplantation
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
It has a longer renal vein
Hyperkalemia
13. What substance is secreted from the kidney in response to hypoxia - and what cells do they come from
Cx<GFR
Inhibits Na/phosphate cotransport leading to phosphate excretion
60% total body water - 40% ICF - 20% ECF
EPO - endothelial cells of peritubular capillaries
14. Bergers' disease - which antibody and What do you see on LM and IF
Staghorn calculi - worsened by alkaluria
Dec - inc - inc
Diabetic glomerulonephropathy
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
15. Who commonly gets acute post strep GN
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Inc Ca/Na exchange to inc Ca reabsoprtion
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
Kids - peripheral and periorbital edema - resolves spontaneously
16. What is the 60-40-20 rule of body weight
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
60% total body water - 40% ICF - 20% ECF
Hypervent - immediate
Medullary cystic disease
17. Subendothelial immune complexes with granular IF
Membranoproliferative glomerulonephritis
Hypokalemia and hypophosphatemic rickets
Bladder cancer
Hypervent - early high altitude - aspirin ingestion early
18. What happens in the collecting tubules
JG cells
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
Reabsorb Na in exchange for secreting K and H
Crescent - moon shape
19. What are the effects of AT II on the adrenal gland
Growth retardation and developmental delay
Diarrhea - glue - RTA - hyperchloremia
Liver
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
20. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
All glomeruli
Carbonic anhydrase
RTA type 2 (proximal)
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
21. most common tumor of urinary tract system (can occur in renal calyces - renal pelvis - ureters - bladder)
Transitional cell carcinoma
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Chronic conditions - multiple myeloma - TB - RA
Macula densa and JG cells
22. Where is potassium conc. Highest? Intra or extra
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Acute renal failure
Intra = HIKIN!
23. dense deposits on EM - type and association
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
NC - dec - dec
Most of the bicarb - sodium - chloride - and water
Type II - C3 nephritic factor
24. What is the BUN/Cr ratio in prerenal azotemia and why?
Dialysis cysts
Invades IVC and spreads hematogenously
EPO - endothelial cells of peritubular capillaries
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
25. Focal
Na reabsorption drives H20 reabsorption
Few glomeruli
Von hippel laundau and gene deletion in chromosome 3
HIV
26. What are the main causes of membranous GN
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
Type II - C3 nephritic factor
Proximal tubule - na/glucose co transporter
Radiolabelled albumin
27. How is plasma volume measured
Diarrhea - glue - RTA - hyperchloremia
Excreted - filtered
Invades IVC and spreads hematogenously
Radiolabelled albumin
28. What does NEG lead to in the efferent arterioles
Inc GFR and mesangial expansion
Growth retardation and developmental delay
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
Cx>GFR
29. What happens to urine in the ascending limb
All glomeruli
Polycystic liver disease - berry aneurysms - mitral valve prolapse
Makes urine less concentrated - impermeable to H20
Excreted - filtered
30. What happens to tubular inulin along the proximal tubule and why
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
Inc in concentration - not amout - due to water reabsorption
Na
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
31. What effect does cxn of the ureter have on RPF - GFR and FF
Simple cysts
Ectopic EPO - ACTH - PTHrP - prolactin
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
NC - dec - dec
32. What 3 disease can lead to RPGN
Triglycerides
Inc Ca/Na exchange to inc Ca reabsoprtion
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
33. in TCC - What does painelss hematuria suggest
Bladder cancer
Hyperkalemia
Nephrotic syndrome
Phenacetin - smoking - aniline dyes - cyclophosphamide
34. What is the effect of of PTH on the distal convoluted tubule
Inc Ca/Na exchange to inc Ca reabsoprtion
Metabolic acidosis
By 10%
Inc in Ca and PO4 absoprtion from the gut
35. What effect does afferent arteriole cxn have on RPF - GFR and FF
Renal in origin
Na reabsorption drives H20 reabsorption
Dec - dec - NC
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
36. What are the main complications of kidney stones
PH - then PC02
Invades IVC and spreads hematogenously
Hydronephrosis and pyelonephritis
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
37. What happens when PTH is secreted
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Size
Type II - C3 nephritic factor
ADPKD
38. Where does renal cell carcinoma originate and What do the cells look like
Involves only glomeruli
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Renal tubular cells - polygonal clear cells
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
39. When is TF/P ratio > 1
Wilms tumor (ages 2-4)
Dec renal bicarb reabsorption - delayed
Dec - dec - dec
Solute is reabsorbed less quickly than water or net secretion of substance
40. In addition to glucose and amino acids - what other components of the filtrate are reabsorbed in the proximal tubule
Hydronephrosis and pyelonephritis
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Angio I to angio II and inhibits bradykinin
Most of the bicarb - sodium - chloride - and water
41. What two cells make up the JGA
Involves glomeruli and other organs
Macula densa and JG cells
Inc renal bicarb resabsoprtion - delayed
Chronic conditions - multiple myeloma - TB - RA
42. What are the LM and EM of minimal change disease
Size
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
LM - nl glomeruli - EM - foot process effacement
60% total body water - 40% ICF - 20% ECF
43. What change (lack of) is common in children with renal failure
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Growth retardation and developmental delay
Hypokalemia - risk for Ca containing kidney stones
1alpha hydroxylase - PTH stimulates it
44. What is the effect of AT II on the proximal tubule - and what kind of alkolosis does this allow for
Angio I to angio II and inhibits bradykinin
Carbonic anhydrase
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
NC - dec - dec
45. What is the net effect of PTH
Inulin
Inc in Ca and PO4 absoprtion from the gut
NC - dec - dec
PH = pKa + log bicarb/0.03PCO2
46. By what percentage does EPRF underestimage true RPF
Acute tubular necrosis
By 10%
Solute is reabsorbed less quickly than water or net secretion of substance
Renal tubular cells - polygonal clear cells
47. The fused basement membrane with heparan sulfate constitutes what portion of the charge
Negative charge
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
Solute and water are reabsorbed at the same rate
48. waxy casts ddx
UTI or acute gastroenteritis
Advanced renal dz - CRF
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
49. What dyslipidemia is most common in renal failure
Triglycerides
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Cx>GFR
Passively reabsorbs water via medullary hypertonicity
50. When is TF/P <1
Acts on V2 receptors leading to insertion of aquaporins on luminal side
Carbonic anhydrase
Filtered - secreted
Solute is reabsorbed more quickly than water