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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 circumstances causes ADH secretion
Inc plasma osm - dec blood volume
Nephritic syndrome
Nephrotic syndrome
Von hippel laundau and gene deletion in chromosome 3
2. What is a normal filtration fraction
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
20 percent
Solute and water are reabsorbed at the same rate
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
3. What is the algorithim for acidosis/alkalosis
Radiolabelled albumin
NC - dec - dec
GFR/RPF
PH - then PC02
4. What happens to pH - PCO2 and bicarb in metabolic acidosis
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Hypervent - early high altitude - aspirin ingestion early
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Dec - dec - dec
5. What change (lack of) is common in children with renal failure
Growth retardation and developmental delay
Bladder cancer
No
Invades IVC and spreads hematogenously
6. What is generated and secreted in the proximal tubule
Ammonia - buffer for secreted H+
Corticosteroids
It has a longer renal vein
Crescent - moon shape
7. coarse - asymmetric - corticomedullary scarring and blunted calyx
Chronic pyelonephritis
Bladder cancer
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
8. waxy casts ddx
Modified smooth muscle of afferent arteriole - secrete renin
Passively reabsorbs water via medullary hypertonicity
Advanced renal dz - CRF
Freely filtered and neither absorbed or secreted
9. What happens in the thin descending loop of henle
EPO - endothelial cells of peritubular capillaries
GFR/RPF
Passively reabsorbs water via medullary hypertonicity
V x Urine concentration
10. What is the effect of PTH on the proximal tubule
Type II - C3 nephritic factor
Inhibits Na/phosphate cotransport leading to phosphate excretion
Inc - inc - inc
Hypokalemia and hypophosphatemic rickets
11. How do the ureters course in relation to the uterine artery and ductus deferens
Under and under
20 percent
V x Urine concentration
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
12. In miminal change disease - who gets it - What are the triggers and What is their selective loss of?
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
13. Why can PAH be used to measure ERPF
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
GFR x plasma concentration
Angio I to angio II and inhibits bradykinin
14. How What does the glomerular filtration barrier distinguish by
Size and charge
Na reabsorption drives H20 reabsorption
Small kidney - poor prognosis
Na and volume loss
15. membranous
Inc in concentration - not amout - due to water reabsorption
Thickening of glomerular BM
Involves glomeruli and other organs
RTA type 1 (distal)
16. What happens when PTH is secreted
Thromboembolism and inc risk of infection
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Vasocxn - inc BP
17. In renal failure - what happens to potassium
Huge palpable flank mass and hematuria
Hyperkalemia
Dialysis cysts
Diarrhea - glue - RTA - hyperchloremia
18. Subendothelial immune complexes with granular IF
Nephrotic syndrome
Few glomeruli
1alpha hydroxylase - PTH stimulates it
Membranoproliferative glomerulonephritis
19. What is the compensatory response in metabolic alkalosis
Complications of chronic kidney disease or HTN
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Hypovent - immediate
Radiolabelled albumin
20. WBC casts - ddx
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
It has a longer renal vein
Deficiency in neutral amino acid (tryptophan) transporter - resulting in pellagra
Amyloidosis
21. What 3 things stimulate the release of renin - and Where is it released from
RTA type 1 (distal)
Invades IVC and spreads hematogenously
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
Diabetic glomerulonephropathy
22. What are the associations with RTA type 4
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
Macula densa and JG cells
Metabolic acidosis
23. In pts with ammonium magnesium phophate stones - What can be the nidus for UTI and what worsens it
Rxn from angiotensinogen to angiontensin I
Staghorn calculi - worsened by alkaluria
Advanced renal dz - CRF
1/4 plasma - and 3/4 interstitial volume
24. At what level of plasma glucose does glucosuria begin and what serum glucose is the transporter fully saturated
Thromboembolism and inc risk of infection
160-200 - 350
RTA type 1 (distal)
Modified smooth muscle of afferent arteriole - secrete renin
25. What does renin do
Nephritic syndrome
Rxn from angiotensinogen to angiontensin I
Cx>GFR
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
26. Where is ACE made and What are 2 of its fxns
Hyperceullular glomeruli
Angio I to angio II and inhibits bradykinin
Thickening of glomerular BM
Polycystic liver disease - berry aneurysms - mitral valve prolapse
27. What is the compensatory response in respiratory acidosis
Antifreeze - ethyelene glycol or vit C abuse
Inc renal bicarb resabsoprtion - delayed
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
28. What happens to urine in the ascending limb
UTI or acute gastroenteritis
60% total body water - 40% ICF - 20% ECF
Makes urine less concentrated - impermeable to H20
Ammonia - buffer for secreted H+
29. How can NSAIDs cause acute renal failure
Triglycerides
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
Principal cells and intercalated cells
30. What is the effect of AT II on the proximal tubule - and what kind of alkolosis does this allow for
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Inc - dec - dec
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Becomes concentrated and hypertonic
31. What needs to happen for postrenal obstruction to creat ARF
NC - dec - dec
Macula densa
20 percent
Needs to be bilateral
32. in acute post strep GN - What do you see on LM - EM and IF
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33. What is renal osteodystrophy
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
Thickening of glomerular BM
Inc plasma osm - dec blood volume
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
34. diffuse
All glomeruli
160-200 - 350
Eosinphilic casts in tubules
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
35. What happens to the urine in the descending limb
Becomes concentrated and hypertonic
RTA type 1 (distal)
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Men 50 to 70 - inc incidence with smoking and obesity
36. In what clinical context does Berger's disease often present
Inc GFR and mesangial expansion
Staghorn calculi - worsened by alkaluria
UTI or acute gastroenteritis
Under and under
37. tram track appearance on EM - typ - path - and associated dz
Thickening of glomerular BM
Von hippel laundau and gene deletion in chromosome 3
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
38. What is the net effect of ANP
Hydronephrosis and pyelonephritis
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Na and volume loss
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
39. primary glomerular dz
Involves only glomeruli
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Chronic pyelonephritis
40. In renal failure with uremia - What are the 5 aspects of uremia
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Dec - inc - inc
Actively reabsorbs NaCl - diluting - makes urine hypotonic
Size
41. What effect does inc plasma protein concentration have on RPF - GFR - and FF
RTA type 4 (hyperkalemic)
NC - dec - dec
No
RPF/(1- Hct)
42. Under what circumstances is aldosterone secreted
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
Triglycerides
43. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
Invades IVC and spreads hematogenously
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
Renal artery - interlobar a - interlobular a
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
44. hypoaldosteronism or lack of collecting tubule response to aldosteron
Stimulates thirst
Amyloidosis
Passively reabsorbs water via medullary hypertonicity
RTA type 4 (hyperkalemic)
45. cortical and medullary cysts resulting from long standing dialysis
Crescent - moon shape
Dialysis cysts
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
Liver
46. in TCC - What does painelss hematuria suggest
Acute renal failure
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
Bladder cancer
Transitional cell carcinoma
47. Where is potassium conc. Highest? Intra or extra
Intra = HIKIN!
160-200 - 350
Inc renal bicarb resabsoprtion - delayed
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
48. What effect does cxn of the ureter have on RPF - GFR and FF
Hypervent - early high altitude - aspirin ingestion early
Kids - peripheral and periorbital edema - resolves spontaneously
NC - dec - dec
Inc GFR and mesangial expansion
49. What is ADPKD also associated with
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
Staghorn calculi - worsened by alkaluria
Polycystic liver disease - berry aneurysms - mitral valve prolapse
50. The fenestrated capillary endothelium constitutes what portion of the barrier
Size
160-200 - 350
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Size and charge