SUBJECTS
|
BROWSE
|
CAREER CENTER
|
POPULAR
|
JOIN
|
LOGIN
Business Skills
|
Soft Skills
|
Basic Literacy
|
Certifications
About
|
Help
|
Privacy
|
Terms
|
Email
Search
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. In a metabolic acidosis What additional calculation is necessary and How do you make it
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
Anion gap = na - (Cl + bicarb)
1alpha hydroxylase - PTH stimulates it
1/4 plasma - and 3/4 interstitial volume
2. What is the formula for secreted
Renal artery - interlobar a - interlobular a
Na and volume loss
NC - dec - dec
Excreted - filtered
3. What are the associations with nephrotic syndrome
NKCC
Vasocxn - inc BP
Thromboembolism and inc risk of infection
Transitional cell carcinoma
4. What is the ddx for respiratory acidosis
Dec - dec - NC
Rxn from angiotensinogen to angiontensin I
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
EPO - endothelial cells of peritubular capillaries
5. Who often has diffuse proliferative GN
Kids - peripheral and periorbital edema - resolves spontaneously
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
Ectopic EPO - ACTH - PTHrP - prolactin
6. What are JG cells and what substance do they secrete
NC - inc - inc
PH = pKa + log bicarb/0.03PCO2
V x Urine concentration
Modified smooth muscle of afferent arteriole - secrete renin
7. what happens to pH - PCO2 - and bicarb in respiratory alkalosis
EPO - endothelial cells of peritubular capillaries
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
Huge palpable flank mass and hematuria
Inc - dec - dec
8. Where is ACE made and What are 2 of its fxns
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Size and charge
Solute is reabsorbed less quickly than water or net secretion of substance
Angio I to angio II and inhibits bradykinin
9. multiple - large - bilateral cysts that ultimately destroy the kidney parenchyma
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Dec - dec - dec
Na reabsorption drives H20 reabsorption
ADPKD
10. do you see casts in bladder cancer - kidney stones with hematuria
No
Inulin
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
Invades IVC and spreads hematogenously
11. coarse - asymmetric - corticomedullary scarring and blunted calyx
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
Chronic pyelonephritis
Transitional cell carcinoma
PH - then PC02
12. What is the henderson hasselbalch equation
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Inc - inc - inc
PH = pKa + log bicarb/0.03PCO2
Size and charge
13. What happens to the urine in the descending limb
Renal tubular cells - polygonal clear cells
Becomes concentrated and hypertonic
Dec - dec - NC
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
14. most common tumor of urinary tract system (can occur in renal calyces - renal pelvis - ureters - bladder)
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
Inhibits Na/phosphate cotransport leading to phosphate excretion
Transitional cell carcinoma
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
15. net tubular secretion of x
Cx>GFR
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
ANP
16. What circumstances causes ADH secretion
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
Inc plasma osm - dec blood volume
CHF - pulmonary edema - HTN
To defend GFR
17. In addition to glucose and amino acids - what other components of the filtrate are reabsorbed in the proximal tubule
Most of the bicarb - sodium - chloride - and water
Involves glomeruli and other organs
Macula densa
Passively reabsorbs water via medullary hypertonicity
18. In pts with ammonium magnesium phophate stones - What can be the nidus for UTI and what worsens it
Triglycerides
Staghorn calculi - worsened by alkaluria
V x Urine concentration
Huge palpable flank mass and hematuria
19. What effect does cxn of the ureter have on RPF - GFR and FF
Vasa recta - interlobular v - interlobar v - renal v
NC - dec - dec
Segmental sclerosis and hylanosis
ANP
20. What percentage of ECF is plasma and What is interstitial volume
No
Men 50 to 70 - inc incidence with smoking and obesity
1/4 plasma - and 3/4 interstitial volume
Dialysis cysts
21. In renal failure What acid - base disturbance is most likely
GFR/RPF
Metabolic acidosis
Macula densa
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
22. In renal failure with uremia - What are the 5 aspects of uremia
Amyloidosis
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Dialysis cysts
23. hyaline casts ddx
Ectopic EPO - ACTH - PTHrP - prolactin
Nonspecific
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
Under and under
24. What happens to urine in the ascending limb
UTI or acute gastroenteritis
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
CHF - pulmonary edema - HTN
Makes urine less concentrated - impermeable to H20
25. Which cells sense decreases in BP
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
1/4 plasma - and 3/4 interstitial volume
JG cells
Hyperceullular glomeruli
26. What is the formula for reabsorption
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
No
Filtered - secreted
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
27. What is the effect of AT II on the hypothalamus
It has a longer renal vein
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Na
Stimulates thirst
28. What does LM - EM - IF show in diffuse proliferative GN
Makes urine less concentrated - impermeable to H20
Glomerulonephritis - inflammation - acute pyelonephritis - malignant HTN
Nephritic syndrome
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
29. What dyslipidemia is most common in renal failure
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
Dec - inc - inc
LM - nl glomeruli - EM - foot process effacement
Triglycerides
30. Defect in proximal tubule HCO3 reabsorption
RTA type 2 (proximal)
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
20 percent
Nonspecific
31. net tubular reabsorption of x
160-200 - 350
Cx<GFR
Negative charge
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
32. membranous
Dec - dec - NC
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Fibrin and plasma proteins (C3b) with glomerular function parietal cells - monocytes and MACS
Thickening of glomerular BM
33. What effect does dec plasma protein concentration have on RPF - GFR - and FF
PH = pKa + log bicarb/0.03PCO2
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
Modified smooth muscle of afferent arteriole - secrete renin
NC - inc - inc
34. benign - common - incidental finding of renal cysts - thin - nonenhancing - cortical - fluid filled
Size
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
Simple cysts
35. What is winter's formula and when do you use it
Proximal tubule - na/glucose co transporter
Bladder cancer
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
36. How are amino acids reabsorbed
Excreted - filtered
JG cells
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
37. How does Wilms tumor present
Huge palpable flank mass and hematuria
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
Diabetic glomerulonephropathy
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
38. What happens in the thin descending loop of henle
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
Rxn from angiotensinogen to angiontensin I
Passively reabsorbs water via medullary hypertonicity
Solute and water are reabsorbed at the same rate
39. hypoaldosteronism or lack of collecting tubule response to aldosteron
Inc
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
RTA type 4 (hyperkalemic)
JG cells
40. What are the two kinds of cells in the collecting tubules
Invades IVC and spreads hematogenously
Tubulointerstitial inflammation - acute pyelonephritis - transplant rejection
Principal cells and intercalated cells
Eosinphilic casts in tubules
41. Why is there anemia in renal failure
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Failure of EPO
Carbonic anhydrase
42. gross hematuria and proteinuria possibly triggered by infxn or immune stimulus - dz - path associated conditions
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
20 percent
Carbonic anhydrase
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
43. How do struvite stones appear on xray
Diuretics - vomiting - antacid - hyperaldosteronism
Antifreeze - ethyelene glycol or vit C abuse
Radiopaque
Passively reabsorbs water via medullary hypertonicity
44. How does RCC spread
Invades IVC and spreads hematogenously
Membranoproliferative glomerulonephritis
ADPKD
Acute tubular necrosis
45. What does renin do
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Rxn from angiotensinogen to angiontensin I
ADPKD
46. What are the effects of PTH hormone on the kidney
Medullary cystic disease
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
Complications of chronic kidney disease or HTN
CHF - pulmonary edema - HTN
47. What happens when PTH is secreted
Makes urine less concentrated - impermeable to H20
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Vasa recta - interlobular v - interlobar v - renal v
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
48. Congo - red stain - apple green birefringence
Triglycerides
V x Urine concentration
Amyloidosis
RTA type 2 (proximal)
49. What effect does inc plasma protein concentration have on RPF - GFR - and FF
NC - dec - dec
Inc - dec - dec
Involves only glomeruli
Macula densa
50. When is TF/P = 1
By 10%
Principal cells and intercalated cells
Involves only glomeruli
Solute and water are reabsorbed at the same rate