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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. In renal failure What acid - base disturbance is most likely
Renal tubular cells - polygonal clear cells
Nephritic syndrome
Staghorn calculi - worsened by alkaluria
Metabolic acidosis
2. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
1alpha hydroxylase - PTH stimulates it
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
Cx = GFR
3. secondary glomerular dz
By 10%
White cell casts
Involves glomeruli and other organs
LM - nl glomeruli - EM - foot process effacement
4. What are the associations with nephrotic syndrome
Thromboembolism and inc risk of infection
Anion gap = na - (Cl + bicarb)
Wilms tumor (ages 2-4)
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
5. What is the most frequent kind of kidney stone and What are causes that lead to it
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
Ectopic EPO - ACTH - PTHrP - prolactin
Hypokalemia - risk for Ca containing kidney stones
Acute pyelonephritis
6. How is plasma volume measured
ADPKD
Radiolabelled albumin
V x Urine concentration
Excreted - filtered
7. What are the features of membranous GN (diffuse membranous glomerulopathy) on LM - EM and IF
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
Diabetic glomerulonephropathy
All glomeruli
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
8. What is hartnup's disease
Deficiency in neutral amino acid (tryptophan) transporter - resulting in pellagra
Inc - dec - dec
Polycystic liver disease - berry aneurysms - mitral valve prolapse
Stimulates thirst
9. What is lost in nephrotic syndrome resulting what urine and serum changes
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
Bladder cancer
The charge barrier - albuminuria - hypoproteinemia - edema and hyperlipidemia
10. The fused basement membrane with heparan sulfate constitutes what portion of the charge
Modified smooth muscle of afferent arteriole - secrete renin
Negative charge
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
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
11. acute interstitial renal inflammation with pyuria with eosinphils - associated with fever - rash - hematuria and CVA tenderness - dz and causative agents
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
White cell casts
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
NKCC
12. What is the formula for filtration fraction
GFR/RPF
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
EPO - endothelial cells of peritubular capillaries
Type 1 - GBM splitting caused by mesangial growth - HBV - HCV
13. What are the associations with RTA type 2
Hypokalemia and hypophosphatemic rickets
All glomeruli
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
HIV
14. What are the effects of AT II on the adrenal gland
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Acute tubular necrosis
Inc
Radiolabelled albumin
15. What serum changes cause a secretion in PTH
Stimulates thirst
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Medullary cystic disease
JG cells
16. multiple - large - bilateral cysts that ultimately destroy the kidney parenchyma
To defend GFR
Antifreeze - ethyelene glycol or vit C abuse
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
ADPKD
17. When is TF/P = 1
Eosinphilic casts in tubules
Solute and water are reabsorbed at the same rate
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
No
18. What do casts indicated about hematuria/pyuria
Solute is reabsorbed less quickly than water or net secretion of substance
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
Renal artery - interlobar a - interlobular a
Renal in origin
19. What is amyloidosis associated with
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Chronic conditions - multiple myeloma - TB - RA
NC - inc - inc
Dec renal bicarb reabsorption - delayed
20. Why is the left kidney taken during living donor transplantation
60% total body water - 40% ICF - 20% ECF
It has a longer renal vein
<3.5 g /day
1alpha hydroxylase - PTH stimulates it
21. What effect does dec plasma protein concentration have on RPF - GFR - and FF
Thickening of glomerular BM
Small kidney - poor prognosis
Cx>GFR
NC - inc - inc
22. medullary cysts sometimes lead to fibrosis and progressive renal insuff with urinary concentrating defects
Liver
Medullary cystic disease
Deficiency in neutral amino acid (tryptophan) transporter - resulting in pellagra
No
23. What 3 things stimulate the release of renin - and Where is it released from
Chronic pyelonephritis
Bladder cancer
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
Few glomeruli
24. What is the effect of AT II on the proximal tubule - and what kind of alkolosis does this allow for
RTA type 2 (proximal)
SLE and MPGN - most common cause of death in SLE (both of these can present as nephrotic syndrome as well)
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Modified smooth muscle of afferent arteriole - secrete renin
25. Where does renal cell carcinoma originate and What do the cells look like
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
Renal tubular cells - polygonal clear cells
Chronic conditions - multiple myeloma - TB - RA
Corticosteroids
26. What are the main complications of kidney stones
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
Hydronephrosis and pyelonephritis
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
27. How do you interpret creatinine clearance
NC - dec - dec
2 ways - base exchanger and between epithelial cells
Eosinphilic casts in tubules
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
28. Focal
Few glomeruli
Radiolabelled albumin
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
GFR x plasma concentration
29. What are the main causes of membranous GN
Podocytes foot processes
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
Small kidney - poor prognosis
Drugs - infections - SLE - solid tumors - most common cause of adult nephrotic syndrome
30. What is the second most common kidney stone
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Na and volume loss
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
Size and charge
31. How do struvite stones appear on xray
Metabolic acidosis
Renal tubular cells - polygonal clear cells
Radiopaque
Cx<GFR
32. What is the effect of AT II on GFR - FF and Na
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
HIV
Inc GFR - in FF but WITH compensatory Na reabsorption in proximal and distal nephron
60% total body water - 40% ICF - 20% ECF
33. What is the formula for renal blood flow
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Polycystic liver disease - berry aneurysms - mitral valve prolapse
RPF/(1- Hct)
34. no net secretion or reabsorption of x
RTA type 4 (hyperkalemic)
Metabolic acidosis
Cx = GFR
Hyperkalemia - inhibition of ammonium excretion in proximal tubule - decrease urine pH due to dec bufferiing capacity
35. Defect in collecting ducts ability to excrete H+
Becomes concentrated and hypertonic
20 percent
Carbonic anhydrase
RTA type 1 (distal)
36. what happens to pH - PCO2 - and bicarb in respiratory acidosis
Acute renal failure
Converts 25- OH vitamin D to 1 -25 -(OH)2 vitamin D which inc intestinal reabsorption of both calcium and phosphate
Dec - inc - dec
Wilms tumor (ages 2-4)
37. How can NSAIDs cause acute renal failure
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
Radiopaque
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
Needs to be bilateral
38. acute generalized cortical infarction of both kidneys - dz - causes and associations
Segmental sclerosis and hylanosis
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Inc GFR and mesangial expansion
39. How is extracellular volume measured
Von hippel laundau and gene deletion in chromosome 3
Inc in concentration - not amout - due to water reabsorption
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Inulin
40. What is the compensatory response in metabolic alkalosis
Acute - ATN - or chronic - HTN - DM
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Hypervent - immediate
Hypovent - immediate
41. What are the effects of AT II on vascular smooth muscle
ADPKD
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Acute pyelonephritis
Vasocxn - inc BP
42. What does renin do
Rxn from angiotensinogen to angiontensin I
Von hippel laundau and gene deletion in chromosome 3
Respiratory compensation in response to metabolic acidosis - PC02 in 0.7mmHg for every mEq/L bicarb
Na and volume loss
43. What are the two kinds of cells in the collecting tubules
NC - dec - dec
Transitional cell carcinoma
UTI or acute gastroenteritis
Principal cells and intercalated cells
44. What is the BUN/Cr ratio in instrinsic renal ARF and why
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Insertion of Na channel on luminal side
Hypokalemia and hypophosphatemic rickets
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
45. hypoaldosteronism or lack of collecting tubule response to aldosteron
Radiopaque
JG cells
RTA type 4 (hyperkalemic)
Involves only glomeruli
46. What is the formula for reabsorption
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
Segmental sclerosis and hylanosis
Na and volume loss
Filtered - secreted
47. fever - CVA tenderness - N/V - affects cortex with relative sparing of glomeruli/vessels
Beta 1
Acute pyelonephritis
Acts on V2 receptors leading to insertion of aquaporins on luminal side
By 10%
48. How is chlorid reabsorbed in the proximal tubule
Hypokalemia and hypophosphatemic rickets
Na
160-200 - 350
2 ways - base exchanger and between epithelial cells
49. What is transporter in the thick ascneding loop of Henle indirectly induces the paracellular reabsorption of Mg and Ca
Macula densa and JG cells
Invades IVC and spreads hematogenously
NKCC
Negative charge
50. net tubular reabsorption of x
Segmental sclerosis and hylanosis
Chronic conditions - multiple myeloma - TB - RA
Hypokalemia - risk for Ca containing kidney stones
Cx<GFR
Sorry!:) No result found.
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