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. Subendothelial immune complexes with granular IF
Inc plasma osm - dec blood volume
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Membranoproliferative glomerulonephritis
2 ways - base exchanger and between epithelial cells
2. 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
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Negative charge
Inc - dec - dec
3. What are the associations with nephrotic syndrome
Acute renal failure
Nephritic syndrome
2 ways - base exchanger and between epithelial cells
Thromboembolism and inc risk of infection
4. What is the compensatory response in respiratory alkalosis
60% total body water - 40% ICF - 20% ECF
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
Dec renal bicarb reabsorption - delayed
LM - nl glomeruli - EM - foot process effacement
5. At what level of plasma glucose does glucosuria begin and what serum glucose is the transporter fully saturated
160-200 - 350
Insertion of Na channel on luminal side
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
6. What aspect of vitamin D metabolism occurs in the proximal tubule of the kidney and What effect does that have on calcium and phosphate
Type II - C3 nephritic factor
Converts 25- OH vitamin D to 1 -25 -(OH)2 vitamin D which inc intestinal reabsorption of both calcium and phosphate
Na and volume loss
Angiotensin II constricts the efferent arteriole - dec RPF - inc GFR - in FF - ACEi reverse
7. What is the ddx for a metabolic acidosis with an inc anion gap
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Nephritic syndrome
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Na reabsorption drives H20 reabsorption
8. What effect does cxn of the ureter have on RPF - GFR and FF
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
Inc - inc - inc
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
NC - dec - dec
9. What are the associations with RTA type 2
It has a longer renal vein
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
Hypokalemia and hypophosphatemic rickets
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
10. massive proteinuria (>3.5g/day) frothy urine - hyperlipidemia - fatty casts - edema
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
Podocytes foot processes
Nephrotic syndrome
Von hippel laundau and gene deletion in chromosome 3
11. What is the most common renal malignancy of early childhood
Cx>GFR
Wilms tumor (ages 2-4)
Insertion of Na channel on luminal side
Failure of EPO
12. multiple - large - bilateral cysts that ultimately destroy the kidney parenchyma
N/anorexia - pericarditis - asterixis - encephalopathy - platelet dysfxn
Macula densa and JG cells
Cx = GFR
ADPKD
13. What is the net effect of PTH
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
Inc in Ca and PO4 absoprtion from the gut
Becomes concentrated and hypertonic
Kids - triggered by recent infxn or immune stimulus - selective loss of albumin not globulins
14. In a metabolic acidosis What additional calculation is necessary and How do you make it
Anion gap = na - (Cl + bicarb)
Negative charge
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
Ectopic EPO - ACTH - PTHrP - prolactin
15. When is TF/P <1
Na and volume loss
Von hippel laundau and gene deletion in chromosome 3
Solute is reabsorbed more quickly than water
Men 50 to 70 - inc incidence with smoking and obesity
16. Why can PAH be used to measure ERPF
Type II - C3 nephritic factor
Actively reabsorbs NaCl - diluting - makes urine hypotonic
Mesangial expansion - GBM thickening - nodular glomerulosclerosis (kimmelstiel - wilson lesion)
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
17. What is the ddx for respiratory acidosis
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Carbonic anhydrase
Inc - dec - dec
Size
18. primary glomerular dz
<3.5 g /day
Makes urine less concentrated - impermeable to H20
Involves only glomeruli
Increased - dec RBF - dec GFR - Na/H20 and urea retained by kidney to conserve volume
19. What is renal osteodystrophy
Radiolabelled albumin
Eosinphilic casts in tubules
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
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
20. Defect in proximal tubule HCO3 reabsorption
Insertion of Na channel on luminal side
RTA type 2 (proximal)
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
Hydronephrosis and pyelonephritis
21. What happens in the early distal convoluted tubule and What does that do to the urine
Actively reabsorbs NaCl - diluting - makes urine hypotonic
Acute - ATN - or chronic - HTN - DM
Inc in concentration - not amout - due to water reabsorption
Membranoproliferative glomerulonephritis
22. What change (lack of) is common in children with renal failure
Growth retardation and developmental delay
RTA type 1 (distal)
Inc plasma osm - dec blood volume
Beta 1
23. What does aldosterone do in the collecting tubule
Cx<GFR
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
Insertion of Na channel on luminal side
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
24. What substance is secreted from the kidney in response to hypoxia - and what cells do they come from
Eosinphilic casts in tubules
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
Converts 25- OH vitamin D to 1 -25 -(OH)2 vitamin D which inc intestinal reabsorption of both calcium and phosphate
EPO - endothelial cells of peritubular capillaries
25. acute generalized cortical infarction of both kidneys - dz - causes and associations
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Carbonic anhydrase
Macula densa and JG cells
LM - nl glomeruli - EM - foot process effacement
26. In pts with ammonium magnesium phophate stones - What can be the nidus for UTI and what worsens it
Proximal tubule - na/glucose co transporter
Involves only glomeruli
Staghorn calculi - worsened by alkaluria
Men 50 to 70 - inc incidence with smoking and obesity
27. What two cells make up the JGA
Growth retardation and developmental delay
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
All glomeruli
Macula densa and JG cells
28. What is the BUN/Cr ratio in instrinsic renal ARF and why
Inc renal bicarb resabsoprtion - delayed
Decreased - ATN - ischemia - toxins leads to obstruction and backflow - dec GFR - BUN reabsorption is impaired
Size
Von hippel laundau and gene deletion in chromosome 3
29. coarse - asymmetric - corticomedullary scarring and blunted calyx
Acute renal failure
Chronic pyelonephritis
Inulin
Dec - inc - inc
30. What are the associations with RTA type 1
Hypokalemia - risk for Ca containing kidney stones
Inc in Ca and PO4 absoprtion from the gut
Calcium (oxalate or phosphate or both) - hypercalcemia caused by cancer - inc PTH
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
31. The fused basement membrane with heparan sulfate constitutes what portion of the charge
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
V x Urine concentration
Macula densa and JG cells
Negative charge
32. When is TF/P = 1
Needs to be bilateral
Simple cysts
Solute and water are reabsorbed at the same rate
Hydronephrosis and pyelonephritis
33. Where does renal cell carcinoma originate and What do the cells look like
Cx>GFR
Renal tubular cells - polygonal clear cells
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Involves only glomeruli
34. How do calcium stones appear on x ray
Radiopaque
ADPKD
Vasocxn - inc BP
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
35. How do the ureters course in relation to the uterine artery and ductus deferens
GFR/RPF
Hypervent - immediate
Under and under
Dec - dec - NC
36. medullary cysts sometimes lead to fibrosis and progressive renal insuff with urinary concentrating defects
Medullary cystic disease
Stimulates thirst
Inhibiting renal production of prostaglandins which keep the afferent arteriole vasodilated to maintain GFR
JG cells
37. What does LM - EM - IF show in diffuse proliferative GN
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
GFR x plasma concentration
Phenacetin - smoking - aniline dyes - cyclophosphamide
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
38. What does thyroidization of the kidney result in
Eosinphilic casts in tubules
Hydronephrosis and pyelonephritis
Simple cysts
Corticosteroids
39. Defect in collecting ducts ability to excrete H+
Hypokalemia and hypophosphatemic rickets
RTA type 1 (distal)
Negative charge
Bladder cancer
40. What does US show with medullary cystic disease
Small kidney - poor prognosis
Passively reabsorbs water via medullary hypertonicity
ANP
JG cells
41. no net secretion or reabsorption of x
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Cx = GFR
Staghorn calculi - worsened by alkaluria
Inc synthesis of IgA and LM and IF - Ics depsoti in mesangium
42. benign - common - incidental finding of renal cysts - thin - nonenhancing - cortical - fluid filled
1/4 plasma - and 3/4 interstitial volume
20 percent
NC - dec - dec
Simple cysts
43. inc in creatinine and BUN over a period of several days
Acute renal failure
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Corticosteroids
Reabsorb Na in exchange for secreting K and H
44. What are the two kinds of cells in the collecting tubules
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Principal cells and intercalated cells
It has a longer renal vein
Radiolabelled albumin
45. membranous
Thickening of glomerular BM
Passively reabsorbs water via medullary hypertonicity
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Goodpastures - type II hypersens - antibodies to GBM and alveolar BM - linear IF - Wegeners (c - ANCA) - mircoscopic polyangiitis (p - ANCA)
46. What effect does ANP have on GFR
NKCC
HIV
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Inc
47. What is the affect of prostaglandins on RPF - GFR - and FF - and why? What would NSAIDs do?
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Inc Ca/Na exchange to inc Ca reabsoprtion
Segmental sclerosis and hylanosis
48. How does RCC manifest clinically
Renal artery - interlobar a - interlobular a
Hematuria - palpable mass - polycythemia - flank pain - fever and weight loss
Radiolabelled albumin
Thickening of glomerular BM
49. What is the formula for filtration fraction
C = UV/P U is urine concetration of substance x - P is plasma concentration of substance x - and V is urine flow rate
GFR/RPF
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
50. What happens to Cl in the proximal 1/3 of the proximal tubule relative to Na
Cx>GFR
Beta 1
Involves glomeruli and other organs
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus