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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 is transporter in the thick ascneding loop of Henle indirectly induces the paracellular reabsorption of Mg and Ca
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
Amyloidosis
NKCC
RTA type 2 (proximal)
2. How is extracellular volume measured
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
Dec - dec - NC
Involves glomeruli and other organs
Inulin
3. What serum changes cause a secretion in PTH
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Ammonia - buffer for secreted H+
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Inc - inc - inc
4. What is the effect of AT II on efferent arterioles
Hypoventilation - obstruction - acute lung dz - chronic lung dz - opiods - narcotics - sedatives - weakening of respiratory muscles
Corticosteroids
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
Contrict leading to inc FF - preserver renal GFR in low volume states
5. in TCC - What does painelss hematuria suggest
Bladder cancer
Kids - peripheral and periorbital edema - resolves spontaneously
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Insertion of Na channel on luminal side
6. most common tumor of urinary tract system (can occur in renal calyces - renal pelvis - ureters - bladder)
Transitional cell carcinoma
Solute is reabsorbed less quickly than water or net secretion of substance
Dec renal bicarb reabsorption - delayed
Inulin
7. What is the genetic etiology of wilms tumor and What is WAGR complex
Deficiency in neutral amino acid (tryptophan) transporter - resulting in pellagra
Inc renal bicarb resabsoprtion - delayed
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
60% total body water - 40% ICF - 20% ECF
8. hyaline casts ddx
Nonspecific
Eosinphilic casts in tubules
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Cx = GFR
9. TCC is associated with problems in your Pee SAC - ??
Rxn from angiotensinogen to angiontensin I
Diffuse cortical necrosis - combo of vasospasm and DIC - associated with obstetric complications and and septic shock
Phenacetin - smoking - aniline dyes - cyclophosphamide
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
10. In renal failure - what happens to potassium
Sodium dependent transporters in proximal tubules - 3 distinct carrier systems - competitive inhibition within each group
Hyperkalemia
AR - congenital hepatic fibrosis - renal failure in utero leading to potters - beyond = HTN - portal HTN - progressive renal insuff
Dec renal bicarb reabsorption - delayed
11. Why does Na conc nearly match Osm
Macula densa
LM - wire looping of caps - EM - subendothelial DNA- anti - DNA IC - IF- granular
Cx>GFR
Na reabsorption drives H20 reabsorption
12. nonenzymatic glycosylation of GBM - inc permeability and thickening
Solute is reabsorbed more quickly than water
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
Diabetic glomerulonephropathy
All glomeruli
13. What is the ddx for a respiratory alkalosis
Acute tubular necrosis - renal ischemia (shock - sepsis) - crush injury (myoglobinuria) - toxins - muddy brown casts
Tumor suppresor gene WT1 on chrom 11 - WAGR =Wilms - Aniridia - Genitourinary malformation and mental - motor Retardation
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
Hypervent - early high altitude - aspirin ingestion early
14. How do struvite stones appear on xray
GFR x plasma concentration
Radiopaque
Dec plasma Ca - inc plasma PO4 - dec plasma 1 -25 OH2 vit D
Inc
15. What enzyme allows for conversion of 25- OH vit D to 1 -25 (OH)2 vit D
In Na channels - Na/K pumps - enhances K and H excretion - upregulates K channels and H channels
1alpha hydroxylase - PTH stimulates it
GFR/RPF
Uric acid - hyperuricemia - dz with inc cell turnover like leukemia
16. What is the compensatory response in respiratory alkalosis
Filtered - secreted
Macula densa and JG cells
Dec renal bicarb reabsorption - delayed
Acute pyelonephritis
17. What is the compensatory response in metabolic acidosis
Chronic pyelonephritis
Hypervent - immediate
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
<3.5 g /day
18. What dyslipidemia is most common in renal failure
Excreted - filtered
Triglycerides
Diuretics - vomiting - antacid - hyperaldosteronism
Hypokalemia - risk for Ca containing kidney stones
19. What happens to the urine in the descending limb
1/4 plasma - and 3/4 interstitial volume
Becomes concentrated and hypertonic
Solute is reabsorbed less quickly than water or net secretion of substance
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
20. fever - CVA tenderness - N/V - affects cortex with relative sparing of glomeruli/vessels
Polycystic liver disease - berry aneurysms - mitral valve prolapse
Negative charge
Acute pyelonephritis
Apical face - K/H ATPase exchanger - H- ATPase secretion basolateral face - Cl/HCO3 exchanger
21. what happens to pH - PCO2 - and bicarb in metabolic alkalosis
Bladder cancer
Inc - inc - inc
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
Ammonium magnesium phosphate (struvite) - infection with urease pos magnesium or radiolucent bugs like (proteus - staph - klebs)
22. What effect does cxn of the ureter have on RPF - GFR and FF
Nephrotic syndrome
PH = pKa + log bicarb/0.03PCO2
NC - dec - dec
Aldosterone secretion leading to inc Na reabsorption and H20 reabsorption
23. in acute cystitis with pyuria - do you see casts
ADH secretion - inc in aquaporin channels in principal cells and H20 reabsorption
<3.5 g /day
No
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
24. What is the least common kidney stone - What causes it and How do you treat it
Stimulates Na/H exchange - increasing Na and H20 reabsorption - contraction alkolosis
LM- glomeruli enlarged and hypercellular - PMNs - 'lumpy- bumpy' appearance EM - supepithelial immunce complex humps - IF- granular
Hypokalemia and hypophosphatemic rickets
Cystine - 2ndary to cystinuria - hexagonal - treat with alkalization of urine
25. Defect in collecting ducts ability to excrete H+
RTA type 1 (distal)
Becomes concentrated and hypertonic
Macula densa
Diabetic glomerulonephropathy
26. acute interstitial renal inflammation with pyuria with eosinphils - associated with fever - rash - hematuria and CVA tenderness - dz and causative agents
Phenacetin - smoking - aniline dyes - cyclophosphamide
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Drug induced interstitial nephritis - diuretics - NSAIDs - penicillin derivatives - sulfonamides - rifampin - act as haptens
Diabetic glomerulonephropathy
27. What is the algorithim for acidosis/alkalosis
NC - inc - inc
Membranoproliferative glomerulonephritis
Huge palpable flank mass and hematuria
PH - then PC02
28. What is the net effect of AT II
Modified smooth muscle of afferent arteriole - secrete renin
Membranoproliferative glomerulonephritis
Inc plasma osm - dec blood volume
Preservation of renal fxn in low volume states with simultaneous Na reabsorption to dec additional volume loss
29. What are the main complications of kidney stones
Na
Hydronephrosis and pyelonephritis
Inc in concentration - not amout - due to water reabsorption
Cx = GFR
30. granular - muddy brown casts - ddx
No
Diuretics - vomiting - antacid - hyperaldosteronism
Acute tubular necrosis
Renal artery - interlobar a - interlobular a
31. What happens in the thin descending loop of henle
Fibrin and plasma proteins (C3b) with glomerular function parietal cells - monocytes and MACS
Failure of vit d hydroxylation - ca wasting - phosphate retention - sencondary hyperPTH
Dilate the afferent arteriole - inc RPF - inc GFR - FF is the same - NSAIDs reverse
Passively reabsorbs water via medullary hypertonicity
32. What is the cutoff of proteinuria in nephritic syndrome
<3.5 g /day
V x Urine concentration
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
Triglycerides
33. How do you interpret creatinine clearance
Solute and water are reabsorbed at the same rate
Approx measure of GFR - slightly overestimates because creatinine is secreted in by the renal tubules
<3.5 g /day
Dec - dec - dec
34. What is the most common renal malignancy of early childhood
Hypervent - early high altitude - aspirin ingestion early
NC - dec - dec
Wilms tumor (ages 2-4)
Most of the bicarb - sodium - chloride - and water
35. What effect does ANP have on Na in the kidney
Inc renal bicarb resabsoprtion - delayed
Inc GFR and mesangial expansion
Acute pyelonephritis
Inc in Na filtration with NO compensatory Na reabsorption in the distal nephron
36. what happens to pH - PCO2 - and bicarb in respiratory acidosis
Dec - inc - dec
MUDPILERS - methanol - uremia - DKA - paraladehyde OR phenformin - Iron/INH - lactic acidosis - ethylene glycol - rhabdomyolysis - salicylates
Men 50 to 70 - inc incidence with smoking and obesity
Dec blood volume and inc plasma K causing in Na reabsorption - inc K secretion and inc H secretion
37. The fused basement membrane with heparan sulfate constitutes what portion of the charge
Reabsorption is slower at first - then matches Na more distally thus relative concentration inc before it plateaus
PAH is freely filtered and actively secreted - all PAH entering kidney is secreted
Radiopaque
Negative charge
38. What change (lack of) is common in children with renal failure
Growth retardation and developmental delay
Rxn from angiotensinogen to angiontensin I
LM - nl glomeruli - EM - foot process effacement
Diuretics - vomiting - antacid - hyperaldosteronism
39. What receptor responds to inc sympathetic discharge leading to renin secretion from JG cells
Beta 1
Inc
Passively reabsorbs water via medullary hypertonicity
Metabolic acidosis
40. How What does the glomerular filtration barrier distinguish by
Size and charge
Staghorn calculi - worsened by alkaluria
Dec - dec - dec
Chronic pyelonephritis
41. What happens when PTH is secreted
Inc Ca reabsoprtion in DCT - dec PO4 reabsorption in - inc in 1 -25 OH2 vit d production
By 10%
Dec - inc - inc
Hypervent - early high altitude - aspirin ingestion early
42. What do casts indicated about hematuria/pyuria
Renal in origin
Acute - ATN - or chronic - HTN - DM
Actively reabsorbs NaCl - diluting - makes urine hypotonic
<3.5 g /day
43. What is the formula for reabsorption
60% total body water - 40% ICF - 20% ECF
Filtered - secreted
Liver
Hyperkalemia
44. What are the two kinds of cells in the collecting tubules
Podocytes foot processes
Principal cells and intercalated cells
LM - nl glomeruli - EM - foot process effacement
Solute and water are reabsorbed at the same rate
45. What is is Alport's syndrome and what else do you see with it other than renal path
Renal in origin
Mutation in type IV collagen - split BM - nerve disorders - ocular disorders - X- linked dominant
ANP
Renal papillary necrosis - sloughing of renal papillae - DM - acute pyelonephritis - phenacetin - sickle cell
46. How is chlorid reabsorbed in the proximal tubule
Dec BP - dec in Osm - inc sympathetic tone - released from kidneys
2 ways - base exchanger and between epithelial cells
Dec - inc - dec
Liver
47. In pts with ammonium magnesium phophate stones - What can be the nidus for UTI and what worsens it
AD - flank pain - hematuria - HTN - urinary infxn - progressive renal failure
All glomeruli
Modified smooth muscle of afferent arteriole - secrete renin
Staghorn calculi - worsened by alkaluria
48. What two cells make up the JGA
Simple cysts
Macula densa and JG cells
Hypokalemia and hypophosphatemic rickets
ANP
49. Why is the left kidney taken during living donor transplantation
Small kidney - poor prognosis
LM - diffuse capillary and GBM thickening - EM - spike and dome with subepithelial deposits - IF - granular
RTA type 2 (proximal)
It has a longer renal vein
50. How do calcium stones appear on x ray
Proximal tubule - na/glucose co transporter
NC - dec - dec
Acts on V2 receptors leading to insertion of aquaporins on luminal side
Radiopaque