2009 final Flashcards
What is the main blood supply to the middle ureter?
Gonadal artery
What secretes renin?
Jextoglomerular cells
Which vessel can be a cause of failure of ascending of kidneys?
Inferior mesenteric artery
What is the result of sympathetic activation?
Increase Na+ reabsorption
What causes a decrease of GFR?
Obstruction of ureters
Concentration of plasma x = 2 mg, GFR = 110, Tm for secretion = 80, clearance of PAH = 550. What is the excretion rate?
300
A patient with concussion then passed a larger amount of water (6L), Na is normal, blood pressure is 110/70, and urine analysis shows no proteinuria and no cells. What further investigation should be done?
- MRI of the brain
- Water deprivation test
?
A 50-year-old patient was unconscious. Plasma Na is normal, urine Na is 25, FENa is <1% (0.23%), and osmolarity is 500. What does he have?
Prerenal failure
A patient with inflammation and edema with lymphocytes and eosinophils
Hypersensitivity type of interstitial nephritis
Which drug causes crystal nephropathy?
Acyclovir
A patient with diffuse GBM thickening and spikes due to hepatitis B
Membranous GN
A patient who is a smoker and hypertensive with obesity. What would be the most cause of ESRD in this patient?
Hypertension
What is pathologically seen in PISGN?
Subepithelial humps
What causes increase of ADH?
Hypernatremia
What is a function of angiotensin II?
Stimulate Na-H exchanger in proximal tubules
Which is an aldosterone antagonist?
Spironolactone
A patient with fever, dysuria, and rigors, with hematuria on examination and a nitrate reductase test was positive. What is the main causative agent?
E. Coli
High absorption of what in the gut would lead to the formation of calcium stones?
Oxalate
What is the best diagnostic method for kidney stones?
CT-KUB
A pregnant lady wanted to check for obstruction in her ureters. What is the best way?
Ultrasound
What is the main risk factor for cysteine stones?
Genetics
A patient with respiratory alkalosis and urine osmolarity of 500. Electrolytes were normal and the pH is 7. What is the best way to compensate?
- Decrease HCO3 reabsorption in PCT
- Increase ammonia secretion
- Increase titrable acids
- Decrease HCO3 synthesis in CD
- Decrease HCO3 synthesis in CD
Which zone of the prostate can be felt in a digital exam if enlarged?
Peripheral zone
A 75-year-old patient with difficulty passing urine, he has no other symptoms
Prostatic hyperplasia
pH = 7.33, HCO3 = 15, CO2 = 31
metabolic acidosis with respiratory compensation
A patient with CO3 = 22 (normal_, CO2 = 40 (normal), PH = 7.38 with urine albumin = 88. Other electrolytes are normal
- Completely compensated metabolic acidosis
- Completely compensated respiratory acidosis
- High anion gap due to albumin secretion
- High anion gap due to albumin secretion
What is the immediate buffer for volatile acids?
Intracellular proteins
What will cause increased potassium secretion in urine?
Increased tubular flow
What causes hypernatremia with increase water intake?
Hyperaldosteronism
In intercalated cells, what is responsible for bicarbonate reabsorbtion to the interstitial fluid?
HCO3-Cl exchanger
EBM: A diagnostic test with pre-test probability of 50%, if it became 10% what will happen?
Sensitivity and specificity will not change, PPV will decrease, NPV will increase
EBM: There was a four-squares box with numbers, if the patient was tested positive, what is the chance of her having the disease?
You calculate it by using the formula (A/A+B)
EBM: What is the importance of the gold standard?
Define disease and non-disease states
EBM: You did a case control study regarding contraceptive use and breast cancer, your cases were taken from the hospital while your controls were taken from the infertility department. What is the problem with the study?
Controls are not appropriate
EBM: The prevalence of getting other types of cancer if you have breast cancer is 6%, while in controls it’s 3%. What measures this?
Odds Ratio
EBM: An RCT was done with an intention to treat analysis. What was the purpose of that?
Keep randomization intact at all cost
