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RENAL module - 4th year > 2009 module exam > Flashcards

2009 module exam Flashcards

1
Q

Midway between transpyloric plane and intertubercular planes

A

Lower pole

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2
Q

5 cm from midline on L1 vertebra spinous process

A

Hilum of kidney

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3
Q

Surgery of the posterior surface of the kidney may affect

A

Ilioinguinal nerve

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4
Q

A 25-year-old female with UTI. What is the disposing factor?

A

Short urethra

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5
Q

Which acts as a physical barrier?

A

Lamina densa of basal lamina

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6
Q

What establish the gradient of hypertonicity?

A

Loop of henle

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7
Q

What forms the macula densa?

A

DCT

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8
Q

What is the Renal Blood Flow if RPF = 600, and plasma is 60%

A

1000 ml

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9
Q

What is RPF when creatinine clearance is 90 and normal FF?

A

450 ml

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10
Q

Podocytes are derived from which layer?

A

Visceral epithelial layer

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11
Q

What is mesangial contraction decrease?

A

Surface area

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12
Q

What normally don’t affect filtration?

A

Hydrolic conduction

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13
Q

Clearance of a substance calculation with Tm for secretion Q

A

30

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14
Q

What does fractional excretion above 1 indicate?

A

Substance filtered and secreted

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15
Q

A patient with lung crackles, dyspnea, chest pain, low blood pressure, heart sound S3 is heard. Creatinine levels were 190. What do we do next?

A

Urine Na+ level

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16
Q

A patient ingested ethylene glycol

A

Necrosis of proximal tubules (nephrotoxic ATN)

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17
Q

A patient with traffic accident developed hemorrhage and shock

A

Renal cortical necrosis

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18
Q

A patient with severe dehydration

A

Necrosis of any part of the nephron (ischemic ATN)

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19
Q

A patient with 3 days history of antibiotic usage

A

Eosinophils infiltration (hypersensitivy interstitial nephritis)

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20
Q

A patient with 10 years of NSAIDs usage developed

A

Lymphocytic infiltration (analgesic nephropathy)

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21
Q

Another question on analgesic nephropathy: associated with?

A

Lymphocytic infiltration

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22
Q

NSAIDs can cause nephrotoxicity and acute renal failure by:

A

Alteration of intraglomerular dynamics

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23
Q

Which drug is associated with ARF with renal artery stenosis?

A

Captopril

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24
Q

Which drug causes ATN with hepatic failure?

A

Acetaminophen

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25
Q

Endogenous immune complex

A

Membranous GN (doctor 9ala7 ygoul this is the answer, even though kan ako bele5tiyarat “cresentic GN” elle ehya elmfroo’9 tkon elejaba el9a7 la2ana anti-GBM disease ohwa eljawab, bs I don’t know lil amana :/)

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26
Q

A 7-year-old child with nephrotic syndrome and normal histology

A

Fusion of foot cell processes

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27
Q

Foot process fusion

A

Minimal change disease

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28
Q

Pathogenesis of membranous GN

A

Complement activation

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29
Q

What is a characteristic of diabetic glomerulosclerosis?

A

Kimmelstein Wilson lesion

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30
Q

Deposition of C3 in peripheral GBM as humps

A

Post-infectious GN

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31
Q

A patient with mesangial and endocapillary proliferation

A

Lupus nephritis

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32
Q

What is mostly seen in post infectious GN?

A

Neutrophilic infiltration in capillary loops

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33
Q

What is the most common risk factor of ESRD in Kuwait?

A

Diabetes

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34
Q

What is the Relative Risk of CVD deaths due to dialysis in ESRD?

A

> 10

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35
Q

Which of the following occur in PCT?

A

80% reabsorption of HCO3-

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36
Q

What is the mechanism of reabsorption of HCO3- in PCT S1?

A

Na-H exchanger

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37
Q

Paracellular reabsorption of solutes in water

A

Solvent drag

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38
Q

A patient increased his Na+ intake by 140 mEq/L. What is supposed to happen?

A

Increase water intake by 1 Kg

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39
Q

A patient with low RBF, slightly changed GFR and increased FF. what is the cause?

A

Angiotensin II

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40
Q

Which hormone is stimulated in volume expansion?

A

ANP

41
Q

Decreased levels of NaCl to macula densa causes

  • Afferent arteriole dilatation
  • Afferent arteriole constriction
A
  • Afferent arteriole dilatation
42
Q

A 60-year-old patient underwent nephrectomy because of acute renal failure. After doing the surgery is GFR was 53, a year later it became 49. What is the reason behind that?

A

Chronic renal disease

43
Q

Dysfunction of podocytes

A

Proteinuria

44
Q

Failure of ureteric bud to contact the metanephric mesenchyme

A

Kidney agenesis

45
Q

What structure develops from the ureteric bud?

A

Collecting duct

46
Q

Failure of connection between renal vesicles and collecting system

A

Polycystic kidney

47
Q

Two ureters in one kidney because of partial ureteric buds

  • Bifid ureter
  • Double ureter
  • Ureter duplication
A
  • Ureter duplication (kilhom kanaw mawjodeen m3na kilhom elmfrooth the same, bs this is the right answer for sure :/)
48
Q

What Increases AQP-2 in luminal cells?

A

Increase ADH secretion

49
Q

What increases renin?

A

Decrease afferent arteriolar pressure

50
Q

What decreases ANP?

A

Decrease stretch of atrial receptors

51
Q

What causes low ADH secretion?

A

Alcohol

52
Q

What causes low medullary interstitium osmolarity?

A

Low levels of urea transporter 1

53
Q

How is the ability of concentrating urine increased?

A

By reducing blood flow to vasa recta

54
Q

Which drug causes hyperglycemia?

A

Hydrochlorothiazide

55
Q

Which diuretic causes testicular atrophy?

A

Spironolactone

56
Q

Which drug is used to preserve K with other diuretics?

A

Amiloride

57
Q

Which drug inhibits stone formation?

A

Chlorothalidone

58
Q

Which cation is highest in ECF?

A

Na

59
Q

What causes hyperchloremic metabolic acidosis with normal Anion Gap?

A

RTA

60
Q

A patient with hypernatremia, urine osmolarity is less than 300

A

Diabetes insipidus

61
Q

Non-responsive to post-vasopressin with urine osmolarity 200

A

Complete nephrogenic DI

62
Q

Same person, later develops uremia and high creatinine

A

Acute renal failure (m3na elmfrooth with diabetes ay sha59 y7ooshah chronic renal failure, bs this is the answer, shlon? Madri :/)

63
Q

A patient eats 1000 mEq/L K+. After half an hour we the K level and it equals 5 which is normal. What is the reason?

A

Transcellular movement of K across the cells

64
Q

What stimulates NaHCO3 reabsorption in a volume depleted patient?

A

Angiotensin II

65
Q

What is the highest ADH stimulant?

A

Exercise in the heat with no water

66
Q

Median umbilical ligament is developed from

A

Urachus

67
Q

A malnourished patient cannot secrete NH4. When given I.V. phosphate solution he could. How?

A

Lack of phosphate prevents acidification of urine

68
Q

A direct clearance question calculation

A

150

69
Q

A medical student during his final exam. His Ph = 7.47, CO2 = 22, HCO3 = 21.

A

Acute respiratory alkalosis

70
Q

Patient with pH = 7.45, HCO3- = 30, CO2 = 45

A

Metabolic alkalosis with respiratory compensation

71
Q

There were two questions on metabolic acidosis and the way of the kidney to compensate, one of them was by increasing HCO-3 synthesis while the other one was by secreting more NH4 than normal. But we don’t remember the questions

A

-

72
Q

A patient with left loin pain. X-ray showed kidney stones, what would be typically be?

A

Calcium oxalate

73
Q

A patient with struvite stones with alkaline urine. What enzyme forms the stones?

A

Bacterial urease

74
Q

Which drug decrease the formation of uric acid stones?

A

Allopurinol

75
Q

What is the cause of metabolic disorder that cause cystinuria?

A

Defective amino acid transport

76
Q

A patient with abdominal pain recurrent of 3 years with high urine calcium

A

Kidney stones

77
Q

Metabolic disorder of lysine/cysteine/arginine will cause formation of which type of stones?

A

Cysteine stones

78
Q

What is the most common cause of community UTI?

A

E-coli

79
Q

When do you take a specimen for Schistosoma UTI?

A

Terminal portion of urine

80
Q

A 6-year-old patient with unilateral hydronephrosis and hydroureter

A

Vesicoureteral reflux

81
Q

What is the most common congenital anomaly in children?

A

Vesicoureteral reflux

82
Q

How do we evaluate urethral stricture?

A

Ascending urethrography

83
Q

A 23-year-old female with hypertension, what is the first modality of diagnosis?

A

Ultrasound

84
Q

What is the first modality in diagnosing a 60-year-old man with prostatit hyperplasia?

A

Ultrasound

85
Q

What is formed by the mesonephric duct?

A

Ductus deferens

86
Q

How is renin released by sympathetics?

A

B agonists

87
Q

A 60-year-old patient smoker with hemoptysis and rapidly progressive renal dysfunction

A

Cresents

88
Q

A 76-year-old man with paraplegia. What would cause UTI?

A

Neurogenic bladder

89
Q

Hyperplasia of which part of the prostate will lead to urinary obstruction?

A

Periurethral

90
Q

Which represents reaction to secretion from ruptured prostatic glands?
145- obstruction?

A

Granulomatous prostatitis

91
Q

Hyperplasia of stromal and epithelial cells

A

Nodular prostatic hyperplasia

92
Q

Which grade shows no glandular differentiation but with solid sheets and nests of tumors with central necrosis in Gleason

A

Grade 5

93
Q

A Gleason score of 5 would show you

A

What’s in grade 2 and 3 because the gleason score is the total of the two nearest grades for the tumor, so it would be showing us a well differentiated tumor…

94
Q

A patient with enlarged prostate but normal PSA

A

Benign prostatic hyperplasia

95
Q

In volume depletion, alpha intercalated cells will work under the effect of?

A

Aldosterone

96
Q

A patient with history of recurrent UTI with leukocytes expressed in the prostatic secretions

A

Chronic bacterial prostatitis

97
Q

What happens in the early distal tubule?

A

Na-Cl symporter

98
Q

Why there is no glucose in urine normally?

A

Because the filtered load is lower the Tm for glucose

RENAL module - 4th year (17 decks)

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