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RENAL module - 4th year > 2012 module exam > Flashcards

2012 module exam Flashcards

1
Q

Which of the following occur in volume contraction?

A

Increased K+ secretion

*Dr. Slava: “Volume contraction doesn’t affect K+ secretion due to the aldosterone paradox”.

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2
Q

Which of the following nerves will be injured during kidney resection?

A

Ilioinguinal nerve

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3
Q

Extensions of the renal cortex into the medulla forms what?

A

Renal column

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4
Q

Joining of the major calyces will form what?

A

Renal pelvis

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5
Q

An 80-year-old woman takes a drug for 2-3 days then develops acute renal failure and skin rash with eosinophils in urine. What is the cause?

A

Drug allergy

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6
Q

What is associated with drug hypersensitivity?

A

Acute tubulointerstitial nephritis

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7
Q

Which drug causes hypersensitivity reaction leading to acute tubular necrosis?

  1. NSAIDs
  2. Lithium
A
  1. NSAIDs
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8
Q

A young patient presented with hypotension after a car accident. After 4 days, serum urea and creatinine were increased. After 2 weeks, he was completely recovered with hemodialysis. Diagnose.

A

Acute tubular necrosis

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9
Q

What will cause an increase in GFR?

A

Hypoalbuminemia

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10
Q

What is responsible for the parasympathetic innervation of micturition?

A

Pelvic splanchnic nerves

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11
Q

Which artery is the most important for supply of the middle part of the ureter?

  1. Gonadal artery
  2. Common iliac artery
  3. Inferior vesical artery
A
  1. Gonadal artery

* Common iliac artery supply of the middle ureter is less consistent

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12
Q

What is true regarding the kidney position?

A

Posteriorly, it extends from the spinous processes of T11-L3

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13
Q

What is the effect of decreased delivery of NaCl to macula densa?

A

Afferent arteriolar dilation

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14
Q

Which structure will become the median umbilical cord?

A

Urachus

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15
Q

A patient with renal failure and increased BUN, decreased GFR and RPF. What explains his condition?

A

A large RBF is needed to excrete waste products

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16
Q

What cells are responsible for renin secretion?

A

Juxtaglomerular cells

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17
Q

What is the mechanism of hypertension in renal artery stenosis?

A

Renin secretion by the afferent arteriole

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18
Q

What causes increased BUN, low GFR, and low RBF to kidneys in renal failure?

  1. Renin release
  2. Sympathetic stimulation
A
  1. Renin release
    * Renin is responsible for angiotensin II release and hence ADH which will insert urea transporter I in the inner medullary collecting duct allowing for the increased BUN reabsorption. Sympathetic stimulation also allows for urea reabsorption and decreases GFR hence reducing its filtration, but it is not as significant.
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19
Q

Calculate excretion rate of x if GFR = 300, PAH clearance=500, and Px=0.3.

A

90

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20
Q

Calculate RBF if creatinine CL=90, PAH=600, Hct=40%.

A

1000

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21
Q

What is true if the filtration fraction of a substance is >1.5?

A

Both filtered and secreted

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22
Q

Which drug causes prerenal vasoconstriction leading to decreased GFR?

A

Cyclosporine

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23
Q

What will increase when there is a defect in nephrin?

A

Oncotic pressure of Bowman’s capsule

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24
Q

What will increase filtration fraction?

A

Increase in oncotic pressure in peritubular capillaries

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25
Q

Clearance of many solutes were studied in a patient. What makes clearance equal to GFR?

  1. Clearance of solute is independent of its plasma concentration
  2. Decrease clearance of solute with increase in plasma concentration
  3. Increase clearance of solute with increase in plasma concentration
A
  1. Clearance of solute is independent of its plasma concentration
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26
Q

What acts as a physical barrier in the glomerular basement membrane?

A

Lamina densa of the basement membrane

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27
Q

A mutation in which transmembrane transporter will lead to familial renal glucosuria?

A

SGLT2

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28
Q

A 51-year old male presented with hematuria and loin pain. Investigations showed a right pelvic mass with hemorrhage and necrosis. Cytology showed malignant cells with papillary appearance. What does he have?

A

Transitional cell carcinoma

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29
Q

A smoking man with a mass in the ureter which showed neoplastic proliferation. He noticed that he had dark urine Diagnose.

A

Transitional cell carcinoma

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30
Q

A 12-year old male boy with edema and bilateral posterior crepitations. What could be the cause?

  1. Post-streptococcal glomerulonephritis
  2. Membranous glomerulonephritis
  3. Lupus glomerulonephritis
  4. IgA glomerulonephritis
A
  1. Post-streptococcal glomerulonephritis
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31
Q

A biopsy of the kidney of a young boy showed neutrophils, mesangial expansion, and swollen endothelial cells. Immunofluorescence showed IgG. Diagnose

  1. Post-streptococcal glomerulonephritis
  2. Membranous glomerulonephritis
  3. Lupus glomerulonephritis
  4. IgA glomerulonephritis
A
  1. Post-streptococcal glomerulonephritis
32
Q

Female with hypertension, rash, and severely decreased renal function with rapidly increase in creatinine and urea. Diagnose

  1. Crescent formation
  2. Membranous glomerulonephritis
  3. Lupus glomerulonephritis
  4. IgA glomerulonephritis
A
  1. Crescent formation
33
Q

A 69-year old man with a 2-week history of periorbital edema, pitting edema, ascites, scrotal edema, and a clear lung when lying down. What diagnostic test should be done?

  1. Renal biopsy
  2. Renal ultrasound
  3. Ascitic tap
A
  1. Renal biopsy
34
Q

What best describes the renal involvement in an SLE patient with hypercellular glomeruli, all glomeruli and entire glomerular tuft are affected?

A

Diffuse global involvement

35
Q

What process happens in the proximal tubules?

A

Reabsorption of bicarbonate

36
Q

What is the best intervention to reduce ESRD?

  1. ACEI
  2. Control glucose
A
  1. ACEI
37
Q

A child presents with raised ASO titer and kidney problems. What will be seen ultrastructurally?

A

Subepithelial humps

38
Q

Which intervention will work for a hypertensive patient with diabetes and microalbuminuria?

A

Angiotensin converting enzyme inhibitor

39
Q

What is the key step involved in increasing the secretion of hydrogen in the proximal tubule?

A

Conversion of angiotensin I to angiotensin II

40
Q

Which of the following increases K+ secretion in a high potassium diet?

A

Increasing of ROMK and BK channels

41
Q

What increases the ability of the kidney to concentrate urine?

A

Increased permeability of the collecting duct to water

42
Q

What increases renal medullary interstitium concentration?

A

Constriction of pericyte in vasa recta

43
Q

What causes the Ca2+ increase required to activate BK channels?

A

Increased tubular flow

44
Q

What is the mechanism of action of thiazide diuretics?

A

Block Na-Cl cotransporter

45
Q

What characterizes proximal renal tubular acidosis?

A

Inability to reabsorb bicarbonate

46
Q

What causes wide osmolar gap metabolic acidosis?

  1. Methanol poisoning
  2. Ketoacidosis
  3. Salicylate overdose
  4. Ingestion of HCl
A
  1. Methanol poisoning
47
Q

A patient with renal failure who was vomiting for the past 12 hours. Which condition will he develop?

  1. Mixed high-anion gap metabolic acidosis and metabolic alkalosis
  2. Metabolic alkalosis
A
  1. Mixed high-anion gap metabolic acidosis and metabolic alkalosis
48
Q

A pregnant medical student was anxious before the exam and was hyperventilating. What will she develop?

A

Respiratory alkalosis

49
Q

A patient had metabolic acidosis with partial compensation. Urinalysis showed negative anion gap. Which of the following is true?

A

NH4+ excretion increased

50
Q

Which of the following is true regarding syndrome of inappropriate ADH secretion?

A

Adrenal and renal tests are normal

51
Q

A patient had low urine osmolarity, high plasma osmolarity, and significant increase in ADH?

  1. Nephrogenic diabetes insipidus
  2. SIADH
A
  1. Nephrogenic diabetes insipidus
52
Q

Which of the following is true regarding a pre-renal azotemia with renal failure?

A

Na <20

53
Q

Which protein is defected in autosomal dominant medullary cystic disease?

  1. Uromodulin
  2. Polycystin
  3. Polyductin
  4. Fibrocystin
  5. Inversin
A
  1. Uromodulin
54
Q

Which protein is associated with Wnt signaling pathway and linked to cystic kidney disease?

  1. Inversin
  2. Uromodulin
  3. Polycystin
  4. Polyductin
  5. Fibrocystin
A
  1. Inversin
55
Q

Which nephronophthisis gene regulates the disease through a cAMP pathway?

  1. NPHP9/NEK8
  2. RPGRIP1L
  3. GLIS2
  4. NPHP4
A
  1. NPHP9/NEK8
56
Q

What is the causative gene of juvenile nephronophthisis, which encodes for a protein in the tight junction of epithelial cells and transitional zone of the cilia?

  1. NPHP4
  2. NPHP9/NEK8
  3. NPHP1
  4. NPHP3
A
  1. NPHP4
57
Q

A dizzy man with metabolic acidosis and urine sodium excretion <10. What is the cause?

  1. Diarrhea
  2. Vomiting
  3. Ketoacidosis
  4. RTA
A
  1. Diarrhea
58
Q

Low pH, low pCO2, low HCO3, normal plasma anion gap, and urinary anion gap -50. What is the cause?

A

HCl

59
Q

Normal pH, HCO3-, pCO2, mild decrease in Cl-, and high anion gap. What is the cause?

A

Increased unmeasurable anion

60
Q

pH=7.32, low pCO2, low HCO3-, high Cl-, and everything else is normal. Anion gap= 14 (8-14). What is the mechanism suggested to happen in this patient?

  1. Loss of HCO3-, accompanied by increased reabsorption of Cl-
  2. Impaired glomerular function of the kidney
A
  1. Loss of HCO3-, accompanied by increased reabsorption of Cl-
61
Q

Low pH, high pCO2, and no change in bicarbonate. What is the cause?

  1. Overdose of sedatives
  2. COPD
A
  1. Overdose of sedatives
62
Q

Low pH, low HCO3, low pCO2, normal PAG, UAG=0. What is the cause?

A

Distal RTA

63
Q

A patient who is normotensive with a non-anion gap metabolic acidosis. What is the cause?

A

Renal tubular acidosis

64
Q

Mistargeting of the peroxisomal enzyme alanine-glyoxalate aminotransferase to mitochondria increases the tendency to develop which stone?

A

Calcium oxalate

65
Q

What describes a benign cyst in a 62-year old male?

A

Homogenous content

66
Q

A 65-year old male treated with intravesical injection of BCG for his bladder. What will he develop?

  1. Granulomatous prostatitis
  2. Acute prostatitis
  3. Chronic abacterial prostatitis
A
  1. Granulomatous prostatitis
67
Q

A newly-married lady in her honeymoon presented with urinary tract infection. The bacteria isolated were catalase positive and novobiocin resistant. What is the causative agent?

  1. Staphylococcus saprophyticus
  2. Staphylococcus epidermidis
A
  1. Staphylococcus saprophyticus
68
Q

When do you take a urine sample to diagnose Schistosoma haematobium UTI?

A

Terminal portion of urine

69
Q

Bilateral hydroureters and hydronephrosis is seen in an ultrasound of the fetus. Diagnose.

  1. Posterior urethral valve
  2. Vesicoureteral reflex
A
  1. Posterior urethral valve
70
Q

Gross appearance of a testicular tumor was bulky, homogenous gray-white, and well-circumscribed mass. Diagnose.

A

Seminoma

71
Q

A woman with tall stature, well-developed breast and no pubic hair. What is true regarding her condition?

  1. Karyotype XY
  2. Turner syndrome
  3. Klinefelter syndrome
A
  1. Karyotype XY

* Presentation is characteristic of androgen insensitivity

72
Q

Intrauterine insemination is highly recommended in which case of male infertility?

  1. Mumps orchitis
  2. Klinefelter 47 XXY
  3. Spinal cord injury
  4. 5α-reductase
A
  1. Mumps orchitis
73
Q

Which lifestyle modification has proven to improve fertility in women?

  1. Smoking cessation
  2. Heavy anaerobic exercise
  3. Low calorie diet (<800)
  4. Avoidance of hormonal contraceptives
  5. Coitus every other day throughout menstrual cycle
A
  1. Smoking cessation
74
Q

A 65-year old man with stony hard prostate on rectal examination with PSA of 20 ng/ml. Diagnose

  1. Prostate cancer
  2. Prostate hyperplasia
A
  1. Prostate cancer
75
Q

A biopsy near to adenocarcinoma revealed a mild nuclear enlargement, pleomorphism, and epithelial hyperplasia. Diagnose.

A

Intraepithelial prostate neoplasia

76
Q

A male presents with low testosterone, FSH, and LH. Diagnose.

A

Kallman syndrome

77
Q

A patient had adenine phosphoribosyltransferase deficiency. Which stone he may develop?

A

Struvite

RENAL module - 4th year (17 decks)

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