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RENAL module - 4th year > 2016 module exam > Flashcards

2016 module exam Flashcards

1
Q

Which structure is most anterior?

a) Renal vein
b) Renal artery
c) Renal pelvis
d) Renal sinus

A

a) Renal vein

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2
Q

What is the biological process that describes the primary function of mesangial
cells?

a) Hormone synthesis and secretion
b) Maintenance of GBM
c) Phagocytosis
d) Na/K secretion

A

c) Phagocytosis

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3
Q

Which of the following disorders is associated with renal cell carcinoma?

A

VHL

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4
Q

What mechanism activates thirst?

a) Hypertension
b) Hypovolemic hypernatremia
c) Isovolemic hyponatremia
d) ANP

A

b) Hypovolemic hypernatremia

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5
Q

Middle aged female hypotension w/ tachycardia, diarrhea, vomiting, BUN high,
creatinine high

a) Pyelonephritis
b) Obstruction
c) Pre-renal AKI

A

c) Pre-renal AKI

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6
Q

Which of the following would increase albumin urinary excretion rate?

a) Increased expression of sialoproteins in GFB
b) Increased expression of megalin in the PCT
c) Mild excerise
d) Decreased expression of nephrin in GFB

A

d) Decreased expression of nephrin in GFB

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7
Q

What increase GFR?

a) Decrease in bowmans capsule
b) Increase in MAP from 100 to 120
c) Nitric oxide

A

c) Nitric oxide

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8
Q

What happens after being on a low sodium diet for a few days

a) Increased expression of ENaC in PC
b) Cellular dehydration
c) Endocytosis of NCC in distal

A

a) Increased expression of ENaC in PC

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9
Q

61 yr female has abdominal pain for the last 5 years, mid-systolic click heard pver
the mitral area during physical examination, ultrasound shows enlarge kidney

a) Berry aneurysm
b) Liver fibrosis
c) Ischemia cardiomegaly
d) Pulmonary fibrosis

A

a) Berry aneurysm

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10
Q

What causes renin in afferent arteriole?

a) B agonist
b) Decreased Na delivered to collecting duct
c) Na/K ATPase

A

a) B agonist

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11
Q

What is the earliest manifestation in patients w/ diabetic nephropathy?

A

Microalbuminurea

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12
Q

35 yr lady presented w/ foul odor smell urine and tests shows leukocute esterase + What is most likely cause?

a) UTI
b) Tumor
c) Acute nephriti

A

a) UTI

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13
Q

20 yr female with bacterial to tonsillitis took ampicillin for 6 days and recovered. Later she developed rash and fever with low urine. Urine microscopy revealed RBCs with no casts or crystals?

a) Post strep
b) ATN

A

b) ATN

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14
Q

5 yr with hemorrhagic cystitis?

A

Adenovirus

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15
Q

What of the following features suggests renal failure that is acute rather than chronic?

a) Presence of anemia
b) Presence of normal function one month previously
c) Normal kidney size

A

b) Presence of normal function one month previously

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16
Q

What is characteristic membranoprolifrative nephropathy?

A

GBM duplication

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17
Q

What is the mechanism of hypocalcemia in CKD ( defecincy of vit D activation 1,25)

a) Decrease absorption of Ca in gut
b) Inhibit PTH

A

a) Decrease absorption of Ca in gut

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18
Q

A biopsy taken from an adult shows diffused thickened membrane with sub epithelial deposits, lab shows that blood nitrogen: normal, creatinine: high, 24 hours urea is high
What is the underlying antigen?

  1. Aso
  2. Collagen type 4
  3. PLA2R1
A
  1. PLA2R1
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19
Q

7 yr with hypercalciurea, what treats his condition?

  1. Loop diuretics
  2. Carbonic anhydrase inhibitors
  3. Thiazide diuretics
  4. Potassium sparing diuretis
  5. Osmotic diuretics
A
  1. Thiazide diuretics
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20
Q

What is a characteristics of Ca reabsorption?

a) CaSR sense hypocalcemia
b) Passive reabsorption in TALH by solavant drag
c) Specific Ca channels on luminal membrane of PC

A

c) Specific Ca channels on luminal membrane of PC

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21
Q

Renal biopsy showed hyper cellularity, endocapillary proliferation, and leukocytes. What could be other findings?

a) High urine protein
b) Dysmorphic RBCs in urine
c) Leukocyte esterase 3+

A

b) Dysmorphic RBCs in urine

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22
Q

Which of the following not causes Acute interstisial nephritis?

a) Analgesics
b) Multiple myloma
c) Sarcoidosis
d) Urea crystals
e) Ischemia

A

e) Ischemia

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23
Q

Which is involved in multiply signalling pathway defect in TTC Ca channel?

a) PC1
b) PC2
c) Fibrocystin
d) Polyductin

A

b) PC2

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24
Q

What develops from metanephrons?

a) Collecting duct
b) DCT

A

b) DCT

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25
Q

Clearance of glucose if Px=3
PAH= 600 Creatinine = 110

a) Zero
b) 330
c) 110
d) 45

A

a) Zero

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26
Q

Child with cystinuria what predispose to form stone?

a) Cysteine insoluble in acidic PH
b) Cysteine insoluble in alkaline PH

A

a) Cysteine insoluble in acidic PH

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27
Q

Mistargeting of which increases the tendency to develop calcium oxalate?

A

a) Alanine-glycoxalate aminotransferase

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28
Q

Which one is not a secondary cause of HTN?

a) Cushing
b) Addison
c) Renal artery stenosis
d) PKD

A

b) Addison

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29
Q

24 yr male admitted for an upper UTI. Ultrasound of abdomen showed pyelonephritis with a large staghorn caliculi in the right kidney. On culture the organism was indole positive. Whats the most likely causative organism?

a) Staph saprophytics
b) Staph haemolytics
c) Proteus miabalis
d) Proteus valguris

A

d) Proteus valguris

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30
Q

28 yr old male with leukemia and was being treated chemotherapy, what will you find in urine analysis?

a) Uric acid crystals
b) Oval fat
c) RBC cast
d) Benz Jones protein

A

a) Uric acid crystals

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31
Q

Which of the following is more likely to cause pyelonephritis?

a) E.coli with K1 antigen
b) E.coli 0175
c) Enterotoxigenic E.coli
d) Enteroaggreggative E.coli

A

a) E.coli with K1 antigen

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32
Q

Surgeon ligated close to left renal vein what would be affected?

a) Spleen
b) Pancreas
c) Left testis

A

c) Left testis

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33
Q 
Patient analysis
HCO3=15.8 (22-26)
PCO2=23 (38-42)
PH=7.5 (7.35-7.45)
Plasma anion gap= 20 (12-16) What best describe his condition?

a) Hyperventilation
b) Metabolic acidosis accompanied by resp alkalosis
c) Compensated resp alkalosis

A

c) Compensated resp alkalosis

34
Q

What is true about nephrotic syndrome in children?

a) Bacterial peritonitis
b) Diuretics will not help to alleviate his edema
c) Kidney biopsy
d) Most are caused by genetic defect in GBM

A

a) Bacterial peritonitis

35
Q

On ultrasound, fetus had a normal left kidney while the right kidney showed dilated pelvis and calyces with normal ureter. What is most likely congenital abnormality?

a) Posterior urethral valve
b) Unilateral VUR
c) Unilateral UPJ obstruction

A

c) Unilateral UPJ obstruction

36
Q

Child with ankle edema with bilateral crepitation with or without galloup. What could be the cause?

a) IgA nephropathy
b) Membranous GN
c) Lupus GN
d) Post strept GN

A

d) Post strept GN

37
Q

US showed smiple cyst, no calcification, not a solid mass

a) Ct KUB
b) CT Contrast
c) No need for follow up

A

c) No need for follow up

38
Q

US showed bilateral small kidney with high echogenicity

a) Renal parenchymal disease
b) Hydronephrosis

A

a) Renal parenchymal disease

39
Q

AT1 blocker could alleviated signs of nephropathy By which mechanism?

a) Decrease intraglomular pressure
b) Decrease intraglomular hypertrophy

A

a) Decrease intraglomular pressure

40
Q

Loss of polarity, detachment of damaged tubular cells and shedding into the urine?

41
Q

Which of the following cells participates in synthesizing the GBM?

a) Fibroblast
b) Mesangial cells
c) Parietal epithelial cells
d) Podocytes
e) Smooth muscle cells

A

b) Mesangial cells

42
Q

The clearance of which of the following equals 50% the clearance of inulin?

a) Urea
b) K
c) Na
d) Cl

43
Q

What is the exrection rate of substance X that is freely filtered and secreted: Px=1
RPF= 660
Creatinine clearance= 90 Tm of secretion= 80

a) 170
b) 100
c) 130
d) 0

44
Q

What is a characteristic of renal tubular acidosis?

a) Decreased GFR
b) Very low Cl plasma conc
c) Normal plasma anion gap
d) Normal and appropriate urine acidification

A

c) Normal plasma anion gap

45
Q

If there is a cancer in the right kidney and the surgeon wants to approach it from posteriolateral abdominal wall, which is most likely to be incised?

a) Tranversalis
b) Parietal peritoneum
c) Visceral peritoneum

A

a) Tranversalis

46
Q

What increases hypertonicity of medullary interstitial?

a) Increase expression of UT1 in IMCD
b) Increase expression of AQP2 in collecting duct

A

a) Increase expression of UT1 in IMCD

47
Q

Amorphous hyaline within the glomeruli of a patient with increased gamma feaction in serum electrophoresis?

A

Multiple myloma

48
Q

What is correct in diabetes nephropathy?

a) Microalbumenia is reversible
b) Increase filteration is irreversible

A

a) Microalbumenia is reversible

49
Q

What is the mechanism in MCD?

A

Cytokines mediated destruction of visceral epithelial cells

50
Q

Patient presented with flulike illness. After 4 days he developed hematuria and then clear urine. One month happened again

a) Post strept GN
b) IgA GN
c) Membranous GN

51
Q

What is the charactertics of immune mediated in proliferative GN?

a) Increase in GFR cuz of inflammation
b) Deposition of non-renal antigen may be a trigger
c) Deposition of immune complex in sub epithelium
d) Podocyte injury due to immune complex activation of alternative pathway

52
Q

Which of these decrease acid secretion?

a) Hypophosphotemia
b) Hyperkalemia

53
Q

Patient present with radio dense stone on ultrasound what is most likely the stone?

a) Calcium oxalate
b) Uric acid
c) Magnesium phosphate
d) Ammonium phosphate

A

a) Calcium oxalate

54
Q

How is K reabsorbed in TALH?

A

Cotransport w/Na & Cl

55
Q

Urine anoin gap over osmolar anion gap

56
Q

What worsen metabolic alkalosis ?

a) Increased intracrllular H+
b) Decreased intracellular H+
c) Increased electrochemical gradient for HCO3 reabsorption

A

a) Increased intracrllular H+

57
Q

One of the main indication in dynamic renal nuclear medicine?

a) Chronic kidney disease
b) Complication of infection
c) Obstruction
d) Reflux

A

c) Obstruction

58
Q

Man presented with wound 7 cm longitudinal with irregular edges on his scalp with brusies. What is the most likely object that caused this lesion?

a) Sharp edge
b) Stap injury
c) Wooden stick
d) Broken glass

A

c) Wooden stick

59
Q

Asian house maid was found with dark hypostasis in the back and pale lower limbs?

a) The patient was suspended and taken down within few minutes
b) The patient was taken down within 1⁄2 an hour
c) Suspended for 3 hours
d) Suspended for 6 hours
e) Suspended for 12 hours

60
Q

Case of renal artery stenosis

a) MAG3 w/ Lasix
b) MAG3
c) MAG3 w/captopril
d) DMSA
e) CT KUB

A

c) MAG3 w/captopril

61
Q

Case of recurrent UTI:

a) MAG3 w/ Lasix
b) MAG3
c) MAG3 w/captopril
d) DMSA
e) CT KUB

62
Q

Which part of the nephron is responsible for secretion of creatinine?

a) PCT
b) DT
c) Loop of henle
d) Thin ascending loop
e) Descending loop

63
Q

Which part of nephron is concerned with hypertonicity of the medulla?

a) PCT
b) DT
c) Loop of henle
d) Thin ascending loop
e) Descending loop

A

c) Loop of henle

64
Q

Renal biopsy showing kimmelstiel Wilson nodules:

A

Advanced glycation end products

65
Q

Mechanism by which diuretics increase K secretion?

A

Increase the flow to stimulate mechanorecptor

66
Q

What increase in nephrotic syndrome?

a) Glucose clearance
b) Albumin clearance
c) Serum creatinine
d) Serum cystatin C
e) Creatinine clearance
f) Cystatin C Clearance
g) Inulin clearance
h) Serum inulin

A

b) Albumin clearance

67
Q

What increase in diabetic patients?

a) Glucose clearance
b) Albumin clearance
c) Serum creatinine
d) Serum cystatin C
e) Creatinine clearance
f) Cystatin C Clearance
g) Inulin clearance
h) Serum inulin

A

a) Glucose clearance

68
Q

What estimates GFR?

a) Glucose clearance
b) Albumin clearance
c) Serum creatinine
d) Serum cystatin C
e) Creatinine clearance
f) Cystatin C Clearance
g) Inulin clearance
h) Serum inulin

A

e) Creatinine clearance

69
Q

What increase to double if GFR decreased to half?

a) Glucose clearance
b) Albumin clearance
c) Serum creatinine
d) Serum cystatin C
e) Creatinine clearance
f) Cystatin C Clearance
g) Inulin clearance
h) Serum inulin

A

d) Serum cystatin C

70
Q

What stimulate H+ secretion in Entire nephron?

a) Endothelin 1
b) Increased intacellular PH
c) Decreased intracellular PH
d) Aldosterone
e) ANG2

A

b) Increased intacellular PH

71
Q

What stimulate H+ secretion in Volume contraction?

a) Endothelin 1
b) Increased intacellular PH
c) Decreased intracellular PH
d) Aldosterone
e) ANG2

72
Q

What stimulate H+ secretion in PCT?

a) Endothelin 1
b) Increased intacellular PH
c) Decreased intracellular PH
d) Aldosterone
e) ANG2

A

a) Endothelin 1

73
Q

Lymphocytic infiltration, tublar atrophy, thyroidisation:

a) Acute pyelonephritis
b) Chronic pyelonephritis
c) Pyonephritis

A

b) Chronic pyelonephritis

74
Q

Abscess and neutrophils:

a) Acute pyelonephritis
b) Chronic pyelonephritis
c) Pyonephritis

A

a) Acute pyelonephritis

75
Q

Scarred cortex:

a) Acute pyelonephritis
b) Chronic pyelonephritis
c) Pyonephritis

A

b) Chronic pyelonephritis

76
Q

Loss of low molecular weight proteins in the urine associated with intake of NSAIDS and analgesics:

a) Microalbumina
b) Macroalbumina
c) Overflow proteinuria
d) Tubular proteinuria
e) Transient proteinuria
f) Orthostatic proteinuria

A

d) Tubular proteinuria

77
Q

Acute febrile illness:

a) Microalbumina
b) Macroalbumina
c) Overflow proteinuria
d) Tubular proteinuria
e) Transient proteinuria
f) Orthostatic proteinuria

A

e) Transient proteinuria

78
Q

Vigorous exercise:

a) Microalbumina
b) Macroalbumina
c) Overflow proteinuria
d) Tubular proteinuria
e) Transient proteinuria
f) Orthostatic proteinuria

A

e) Transient proteinuria

79
Q

Only when standing:

a) Microalbumina
b) Macroalbumina
c) Overflow proteinuria
d) Tubular proteinuria
e) Transient proteinuria
f) Orthostatic proteinuria

A

f) Orthostatic proteinuria

80
Q

Anti GBM:

a) Pulmonary renal syndrome
b) RPGN
c) Nephrotic syndrome
d) Nephritic syndrome

A

a) Pulmonary renal syndrome

81
Q

Pauce immune:

a) Pulmonary renal syndrome
b) RPGN
c) Nephrotic syndrome
d) Nephritic syndrome

RENAL module - 4th year (17 decks)

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