Exam III studying Flashcards
The larger caliber of the afferent arteriole compared to the efferent arteriole (when angiotensin II constricts the vessels to raise BP) results in what?
A. Increased hydrostatic pressure in the glomerulus
B. Decreased filtration pressure
C. Equal pressures in both vessels
D. Reduced reabsorption of solutes
A. Increased hydrostatic pressure in the glomerulus
Which substance is normally not reabsorbed by the renal tubules?
A. Sodium
B. Glucose
C. Bicarbonate
D. Protein
D. Protein
Which substance does not go through the glomerulus in normal physiology?
A. Sodium
B. Glucose
C. Bicarbonate
D. Protein
D. Protein
When kidney perfusion is impaired, the macula densa primarily:
A. Increases urine production
B. Senses low tubular flow and signals JG cells to release renin
C. Directly dilates the afferent arteriole
D. Releases nitric oxide into the bloodstream
B. Senses low tubular flow and signals JG cells to release renin
Nitric oxide (NO) released by the juxtaglomerular apparatus acts to:
A. Constrict the efferent arteriole
B. Dilate the afferent arteriole
C. Inhibit renin release
D. Increase sodium reabsorption
B. Dilate the afferent arteriole
What is the correct sequence for activation of the renin-angiotensin-aldosterone system (RAAS)?
A. Renin → angiotensin I → ACE converts to angiotensin II → aldosterone release
B. ACE converts angiotensinogen → renin → angiotensin II → aldosterone release
C. Aldosterone release → renin secretion → angiotensin II formation → ACE activation
D. Renin → aldosterone release → ACE converts angiotensinogen → angiotensin II
A. Renin → angiotensin I → ACE converts to angiotensin II → aldosterone release
Angiotensin II primarily increases glomerular filtration by:
A. Dilating the efferent arteriole
B. Dilating both arterioles equally
C. Constricting the efferent arteriole
D. Constricting the afferent arteriole
C. Constricting the efferent arteriole
Angiotensin II primarily increases glomerular filtration by:
A. Dilating the efferent arteriole
B. Dilating both arterioles equally
C. Constricting the efferent arteriole
D. Constricting the afferent arteriole
C. Constricting the efferent arteriole
Which hormone increases water reabsorption in the collecting ducts back to the kidney by stimulating aquaporin production?
A. Aldosterone
B. Antidiuretic hormone (ADH)
C. Renin
D. Atrial natriuretic peptide
B. Antidiuretic hormone (ADH)
Aldosterone promotes sodium reabsorption by acting on:
A. The proximal convoluted tubule
B. The loop of Henle
C. The distal convoluted tubule
D. ENaC channels in the collecting ducts
D. ENaC channels in the collecting ducts
Increased activity of carbonic anhydrase in the collecting ducts (as a result of aldosterone) results in:
A. Enhanced bicarbonate reabsorption and production
B. Decreased pH in the urine
C. Increased secretion of potassium
D. Reduced water reabsorption
A. Enhanced bicarbonate reabsorption and production
In prerenal acute kidney injury (AKI), the blood urea nitrogen (BUN) to creatinine ratio is typically about:
A. 20:1
B. 10:1
C. 5:1
D. 30:1
A. Approximately 20:1
Which of the following best describes the urinary findings in prerenal AKI?
A. Dilute urine with high sodium content
B. Normal urine osmolality
C. Concentrated urine with high osmolality and low sodium concentration
D. Urine with numerous red blood cell casts
C. Concentrated urine with high osmolality and low sodium concentration
Acute tubular necrosis (ATN) is most notably associated with the presence of which type of urinary cast?
A. Granular casts
B. Hyaline casts
C. Fatty casts
D. “Waxy brown” casts
D. “Waxy brown” casts
The nephrotoxic type of ATN is commonly caused by which of the following agents?
A. Hypotension
B. Aminoglycoside antibiotics
C. Autoimmune injury
D. Urinary obstruction
B. Aminoglycoside antibiotics
White blood cell (WBC) casts in the urine are most indicative of:
A. Glomerulonephritis
B. Pyelonephritis
C. Nephrotic syndrome
D. Renal papillary necrosis
B. Pyelonephritis
Allergic interstitial nephritis is classically associated with:
A. Hematuria and hypertension
B. Oliguria without systemic symptoms
C. Fever, rash, hematuria, and eosinophilia following a new drug exposure
D. Severe flank pain with kidney stones following pollen exposure
C. Fever, rash, and eosinophilia following a new drug exposure
NSAIDs contribute to kidney injury by:
A. Increasing renin secretion
B. Enhancing prostaglandin synthesis
C. Dilating both arterioles
D. Inhibiting prostaglandin production, leading to tubule constriction
D. Inhibiting prostaglandin production, leading to tubule constriction
Nephrosclerosis is most directly related to which condition?
A. Diabetes mellitus
B. Chronic hypertension
C. Acute glomerulonephritis
D. Urinary tract infection
B. Chronic hypertension
(doesn’t typically result in renal failure)
Chronic kidney disease (CKD) is characterized by all of the following changes except:
A. Glomerulosclerosis
B. Tubular sclerosis
C. Vascular sclerosis
D. Acute tubular dilation
D. Acute tubular dilation
Nephrotic syndrome is marked by:
A. Hematuria with RBC casts
B. Oliguria and low urine sodium
C. Heavy proteinuria, hypoalbuminemia, and edema
D. Isolated elevation of creatinine
C. Heavy proteinuria, hypoalbuminemia, and edema
In children, the most common cause of nephrotic syndrome is:
A. Focal segmental glomerulosclerosis
B. Membranous nephropathy
C. IgA nephropathy
D. Minimal-change disease
D. Minimal-change disease
Membranous nephropathy is best characterized by:
A. Mesangial proliferation
B. Subepithelial immune complex deposits
C. Crescent formation in Bowman’s space
D. IgA deposition in the mesangium
B. Subepithelial immune complex deposits
Nephritic syndrome typically presents with:
A. Massive proteinuria and edema
B. Isolated hypertension
C. Hematuria with RBC casts and mild proteinuria
D. Hyperlipidemia and fatty casts
C. Hematuria with RBC casts and mild proteinuria
Alport syndrome is due to mutations in genes encoding which of the following, and is associated with:
A. Type I collagen; blue sclerae
B. Type III collagen; joint hypermobility
C. Type II collagen; early osteoarthritis
D. Type IV collagen; sensorineural hearing loss and ocular abnormalities
D. Type IV collagen; sensorineural hearing loss and ocular abnormalities
Bronchiectasis is best described as:
A. Reversible airway narrowing due to smooth muscle spasm
B. Diffuse alveolar damage leading to fibrosis
C. A transient increase in airway resistance during infections
D. Irreversible dilation of the bronchi due to chronic infection and inflammation
D. Irreversible dilation of the bronchi due to chronic infection and inflammation
Idiopathic pulmonary fibrosis, which looks like honeycombing on CT scans, affects what function of the lungs?
Surfactant
What condition that leads to restrictive disease may be linked to GERD and loss of telomerase and cell senescence?
Idiopathic Pulmonary Fibrosis
Asbestosis increases the risk of developing which malignancy?
A. Adenocarcinoma of the lung
B. Small-cell carcinoma
C. Squamous cell carcinoma
D. Mesothelioma
D. Mesothelioma
Which type of lung cancer is most notably associated with paraneoplastic syndromes such as SIADH or Cushing’s?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Large-cell carcinoma
D. Small-cell carcinoma
D. Small-cell carcinoma
- Which heart valve is most commonly affected by calcific stenosis in the elderly?
A) Mitral valve
B) Tricuspid valve
C) Aortic valve
D) Pulmonic valve
D) Pulmonic valve
What is the leading cause of death in the United States related to heart disease?**
A) Valvular heart disease
B) Congenital heart disease
C) Ischemic heart disease
D) Cardiomyopathy
C) Ischemic heart disease
9. Eisenmenger syndrome is associated with:
A) Small ASDs that close spontaneously
B) Long-standing large left-to-right shunts that reverse
C) Right ventricular failure without pulmonary hypertension
D) Valve stenosis with calcification
B) Long-standing large left-to-right shunts that reverse
What is the mortality rate for untreated calcific aortic stenosis within 2 years?**
A) 10%
B) 25%
C) 50%
D) 75%
C) 50%
Which type of cardiomyopathy accounts for about 90% of all cases?
A) Dilated cardiomyopathy
B) Hypertrophic cardiomyopathy
C) Restrictive cardiomyopathy
D) Arrhythmogenic cardiomyopathy
A) Dilated cardiomyopathy
In hypertrophic cardiomyopathy, what is the primary genetic defect?
A) Mutations in cytoskeletal proteins
B) Mutations in sarcomere proteins
C) Mutations in ion channel proteins
D) Mutations in membrane proteins
B) Mutations in sarcomere proteins
What is the most common primary cardiac tumor?
A) Fibroma
B) Myxoma
C) Rhabdomyoma
D) Angiosarcoma
B) Myxoma
What is the mechanism by which a large VSD can lead to Eisenmenger syndrome?
A) Direct shunting of deoxygenated blood to the systemic circulation
B) Development of pulmonary hypertension that reverses shunt flow
C) Progressive calcification of the ventricular septum
D) Decreased right ventricular function
B) Development of pulmonary hypertension that reverses shunt flow
In coarctation of the aorta, which presentation tends to be more symptomatic early in life?
A) Preductal (infantile)
B) Postductal (adult)
C) Both are equally symptomatic
D) Neither is symptomatic
A) Preductal (infantile)
What is the typical heart murmur associated with patent ductus arteriosus?
A) Harsh systolic murmur
B) Mid-diastolic rumble
C) “Machinery-like” murmur heard in both systole and diastole
D) Soft ejection murmur
C) “Machinery-like” murmur heard in both systole and diastole
Which condition is characterized by abnormal relaxation of the ventricular muscle, leading to inadequate filling?
A) Systolic dysfunction
B) Diastolic dysfunction
C) Valvular stenosis
D) Pericardial effusion
B) Diastolic dysfunction
