extras Session 5-8

Question 1

Which hormone acts directly at the CD to increase expression of ENaC and causes an increase in renal excretion of K+and therefore hypokalemia

Answer 1

Aldosterone

increased ENAC and ROMK, increases renal K+ excretion

Question 2

Features of Trimethoprim

Answer 2

Competitive inhibitor of ENAC

Causes drug induced hyperkalaemia

Question 3

What do thiazides do

Answer 3

Inhibit Na-Cl symporter in DCT, increased ENAC, increase Na/K exchange, K loss

Question 4

What effect does sweating have on osmolarity and volume of plasma

Answer 4

Osmolarity increased, volume decreased

Sweat is hypoosmotic, lots of water and few salts

Question 5

What fluids would you give to an 86 year old woman who is NBM

Answer 5

1 litre 0.18% sodium chloride, 4% dextrose over 12 hours

Or

500ml 0.18% sodium chloride, 4% dextrose over 12 hours

Don’t want to overload too quickly as old, needs dextrose as NBM

Question 6

What do alpha cells do at late DCT and CD

Answer 6

Alpha intercalated cells usually secrete H+ ions

Question 7

Management of a patient with severe sepsis following a perforated appendix and hyperkalaemia

Answer 7

Haemofiltration

Less cardiovascular strain than haemodialysis, better for haemodynamically unstable patients

Question 8

Old man is tired and has enlarged prostate. Most likely renal abnormality?

Answer 8

Cortical atrophy

prostatic hyperplasia, obstructive uropathy, bilateral hydronephrosis, cortical atrophy, chronic renal failure

Question 9

Screening for early kidney disease using albumin-creatinine ratio is most important in who

Answer 9

Patients with diabetes- early sign of damage

Question 10

How does PTH affect the kidneys handling of phosphate

Answer 10

Decreases phosphate reabsorption in the PCT

Question 11

What does PTH do overall

Answer 11

Increase Ca2+ reabsorption,
Increase bone resorption,
Increase vitamin D activation
Decrease phosphate reabsorption in the PCT

Question 12

Which hormone is responsible for short term regulation of serum calcium

Answer 12

Parathyroid hormone

Question 13

Short and long term regulation of calcium

Answer 13

Calcitriol = long term

PTH - short term

Question 14

5 year old boy has nephrotic syndrome, what is most likely cause

Answer 14

Minimal change diseae

Question 15

Which urinalysis is most likely to be found in someone with minimal change disease

Answer 15

Proteinuria/Albuminuria

Nephrotic syndrome

Question 16

Normal bladder capacity

Answer 16

400-500ml

Question 17

Fill in the table

Answer 17