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5th Committee 2nd Class > Gül > Flashcards

Gül Flashcards

1
Q

Which of the following electrolyte imbalances can develop due to hyperaldosteronism?

a) Hyponatremia
b) Hypocalcemia
c) Hypochloremia
d) Hypomagnesemia
e) Hypokalemia

A

e) Hypokalemia

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2
Q

What would tend to decrease plasma potassium concentration by causing a shift of potassium from the extracellular fluid into the cells?

a) Strenuous exercise
b) B-adrenergic blockade
c) Insulin excess
d) Aldosterone deficiency
e) Acidosis

A

c) Insulin excess

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3
Q

Which one does not stimulate renin secretion from the juxtaglomerular apparatus?

a) Decrease in arterial pressure
b) An increase in the activity of renal sympathetic nerves
c) Decreased GFR and flow to macula densa
d) Excess sweating
e) Increased NaCl delivery to macula densa

A

e) Increased NaCl delivery to macula densa

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4
Q

Which one corresponds to an increase in plasma H+ , a decrease in plasma HCO3-, and a decrease in plasma CO₂ concentration?

a) Metabolic alkalosis
b) Respiratory acidosis

C) Metabolic acidosis

d) Normal condition
e) Respiratory alkalosis

A

C) Metabolic acidosis

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5
Q

Which sentence is not correct?

a) Vasa recta has no role to maintain the medullary hypertonicity
b) Vasa recta works as a counter-current exchange system
c) The kidneys may form concentrated urine, still containing little amount of sodium chloride
d) Increased medullary blood flow may decrease the ability of the kidneys to concentrate the urine.
e) Medullary blood flow is low

A

a) Vasa recta has no role to maintain the medullary hypertonicity

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6
Q

In the examination of arterial blood gas analysis pH=7.2: plasma HCO3- 29 mmol/L: plasma pCO₂ = 75 mmHg. What is this patient’s acid-base disorder?

a) Respiratory alkalosis with renal compensation.
b) Respiratory acidosis with partial renal compensation
c) Acute metabolic acidosis without respiratory compensation
d) Metabolic acidosis with partial respiratory compensation
e) Acute respiratory acidosis without renal compensation.

A

b) Respiratory acidosis with partial renal compensation

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7
Q

Which one does not cause prerenal acute renal injury?

a) Myocardial infarction
b) Thrombosis of renal artery or vein

C) Anaphylactic shock

d) Hemorrhage
e) Acute glomerulonephritis

A

e) Acute glomerulonephritis

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8
Q

In an adult with a regular diet, in which part of the tubules the potassium is absorbed most?

a) Proximal convoluted tubule
b) Assending loop of Henle
c) Distal tubule
d) Medullary collecting duct
e) Descending loop of Henle

A

a) Proximal convoluted tubule

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9
Q

Which of the following statements inhibits growth hormone secretion?

a) Exercising
b) Testosterone
c) Obesity
d) Trauma
e) Starvation

A

c) Obesity

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10
Q

Which one of the following blood-gas values is consistent with metabolic acidosis?

A) PaCO₂(mmHg): 25, HCO3 (mM): 30, pH: 7.3

B) PaCO₂ (mmHg): 35, HCO3 (mM): 20, pH: 7.3

C) PaCO₂ (mmHg): 40, HCO3(mM): 25, pH: 7.4

D) PaCO₂ (mmHg): 50, HCO3(mM): 30, pH: 7.1

E) PaCO₂ (mmHg) 60, HCO3 (mM): 20, pH: 7.1

A

B) PaCO₂ (mmHg): 35, HCO3 (mM): 20, pH: 7.3

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11
Q

Which part of the tubule is not permeable to water?

A) Proximal convoluted tubule

B) Thick ascending limb of Henle’s loop

C) Descending thin limb of Henle’s loop

D) Distal convoluted tubule

E) Medullary collecting duct

A

B) Thick ascending limb of Henle’s loop

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12
Q

Which substance is totally reabsorbed after it undergoes glomerular filtration?

A) Amino acids

B) Bicarbonate ions

C) Creatinine

D) Inulin

E) Urea

A

A) Amino acids

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13
Q

Which substance has higher concentration in uremic plasma compared with dialysis fluid?

A) Ca++

B) Creatinine

C) HCO3-

D) Glucose

E) Mg++

A

B) Creatinine

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14
Q

Some cells secrete chemicals into the extracellular fluid that act on same cells in the same tissue. Which of the following refers to this type of regulation?

A) Neural

B) Endocrine

C) Neuroendocrine

D) Paracrine

E) Autocrine

A

E) Autocrine

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15
Q

Which one does not stimulate renin secretion from the juxtaglomerular apparatus?

a) Decreased GFR and flow to macula densa
b) An increase in the activity of renal sympathetic nerves
c) Excess sweating
d) Decrease in arterial pressure
e) Increased NaCl delivery to macula densa

A

e) Increased NaCl delivery to macula densa

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16
Q

Which of the following tends to decrease potassium secretion by the cortical collecting tubule?

a) High sodium intake
b) Acute alkalosis
c) A diuretic that inhibits the action of aldosterone (e.g.. spironolactone)
d) Increased plasma potassium concentration
e) A diuretic that decreases proximal tubule sodium reabsorption

A

c) A diuretic that inhibits the action of aldosterone (e.g.. spironolactone)

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17
Q

Which one is not correct about diabetes mellitus?

A), In type 2 diabetes mellitus insulin is usually present in plasma.

B) Weight loss is not useful in the treatment of type 2 diabetes mellitus.

C) In type 1 diabetes mellitus, insulin is absent.

D) Severe untreated insulin deficiency can cause coma and death.

E) The sulfonylureas lower plasma glucose by acting on the beta cells to stimulate insulin secretion.

A

B) Weight loss is not useful in the treatment of type 2 diabetes mellitus.

18
Q

Which clearence of an endogenic substance is used in clinics to follow the kidney functions?

A) Inulin

B) Para-amino-hippurate

C) Creatinine

D) Albumin

E) Glucose

A

C) Creatinine

19
Q

Which one is the most common cause of the end

stage renal disease?

A) Polycystic kidney disease

B) Hypertrophy of prostate

C) Hypertension

D) Glomerulonephritis

E) Diabetes mellitus

A

E) Diabetes mellitus

20
Q

Which one does not cause prerenal acute renal failure?

A) Hemorrhage

B) Acute glomerulonephritis

C) Myocardial infarction

D) Anaphylactic shock

E) Thrombosis of renal artery or vein

A

B) Acute glomerulonephritis

21
Q

Which osmotic diuretic is preferred to prevent or decrease the brain edema in clinical conditions such as stroke or cranial trauma?

A) Trianterene

B) Furosemide

C) Mannitol 20%

D) Acetazolamide

E) Spironolactone

A

C) Mannitol 20%

22
Q

The concentration of which substance is higher in the dialyzing fluid compared with the blood of the patient with renal failure?

A) Urea

B) Sodium

C) Potassium

D) Bicarbonate

E) Urate

A

D) Bicarbonate

23
Q

Which one is wrong related with the control of the bladder?

A) Detrusor muscle contraction is inhibited during micturition.

B) Parasympathetic stimulation causes contraction in detrussor muscle.

C) Sympathetic stimulation causes contraction in internal urethral sphincter.

D) Internal urethral sphincter is stimulated during filling.

E) Somatic motor stimulation causes contraction in external urethral sphincter,

A

A) Detrusor muscle contraction is inhibited during micturition.

24
Q

Which one cases hypokalemia?

A) Strenuons exercise

B) Disbetes mellitus

C) Metabolic alkalosis

D) Decreased aldosterone secration

E) Renal failure

A

C) Metabolic alkalosis

25
Q

Which one regarding the ADH bormone secretion and osmolarity is not correct?

A) ADH is released from the posterior pituitary

B) ADH is synthestand in the supraoptic and paraventricular nuclei of the hypothalamus

C) When the water ingestion is decreased ADH secretin will be stimulated

D) When blood osmolarity goes down ADH secretion will be inhibited

E) Volume depletion increases the ADH secretion more than the increase in blood osmolarity

A

E) Volume depletion increases the ADH secretion more than the increase in blood osmolarity

26
Q

When the glomerular filtration rate starts to decrease for any reason, the concentration of which substance starts to increase first?

A) Creatinine

B) Urate

C) Sodium

D) Phosphate

E) Chloride

A

A) Creatinine

27
Q

Which one increases the movement of potassium from the intracellular fluid to the extracellular fluid compartment ?

A) Seremuous exercise

B) Beta-adresergic stimuli

C) Insulin

D) Aldosterone

E) Alkalosis

A

A) Seremuous exercise

28
Q

Which one is not seen in a patient with chronic renal failure?

A) Acidosis

B) Polycythemia

C) Uremia

D) Osteomalacia

E) Water retention and development of edema

A

B) Polycythemia

29
Q

What is the obligatory urine volume per day in a normal 70-kilogram human?

A) 0.25 L/day

B) 0.10 L/day

C) 1.0 L/day

D) 1.5 L/day

E) 0.5 L/day

A

E) 0.5 L/day

30
Q

Which one increases the movement of potassium from the extracellular fluid to the intracellular fluid compartiment?

A) Strenuous exercise

B) Cell lysis

C) Insulin

D) Acidosis

E) Beta-blockade

A

C) Insulin

31
Q

Which substance has higher concentration in dialysis fluid compared with uremic plasma?

A) Na+

B) Urea

C) K+

D) Creatinine

E) HCO3-

A

E) HCO3-

32
Q

Which diuretic is a loop diuretic inhibiting Na-K-CL co-transport in luminal membrane of the thick ascending loop of Henle?

A) Mannitol 20%

B) Spironolactone

C) Acetazolamide

D) Hydrochlorothiazide

E) Furosemide

A

E) Furosemide

33
Q

Which change would you expect to find in a patient who developed acute renal failure after ingesting poisonous mushrooms that caused renal tubular necrosis?

A) Increased plasma bicarbonate concentration

B) Metabolic acidosis

C) Decreased plasma potassium concentration

D) Decreased blood urea nitrogen concentration

E) Decreased hydrostatic pressure in Bowman’s cap- sule

A

B) Metabolic acidosis

34
Q

Which diuretic inhibits Na+-2CI–K+ cotransport in the loop of Henle as its primary action?

A) Thiazide diuretic

B) Furosemide

C) Carbonic anhydrase inhibitor

D) Osmotic diuretic

E) Amiloride

A

B) Furosemide

35
Q

A 26-year-old construction worker is brought to the emergency department with a change in mental status after working a 10-hour shift on a hot summer day (average outside temperature was 97°F [36°C]). The man had been sweating profusely during the day but did not drink fluids. He has a fever of 102°F [39°C], a heart rate of 140 beats/min, and a blood pressure of 100/55 mm Hg in the supine position. Upon examination, he has no perspiration, appears to have dry mucous membranes, and is poorly oriented to person, place, and time. Assuming that his kidneys were normal yesterday. which set of hormone levels describes his condition, compared with normal?

A) High ADH, high renin, low angiotensin II, low aldosterone

B) Low ADH, low renin, low angiotensin II, low aldosterone

C) High ADH, low renin, high angiotensin II, low aldosterone

D) High ADH, high renin, high angiotensin II, high aldosterone

E) Low ADH, high renin, low angiotensin II, high aldosterone

A

D) High ADH, high renin, high angiotensin II, high aldosterone

36
Q

Ezber

If a radioimmunoassay is properly conducted and the amount of radioactive hormone bound to antibody is low, what would this result indicate?

A) Plasma levels of endogenous hormone are high

B) Plasma levels of endogenous hormone are low

C) More antibody is needed

D) Less radioactive hormone is needed

A

A) Plasma levels of endogenous hormone are high

37
Q

In a person with normal kidneys and normal lungs who has chronic metabolic acidosis, you would expect to find all of the following, compared with normal, except:

A) Increased renal excretion of NH4CI

B) Decreased urine pH

C) Decreased urine HCO3excretion

D) Increased plasma HCO3 concentration

E) Decreased plasma Pco2

A

D) Increased plasma HCO3 concentration

38
Q

What would cause the greatest degree of hyperkalemia?

A) Increase in potassium intake from 60 to 180 mmol/day in a person with normal kidneys and a normal aldosterone system

B) Chronic treatment with a diuretic that inhibits the action of aldosterone

C) Decrease in sodium intake from 200 to 100 mmol/day

D) Chronic treatment with a diuretic that inhibits loop of Henle Na+-2CI–K+ co-transport

E) Chronic treatment with a diuretic that inhibits sodium reabsorption in the collecting ducts

A

B) Chronic treatment with a diuretic that inhibits the action of aldosterone

39
Q

PTH does what directly?

A) Controls the rate of 25-hydroxycholicalciferol formation

B) Controls the rate of calcium transport in the mu- cosa of the small intestine

C) Controls the rate of formation of calcium-binding protein

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

E) Stimulates renal tubular phosphate reabsorption

A

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

40
Q

PTH does what directly?

A) Controls the rate of 25-hydroxycholicalciferol formation

B) Controls the rate of calcium transport in the mu- cosa of the small intestine

C) Controls the rate of formation of calcium-binding protein

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

E) Stimulates renal tubular phosphate reabsorption

A

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

41
Q

Which change would you expect to find in a dehydrat- ed person deprived of water for 24 hours?

A) Decreased plasma renin activity

B) Decreased plasma antidiuretic hormone concentration

C) Increased plasma atrial natriuretic peptide concentration

D) Increased water permeability of the collecting duct

A

D) Increased water permeability of the collecting duct

5th Committee 2nd Class (8 decks)

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