Incorrect Q's 4/7/17

Question 1

Pyruvated dehydrogenase deficiency presents with ______.

Answer 1

Lactic acidosis and neurologic changes.

Pyruvate and alanine can’t enter TCA cycle and are accumulated.

Congenital or acquired (alcoholics)

Question 2

Pyruvate kinase is _______.

Answer 2

An enzyme in glycolytic pathway– converts PEP to pyruvate.

Deficiency= hemolysis since rbc’s depend on glycolysis to produce energy.

Question 3

PSGN IF microscopy shows _____.

Answer 3

Granular deposits of IgG, IgM and C3.

Question 4

The ureteric bud (kidney) gives rise to _____.

Answer 4

Collecting systems of kidney:

collecting tubules and ducts, major and minor calyces, renal pelvis and ureters.

Question 5

The metanephric mesoderm (blastema) (kidney) gives rise to _____.

Answer 5

Glomeruli, Bowman’s space, proximal tubules, loop of henle, distal convoluted tubules.

Question 6

In nephrotic syndrome, the plasma oncotic pressure is _______.

Answer 6

Decreased (hypoalbuminemia).

Increases net plasma filtration in capillary beds (interstitial edema).

Question 7

At what level are the mature kidneys located?

Answer 7

T12-L3.

Left lobe is higher.

Question 8

Pts with multiple sclerosis most commonly develop ______ due to loss of CNS inhibition of detrusor contraction in the bladder.

Answer 8

Urge incontinence.

As dx progresses, bladder can become atonic and dilated–> overflow incontinence.

Question 9

Chronic renal hypoperfusion can cause ______ of the juxtaglomerular apparatus?

Answer 9

Hyperplasia.

Question 10

Good rule of thumb for GFR and serum creatinine relationship?

Answer 10

Every time GFR halves, serum creatinine doubles.

Serum creatinine= most common indicator of kidney function in clinical use.

Question 11

What are the most common causes of metabolic alkalosis?

Answer 11

1. Vomiting or nasogastric suctioning
2. Thiazide or loop diuretic use
3. Mineralocorticoid excess state

1 and 2–> can cause volume and Cl- depletion.

Question 12

What can help you identify the cause of metabolic alkalosis?

Answer 12

Pt’s volume status and measuring urinary chloride concentration.

Question 13

What are the primary mediators of K+ regulation in the urine?

Answer 13

Principal (secretion with normal/excess K+) and a-intercalated (reabsorption with depletion of K+) cells of the late distal and cortical collecting tubules.

Question 14

Where in the kidney does ADH act?

Answer 14

Medullary segment of the collecting duct.

Question 15

What does ADH do in the kidney?

Answer 15

Increases urea and water reabsorption–> production of max. concentrated urine.

Question 16

Pt w membranous nephropathy, flank pain, hematuria and left varicocele?

Answer 16

Renal vein thrombosis as a result of nephrotic syndrome.

Question 17

Nephrotic syndrome is a ____ state.

Answer 17

Hypercoagulable.

Loss of anticoagulant factors, esp. antithrombin III, is responsible for thrombotic and thromboembolic complications of nephrotic syndrome.

Question 18

Foscarnet has what impact on the kidney?

Answer 18

Promotes nephrotoxic renal magnesium wasting.

Analog of pyrophosphate–> chelates Ca2+. Toxicities can give hypocalcemia and hypomagnesemia–> seizures.

Question 19

Acyclovir causes _____.

Answer 19

Crystalline nephropathy (if adequate hydration isn’t provided).

Question 20

When do you usually see decreased serum C3/C4 levels?

Answer 20

Dxs w prominent immune complex formation (ie: PSGN, SLE, membranoproliferative glomerulonephritis).

Question 21

Which kidney dx has prominent fibrin deposition?

Answer 21

Rapidly progressive glomerulonephritis.