Nphro - AdptKI

Question 1

This hypothesis states that reduction in the number of nephrons results in glomerular hypertension, hyperfiltration, and enlargement of glomeruli

Answer 1

Brenner Hyperfiltration Hypothesis

Question 2

True about Brenner Hyperfiltration Hypothesis

a. reduction in nephrons results in glomerular hypotension, and enlargement of glomeruli
b. injury to glomeruli will give positive feedback resulting in hyperfiltration
c. both
d. neither

Answer 2

B

Question 3

The following will experience Hyperfiltration except

a. low birth weight infants
b. CKD
c. CAKUT
d. Obese
e. AOTA

Answer 3

E

Question 4

What is the most important prenatal environmental factor responsible for reduced nephron number in the fetus?

Answer 4

growth restriction within the uterus

Question 5

Drugs that inhibit nephrogenesis (5)

Answer 5

DAANG
Dexamethasone
ACEi
ARBs
NSAIDs
Gentamicin

Question 6

part of kidney most susceptible to hypoxia

a. inner medulla
b. outer medulla
c. cortex

Answer 6

B

Question 7

What is acute renal success according to Thurau

Answer 7

reduction in glomerular filtration as an adaptive response to hypoxia to reduce the “work” reqt for reabsorption of solutes by the tubule

Question 8

True about adaptive response to kidney injury

a. in acute hypoxic kidney injury there is increase in sodium excretion
b. in chronic hypoxia of the kidneys, there is decreased sodium excretion
c. adaptive response to kidney injury is achieved via TGF
d. AOTA

Answer 8

C;
not increased natriuresis in acute hypoxia
increased natriuresis in chronic hypoxia

Question 9

Gene activated by hypoxia that distal effectors of the pathway are involved in energy metabolism, angiogenesis and apoptosis

Answer 9

HIF alpha

hypoxia inducible factor alpha accumulates because of inhibition of HIF prolyl hydroxylase which normally promote degradation of HIF alpha.

HIF alpha dimerizes with HIG1 beta and the dimer moves to the nucleus where it upregulates the said effectors

Question 10

Inhibitor of HIF alpha

Answer 10

HIF prolyl hydroxylase

Question 11

Relationship between nephron number and hypertension in adults

Answer 11

inverse, lower nephron number, higher BP

Question 12

this was defined by Hinman in 1923 as attempt on the part of the less injured or uninjured portion of the kidney to take over the work of the more injured portion

Answer 12

Renal counterbalance

Question 13

2 types of renal reserve according to Hinman

Answer 13

Natural

Acquired

Question 14

Growth compensation due to overstiumulation

Answer 14

Acquired renal reserve

Question 15

if a kidney is injured by ischemia, and the other kidney is removed before the post ischemic kidney becomes severely atrophied, what would happen to the postischemic kidney?

Answer 15

hypertrophy

Question 16

The following statements are true

a. nephrons of mammals regenerate and hypertrophy in response to acute injury
b. hyperfiltration of remaining kidney is related to increase in RBF in post nephrectomy of a donor.
c. increase in RBF is secondary to dilatation of efferent arteriole
d. arteriole dilate in response to NO.

Answer 16

B and D

a. do not regenerate, only hypertrophy
c. afferent arteriole

Question 17

True of increased RBF and hyperfiltration

a. incrased wall tension and force is counteracted by contractile properties of endothelium and elastic properties of GBM
b. podocytes adapt by increasing cell adhesion
c. both
d. neither

Answer 17

C

Question 18

With decrease in the number of functioning nephrons, each remaining nephron has to adapat to carry a larger burden of transport, synthetic function, and regulatory function. What hypothesis is this?

Answer 18

Intact nephron hypothesis

Question 19

True of potassium balance in CKD EXCEPT

a. in CKD, patient has to be protected from lethal hyperkalemia
b. hyperkalemia could be adaptive
c. CKD patients can excrete potassium, but requires higher serum potassium to do so
d. effect of hyperkalemia on potassium excretion is influenced by aldosterone

Answer 19

D

Question 20

True statement

a. in CKD, the excretion of dietary load of potassium occurs at the expense of an elevation in serum potassium concentrations
b. hyperkalemia upregulate aldosterone
c. aldosterone affect basolateral NaKAtpase of the collecting duct
d. aldosterone affect increase the number of apical Na channels of the collecting duct
e. AOTA

Answer 20

E

Question 21

activation by the organism of intrinsic defense mechanisms to cope with pathologic conditions

Answer 21

preconditioning

Question 22

what is ischemic preconditioning?

Answer 22

prior ischemic insult renders organ resistant to subsequent ischemic result

Question 23

main difference in normal TGF vs. CKD TGF in terms of sodium balance with high sodium intake

Answer 23

in normal TGF, high sodium intake causes negative feedback. High sodium conc to distal delivery reduces GFR, however in CKD, this becomes positive feedback, therefore increasing GFR, in turn increases sodium filtration; triggered by adonesine-dominated vasoconstrictive feedback

Question 24

Adpatation in terms of acid base homeostasis in the setting of reduced renal functional mass (3)

Answer 24

increased hydrogen secretion

Question 25

how does the body compensate when there’s decreased renal 1,25 hydroxy vtD and decreased phosphate secretion?

Answer 25

increase PTH and FGF 23