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[OS 206] 3rd Exam > OS 206 E3 Samplex 2012 > Flashcards

OS 206 E3 Samplex 2012 Flashcards

1
Q

What is true about body fluid physiology?

a. plasma Na is greater than interstitial fluid
b. anions and cations are equal in ICF and ECF
c. proteins are greater in plasma
d. B and C
e. AOTA

A

E

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2
Q

Administration of 1L isotonic solution will

a. inc. ECF omolality
b. inc. ECF volume
c. shift 2/3 of volume into ICF
d. AOTA

A

B

Addition of isotonic solution will NOT change the
osmolality of ICF and ECF. It will only increase the volume of the ECF.

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3
Q

Osmoregulators in the hypothalamus stimulate ADH secretion when:

a. there is at least 1% increase in plasma osmolality
b. increase in BUN in kidney failure patients
c. 5-10% increase in blood volume
d. AOTA

A

A

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4
Q

With regards to the the thirst mechanism, all of the
following are true EXCEPT:

a. osmoreceptors are the same that subserve ADH
b. 2-3% increase in osmolality stimulates thirst mechanism
c. decrease of 10-15% in plasma volume stimulates thirst
d. NOTA

A

A

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5
Q

A patient with generalized edema would have inc. fluid volume in:

a. plasma volume
b. interstitial space
c. intracellular component
d. AOTA

A

B

In edema, fluid leaks from the capillaries to the interstitial compartment. Therefore, there is increased interstitial volume and dec. plasma volume.

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6
Q

If GFR is 125 ml, glucose is not seen in the urine until plasma concentration exceeds:

a. 100 mg/dl
b. 200 mg/dl
c. 300 mg/dl
d. 400 mg/dl

A

C

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7
Q

The concentration of plasma substance above which the substance appears in the urine.

a. transport maxima
b. renal threshold
c. renal clearance
d. fractional secretion of glucose

A

B

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8
Q

Mutation of which transporter causes Gitelman’s
syndrome?

a. Na-H antiporter
b. Na-Cl symporter
c. Na-K-2Cl cotransporter
d. Na-Ca antiporter

A

B

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9
Q

True of cortical collecting duct:

a. principal cells absorb Na and H2O and secretes K+
b. intercalated cells secretes H+ and K+
c. determines the final concentration of urine
d. AOTA

A

D

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10
Q

True of angiotensin II, EXCEPT:

a. stimulates secretion of aldosterone
b. promotes constriction of the efferent arteriole
c. inhibits release of ADH
d. promotes Na+ reabsorption

A

C

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11
Q

What is the effect of aldosterone that increases K+
secretion?

a. stimulate Na-K ATPase
b. inc. permeability at luminal surface
c. BOTA
d. NOTA

A

C

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12
Q

PTH decreases the activity of the Na+-H+ antiport system.

What is the effect on proximal reabsorption of bicarbonate:

A. increase
B. decrease
C. no change

A

B

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13
Q

PTH decreases the activity of the Na+-H+ antiport system.

What is the effect on proximal reabsorption of chloride:

A. increase
B. decrease
C. no change

A

B

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14
Q

PTH decreases the activity of the Na+-H+ antiport system.

What is the effect on proximal reabsorption of water:

A. increase
B. decrease
C. no change

A

B

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15
Q

What is the effect of drinking 1.5L of water on volume of ICF?

a. increase
b. decrease
c. no change

A

A

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16
Q

The most important hormone that shifts K+ into cells after ingestion of K+ in a meal is:

a. aldosterone
b. insulin
c. epinephrine
d. ADH

A

B

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17
Q

Which of the ff will decrease ECF K+ concentration?

a. metabolic acidosis
b. inc. ECF osmolality
c. B2 receptor stimulation
d. exercise

A

C

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18
Q

Which of the ff. segments can either secrete or
reabsorb potassium?

a. proximal tubule and loop of Henle
b. PT and DT
c. LH and DT
d. DT and collecting tubule

A

D

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19
Q

The above segment of the nephron:

a. K+ transport into cell across basolateral membrane occurs through Na-K ATPase
b. K+ secretion into tubular fluid occurs in intercalated cells
c. K+ movement across apical membrane is via Na-K antiport mechanism
d. K+ secretion occurs against electrochemical gradient

A

A

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20
Q

Calcium plays a major role in:

a. bone resorption
b. muscle contraction
c. neurotransmitter release
d. blood coagulation
e. AOTA

A

E

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21
Q

The collecting duct in the distal nephron is:

  1. relatively impermeable to water, urea, NaCl
  2. permeable to water resulting to high volume, hypoosmotic urine in the presence of ADH
  3. impermeable to NaCl and provides effective osmotic gradient between tubular fluid and interstitium
  4. involved in addition of AQPN2 in the apical side in the presence of aldosterone
A. 1,2,3
B. 1,3
C. 2,4
D. 4
E. 1,2,3,4
A

B

22
Q

Substance x increases renal blood flow but only
slightly increases GFR. Mechanism of substance x is:

A. dilate afferent arteriole
B. dilate efferent arteriole
C. dilate afferent and efferent arteriole
D. dilate afferent and constrict efferent arteriole

A

C

23
Q 
Best kidney function test to know the differential
function of the kidney is the

A. creatinine clearance
B. renal nuclear imaging
C. inulin clearance
D. serum creatinine levels

A

C

24
Q

A med resident wants to adjust the dosage of the drug that is primarily excreted by the kidney. He will utilize this test to estimate the kidney function of his patient

A. plasma creatinine
B. creatinine clearance
C. nuclear GFR
D. cockroft- gault formula

A

B

25
Q

Why is creatinine not the ideal substance for measuring GFR?
A. a steady state concentration of creatinine in the plasma cannot be acheived
B. the plasma concentration of creatinine is affected by muscle mass
C. creatinine is secreted by the tubule
D. 20% of creatinine is bound to albumin

A

C

26
Q

Most important determinant of the plasma ultrafiltrate is

A. Kf
B. hydraulic pressure of bowman’s space
C. hydraulic pressure of glomerular capillary
D. plasma oncotic pressure

A

A

27
Q

Which of the ff offers the greatest resistance to the
passage of plasma along the glomerulus?

A. endothelium
B. basement membrane
C. epithelial cells
D. mesangium

A

B

28
Q

What is true about the glomerular filtrate

A. protein free
B. same with urine
C. content are not used by the body
D. NOTA

A

A

29
Q

The ff can affect the Kf except

A. surface area of the glomerular membrane
B. permeability of the glomerular membrane
C. hydrostatic pressure of the bowman’s capsule
D. contraction of the mesangial cell

A

D

30
Q

Which of the ff is involved in the autoregulation of GFR?

A. automatic constriction of the afferent arteriole
when it is stretched
B. inc delivery of Na and Cl to the macula densa cause vasodilation of aff arteriole
C. sympathetically induced vaso constriction of aff
arteriole
D. vasoactive substances released from the renal nerves cause aff arteriole vasoconstriction

A

A

31
Q

Which produces least filtration fraction?

A. dilation of the afferent arteriole
B. dilation of efferent arteriole
C. constriction of afferent arteriole
D. constriction of efferent arteriole

A

D

32
Q

A 26year old male weighing 60kg is being medically evaluated prior to acceptance in a nephrology fellowship training program. He is noted to be hypertensive, slightly pale with proteinuria by dipstick method. Creatinine is 4mg/dl 24hr urine collection shows a urine volume of 1000ml, protein of 4.5gms and urine creatinine of 120mg/dl
What is the creatinine clearance?

A. 10ml/min
B. 20ml/min
C. 30ml/min
D. 40ml/min

A

B

33
Q

Compliance in the urinary bladder means being able to maintain _______ pressure in the bladder despite _______ in volume

A. high, decrease
B. high, increase
C. low, increase
D. low, decrease

A

C

34
Q

This is the only peripheral nerve involved in the
micturition cycle which is under somatic control

A. pelvic
B. hypogastric
C. pudendal
D. obturator

A

C

35
Q

Your cortex would increase in sending inhibitory
impulse to the pons in this situation

A. you’re ready to initiate voiding
B. your bladder is full but you are still in line for an
empty toilet
C. you are halfway in emptying your bladder
D. your bladder is filled with 100cc of urine

A

B

36
Q

The ff. causes hyposthenuria (Excretion of urine of
low specific gravity due to an inability of the tubules of the kidneys to produce concentrated urine)

A. mannitol
B. penicillin
C. detergents
D. furosemide

A

D

37
Q

The sensation of bladder fullness is dependent on
signals coming from

A. pelvic nerve
B. hypogastric nerve
C. vesical nerve
D. pudendal nerve

A

A

38
Q

The outline of the renal shadows are visible on a
plane film of the abdomen because of the:

a. Low density of perirenal fat
b. Uptake of contrast by the kidneys
c. Low soft density of the tissues of the psoas
d. Presence of surrounding bowel gas

A

A

39
Q

All may be found in a pyelogram of a kidney with
hydronephrosis except:

a. flattening of the concavity of the calyx
b. reversal of convexity of renal papilla
c. atrophy of the renal pelvis
d. enlarged calyx

A

C

40
Q

Which statement does not describe the perirenal
fascia?

a. it encloses the perirenal fat
b. it is also known as Gerota’s fascia
c. it anchors the kidney to its surrounding structures and to the abdominal wall.
d. It is the innermost of the 3 tissue layers that surround the kidney

A

D

41
Q

Which cells are sensitive to sodium
concentration?

a. Bowman’s Capsule
b. Juxtaglomerular cells
c. Macula densa
d. Lacis cells
e. Principal cells

A

C

42
Q

True of the proximal convoluted tubule.

a. Located in the cortex and medulla of the renal lobule
b. Reabsorbs most of the filtrate using osmotic gradient.
c. Generates the osmotic gradient within the medullary insterstitium
d. Distinguished from the DCT by its brush border.
e. All of the above

A

D

43
Q

True of the loop of Henle:

a. thin descending limb is permeable to water while thin ascending limb is impermeable to water
b. affected by aldosterone secretion
c. creates an osmotic gradient in the renal columns
d. reabsorbs substance from the urine filtrate into the blood
e. all of the above

A

E

44
Q

Fluid & solutes from the proximal and distal
convoluted tubules are taken back into the
circulation by which of the following:

a. vasa recta
b. podocytes
c. collecting duct
d. peritubular arteries
e. arcuate arteries

A

D

45
Q

Glomerular cells that has phagocytic properties:

a. mesangial
b. podocytes
c. endothelial
d. epithelial

A

A

46
Q

True of the uriniferous tubules

a. composed of cortical nephrons, collecting tubules and collecting ducts
b. with glomerular and cortical nephrons
c. functional unit of the kidney
d. different permeability of tubules to water and solutes
e. all of the above

A

E

47
Q

In a Rugby game, someone was injured. It was
found that there was laceration in right lateral
border of kidney. Which zone would you expect
to draw primary blood sample?

a. zone 1
b. zone II
c. zone III
d. zone IV
e. timezone

A

B

48
Q

A 2mm radioopaque kidney stone migrated from
the major calyx down the renal pelvis and ureter.
If this stone will not be able to make its way into
the bladder, this will be expected to be seen,
radiologically at w/c level?

a. at the junction of renal pelvis and ureter
b. at the L2 level
c. at the area where ureter enters the
bladder
d. at the level of bifurcation of the aorta
e. at the level of common iliac vessels

A

C

49
Q

This statement is true for the kidneys:

a. it is located in zone I of the retroperitoneum
b. its lateral border is almost in the same vertical plane as the vertebral column
c. it has an average size of 10x5x2.5 cm with equal corticomedullary thickness on ultrasound.
d. Its immediate covering after the fibrous capsule is the renal or Gerota’s Fascia
e. Its position becomes fixed only after it has migrated to the posterior abdominal wall.

A

C

50
Q

What are abnormal radiologic ultrasound
findings?

a. clubbing of calyx
b. size of R & L not the same
c. Uteropelvic
d. Uterovesical not visualized
e. Urine left after voiding

A

A

51
Q

Which of the following is true?

a. Filtration flow: Bowman’s capsule – Proximal tubule – ascending limb of Henle’s loop – descending limb of Henle’s loop – distal tubule – collecting duct
b. Blood flow: segmental arteries – interlobar arteries – arcuate arteries – interlobular arteries – afferent arteriole – glomerular arteries – efferent arteriole – peritubular capillaries – vasa recta – interlobular, arcuate, interlobar veins
c. Tubular flow – cuboidal walls of brushborder – squamous cells – cuboidal cells without brushborder – stratified columnar cells – stratified squamous cells
d. All of the above

A

B

[OS 206] 3rd Exam (6 decks)

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