Prodigy- Renal Flashcards
At what serum concentration does glucose spill into the urine?
> 200
___% of water reabsorption occurs in the proximal tubule
65%
+ glucose, Nacl, hydrogen, K, vitamins
Where does ANP work
in the distal tubules and collecting ducts to decrease the reabsorption of water
Hypovolemia will cause the BUN/crt ratio to become increased or decreased
increased
Most of the glucose in urinary filtrate is reabsorbed by what part of the nephron? A. Proximal tubule B. Late distal tubule C. Loop of Henle D. Glomerulus
A
Renin works to increase systemic blood pressure by increasing the serum concentration of A. epinephrine B. dopamine C. norepinephrine D. angiotensin I
D
The primary function of vitamin D is
A. activation of melanin in the skin
B. increasing the absorption of calcium in the ileum
C. blocking the metabolic actions of thyroid hormone
D. increasing the urinary excretion of magnesium
B
Through what range of mean arterial pressures is renal blood flow autoregulated? A. 90-190 mmHg B. 50-180 mmHg C. 50-90 mmHg D. 40-140 mmHg
B
The renal artery, renal vein, and ureters enter the kidney at the A. hilus B. cortex C. medulla D. pyramid
A
Which event would occur as part of normal renal blood flow regulation if the blood pressure decreases?
A. The efferent arteriole dilates
B. The afferent arteriole constricts
C. The juxtaglomerular apparatus secretes renin
D. The renal artery constricts
C
The arterioles that surround the loop of Henle are known as the A. afferent arterioles B. peritubular capillaries C. efferent arterioles D. vasa recta
D
The final step in the activation of vitamin D occurs in the A. liver B. kidneys C. thymus D. brain
B
What is the correct sequence of vessels as they enter and pass through the renal circulation?
A. Interlobar artery, lobar artery, arcuate artery, interlobular artery
B. Interlobular artery, interlobar artery, lobar artery, arcuate artery
C. Lobar artery, arcuate artery, interlobar artery, interlobular artery
D. Lobar artery, interlobar artery, arcuate artery, interlobular artery
D
What cells in the nephron are responsible for secreting bicarbonate and reabsorbing hydrogen ions in states of alkalosis? A. Type A intercalated cells B. Type B intercalated cells C. Juxtaglomerular cells D. Vasopressin cells
B
Complete the statement. \_\_\_\_\_\_\_\_\_\_ is a product of phosphocreatine breakdown in muscle and is normally completely filtered by the kidneys. A. Urea B. Glucose C. Creatinine D. Myoglobin
C
Which of the following is an effect of angiotensin II?
A. Arteriolar constriction
B. Inhibition of aldosterone release
C. Blockade of the sodium-potassium-ATPase pumps in the loop of Henle
D. Increased sodium excretion in the urine
A
What’s important to know about Dig and lasix together
hypokalemia caused by lasix can lead to toxic levels of dig
How do loop diuretics affect NMB?
potentiates it (hypokalemic, weak muscles, prolonged effects of nmb)
Thiazide diuretics exert there effects in the (early/late) distal convoluted tubule
early
Which diuretic class can produce vasodilation?
thiazides
Dose, peak and duration of demopressin
0.3mcg/kg SQ or IV
peak 2-4 hours
duration 6-8 hours
The hallmark signs of DI are a urine SG < _____ and urine os < ______
urine SG < 1.005
urine os < 200 mOsm/kg
which oral hypoglycemic agent increases ADH levels
chlorpropamide
SIADH is expressed as elevated ______ levels
vasopressin (ADH)
3 hallmark signs of SIADH
- hyponatremia
- high urine osmolality
- low serum os
is DI or SIADH treated with fluid restriction
SIADH (internally drowning)
Someone has repeat kidney stones… what should you be thinking as potential illnesses that could be causing it (3)
- hyperparathyroidism
- sarcoidosis
- cancer
(all can elevate calcium levels)
T/F- even if the SBP is maintained above 90mmHg, anesthetics can still produce a 30-40% decrease in renal blood flow
true
When placing an epidural for lithotripsy (who fucking does that?), you should use a fluid-filled or air-fileld syringe for loss of resistance
fluid-filled
Which of the following is a cause of intrinsic acute kidney injury (AKI)? A. Acute interstitial nephritis B. Urethral obstruction C. Increased intra-abdominal pressure D. Systemic vasodilation
A
The pharmacokinetics of which anesthetic agent would most likely be affected in a patient taking loop diuretics? A. Rocuronium B. Sevoflurane C. Ketamine D. Propofol
A
Which diuretics enhance the reabsorption of calcium in the distal tubule and can potentially result in hypercalcemia? A. Osmotic diuretics B. Loop diuretics C. Carbonic anhydrase inhibitors D. Thiazides
D
Which of the following is one of the hallmark manifestations of the syndrome of inappropriate antidiuretic hormone secretion (SIADH)?
A. Decreased serum osmolality
B. Urine that is hypotonic relative to the plasma
C. Hypernatremia
D. High urine output
A
The cardiovascular side effects of chronic kidney disease are primarily the result of A. hyperkalemia B. hypercalcemia C. hypophosphatemia D. sodium retention and hypervolemia
D
You are performing a general anesthetic for a patient undergoing a transurethral resection of prostate. The entire surgery takes 75 minutes, and the prostate resection takes about 25 minutes. What is the estimated amount of irrigation fluid absorbed during the procedure? A. 250 mL B. 500 mL C. 1000 mL D. 1500 mL
B (20mls/min x 25 min)
Which of the following is a common complication of peritoneal dialysis? A. Bleeding from heparinization B. Hypotension C. Hyperglycemia D. Arteriovenous graft infection
C
Which intervention has the highest incidence of acute kidney injury (AKI)? A. Lithotripsy B. Thoracic aortic surgery C. Cystoscopy D. Cardiopulmonary bypass
B
What is the most appropriate agent for treating central diabetes insipidus intraoperatively? A. Desmopressin B. Furosemide C. Acetazolamide D. Aldactone
A
The pharmacokinetics of which agent are least affected by chronic kidney disease? A. Midazolam B. Lorazepam C. Propofol D. Dexmedetomidine
C
Which of the following agents is a loop diuretic? A. hydrochlorothiazide B. acetazolamide C. indapamide D. bumetanide
D (bumex)
A patient undergoing a TURP begins to exhibit widening of the QRS complex and ST segment elevation on the electrocardiogram. Based on this evidence, you would estimate the serum sodium to be A. 110 mEq/L B. 115 mEq/L C. 100 mEq/L D. 120 mEq/L
not A….
What is the least common cause of acute kidney injury (AKI)? A. Prerenal AKI B. Intrinsic AKI C. Postrenal AKI D. Hypovolemic AKI
not B
-probably C
indapamide is A. loop diuretics B. thiazide diuretics C. carbonic anhydrase inhibitors D. osmotic diuretics
B
A patient with chronic renal disease exhibits a widened QRS and peaked T waves on the ECG. What is the most likely cause? A. hypophosphatemia B. hyperkalemia C. hypokalemia D. hypermagnesemia
B
Where in the nephron do thiazide diuretics work? A. The early distal tubule B. The cortical collecting duct C. The late distal tubule D. The proximal convoluted tubule
A
The pharmacokinetics of which anesthesia drug class are most likely to be altered in a patient with chronic kidney disease? A. Intravenous induction agents B. Volatile anesthetics C. Steroidal neuromuscular relaxants D. Benzodiazepines
C
Where in the nephron do potassium-sparing diuretics such as spironolactone work?
A. Thin, descending segment of the loop of Henle
B. Late distal tubule
C. Thick, ascending segment of the loop of Henle
D. Proximal convoluted tubule
B
