Questions Flashcards
Inulin and substance X was found in kidney. Ratio of inulin to X was 2:1 intially in the early tubule of the kidney but after which in later portions of the kidney the ratio became 1:1
a. substance X is secreted
b. inulin is reabsorbed
c. X is reabsorbed
d. inulin is secreted
A. Inulin remains unchanged in the nephron
Which of the following is NOT a morphological feature characteristic of acute tubular necrosis?
A) Dilated tubules
B) Infarction of renal parenchyma
C) cell swelling
D) edema (of the interstitium?)
E) vacuolation
B
Which of the following is NOT a clinical/laboratory finding of acute pyelonephritis?
A) Fever
B) Flank pain
C) Nephrotic-range proteinuria
D) Increased
C
Sodium reabsorption in the proximal tubule is
A) Regulated by aldosterone
B) By secondary transport
C) By renal perfusion
D) Increases when plasma Na+ concentration in the peritubular capillaries is high
B. Na+ is reabsorbed, cotransporting glucose, amino acids and organic anions e.g. phosphate and citrate, by secondary active transporters, with the concentration gradient created by the Na+/K+ ATPase at the basolateral side.
Which of the following happens when you infuse isotonic dextrose (glucose in saline)
C) Increase BP as effectively as infusing the equal volume of isotonic saline
D) It expands intracellular compartment more than extracellular compartment after several hours
E) Increased reabsorption in venous end of systemic capillary
C. Assume the question means glucose in isotonic saline: after infusion, glucose will be taken into the cells, increasing the osmolarity of the intracellular compartment, and fluid will enter the intracellular compartment, expanding it - the extent to which depends on the concentration of glucose. After some time, the glucose will be metabolised and the osmolarity of the intracellular compartment will return to what it was before, and water will leave the intracellular compartment, so the effects of the infusion will effectively be the same as the infusion of an equal volume of isotonic saline.
Carbonic anhydrase inhibitors may
A) Increase bicarbonate reclamation by the proximal tubule
B) Decrease H2O reabsorption by the proximal tubule
C) Increase alkaline tide
D) Increase CO2 carrying capacity of red blood cells
E) Treat metabolic alkalosis
E. In the proximal convoluted tubule, the Na+/H+ exchanger (NHE) transports H+ from the proximal tubule cell into the tubule lumen using the Na+ gradient from the tubule lumen into the proximal tubule cell. H+ in the tubule lumen then reacts with HCO3- to form H2CO3. Carbonic anhydrase in the tubule lumen catalyses the reaction H2CO3 -> H2O + CO2, and CO2 diffuses into the proximal tubule cell, where it reacts with water in the reaction catalysed by carbonic anhydrase to give H2CO3, which dissociates to form H+ which is secreted and HCO3- which is transported into the interstitial fluid by the HCO3-/Cl- exchanger. Inhibition of carbonic anhydrase will thus reduce H+ excretion and HCO3- reclamation, which treats metabolic alkalosis.
Segmental arteries to the kidneys:
a. originate from the aorta
b. supply the suprarenal glands
c. have poor anastomosis
d. supply only the renal cortex
e. are usually 3 in number
(C) Have poor anastomosis
The renal artery divides closer to the hilum of the kidney into 5 segmental arteries: apical segmental artery, anterior superior segmental artery, anterior inferior segmental artery, inferior segmental artery and posterior segmental artery. These arteries do not anastomose significantly with each other, so the area supplied by each segmental artery is an independent, resectable unit.
this muscle is innervated by the femoral nerve
a. rectus abdomims
b. iliacus
c. internal oblique
d. transverse abdominis
e. quadratus lumborum
B
The abdominal aorta passes through the diaphragm at which vertebral level?
a. T8
b. T10
c. T12
d. L1
e. L2
c. Aortic hiatus (12 letters in total) occurs at the vertebral level T12. Other important landmarks to remember are: T10: where the oesophagus (10 letters) passes the diaphragm into the abdomen; T8: where the vena cava (8 letters) passes the diaphragm into the abdomen (also known as the caval hiatus).
In the human kidney, the renal papilla projects directly into the:
a. renal pyramid
b. ureter
c. major calyx
d. renal columns
e. minor calyx
E.
- Which nerve is identified by its position on the anterior surface of the psoas major muscle?
a. Femoral
b. ilioinguinal
c. genitofemoral
d. obturator
e. lateral femoral cutaneous
Genitofemoral nerve
The genitofemoral nerve pierces the psoas major and runs inferiorly on its anterior surface, deep to the psoas fascia. The femoral nerve emerges from the lateral border of the psoas major muscle and passes deep to the inguinal ligament to the anterior thigh. The ilioinguinal nerve enters the abdomen posterior to the medial arcuate ligament and passes inferolaterally, anterior to the quadratus lumborum. The ilioinguinal nerve is also found in the inguinal canal. The obturator nerve emerges from the medial border of the psoas major and passes into the lesser pelvis, passing through the obturator foramen into the thigh. The lateral femoral cutaneous nerve runs inferolaterally on the iliacus and enters the thigh deep to the inguinal ligament
- Which is NOT a posterior relation to the kidney?
a. Diaphragm
b. Costodiaphramagtic recess
c. Psoas muscle
d. Transversus abdominis
e. Iliacus
e. The iliacus originates from the iliac fossa and inserts into the lesser trochanter of the femur; its location is way below the kidneys. Evidently, it is not a posterior relation to the kidney in normal anatomy
As the renal artery approaches the kidney, it branches to supply the renal glomeruli. Place the following in the correct sequence starting from the renal artery. 1: arcuate artery, 2: interlobular artery, 3: interlobar artery, 4: afferent arteriole
a. (2,1,3,4)
b. (2,3, 1,4)
c. (1,3,4,2)
d. (4,3,1,2)
e. (3,1,2,4)
E. The renal artery first split into segmental arteries (usually 5 segmental arteries) which then further branches to give interlobar artery, which continues as the arcuate artery, traversing the bases of the renal pyramids. From the arcuate artery, numerous interlobular arteries arises, after which the interlobular arteries further branch to give afferent arterioles which supplies the renal glomeruli.
- Podocytes make up the:
a. Visceral layer of the nephron
b. Visceral layer of the glomerulus
c. Visceral layer of the renal capsule
d. Visceral layer of the Bowman’s Capsule
D. The visceral layer of the Bowman’s capsule consists of the thickened basal lamina of the glomerulus and the podocytes while the parietal layer of the Bowman’s capsule is made up of simple squamous epithelium. The space between the visceral and parietal layer contains the filtrate. The glomerulus (the only capillary network exclusively composed of arterioles) is made up of a fenestrated endothelial layer supported by a thickened glomerular basement membrane.
- The left renal arteries DO NOT (2 correct answers)
a. Arise from the abdominal aorta
b. Supply the suprarenal glands
c. Have branches that anastamose freely with each other in the kidney
d. Originate below L2
e. Have segmental arteries
