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Renal Final > Questions > Flashcards

Questions Flashcards

1
Q

A buffer pair (HA/A-) has a pK of 5.4. At a blood pH of 7.4, the concentration of HA is:

A. 1/100 that of A-
B. 1/10 that of A-
C. Equal to that of A-
D. 10 times that of A-
E. 100 times that of A-
A

A. 1/100 that of A-

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2
Q

Which of the following would produce an increase in the reabsorption of isosmotic fluid in the proximal tubule?

A. Increased filtration fraction
B. ECF volume expansion
C. Decreased peritubular capillary protein concentration
D. Increased peritubular capillary hydrostatic pressure
E. Oxygen deprivation

A

A. Increased filtration fraction

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3
Q

At plasma PAH concentrations below the transport maximum (Tm), PAH

A. Reabsorption is not saturated
B. Clearance equals inulin clearance
C. Secretion rate equals PAH excretion rate
D. Concentration in the renal vein is close to zero
E. Concentration in the renal vein equals PAH concentration in the renal artery

A

D. Concentration in the renal vein is close to zero

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4
Q

Experiments with inbred strains of mice have provided much of our knowledge of transplantation immunology. All mice of one inbred strain are genetically identical to one another and homozygous for all genes. Assume that strains A and B are inbred strains that differ from each other at all MHC gene loci but not at other loci. A mating of a strain A mouse with a strain B mouse (AxB) yields AxB F1 progeny. Which of the following skin grafts would not be rejected?

A. AxB F1 donor to A recipient
B. AxB F1 donor to B recipient
C. A donor to AxB F1 recipient
D. B donor to A recipient
E. A donor to B recipient
A

C. A donor to AxB F1 recipient

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5
Q

A rheumatologist orders lab tests to monitor a patient who is taking a medication that can result in kidney injury. The following results are obtained:

Urine osmolality = 450 mOsm/L
Plasma osmolality = 297 mOsm/L
Urine flow rate = 1.5 mL/min

Which of the following does NOT represent the patient’s free water clearance?

A. Excess solutes are being removed
B. Free water is being excreted
C. Free water is being conserved
D. Free water clearance is a negative value

A

B. Free water is being excreted

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6
Q

Hyponatremia can sometimes be seen in individuals whose ECF volume is decreased by more than 10%. Which of the following factors contributes to the development of hyponatremia in this situation?

A. Decreased levels of ADH
B. Elevated levels of natriuretic peptides
C. Increased excretion of sodium by the kidneys
D. Reduced excretion of solute-free water by the kidneys
E. Development of positive sodium balance

A

D. Reduced excretion of solute free water by the kidneys

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7
Q

A 42 y/o female is recovering in the hospital from a benign brain tumor. She develops SIADH, and her plasma [Na+] falls from 142 mEq/L to 128 mEq/L. Urine osmolality is 600 mOsm/Kg H2O. Administering 1 L of isotonic saline to this woman would result in which of the following changs in her plasma [Na] and urinary [Na] excretion?

A. No change in plasma sodium, decreased urinary Na excretion
B. Decreased plasma sodium, increased urinary Na excretion
C. Increased plasma [Na], no change in urinary Na excretion
D. Increased plasma [Na], decreased urinary Na excretion

A

B. Decreased plasma sodium, increased urinary Na excretion

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8
Q

Renin is produced and secreted from granules located in the:

A. Macula densa
B. Mesangial cells
C. Intercalated cells
D. Afferent arterioles
E. Interstitial cells
A

D. Afferent arterioles

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9
Q

About 4-6 days after you place a normal person on a low-sodium diet, which of the following will be observed?

A. Plasma renin and aldosterone are below normal
B. Plasma renin and aldosterone are above normal
C. Plasma sodium concentration is below normal
D. Plasma sodium concentration is normal
E. B and D are correct

A

E. B and D are correct

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10
Q

The tonicity of the urine as it enters the renal collecting duct is:

A. Isotonic
B. Hypotonic or isotonic, but never hypertonic
C. Hypotonic
D. Hypertonic
E. Hypertonic or isotonic, but never hypotonic

A

B. Hypotonic or isotonic, but never hypertonic

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11
Q

Which of the following might you expect to find associated with chronic renal failure?

A. Elevated hematocrit
B. Abnormally low plasma creatinine concentration
C. Decreased bone density
D. Lower than normal PTH
E. None of the above
A

C. Decreased bone density

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12
Q

A 70-year-old male with a body weight of 70 kg and a history of current lung cancer develops SIADH. He is admitted to the hospital and the following lab results are obtained. His vitals and physical exam are normal. There is no evidence of ECF volume contraction of ECF volume expansion. Assume the patient ingests approximately 80 mEq/day of Na+.

Serum Na = 120 mEq/L (135-147 normal)

Urine osmolality = 600 mOsm/kg H2O (500-800 normal)

Urine Na excretion = 80 mEq/day

Which of the following is the source of this patient’s hyponatremia?

A. He is reabsorbing too much Na
B. He is excreting too much Na
C. He is in a positive water balance
D. He is in a negative water balance

A

C. He is in a positive water balance

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13
Q

Which of the following is NOT one of the three effects that ADH exerts in the kidney?

A. Insertion of aquaporin 2 into apical membrane of the principal cells in late DT and CD
B. Increases activity of NKCC2 in TAL
C. Increases activity of Na/K pump in basolateral membrane
D. Increases urea permeability in inner medullary CD

A

C. Increases activity of Na/K pump in basolateral membrane

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14
Q

Which of the following will NOT lead to a decrease in flow of the tubular fluid and a decrease in Na delivery and Na concentration past the macula densa?

A. Decreased renal perfusion pressure
B. Vasodilation of the afferent arteriole
C. Reduced filtered load
D. Enhanced proximal fluid reabsorption

A

B. Vasodilation of the afferent arteriole

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15
Q

After eating 2 bags of salty pork rinds containing approximately 3 g of sodium, which of the following signals is crucial for the excess electrolyte content to be sent to vascular receptors and thus be eliminated from the body?

A. A decrease in effective arterial blood volume
B. A decrease in plasma oncotic pressure
C. A decrease in plasma osmolarity
D. An increase in effective arterial blood volume
E. An increase in plasma oncotic pressure

A

D. An increase in effective arterial blood volume

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16
Q

A 24 y/o woman is placed on overnight water restrcition. Before consuming any fluids the next morning, her urine flow rate is 1 mL/min. The tubular fluid with the lowest osmolarity will be found at which area?

A. PCT
B. Late DT and CCD
C. Medullary collecting duct
D. Cortical TAL and early DT
E. Medullary TAL
A

C. Medullary collecting duct

17
Q

Which of the following is most likely to result in respiratory acidosis?

A. Patient with gastroenteritis who is vomiting profusely
B. Patient with diarrhea of about 2 days duration
C. Patient who overdosed on heroin and is breathing very slowly
D. Patient who recently moved to CO and is hiking in the mountains

A

C. Patient who overdosed on heroin and is breathing very slowly

18
Q

A patient presents with prerenal azotemia. When asked what she’s been doing the last few days, she can’t remember. Her plasma osmolarity is 600 (normal = <295) and her plasma ADH is extremely low. Which of the following is most likely?

A. SIADH
B. Nephrogenic diabetes insipidus
C. Central diabetes insipidus
D. Primary polydipsia
E. Dehydration
A

C. Central diabetes insipidus

19
Q

Furosemide is a loop diuretic that produces natriuresis. Which of the following is a potential complication with long-term use?

A. Hyponatremia
B. Hypomagnesemia
C. Hyperkalemia
D. Hypercalcemia
E. Hyperphosphatemia
A

B. Hypomagnesemia

20
Q

A 3 y/o male pt is brought in by his mom after ingesting 0.5 L of ethylene glycol. You are concerned with which of the following complications?

A. Gastric ulcer
B. Insulin deficiency
C. Hypocalcemic tetany
D. Hyperkalemia
E. Cell lysis
A

C. Hypocalcemic tetany

21
Q

A 43 y/o male with hx of chronic liver failure presents to the ED to get fluid off his abdomen. PE reveals jaundice and +fluid wave indicative of ascites. What changes likely occured in his angiotensin II, ADH, total extracellular Na, plasma Na, and TBW?

A

Ang II increased

ADH increased

Total extracellular Na increased

Plasma Na concentration decreased

TBW increased

22
Q

32 y/o female presents with decreased urination for 1 week. She had a kidney transplant 2 years ago and did not have any problems before a week ago. This reaction to the graft is similar to what other reaction?

A. Arthrus reaction
B. Patient with hx of multiple blood transfusions
C. A patient receiving a PPD
D. A patient with a peanut allergy

A

C. A patient receiving a PPD

23
Q

Acute metabolic acidosis tends to cause a ______ in intracellular K+ concentration and a(n) _______ in K+ secretion by the CCD

A. Increase, increase
B. Increase, decrease
C. Decrease, increase
D. Decrease, decrease
E. No change, increase
F. No change, no change
A

D. Decrease, decrease

24
Q

Which of the following nephron segments is the primary site of Mg reabsorption under normal conditions?

A. PT
B. Descending LOH
C. Ascending LOH
D. DCT
E. CD’s
A

C. Ascending LOH

25
Q

A 36 y/o male presents with low renin essential HTN. Renin release from the JG apparatus is normally inhibited by which of the following?

A. Beta-adrenergic agonists
B. Aldosterone
C. Stimulation of the macula densa
D. Increased pressure within the afferent arteriole

A

D. Increased pressure within the afferent arteriole

26
Q

The ability of the kidney to excrete concentrated urine will increase if which of the following is occurs?

A. The reabsorption of Na by the PT decreases
B. The glomerular capillary pressure increases
C. The flow of filtrate through the LOH increases
D. The activity of the Na/K pump in the LOH increases
E. The permeability of the CD to water decreases

A

D. The activity of the Na/K pump in the LOH increases

27
Q

A 58 y/o male with hx of alcohol abuse and liver failure presents to clinic. On PE, he has + fluid wave indicative of ascites. Which of the following would you expect to see?

A. Decreased renin, increased ADH, decreased plasma Na, increased ECF volume
B. Decreased renin, decreased ADH, increased plasma Na, increased ECF volume
C. Increased renin, increased ADH, decreased plasma Na, increased ECF volume
D. Increased renin, increased ADH, decreased plasma Na, decreased ECF volume

A

C. Increased renin, increased ADH, decreased plasma Na, increased ECF volume

28
Q

A 25 yo male presents to the ED with severe hemorrhage and a bp of 80/50. Lab tests show elevated creatinine. You treat his low blood pressure and the pt recovers. On repeat lab tests, his creatinine has returned to normal. Of the following, what most likely occurred?

A. Increased IL-4 and IL-10
B. Increased IFN-gamma
C. Decreased FOXP3 cells
D. Increased STAT3 cells

A

A. Increased IL-4 and IL-10

29
Q

A buffer pair (HA/A-) has a pK of 5.4. At a blood pH of 7.4, the concentration of HA is

A. 1/100 that of A-
B. 1/10 that of A-
C. Equal to that of A-
D. 10x that of A-
E. 100x that of A-
A

A. 1/100 that of A-

30
Q

Which of the following would produce an increase in the reabsorption of isosmotic fluid in the PT?

A. Increased filtration fraction
B. ECF volume expansion
C. Decreased peritubular capillary protein concentration
D. Increased peritubular capillary hydrostatic pressure
E. Oxygen deprivation

A

A. Increased filtration fraction

31
Q

At plasma PAH concentration below the Tm, PAH

A. Reabsorption is not saturated
B. Clearance equals inulin clearance
C. Secretion rate = PAH excretion rate
D. Concentration at the renal vein is close to zero
E. Concentration in the renal vein = PAH concentration in renal artery

A

D. Concentration at the renal vein is close to zero

32
Q

Which of the following would best distinguish an otherwise healthy person with severe water deprivation with a person with SIADH?

A. Free water clearance
B. Urine osmolarity
C. Plasma osmolarity
D. Circulating ADH levels
E. Corticopapillary osmotic gradient
A

C. Plasma osmolarity

33
Q

Which of the following causes a decrease in Ca clearance?

A. Hypoparathyroidism
B. Treatment with chlorothiazide
C. Treatment with furosemide
D. ECF volume expansion
E. Hypermagnesemia
A

B. Treatment with chlorothiazide

34
Q

A man presents with HTN and hypokalemia. Arterial blood gases: pH = 7.5 and HCO3 = 32 mEq/L. Serum cortisol and urinary VMA are normal. Serum aldosterone is increased, and plasma renin is decreased. Which of the following is the most likely cause of his HTN?

A. Cushing’s disease
B. Cushing’s syndrome
C. Conn’s syndrome
D. Renal artery stenosis
E. Pheochromocytoma
A

C. Conn’s syndrome

35
Q

At which nephron site is the tubular fluid/plasma (TF/P) osmolarity the lowest in a person who has been deprived of water?

A. At the glomerulus
B. Proximal tubule
C. Loop of henle
D. Early DT
E. Collecting duct
A

D. Early DT

36
Q

At which nephron site is the tubular fluid inulin concentration highest during antidiuresis?

A. At the glomerulus
B. Proximal tubule
C. Loop of henle
D. Early DT
E. Collecting duct
A

E. Collecting duct

37
Q

At which nephron site is the tubular fluid inulin concentration the lowest?

A. At the glomerulus
B. Proximal tubule
C. Loop of henle
D. Early DT
E. Collecting duct
A

A. At the glomerulus

38
Q

At which nephron site is the tubular fluid glucose concentration highest?

A. At the glomerulus
B. Proximal tubule
C. Loop of henle
D. Early DT
E. Collecting duct
A

A. At the glomerulus

39
Q

A person who takes an aspirin overdose is treated in the ED. The treatment produces a change in urine pH that increases the excretion of salicylic acid. What was the change in urine pH, and what is the mechanism of increased salicylic acid secretion?

A. Acidification, which converts salicylic acid to its HA form
B. Alkalinization, which converts salicylic acid to its A- form
C. Acidification, which converts salicylic acid to its A- form
D. Alkalinization, which converts salicylic acid to its HA form

A

B. Alkalinization which converts salicylic acid to its A- form

Renal Final (10 decks)

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