Quiz Qs Flashcards
In a patient in whom sodium intake exceeds sodium output: There would be a decrease in ICF volume.
True
excess sodium is restricted to the ECF by the action of the Na+/K+-pump, water, which is freely permeable across cell membranes, will move out of cells to equalise the osmolarity inside and outside the cell.
In the proximal convoluted tubule: Parathyroid hormone (PTH) impairs the reabsorption of phosphate ions.
True
PTH increases phosphate excretion in the urine by decreasing phosphate reabsorption in the proximal tubule. This means there is less plasma phosphate for calcium ions to bind to. It therefore tends to increase plasma calcium ion concentration.
Antidiuretic hormone (ADH): Is produced by neurones in the supraoptic and paraventricular nuclei in the hypothalamus.
True
The cell bodies of the ADH-producing neurones lie in the supraoptic and paraventricular nuclei of the hypothalamus and the hormone is released from their axon terminals in the posterior pituitary.
Regarding glomerular filtrate: Glomerular filtrate is produced at a lower rate by subjects suffering from hypoproteinemia.
False
osmotic pressure exerted by the plasma proteins will be lower than normal, hence the net filtration pressure will be increase so glomerular filtration rate will be higher than normal
Considering the renin-angiotensin-aldosterone system: Aldosterone promotes the reabsorption of both sodium and potassium at the distal tubule.
False
Aldosterone promotes the reabsorption of sodium but not potassium.
Regarding glomerular filtrate: Over physiological ranges, glomerular filtrate is produced at a rate that is directly proportional to renal arterial blood pressure.
False
Over physiological ranges of renal arterial pressure, pressure autoregulation takes place so that glomerular filtration rate is largely independent of arterial pressure.
In the proximal convoluted tubule: Parathyroid hormone (PTH) impairs the reabsorption of calcium ions.
False
Low plasma calcium ion concentration stimulates secretion of parathyroid hormone, which then increases calcium ion reabsorption in the kidney. Yet another negative feedback loop.
Which symptom typically presents with bladder cancer?
Painless haematuria
A 44 year old man has a cupful of fresh haemoptysis. He has a four month history of nasal stuffiness, recurrent nose bleeds and oral ulceration. Urinalysis shows blood 3+ and protein 2+. Investigations: serum urea 27.3 mmol/L (2.5–7.0), serum creatinine 342 µmol/L (60–110), PR3-ANCA 89 U/mL (<5). Which of the following is the most likely diagnosis?
Wegener’s granulomatosis accompenied by polyangiitis = vascular inflamm = VASCULITIC PICTURE
A 26 year old woman has urinary frequency and burning dysuria. Culture of mid-stream specimen of urine grows Escherichia coli. Which category does Escherichia coli belong to?
Gram negative bacillus
A 25 year old woman has right sided loin pain. She is hypertensive with a blood pressure of 168/96 mmHg and has a fullness in her abdomen. Investigations: abdominal ultrasound: polycystic kidneys. Genetic testing confirms she is a heterozygote for adult polycystic kidney disease, an autosomal dominant condition. What is the chance that her son has inherited the condition?
50%
A 24 year old woman has 12 hours of dysuria and urinary frequency. On examination, she has suprapubic tenderness. Urinalysis shows blood 2+, and is positive for both leucocytes and nitrites. Investigations: serum creatinine 62 µmol/L (60–110), What is the most likely causative organism?
Escherichia coli
A 78 year old man has an episode of visible haematuria. He reports weight loss of 5 kg over the last six months. On examination, he is tender in his left flank. Urinalysis shows blood 3+. Investigations: haemoglobin 172 g/L (115–165), platelet count 248 (150–400), serum creatinine 92 µmol/L (60–110). What is the most likely diagnosis?
renal cell carcinoma
A patient with acute renal failure provides a urine specimen that demonstrates normal osmolality and sodium content. The urine contains no casts, but RBCs are present. Which of the following is the most likely aetiology of this patient’s acute renal failure?
Postrenal Cause
A 64 year old man has severe haematemesis and melaena. He has a history of hypertension and peripheral vascular disease and his usual medication is aspirin, ramipril and bendroflumethiazide. On admission, his pulse is 102 bpm and his blood pressure is 88/64 mmHg. His usual medication is stopped and he is treated with high-dose omeprazole, blood transfusion and endoscopic cautery of a bleeding duodenal ulcer. His blood pressure improves to 144/88 mmHg but, over the next 3 days, he passes only 100-200 ml of urine per day and his serum creatinine rises progressively to 540 µmol/L (Range <110 µmol/L) . A urethral catheter is passed – the residual volume is 60 ml. What is the most likely cause of kidney injury?
a. acute interstitial nephritis
b. acute tubular necrosis
c. acute tubular obstruction
d. acute glomerulonephritis
e. acute cortical necrosis
Acute Tubular Necrosis
Acute tubular necrosis is damage and death (necrosis) of the epithelial cells of the renal tubules. It is the most common cause of acute kidney injury. Damage to the kidney cells occurs due to ischaemia or toxins. The epithelial cells have the ability to regenerate making acute tubular necrosis reversible. It usually takes 7-21 days to recover.
