Renal

Question 1

Ischaemia leads to inflammatory response in the kidney by which 3 mechanisms?

Answer 1

ATP depletion (necrosis)

Increased hypoxia inducible factor (HIF)

Reactive oxygen species generation (ROS)

Question 2

Vasopressin/adh acts on which receptor in the kidney

Answer 2

V2 receptor

Question 3

What is the equation for renal blood Flow?

Answer 3

RBF= (renal artery pressure- renal vein pressure)/ total renal vascular resistance

Question 4

What G protein is V2 receptors linked with and what secondary messenger?

Answer 4

Gs and cyclic AMP —-> protein kinase A

Question 5

What is the overall survival to discharge for dogs with AKI?

Answer 5

50-70%

Vaden JVIM 56%
Legatti Plos One 55%
Rimer JVIM 67%

Question 6

What is the definition of IRIS AKI grade I?

Answer 6

Increase in 0.3mg/dL or 26.4umol/L

Question 7

What are the stages of AKI?

Answer 7

5 phases

1. Insult
2. Initiation
3. Extension
4. maintenance
5. Recovery

Question 9

Name 5 drugs which are nephrotoxic

Answer 9

Aminoglycosides
Penicillins
Vancomycin
Amphotericin B
Sulfadiazine
Acetaminophen
Cimetidine
Apomorphine
Lithium
Azathioprine
Anti depressants
Vitamin D analogues
Heavy metals e.g Gold, lead, mercury

Question 10

Name 5 non drug agents that are nephrotoxic

Answer 10

Snake venom
Bee venom
Grapes/raisins
Radiocontrast agents
Lilies
Mushrooms
Illicit drugs
Vitamin D containing rodenticides

Question 12

What is the function of principal cells?

Answer 12

Reabsorb Na and water
Secrete potassium
Site of action of aldosterone and ADH

Question 13

What stimulates aldosterone release?

Answer 13

Decreased circulating volume—> RAAS activation
Hyperkalaemia
ACTH release
Hyponatraemia

Question 15

What is the function of intercalated cells?

Answer 15

Alpha -H +secreting
Beta- HCO3 secreting

Question 16

What are the main controllers of Nacl and water excretion?

Answer 16

1. Renal SNS
2. RAAS
3. Natriuretic peptides
4. ADH

Question 17

Where is ADH synthesised?

Answer 17

Supraoptic and paraventricular nuclei of hyothalamus

Question 18

Where is ADH stored?

Answer 18

Posterior pituitary

Question 19

What stimulates ADH release?

Answer 19

Increased osmolality
Decrease effective circulating volume
Nausea
Angiotensin II
Pain

Question 20

What is the filtration fraction?

Answer 20

FF= GFR/RBF

Represents proportion of fluid reaching the kidney that ends up in the tubules

20%

Question 23

What are the cut off for each IRIS stage for AKI

Answer 23

Question 24

Name the components of nephrotic syndrome

Answer 24

Proteinuria,
Hypoalbuminaemia
Extravascular accum of fluid and hyperlipidemia

Question 25

What comprises the juxtaglomerular apparatus

Answer 25

Extraglomerular mesangial cells Macula densa Juxtaglomerular cells

Question 26

What are renal causes of hypokalaemia

Answer 26

Question 27

Aldosterone is stimulated by what 4 things

Answer 27

Decreased circulating volume—> RAAS Hyperkalaemia ACTH release hyponatraemia

Question 28

What stimulates ADH release

Answer 28

Increased osmolality Hypovolaemia Nausea Angiotensin II Pain