Renal

Question 1

action of tolvaptan and its use

Answer 1

used to increase Na
vasopressin V2 antagonist on the collecting ducts of the kidney

Question 2

action of desmopressin and its use

Answer 2

used to decrease Na
vasopressin V2 agonist on the collecting ducts

Question 3

action of mannitol

Answer 3

osmotic diuresis

Question 4

action of acetazolamide

Answer 4

carbonic anhydrase inhibitor
acts on proximal convoluted tubule
causes NaHC03 diuresis

Question 5

name 3 K sparing diuretic drugs

Answer 5

spironolactone
epleronone
amiloride
triamterene

Question 6

action of k sparing diuretics

Answer 6

all act on the cortical collecting tubule
spironolactone and epleronone are aldosterone antagonists
amiloride and triameterene block Na channels

Question 7

action of loop diuretics

Answer 7

inhibit co-transporter of thick ascending loop of henge (Na/k/cl)

Question 8

side effects of loop diuretics

Answer 8

low electrolytes
interstitial nephritis
ototoxicity
sulfa allergy
metabolic alkalosis
gout

Question 9

action of thiazide like diuretics

Answer 9

inhibit NaCl reabsorption in the early DCT
decrease dilution of nephron = increase Cl excretion

Question 10

side effects of thiazide like diuretics

Answer 10

hyperGLUC
hyperglycaemia
hyperlipidaemia
hyperuricaemia
hypercalcaemia

Question 11

side effects of k sparing diuretics

Answer 11

hyperkalaemia
endocrine i.e. gynaecomastia

Question 12

side effects of acetazolamide

Answer 12

type 2 RTA, calcium phosphate stones, sulpha allergy, paraesthesia, NH3 toxicity

Question 13

uses for acetazolamide

Answer 13

glaucoma
altitude sickness
metabolic alkalosis

Question 14

contraindications for mannitol

Answer 14

HF
anuria

Question 15

how does ACE inhibitors cause reduced eGFR

Answer 15

cause dilatation of the efferent arterioles

Question 16

difference in effects of ACE I vs ARB

Answer 16

have the same effects except ARB’s don’t increase bradykinin

Question 17

action of alskinin

Answer 17

direct renin antagonist

Question 18

contraindications for alskinin

Answer 18

pregnancy
concurrent use with ACE I or ARB

Question 19

side effects of ACE inhibitors

Answer 19

captains CATCHH
cough
angioedema
teratogenic
creatinine (increased. decrease eGFR)
hypotension
hyperkalaemia

Question 20

Blockage of the epithelial sodium channel in the collecting duct

Answer 20

potassium-sparing diuretics like amiloride or triamterene

Question 21

induction of osmotic diuresis

Answer 21

mannitol (hyponatraemia with high serum osmolality)

Question 22

why are ACE inhibitors reno-protective in diabetics

Answer 22

reduces renal excretion of albumin thereby reducing proteinuria

Question 23

what mediciation can be used for altitude sickness and mode of action

Answer 23

acetazolamide
carbonic anhydrase inhibitor - inhibits HC03 reabsorption in the proximal tubules

Question 24

raised anion gap metabolic acidosis with rasied oxoproline

Answer 24

chronic acetaminophen use

Question 25

how does ADH act on the kidneys

Answer 25

inserts aquaporin channels of renal collecting duct

Question 26

treatment for central diabetes insipidus

Answer 26

desmopressin (DDVAP)

Question 27

the treatment for central diabetes insipidous is also used to treat another condition. what is this?

Answer 27

desmopressin / DDVAP DDVAP also used in Von Willebrands disease

Question 28

toxicity with elevated serum osmolality, high anion gap metabolic acidosis, confusion, hematuria, and crystalluria.

Answer 28

ethylene glycol

Question 29

toxicity with elevated formic acid levels and blindness

Answer 29

methanol

Question 30

what diuretic is used in people with sulfa allergy

Answer 30

ethacrynic acid

Question 31

action of ethacrynic acid

Answer 31

nonsulphonamide inhibitor of Na/K/Cl cotransporter on thick ascending loop of henle

Question 32

side effects of ethacrynic acid

Answer 32

same as loop diuretics but no allergy to sulpha more ototoxic

Question 33

what part of the tubule does K sparing diuretics act on

Answer 33

cortical collecting tubule

Question 34

what part of the tubule does thiazide like diuretics act on

Answer 34

early distal convoluted tubule

Question 35

what part of the tubule does mannitol act on

Answer 35

proximal convoluted tubule

Question 36

what part of the tubule does acetazolamide act on

Answer 36

proximal convuluted tubule

Question 37

mechanism by which NSAIDS cause AKI

Answer 37

increased afferent arteriole constriction/tone

Question 38

mechanism by which antivirals i.e. aciclovir can cause AKI

Answer 38

crystal induced tubular obstruction

Question 39

mechanism by which ACE inhibitors cause AKI

Answer 39

decrease in efferent arteriole constriction/tone