Urinary Formative

Question 1

GFR would increase if

Answer 1

The efferent arteriolar is constricted

Question 2

How would drinking a large amount of water affect osmolarity and volume of the ECF?

Answer 2

Decreased osmolarity and increased volume

Question 3

ADH is released in response to

Answer 3

Cellular dehydration

Question 4

If drug A’s clearance is greater than inulin clearance, then what has occurred?

Answer 4

Net secretion

Question 5

What could be the cause?

Answer 5

Clearly acidosis as look at pH first,

This could be due to impaired renal function (unable to absorb bicarbonate)

Question 6

The following acid/base balance values were obtained: pH 7.45, HCO3 12mmoles/L, PCO2 2.7kPa

Answer 6

The subject is likely to have spent a long time at altitude as respiratory alkalosis

Question 7

The following acid/base values are obtained: pH 7.28, HCO3 36mmoles/L, PCO2 8kPa (60mmHg)

Answer 7

The subject will be excreting large amount of ammonium ions

Question 8

The following acid/base cavaliers were obtained: pH 7.5, HCO3 45mmoles/l, PCO2 8pKa

Answer 8

Elevated bicarbonate, not respiratory, the subject will be excreting bicarbonate ions

Question 9

Answer 9

Cx = u x v / px

Question 10

A patient with lung cancer develops the syndrome of inappropriate ADH secretion. Which of the following values for Na+ concentration might be expected to be seen?
A 140 mmol/l
B 145 mmol/l
C 150 mmol/l
D 138 mmol/l
E 128 mmol/l

Answer 10

D 138 mmol/l and E 128 mmol/l but E most likely

Question 11

What happens when there is absence of ADH?

Answer 11

Diabetes Insipidus

Question 12

What is an example of a loop diuretics?

Answer 12

Furosemide, inhibits Na channels in Loop of Henle

Question 13

A 6yo presents with face and leg swelling. His serum albumin concentration is 18g/l (normal 37-42) and his mother notices that his urine is frothy. What is the most likely diagnosis?

Answer 13

Minimal change disease, flattening of podocytes on microscopy, it should respond to steroid treatment

Question 14

A 23yo woman complains of flank pain, dysuria and frequency of micturition. She has taken ibuprofen for the pain. Her urinalysis shows protein, nitrites and blood. What is the likely diagnosis?

Answer 14

Acute pyelonephritis - infection that has reached the kidneys

Question 15

A 40yo man was found to have asymptomatic proteinuria and microscopic haematuria during routine employment-related examination. Hi BP was 160/100mmHg and serum creatinine 170micromol/L (normal 86-116). He has no urinary symptoms. What is the next important investigation?

Answer 15

US of the urinary tract, to ensure kidneys are same size etc, then kidney biopsy can be taken. This is most likely a case of IgA nephropathy

Question 16

A 60yo man has stage 5 CKD with a serum creatinine of 500micromol/L (normal 88-116). What is likely to be present?

Answer 16

High serum phosphate, hypocalcaemia as less Ca absorption, this stimulates the parathyroid gland leading to renal bone disease. Treated with phosphate binders (Ca or non Ca containing) & alphacalcitriol

Question 17

Patients with renal failure are often anaemia. What is the best treatment for their anaemia?

Answer 17

Erythropoietin

Question 18

A 70yo man complains of poor stream of urine, nocturnal and post-micturition dribbling. What is the most likely cause?

Answer 18

Prostatic hypertrophic

Question 19

What is the commonest urological malignancy in patients with painless frank haematuria?

Answer 19

Bladder cancer

Question 20

The following antibiotics are generally suitable for empirical treatment of complicated UTIs except:
Vancomycin, ciprofloxacin, Cetriaxone, Gentamicin, Coampxiclav

Answer 20

Vancomycin