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Medicine related kidney questions

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Kidney 2

Frage 1 von 19

1

Sodium enters passively down the membrane down its concentration gradient. It is actively extruded across the basolateral membrane by the Na/K/ATPase pump. Na+ reabsorption is in the PCT, followed by the LOH, DCT and CD.
In the PCT- exchanger at the apical membrane, at the basolateral membrane NA/K/ATPase and Na/HCO3 transporter.
In the thick limb of the LOH - cotransporter (NKCC2)...which can be inhibited by , leading to increased sodium in the DCT and therefore less water loss.
Na transport in the DCT is via transcellular reabsorption (Na/Cl transporter NCC)--thiazide diuretics can inhibit this.
In the cortical collecting duct, Na transport is mediated primarily by the principle cells. It crosses through ENAC's and can be inhibited by amiloride. reabsorption in the proximal tubule is linked to Na+ reabsorption.

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    apical
    largest
    least
    Na/H
    Na/Cl-
    Na/K
    Na/K/Cl
    Na/HCO3
    Na/Glucose
    frusemide
    thiazide
    aldosterone
    Water
    chloride
    glucose

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Frage 2 von 19

1

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( Angiotensin 2, Angiontensin 1 ) binds to AT1 receptors of the proximal tubule. They also stimulate Na-H exchange in the TAL and ENAC's in the initial collecting tubules. All promote ( sodium, calcium, potassium ) reabsorption.
Aldosterone stimulates sodium reabsorption by the initial tubule and CCT. It upregulates apical ENAC's and therefore Na+ permeability.
ADH- overall effect is to produce urine which a ( high, low ) osmolality. In the TAL, ADH stimulates NKCC2 receptors and K+ channels. In the principle cells of the initial collecting tubule and CCT, ADH stimulates Na+ transport by increasing the number of open Na+ channels.

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Frage 3 von 19

1

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Most of the K is absorbed in the as well. The cell is the Major Regulator of Potassium with % of potassium being managed here.
The Epithelial Na Channels gets us to dump all the potassium by an gradient
The sodium delivered the more potassium dumped. In the proximal tubule K+ reabsorption occurs passively and is via solvent drag. In the TAL K+ is reabsorbed paracellularly and through the - contransporter. In the cortical collecting duct- K+ reabsorption by intercalated discs occurs through the apical K+ uptake mediated by the Pump, followed by passively efflux across the basolateral membrane. In the cortical collecting ducts (principle cells), the K+ occurs by active uptake across basolateral membrane, followed by passive diffusion through apical K+ channels.

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Frage 4 von 19

1

Stimulators of K+ excretion include?

Wähle eine oder mehr der folgenden:

  • Increased K+ intake

  • Increased pH

  • Aldosterone

  • ADH

  • Increased sodium delivery

  • Ameloride

  • Thiazides

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Frage 5 von 19

1

Chloride is reabsorbed via the pathway early in the PCT via solvent drag,
Later in the PCT at the apical memrane via Cl-base exchanger (Cl- out of lumen, Base in), following + out of lumen. At the basolateral membrane via Cl- channels and K/Cl- cotransporter.
In the thick ascending limb via - cotransporter.
In the ducts via paracellular reabsorption, apically via Cl-HCO3- exchanger and Cl- channels basolateral membrane.

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    paracellular
    transcellular
    Na
    Ca
    K
    Na/K/2Cl
    Cl/HCO3-
    collecting
    distal

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Frage 6 von 19

1

What are the two most important regulators of calcium?

Wähle eine der folgenden:

  • Na and PTH

  • PTH and Vitamin D

  • TSH and Vitamin D

  • PTH and K

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Frage 7 von 19

1

Most (80%) of the phosphate is reabsorbed at the PCT.
Which factors increase phosphate reabsorption?

Wähle eine oder mehr der folgenden:

  • high plasma calcium

  • PTH

  • low plasma calcium

  • ADH

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Frage 8 von 19

1

The pre-renal causes of AKI include?

Wähle eine oder mehr der folgenden:

  • Volume expansion

  • Volume depletion

  • GI losses

  • Glomerulonephritis

  • NSAID's

  • Cutaneous losses

  • Bladder Disease

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Frage 9 von 19

1

Renal causes of AKI include?

Wähle eine oder mehr der folgenden:

  • Inflammatory glomerulonephritis

  • Acute tubular necrosis

  • Rhabdomyolysis

  • Extra-tubular obstruction

  • Acute Interstitial Nephritis

  • Nephrotoxicity

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Frage 10 von 19

1

A serum creatinine level of 2-3 x the normal amount would place the person in which stage of kidney disease?

Wähle eine der folgenden:

  • 1

  • 2

  • 3

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Frage 11 von 19

1

Which of these is not a novel biomarker for acute kidney injury?

Wähle eine der folgenden:

  • Urinary Neutrophil Gelatinase- Associated Lipocalin

  • Urinary IL-22

  • Urinary IL-18

  • Urinary Kidney-Injury molecule 1

  • Cystatin C

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Frage 12 von 19

1

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In the RIFLE classification of AKI. Describe the following components.
R- (Risk) = 1.5 x increase in serum creatinine, GFR less 25% or urine output <( 0.5mL, 1mL )/kg per hour for 6 hours
I- (( Injury, Ischaemia )) = 2 x serum creatinine, GFR 50%, or urine output <0.5mL/kg for 12 hours
F- (Failure) = 3 x SC, GFR 75% drop, urine output <0.5mL/kg 24 hours or ( anuria, proteinuria ) 12 hours
L- (Loss) = complete loss of kidney function > ( 4 weeks, 8 weeks, 12 weeks )
E- (ESRD) = > 3 months

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Frage 13 von 19

1

Acute Tubular Necrosis is due to tubular injury and prolonged disturbances in blood flow. Which of these is not a common histological feature?

Wähle eine der folgenden:

  • Loss of brush border

  • Cell detachment

  • Distal tubule casts

  • Areas of cellular regeneration

  • Low tubule calcium

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Frage 14 von 19

1

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The classic triad of Acute Interstitial Nephritis is: , Eosinophilia and .
It is most commonly caused by drugs such as , and NSAID's.
It often after halting these.

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Frage 15 von 19

1

Hyperkalemia is a common problem of AKI. The mainstay of treatments are
- to drive K+ intracellularly
-Resonium which exchanges K+ and Na+ in the large intestine reducing intake
-Insulin and Glucose which drives K+ intracellularly
- to correct myocardium potential

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    B2 agonist
    Isotonic Saline
    Digoxin
    Lasix
    Calcium gluconate
    Sodium Hydrate
    Calcium Phosphate

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Frage 16 von 19

1

Which of these is not a role of the mesangium (the space between the capillaries of glomerulus)?

Wähle eine der folgenden:

  • Provide structural support to glomerulus

  • Contractile components

  • Phagocytic function

  • Sequester iron

  • Proliferation and laying down of collagen

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Frage 17 von 19

1

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A thin layer of endothelial cells with tight junctions surround the capillary lumen

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Frage 18 von 19

1

Nephrotic Syndrome is characterised by:

Wähle eine oder mehr der folgenden:

  • Large amount of Red Blood Cells

  • Heavy protein > 3.5g/ day

  • Oedema

  • Hyperalbuminaemia

  • Hypoalbuminaemia

  • Lipids

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Frage 19 von 19

1

NSAID's, ACE-Inhibitors and Diuretics can impair kidney function by?

Wähle eine oder mehr der folgenden:

  • Dilation of afferent arteriole

  • Constriction of afferent arteriole

  • Dilation of efferent arteriole

  • Constriction of efferent arteriole

  • Promoting increased perfusion via volume expansion

  • Promoting decreased perfusion via volume contraction

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