Melissa Denker
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Kidney function and anatomy

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Melissa Denker
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REPRO/NEPHRO BLOCK: Week 4 - More Kidneys

REPRO/NEPHRO BLOCK: Week 4 - More Kidneys

Question 1 of 37

1

What is the correct order of blood vessels in the kidney?

Select one of the following:

  • Renal artery
    Segmental arteries
    Lobar arteries
    Interlobar arteries
    Arcuate arteries
    Cortical radiate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Segmental arteries
    Lobar arteries
    Interlobar arteries
    Cortical radiate arteries
    Arcuate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Lobar arteries
    Interlobar arteries
    Segmental arteries
    Cortical radiate arteries
    Arcuate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Interlobar arteries
    Lobar arteries
    Arcuate arteries
    Cortical radiate arteries
    Segmental arteries
    Afferent arterioles
    Glomerulus

Explanation

Question 2 of 37

1

What is the correct order of veins in the kidney?

Select one of the following:

  • Glomerulus
    Efferent arterioles
    Cortical radiate veins
    Arcuate veins
    Interlobar veins
    Lobar veins
    Segmental veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Arcuate veins
    Cortical radiate veins
    Interlobar veins
    Lobar veins
    Segmental veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Segmental veins
    Lobar veins
    Interlobar veins
    Arcuate veins
    Cortical radiate veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Cortical radiate veins
    Arcuate veins
    Lobar veins
    Interlobar veins
    Segmental veins
    Renal vein

Explanation

Question 3 of 37

1

What is the lymphatic drainage of the kidneys?

Select one of the following:

  • Para-aortic/lumbar lymph nodes

  • Deep inguinal lymph nodes

  • Superficial inguinal lymph nodes

  • Groin lymph nodes

Explanation

Question 4 of 37

1

Fill the blank spaces to complete the text.

Describe the process of bicarbonate reabsorption.
1. Bicarbonate is filtered by the glomerulus
---Inside the tubule it associates with to form
2. catalyses the of carbonic acid into
---These can then be into the tubular cells
3. Inside the cell, catalyses the reaction between H2O and CO2 to form again
4. The carbonic acid then into again
5. ensures that the ions are transported in the right directions:
---H+ is , as H+ channels are only found on the side
---Bicarbonate is , as bicarbonate channels are only found on the side

Explanation

Question 5 of 37

1

Fill the blank spaces to complete the text.

Describe the process of H+ excretion via titration with phosphate.
1. react to form inside tubular cells, catalysed by
---NOTE: the H2O and CO2 is , i.e. produced inside the cell and not reabsorbed from the filtrate
2. Carbonic acid dissociates to form
3. is absorbed into the capillary from the side (via selective permeability)
4. is secreted back into the (via selective permeability)
5. Some H+ associates with to form
---This is then excreted in the urine

Explanation

Question 6 of 37

1

How much H+ is excreted via titration with phosphate per day?

Select one of the following:

  • 40 mmol/day

  • 50 mmol/day

  • 60 mmol/day

  • 70 mmol/day

Explanation

Question 7 of 37

1

Fill the blank spaces to complete the text.

Describe the excretion of H+ via titration with ammonia.
1. is produced in the :
--- is reabsorbed from the filtrate
---Inside the tubular cell, catalyses the breakdown of glutamine into
--- is reabsorbed into the capillary
--- is secreted into the lumen
---NH4+ is converted to
2. react to form carbonic acid inside tubular cells, catalysed by
---NOTE: the H2O and CO2 is new, i.e. produced inside the cell and not reabsorbed from the filtrate
3. Carbonic acid dissociates to form
4. is absorbed into the capillary from the side (via selective permeability)
5. is secreted back into the (via selective permeability)
6. Some H+ associates with to form
7.NH4+ is then excreted in the urine

Explanation

Question 8 of 37

1

How much H+ is excreted per day via titration with ammonia?

Select one of the following:

  • 10-50 mmol/day

  • 50-100 mmol/day

  • 70-100 mmol/day

  • 80-130 mmol/day

Explanation

Question 9 of 37

1

How is the amount of H+ excretion in the urine increased when there are high levels of H+ in the blood?

Select one of the following:

  • Upregulation of glutaminase, leading to increased H+ excretion via titration with ammonia

  • Increased phosphate excretion, leading to more phosphate in the tubules and increased H+ excretion via titration with phosphate

  • Increased bicarbonate production in the tubular cells, leading to increased buffering in the blood to decrease H+ levels

  • Down-regulation of H2O and CO2 transport into tubular cells, leading to increased H+ excretion in carbonic acid

Explanation

Question 10 of 37

1

What is the function of the mesangial cells in the juxtaglomerular apparatus?

Select one of the following:

  • Unknown

  • Unclear: possibly erythropoietin or smooth muscle-like functions

  • Constriction of the efferent arteriole to maintain GFR

  • Vasodilation of the afferent arteriole to maintain GFR

Explanation

Question 11 of 37

1

What is the function of juxtaglomerular cells?

Select one of the following:

  • Secretion of renin

  • Secretion of adenosine

  • Detection of tubular flow

  • Vasodilation of the afferent arteriole to maintain GFR

Explanation

Question 12 of 37

1

What is the function of the macula densa?

Select one or more of the following:

  • Detect tubular flow

  • Adenosine secretion

  • Renin secretion

  • Vasodilation of the afferent artiole to maintain GFR

Explanation

Question 13 of 37

1

How big are the ureters?

Select one of the following:

  • Length: 25-30 cm
    Diameter: 3-4 mm

  • Length: 30-35 cm
    Diameter: 4-5 mm

  • Length: 20-25 cm
    Diameter: 2-3 mm

  • Length: 35-40 cm
    Diameter: 3-4 mm

Explanation

Question 14 of 37

1

Where are kidney stones most likely to get stuck?

Select one or more of the following:

  • Uteropelvic junction

  • Crossing over the common iliac arteries at the pelvic brim

  • Where ureters enter the bladder

  • Medial aspect of the psoas major muscle

  • Point at which it enters the retroperitoneum

Explanation

Question 15 of 37

1

Which of the following can cause kidney stones?

Select one or more of the following:

  • Primary hyperparathyroidism

  • Primary hypoparathyroidism

  • Hypercalcaemia

  • Hypocalcaemia

  • Primary/secondary hyperoxaluria

  • Primary/secondary hypooxaluria

  • Renal tubular acidosis

  • Hypocitraturia

  • Hypercitraturia

Explanation

Question 16 of 37

1

What is the correct order for the proportions of different types of kidney stones, from most common to least common?

Select one of the following:

  • Calcium containing (calcium phosphate/oxalate)
    Magnesium ammonium phosphate (Struvite)
    Urate
    Cysteine
    Mixed

  • Mixed
    Calcium containing (calcium phosphate/oxalate)
    Magnesium ammonium phosphate (Struvite)
    Urate
    Cysteine

  • Mixed
    Magnesium ammonium phosphate (Struvite)
    Calcium containing (calcium phosphate/oxalate)
    Cysteine
    Urate

  • Magnesium ammonium phosphate (Struvite)
    Calcium containing (calcium phosphate/oxalate)
    Mixed
    Cysteine
    Urate

Explanation

Question 17 of 37

1

What is the most common composition of kidney stones?

Select one of the following:

  • Calcium containing (calcium phosphate/oxalate)

  • Urate

  • Cysteine

  • Struvite

  • Mixed

Explanation

Question 18 of 37

1

How thick should the kidney cortex be?

Select one of the following:

  • 1-2 cm

  • 2-3 cm

  • 3-4 cm

  • 4-5 cm

Explanation

Question 19 of 37

1

How much of the filtrate is reabsorbed by kidneys?

Select one of the following:

  • 99% (180 L/day)

  • 95% (175 L/day)

  • 90% (165 L/day)

  • 80% (140 L/day)

Explanation

Question 20 of 37

1

Why is osmolality used to measure electrolyte concentrations, not osmolarity?

Select one of the following:

  • Osmolality is temperature independent

  • Osmolality is easier to calculate

  • Osmolality is a more reliable measurement

  • Osmolality is recognised internationally

Explanation

Question 21 of 37

1

How long is the PCT?

Select one of the following:

  • 14mm

  • 10mm

  • 16mm

  • 18mm

  • 12mm

Explanation

Question 22 of 37

1

How is sodium reabsorbed in the PCT? NOTE: not the co-transporters, just sodium on its own!

Select one of the following:

  • Na+/H+ exchanger

  • Na+ channel

  • Na+/HCO3- exchanger

  • Na+/Cl- exchanger

Explanation

Question 23 of 37

1

How long is the DCT?

Select one of the following:

  • 1mm

  • 2mm

  • 3mm

  • 4mm

Explanation

Question 24 of 37

1

What proportion of total reabsorption happens in the DCT?

Select one of the following:

  • 25%

  • 5%

  • 15%

  • 30%

  • 10%

Explanation

Question 25 of 37

1

What proportion of total reabsorption happens in the thick ascending loop of Henle?

Select one of the following:

  • 25%

  • 20%

  • 30%

  • 35%

Explanation

Question 26 of 37

1

Fill the blank spaces to complete the text.

Describe the action of aldosterone.
1. binds to the intracellular
2. Aldosterone-receptor complex binds to and acts as a transcription factor, causing:
---
--- (therefore more potassium )
--- (therefore more sodium )

Explanation

Question 27 of 37

1

What proportion of creatinine is excreted via tubular secretion?

Select one of the following:

  • 0.5%

  • 5%

  • 10%

  • 20%

Explanation

Question 28 of 37

1

What are the correct values of minimum and maximum urine osmolality?

Select one of the following:

  • Minimum osmolality: 50 mosm/Kg
    Maximum osmolality: 1400 mosm/Kg

  • Minimum osmolality: 100 mosm/Kg
    Maximum osmolality: 2000 mosm/Kg

  • Minimum osmolality: 60 mosm/Kg
    Maximum osmolality: 1400 mosm/Kg

  • Minimum osmolality: 50 mosm/Kg
    Maximum osmolality: 1200 mosm/Kg

Explanation

Question 29 of 37

1

How much waste is excreted in the urine per day?

Select one of the following:

  • 600 mosmol/day

  • 400 mosmol/day

  • 800 mosmol/day

  • 1000 mosmol/day

Explanation

Question 30 of 37

1

What are the correct values for minimum and maximum daily urine output?

Select one of the following:

  • Minimum urine output: 0.4 L/day
    Maximum urine output: 12 L/day

  • Minimum urine output: 0.3 L/day
    Maximum urine output: 14L/day

  • Minimum urine output: 0.5 L/day
    Maximum urine output: 12 L/day

  • Minimum urine output: 0.6 L/day
    Maximum urine output: 14 L/day

Explanation

Question 31 of 37

1

What can cause dysfunctional reabsorption in the PCT?

Select one or more of the following:

  • Fanconi's syndrome

  • Acetzolamide

  • Bartter's syndrome

  • Gitelman's syndrome

  • Liddle's syndrome

  • Loop diuretics

  • Thiazide diuretics

  • K-sparing diuretics

Explanation

Question 32 of 37

1

What can cause defective absorption through NKCC2 channels?

Select one or more of the following:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explanation

Question 33 of 37

1

What can cause dysfunctional absorption through NCC channels?

Select one or more of the following:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explanation

Question 34 of 37

1

What can cause dysfunctional reabsorption through ENaC channels?

Select one or more of the following:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explanation

Question 35 of 37

1

What is the normal (healthy) range of urine output per day?

Select one of the following:

  • 0.8-2 L/day

  • 0.5-4 L/day

  • 0.4-12 L/day

  • 0.6-3 L/day

Explanation

Question 36 of 37

1

What is used for the quantification of protein in urinalysis?

Select one of the following:

  • Spot urinalysis for protein levels

  • Urinary protein:creatinine ratio

  • 24 hour urine collection and urinary protein levels

  • Consecutive spot urinalysis for protein levels

Explanation

Question 37 of 37

1

Fill the blank spaces to complete the text.

What are the main causes of acute kidney injury or chronic kidney disease?
1.
2.
3.
4.

Explanation

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