Kidney Function: Producing Dilute Urine

Descripción

Principles of Physiology and Pharmacology Test sobre Kidney Function: Producing Dilute Urine, creado por Charlotte Jakes el 24/12/2019.
Charlotte Jakes
Test por Charlotte Jakes, actualizado hace más de 1 año
Charlotte Jakes
Creado por Charlotte Jakes hace casi 5 años
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Resumen del Recurso

Pregunta 1

Pregunta
How much waste are we obliged to eliminate in urine per day?
Respuesta
  • 600mosmol
  • 600osmol
  • 800mosmol
  • 1osmol

Pregunta 2

Pregunta
What is the maximum urinary osmolarity possible?
Respuesta
  • 1400mosm/l
  • 140mosm/l
  • 14osm/l
  • 1.4mosm/l

Pregunta 3

Pregunta
How much urine are we obliged to produce per day if we need to eliminate 600mosmol but can only produce urine concentrated up to 1400mosm/l?
Respuesta
  • 600/1400 = 0.428l
  • 600/1400 = 0.428ml
  • 600 x 1400 = 840,000ml
  • 1400/600 = 2.3l

Pregunta 4

Pregunta
What is oliguria?
Respuesta
  • Daily urine output of less than 0.428l
  • Daily urine output of more than 0.428l
  • Hourly urine output of less than 0.428l
  • The presence of starch in the urine

Pregunta 5

Pregunta
What is polyuria?
Respuesta
  • Urinary output above 3l per day
  • Urinary output below 3l per day
  • Urinary concentration of over 300mosmol/litre
  • Urinary concentration of less than 300/mosmol/litre

Pregunta 6

Pregunta
Why do we consider urine dilute when it has a concentration of less than 300mosmol/litre?
Respuesta
  • The osmolality of plasma is 300mosmol/l
  • The osmolality of the filtrate is 300mosmol/l
  • The osmolality of interstitial fluid is 300mosmol/l
  • The osmolality of intracellular fluid is 300mosmol/l

Pregunta 7

Pregunta
What is the name given to the volume of plasma cleared of osmotically active particles per unit time?
Respuesta
  • Osmolar clearance
  • Free water clearance
  • Renal clearance
  • Reabsorption

Pregunta 8

Pregunta
What is the correct equation for osmolar clearance if... V = urine flow rate Uosm = urine osmolarity Posm = plasma osmolarity
Respuesta
  • (Uosm x V) / Posm
  • (Uosm x Posm) / V
  • (Uosm + Posm) / V
  • Uosm x Posm x V

Pregunta 9

Pregunta
What is the correct equation for free water clerance if... V = urine flow rate Uosm = urine osmolarity Posm = plasma osmolarity
Respuesta
  • V - (Uosm x V)/Posm
  • V + (Uosm x V)/Posm
  • V + (Uosm x Posm)/V
  • V - V/(Uosm x Posm)

Pregunta 10

Pregunta
If free water clearance is greater than 0, the urine will be hypo-osmotic or [blank_start]dilute[blank_end]. If free water clearance is 0, the urine will be [blank_start]iso[blank_end]-osmotic with respect to [blank_start]plasma[blank_end]. If free water clearance is less than 0, the urine will be [blank_start]hyper[blank_end]-osmotic or concentrated.
Respuesta
  • dilute
  • iso
  • plasma
  • hyper

Pregunta 11

Pregunta
Where are the osmoreceptors found in the brain?
Respuesta
  • Organum vasculosum lamina terminalus
  • Median preoptic nucleus
  • Subfomical organ
  • Posterior pituitary
  • Paraventricular nuclei
  • Supraoptic nuclei

Pregunta 12

Pregunta
Fill in the blanks below to describe the release of ADH. 1. When plasma osmolality is [blank_start]high[blank_end], receptors in the o[blank_start]rganum vasculosum lamina[blank_end], m[blank_start]edian preoptic nucleus[blank_end] and s[blank_start]ubfomical organ[blank_end] signal to neurosecretory cells in the [blank_start]paraventricular[blank_end] and [blank_start]supraoptic[blank_end] nuclei in the [blank_start]hypothalamus[blank_end]. 2. The nuclei synthesise a [blank_start]precursor[blank_end] of ADH 3. The [blank_start]precursor[blank_end] is passed into axons of neurons where it is cleaved into a [blank_start]9[blank_end] amino acid ADH molecule in the [blank_start]posterior pituitary[blank_end] 4. ADH is released into the blood of the [blank_start]internal carotid[blank_end] artery to be targeted to the [blank_start]collecting duct[blank_end]
Respuesta
  • high
  • rganum vasculosum lamina
  • edian preoptic nucleus
  • ubfomical organ
  • paraventricular
  • supraoptic
  • hypothalamus
  • precursor
  • precursor
  • 9
  • posterior pituitary
  • internal carotid
  • collecting duct

Pregunta 13

Pregunta
ADH has a long half life in the blood.
Respuesta
  • True
  • False

Pregunta 14

Pregunta
Alcohol inhibits ADH secretion.
Respuesta
  • True
  • False

Pregunta 15

Pregunta
Nicotine, nausea, pain and stress stimulate ADH secretion.
Respuesta
  • True
  • False

Pregunta 16

Pregunta
Which factor is ADH secretion most sensitive to?
Respuesta
  • Plasma osmolality
  • Blood pressure
  • Blood volume
  • Blood temperature

Pregunta 17

Pregunta
What symptoms characterise diabetes insipidus?
Respuesta
  • Polyuria, polydipsia and nocturia
  • Oliguria, hematuria
  • Polydipsia, oliguria, dehydration
  • Jaundice, hematuria

Pregunta 18

Pregunta
What is neurogenic diabetes insipidus?
Respuesta
  • Lack of ADH secretion due to a congenital brain defect or head injury
  • Mutated V2 receptors or aquaporins
  • Caused by side effect of drugs or infection
  • Increased urination due to small molecules in renal tubule lumen causing excess water reabsorption

Pregunta 19

Pregunta
What name is given to diabetes insipidus caused by mutated V2 receptors or aquaporin channels OR acquired by infection or drug use?
Respuesta
  • Nephrogenic diabetes insipidus
  • Inflammatory diabetes insipidus
  • Neurogenic diabetes insipidus
  • Mutagenic diabetes insipidus

Pregunta 20

Pregunta
What condition is typical of diabetes mellitus whereby the presence of small molecules in the renal tubule prevents water reabsorption causing production of large quantities of dilute urine?
Respuesta
  • Osmotic diuresis
  • Neurogenic diabetes insipidus
  • Oliguria
  • Hematuria

Pregunta 21

Pregunta
Potassium has a concentration of [blank_start]5[blank_end]mM in the extracellular fluid and [blank_start]150[blank_end]mM in the intracellular fluid.
Respuesta
  • 5
  • 150

Pregunta 22

Pregunta
In the proximal tubule, the Na+/K+ [blank_start]pump[blank_end] moves potassium ions [blank_start]into[blank_end] the epithelial cell. This concentration gradient draws potassium into the epithelial cell from the [blank_start]lumen[blank_end] and out into the [blank_start]interstitial[blank_end] fluid via [blank_start]channel[blank_end] proteins. Potassium can also diffuse between cells via [blank_start]tight junctions[blank_end].
Respuesta
  • pump
  • into
  • lumen
  • interstitial
  • channel
  • tight junctions

Pregunta 23

Pregunta
How does potassium enter the epithelial cells of the thick ascending limb of the loop of Henle?
Respuesta
  • Na+/K+/2Cl- transporter
  • Na+/K+ ATPase
  • Renal outer medullar K+ channel (ROMK)
  • K+/H+ ATPase

Pregunta 24

Pregunta
How does potassium enter the epithelial cells of the distal tubule?
Respuesta
  • K+/H+ exchanger
  • Na+/K+ ATPase
  • Na+/K+/2Cl ATPase
  • Renal outer medullar K+ channel (ROMK)

Pregunta 25

Pregunta
In the collecting duct, potassium is reabsorbed by [blank_start]type A[blank_end] intercalated cells in exchange for [blank_start]H+[blank_end] ions. This is outweighed by [blank_start]secretion[blank_end] by the [blank_start]prinicipal[blank_end] cells. In the principal cells, potassium moves out of the epithelium via [blank_start]renal outer medullar K+ channels[blank_end] (ROMKs). It also moves out through [blank_start]calcium[blank_end]-activated big-[blank_start]conductance[blank_end] K+ channels when tubular flow rates are [blank_start]high[blank_end]. The K+/[blank_start]Cl-[blank_end] transporter also removes potassium from the cell.
Respuesta
  • type A
  • H+
  • secretion
  • prinicipal
  • renal outer medullar K+ channels
  • calcium
  • conductance
  • high
  • Cl-

Pregunta 26

Pregunta
If more sodium enters the principal cells in the collecting duct epithelium, what happens to the secretion of potassium?
Respuesta
  • Increases because the filtrate becomes less positively charged
  • Increases because the filtrate becomes more positively charged
  • Decreases because the filtrate becomes more positively charged
  • Decreases because the filtrate becomes less positively charged

Pregunta 27

Pregunta
What hormone stimulations the K+ channels, Na+ channels and Na+/K+ ATPases of the collecting duct to increase secretion?
Respuesta
  • Aldosterone
  • ADH
  • Adrenaline
  • Testosterone

Pregunta 28

Pregunta
Which favours secretion more?
Respuesta
  • High tubular flow rates
  • Low tubular flow rates

Pregunta 29

Pregunta
What is hypokalaemia?
Respuesta
  • Plasma potassium concentration of less than 3.5mM
  • Plasma potassium concentration of more than 3.5mM
  • Intracellular potassium concentration of more than 3.5mM
  • Urinary potassium concentration of less than 3.5mM

Pregunta 30

Pregunta
Hypokalaemia can occur due to increased internal losses. For example, in the kidney, [blank_start]high[blank_end] tubular flow rates favour [blank_start]high[blank_end] rates of potassium [blank_start]secretion[blank_end]. Hyperaldosteronism [blank_start]increases[blank_end] the activity of the potassium channels, favouring potassium [blank_start]secretion[blank_end]. Alkalosis is also associated with hypokalaemia because potassium is secreted due to changed in [blank_start]electrochemical gradients[blank_end]. In the GI tract, vomiting and [blank_start]diarrhea[blank_end] can cause excess potassium loss. Potassium can be lost from the skin due to burns or intense [blank_start]sweating[blank_end].
Respuesta
  • high
  • high
  • secretion
  • increases
  • secretion
  • electrochemical gradients
  • diarrhea
  • sweating

Pregunta 31

Pregunta
How does insulin affect potassium uptake in cells?
Respuesta
  • Activates Na+/K+ ATPase
  • Deactivates Na+/K+ ATPase
  • Activates K+ channels
  • Activates Na+/H+ channels

Pregunta 32

Pregunta
Why does potassium intake into cells increase due to metabolic alkalosis?
Respuesta
  • H+ ions bound to buffers leave cells, K+ enter to maintain charge
  • H+ ions bound to buffers enter cells, K+ leave to maintain charge
  • K+ ions act as buffers to reduce plasma pH
  • K+ ions are exchanged for H+ on the K+/H+ exchanger

Pregunta 33

Pregunta
What is severe hypokalaemia?
Respuesta
  • < 2.5mM
  • > 2.5mM
  • < 3.5 mM
  • < 5 mM

Pregunta 34

Pregunta
In hypokalaemia, membrane potentials become more [blank_start]negative[blank_end]. Therefore, a larger intake of [blank_start]sodium[blank_end] is required to exceed the [blank_start]threshold[blank_end] and fire an [blank_start]action potential[blank_end]. Therefore, action potentials are less likely to fire and the [blank_start]refractory[blank_end] period is [blank_start]longer[blank_end] so muscles become weak and paralysed.
Respuesta
  • negative
  • sodium
  • threshold
  • action potential
  • longer
  • refractory

Pregunta 35

Pregunta
What is hyperkalaemia?
Respuesta
  • > 5.5mM
  • < 5.5mM
  • < 3.5 mM
  • > 3.5 mM

Pregunta 36

Pregunta
Reduced release of what hormone can cause hyperkalaemia?
Respuesta
  • Aldosterone
  • Adrenaline
  • ADH
  • Oestrogen

Pregunta 37

Pregunta
Hyperkalaemia can be caused by redistribution of potassium out of cells. Check the two specific examples of this.
Respuesta
  • Renal failure
  • Hypoaldosteronism
  • Action of drugs
  • Acidosis
  • Tissue destruction/cell lysis

Pregunta 38

Pregunta
In hyperkalaemia, the resting membrane potential becomes more [blank_start]positive[blank_end]. This means less [blank_start]sodium[blank_end] is required to exceed the [blank_start]threshold[blank_end] and fire an [blank_start]action potential[blank_end]. Action potentials are [blank_start]more[blank_end] likely to fire, causing hyperreflexia and [blank_start]cramping[blank_end] of the muscles.
Respuesta
  • positive
  • sodium
  • threshold
  • action potential
  • cramping
  • more

Pregunta 39

Pregunta
What can we administer intravenously to treat hyperkalaemia to decrease the action potential threshold in the heart?
Respuesta
  • Na+
  • K+
  • Ca2+
  • Acetylcholine

Pregunta 40

Pregunta
Which drug could we administer during hyperkalaemia to shift K+ into cells?
Respuesta
  • Insulin
  • Glucagon
  • Adrenaline
  • Diuretics

Pregunta 41

Pregunta
Of the treatments listed below, which are appropriate for treating hypokalaemia?
Respuesta
  • Eating potassium-rich foods
  • Oral or IV administration of KCl
  • Correction of alkalosis
  • Use of K+-sparing diuretics
  • Administration of insulin
  • IV Ca2+
  • IV Na+

Pregunta 42

Pregunta
What is severe hyperkalaemia?
Respuesta
  • > 7.5mM
  • < 7.5mM
  • > 5.5mM
  • < 5.5mM
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