Pregunta 1
Pregunta
What is the correct order of blood vessels in the kidney?
Respuesta
-
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
Pregunta 2
Pregunta
What is the correct order of veins in the kidney?
Respuesta
-
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
Pregunta 3
Pregunta
What is the lymphatic drainage of the kidneys?
Respuesta
-
Para-aortic/lumbar lymph nodes
-
Deep inguinal lymph nodes
-
Superficial inguinal lymph nodes
-
Groin lymph nodes
Pregunta 4
Pregunta
Describe the process of bicarbonate reabsorption.
1. Bicarbonate is filtered by the glomerulus
---Inside the tubule it associates with [blank_start]H+[blank_end] to form [blank_start]carbonic acid[blank_end]
2. [blank_start]Carbonic anhydrase[blank_end] catalyses the [blank_start]dissociation[blank_end] of carbonic acid into [blank_start]H2O and CO2[blank_end]
---These can then be [blank_start]absorbed[blank_end] into the tubular cells
3. Inside the cell, [blank_start]carbonic anhydrase[blank_end] catalyses the reaction between H2O and CO2 to form [blank_start]carbonic acid[blank_end] again
4. The carbonic acid then [blank_start]dissociates[blank_end] into [blank_start]H+ and bicarbonate[blank_end] again
5. [blank_start]Selective permeability[blank_end] ensures that the ions are transported in the right directions:
---H+ is [blank_start]secreted back into the lumen[blank_end], as H+ channels are only found on the [blank_start]luminal[blank_end] side
---Bicarbonate is [blank_start]absorbed into the capillaries[blank_end], as bicarbonate channels are only found on the [blank_start]basolateral[blank_end] side
Pregunta 5
Pregunta
Describe the process of H+ excretion via titration with phosphate.
1. [blank_start]H2O and CO2[blank_end] react to form [blank_start]carbonic acid[blank_end] inside tubular cells, catalysed by [blank_start]carbonic anhydrase[blank_end]
---NOTE: the H2O and CO2 is [blank_start]new[blank_end], i.e. produced inside the cell and not reabsorbed from the filtrate
2. Carbonic acid dissociates to form [blank_start]H+ and a new bicarbonate ion[blank_end]
3. [blank_start]Bicarbonate[blank_end] is absorbed into the capillary from the [blank_start]basolateral[blank_end] side (via selective permeability)
4. [blank_start]H+[blank_end] is secreted back into the [blank_start]lumen[blank_end] (via selective permeability)
5. Some H+ associates with [blank_start]phosphate ions[blank_end] to form [blank_start]H2PO4[blank_end]
---This is then excreted in the urine
Pregunta 6
Pregunta
How much H+ is excreted via titration with phosphate per day?
Respuesta
-
40 mmol/day
-
50 mmol/day
-
60 mmol/day
-
70 mmol/day
Pregunta 7
Pregunta
Describe the excretion of H+ via titration with ammonia.
1. [blank_start]Ammonia[blank_end] is produced in the [blank_start]PCT[blank_end]:
---[blank_start]Glutamine[blank_end] is reabsorbed from the filtrate
---Inside the tubular cell, [blank_start]glutaminase[blank_end] catalyses the breakdown of glutamine into [blank_start]NH4+ and bicarbonate[blank_end]
---[blank_start]Bicarbonate[blank_end] is reabsorbed into the capillary
---[blank_start]NH4+[blank_end] is secreted into the lumen
---NH4+ is converted to [blank_start]NH3[blank_end]
2. [blank_start]H2O and CO2[blank_end] react to form carbonic acid inside tubular cells, catalysed by [blank_start]carbonic anhydrase[blank_end]
---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 [blank_start]H+ and a new bicarbonate ion[blank_end]
4. [blank_start]Bicarbonate[blank_end] is absorbed into the capillary from the [blank_start]basolateral[blank_end] side (via selective permeability)
5. [blank_start]H+[blank_end] is secreted back into the [blank_start]lumen[blank_end] (via selective permeability)
6. Some H+ associates with [blank_start]NH3[blank_end] to form [blank_start]NH4+[blank_end]
7.NH4+ is then excreted in the urine
Pregunta 8
Pregunta
How much H+ is excreted per day via titration with ammonia?
Respuesta
-
10-50 mmol/day
-
50-100 mmol/day
-
70-100 mmol/day
-
80-130 mmol/day
Pregunta 9
Pregunta
How is the amount of H+ excretion in the urine increased when there are high levels of H+ in the blood?
Respuesta
-
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
Pregunta 10
Pregunta
What is the function of the mesangial cells in the juxtaglomerular apparatus?
Respuesta
-
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
Pregunta 11
Pregunta
What is the function of juxtaglomerular cells?
Pregunta 12
Pregunta
What is the function of the macula densa?
Pregunta 13
Pregunta
How big are the ureters?
Respuesta
-
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
Pregunta 14
Pregunta
Where are kidney stones most likely to get stuck?
Respuesta
-
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
Pregunta 15
Pregunta
Which of the following can cause kidney stones?
Respuesta
-
Primary hyperparathyroidism
-
Primary hypoparathyroidism
-
Hypercalcaemia
-
Hypocalcaemia
-
Primary/secondary hyperoxaluria
-
Primary/secondary hypooxaluria
-
Renal tubular acidosis
-
Hypocitraturia
-
Hypercitraturia
Pregunta 16
Pregunta
What is the correct order for the proportions of different types of kidney stones, from most common to least common?
Respuesta
-
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
Pregunta 17
Pregunta
What is the most common composition of kidney stones?
Pregunta 18
Pregunta
How thick should the kidney cortex be?
Respuesta
-
1-2 cm
-
2-3 cm
-
3-4 cm
-
4-5 cm
Pregunta 19
Pregunta
How much of the filtrate is reabsorbed by kidneys?
Respuesta
-
99% (180 L/day)
-
95% (175 L/day)
-
90% (165 L/day)
-
80% (140 L/day)
Pregunta 20
Pregunta
Why is osmolality used to measure electrolyte concentrations, not osmolarity?
Respuesta
-
Osmolality is temperature independent
-
Osmolality is easier to calculate
-
Osmolality is a more reliable measurement
-
Osmolality is recognised internationally
Pregunta 21
Pregunta
How long is the PCT?
Pregunta 22
Pregunta
How is sodium reabsorbed in the PCT? NOTE: not the co-transporters, just sodium on its own!
Respuesta
-
Na+/H+ exchanger
-
Na+ channel
-
Na+/HCO3- exchanger
-
Na+/Cl- exchanger
Pregunta 23
Pregunta
How long is the DCT?
Pregunta 24
Pregunta
What proportion of total reabsorption happens in the DCT?
Pregunta 25
Pregunta
What proportion of total reabsorption happens in the thick ascending loop of Henle?
Pregunta 26
Pregunta
Describe the action of aldosterone.
1. [blank_start]Aldosterone[blank_end] binds to the intracellular [blank_start]mineralocorticoid receptor[blank_end]
2. Aldosterone-receptor complex binds to [blank_start]nucleus[blank_end] and acts as a transcription factor, causing:
---[blank_start]Stimulation of Na+/K+ ATPase[blank_end]
---[blank_start]Increased expression of K+ channels[blank_end] (therefore more potassium [blank_start]excretion[blank_end])
---[blank_start]Increased expression of Na+ channels[blank_end] (therefore more sodium [blank_start]reabsorption[blank_end])
Respuesta
-
Aldosterone
-
mineralocorticoid receptor
-
nucleus
-
Stimulation of Na+/K+ ATPase
-
Increased expression of K+ channels
-
excretion
-
Increased expression of Na+ channels
-
reabsorption
Pregunta 27
Pregunta
What proportion of creatinine is excreted via tubular secretion?
Pregunta 28
Pregunta
What are the correct values of minimum and maximum urine osmolality?
Respuesta
-
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
Pregunta 29
Pregunta
How much waste is excreted in the urine per day?
Respuesta
-
600 mosmol/day
-
400 mosmol/day
-
800 mosmol/day
-
1000 mosmol/day
Pregunta 30
Pregunta
What are the correct values for minimum and maximum daily urine output?
Respuesta
-
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
Pregunta 31
Pregunta
What can cause dysfunctional reabsorption in the PCT?
Respuesta
-
Fanconi's syndrome
-
Acetzolamide
-
Bartter's syndrome
-
Gitelman's syndrome
-
Liddle's syndrome
-
Loop diuretics
-
Thiazide diuretics
-
K-sparing diuretics
Pregunta 32
Pregunta
What can cause defective absorption through NKCC2 channels?
Respuesta
-
Fanconi's syndrome
-
Acetazolamide
-
Bartter's syndrome
-
Loop diuretics
-
Gitelman's syndrome
-
Thiazide diuretics
-
Liddle's syndrome
-
K-sparing diuretics
Pregunta 33
Pregunta
What can cause dysfunctional absorption through NCC channels?
Respuesta
-
Fanconi's syndrome
-
Acetazolamide
-
Bartter's syndrome
-
Loop diuretics
-
Gitelman's syndrome
-
Thiazide diuretics
-
Liddle's syndrome
-
K-sparing diuretics
Pregunta 34
Pregunta
What can cause dysfunctional reabsorption through ENaC channels?
Respuesta
-
Fanconi's syndrome
-
Acetazolamide
-
Bartter's syndrome
-
Loop diuretics
-
Gitelman's syndrome
-
Thiazide diuretics
-
Liddle's syndrome
-
K-sparing diuretics
Pregunta 35
Pregunta
What is the normal (healthy) range of urine output per day?
Respuesta
-
0.8-2 L/day
-
0.5-4 L/day
-
0.4-12 L/day
-
0.6-3 L/day
Pregunta 36
Pregunta
What is used for the quantification of protein in urinalysis?
Respuesta
-
Spot urinalysis for protein levels
-
Urinary protein:creatinine ratio
-
24 hour urine collection and urinary protein levels
-
Consecutive spot urinalysis for protein levels
Pregunta 37
Pregunta
What are the main causes of acute kidney injury or chronic kidney disease?
1. [blank_start]Ineffective blood supply[blank_end]
2. [blank_start]Glomerular disease[blank_end]
3. [blank_start]Tubulo-interstitial disease[blank_end]
4. [blank_start]Obstructive uropathy[blank_end]