What is the functional unit of the kidney?
glomerulus
nephron
medulla
cortex
Which part of the nephron is mainly responsible for regulating the concentration of urine?
Distal tubule
Proximal tubule
Loop of Henle
Collecting duct
Which hormone is required for the reabsorption of water in the collecting tubule?
Renin
Angiotensin
ADH
ANP
What is the main solute that is reabsorbed in the proximal tubule?
potassium K
sodium chloride NaCl
hydrogen H
urea
Which hormones serve to increase blood pressure? Select all.
angiotensin
aldosterone
epinephrine
norepinephrine
What is the net outward pressure that influences glomerular filtration?
20 mmHg
10 mmHg
15 mmHg
5 mmHg
Which hormone is produced by the nephrons?
Epinephrine
Up to __% of renal function can be lost before renal failure is noticeable.
80%
75%
20%
50%
60-70% of acute renal failure is caused by which type of failure?
Pre-renal failure
Intra-renal failure
Post-renal failure
Pre-renal failure is caused by what?
Renal hypo-perfusion
Obstruction to the urinary tract
Acute tubular necrosis
Glomerulonephritis
Check off all possible causes of post-renal failure.
renal calculi
ureteral stricture
benign prostatic hyperplasia
dehydration
cardiogenic shock
glomerulonephritis
pyelonephritis
Check off all possible causes of intra-renal failure.
nephrotic syndrome
90% of intra-renal failure is caused by which of the following?
Pyelonephritis
Nephrotic syndrome
Acute tubular necrosis (intra-renal failure) is caused by which of the following? Select all.
Prolonged renal ischemia from pre-renal failure
Exposure to nephrotoxic drugs
Intratubular obstruction (e.g. muscle trauma - release of myoglobin)
An immunologic disorder causing glomerular inflammation
Proteinuria and hematuria, two main symptoms of glomerulonephritis, are caused by what?
Entrapment in the glomerulus of antigen-antibody complexes produced in response to an infection
Nephrotoxic drugs, such as aminoglycoside antibiotics and radiologic contrast media
Baroreceptor-mediated activation of the sympathetic nervous system
Loss of transport proteins is part of the process of nephrotic syndrome. What is the result of this loss?
Decreased Vitamin D and thyroxine
Increased filtration of plasma proteins
Renal ischemia
Intratubular obstruction
Pyelonephritis is caused by which of the following?
Bacterial infection
Nephrotoxic drugs
Benign prostatic hyperplasia
Women and the elderly are at higher risk for which of the following?
In which stage of acute renal failure would you expect to see the following: renal flow at 25% of normal, decreased O2 saturation, decreased urine output, and increased Na in urine?
Initiating stage
Oliguric-anuric stage
Diuretic stage
Recovery stage
Does increased urine output happen early or late in the process of acute renal failure?
Early
Late
Select all signs and symptoms of acute uremia.
Hypokalemia
Increased BUN
Pruritus
Potential anemia
Hyperventilation
Thrombosis
What are the leading causes of chronic renal failure?
Recurrent urinary tract infections
Diabetes
Hypertension
A patient presents with the following: mild anemia, increased BUN and serum creatinine, and nocturia. This patient is in which stage of chronic renal failure?
Reduced renal reserve
Renal insufficiency
Renal failure
ESRD
Hyperkalemia, hypernatremia, and hyperphosphatemia are all signs of which stage of chronic renal failure?
Renal osteodystrophies is a clinical manifestation of chronic renal failure. What is the cause of this manifestation?
Impaired vitamin D synthesis
Metabolic acidosis
Negative nitrogen balance due to high protein breakdown
Decreased platelet activity
Are thyroid hormones low or high in chronic kidney disease?
High
Low
Select all appropriate therapeutic interventions for a patient with chronic kidney disease.
Supplemental vitamin D
High potassium diet
ACE inhibitors
Dialysis
Which symptom is common throughout ALL stages of chronic kidney disease?
Hyperphosphatemia
Anemia
HTN
Hyperkalemia
Select all possible causes of decreased pH of the urine.
Starvation
UTI
Consumption of citrus
Select all possible causes of a decrease in specific gravity of the urine.
Dehydration
Excessive fluid intake
What are the normal values of urine pH?
4.8-8.0
4.0-6.0
2.0-3.8
6.0-9.0
What are the normal ranges of specific gravity of urine?
1.025-1.032
1.0-2.0
1.020-1.045
What is the normal range of BUN?
10-20 mg/dL
10-20 mg/mL
15-30 mg/dL
20-25 mg/mL
What is the normal range of creatinine clearance?
0.7-1.5 mg/dL
0.8-2.0 mg/dL
0.7-1.0 mg/mL
0.5-1.5 mg/mL
The rate of _____ clearance is directly proportional to the rate of filtration of water and solutes across the glomerular membrane.
Inulin
Creatinine
Urea
Sodium
The GFR is directly related to:
Perfusion pressure in the glomerular capillaries
Diffusion rate in the renal cortex
Diffusion rate in the renal medulla
Glomerular active transport
What force(s) creates passive transport of water in the proximal tubule?
Peritubular capillary hydrostatic pressure
Peritubular capillary oncotic and osmotic pressures
Interstitial hydrostatic pressure
Interstitial oncotic and osmotic pressures
______ is a hormone synthesized and secreted by the kidneys.
Erythropoietin
Aldosterone
A patient exhibits symptoms including hematuria with RBC casts and proteinuria exceeding 3-5 g/day, with albumin as the major protein. These data suggests the presence of which disorder?
Cystitis
Chronic pyelonephritis
How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?
Glucose has an osmotic effect, which attracts water and sodium, resulting in more dilute blood and a lower potassium concentration.
When insulin transports glucose into the cell, it also carries potassium with it.
Potassium attaches to receptors on the cell membrane of glucose and is carried into the cell.
Increasing insulin causes ketoacidosis, which causes potassium to move into the cell in exchange for hydrogen.
