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

Questão 1 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 2 de 37

1

What is the correct order of veins in the kidney?

Selecione uma das seguintes:

  • 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

Explicação

Questão 3 de 37

1

What is the lymphatic drainage of the kidneys?

Selecione uma das seguintes:

  • Para-aortic/lumbar lymph nodes

  • Deep inguinal lymph nodes

  • Superficial inguinal lymph nodes

  • Groin lymph nodes

Explicação

Questão 4 de 37

1

Preencha os espaços em branco para completar o texto.

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

Explicação

Questão 5 de 37

1

Preencha os espaços em branco para completar o texto.

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

Explicação

Questão 6 de 37

1

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

Selecione uma das seguintes:

  • 40 mmol/day

  • 50 mmol/day

  • 60 mmol/day

  • 70 mmol/day

Explicação

Questão 7 de 37

1

Preencha os espaços em branco para completar o texto.

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

Explicação

Questão 8 de 37

1

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

Selecione uma das seguintes:

  • 10-50 mmol/day

  • 50-100 mmol/day

  • 70-100 mmol/day

  • 80-130 mmol/day

Explicação

Questão 9 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 10 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 11 de 37

1

What is the function of juxtaglomerular cells?

Selecione uma das seguintes:

  • Secretion of renin

  • Secretion of adenosine

  • Detection of tubular flow

  • Vasodilation of the afferent arteriole to maintain GFR

Explicação

Questão 12 de 37

1

What is the function of the macula densa?

Selecione uma ou mais das seguintes:

  • Detect tubular flow

  • Adenosine secretion

  • Renin secretion

  • Vasodilation of the afferent artiole to maintain GFR

Explicação

Questão 13 de 37

1

How big are the ureters?

Selecione uma das seguintes:

  • 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

Explicação

Questão 14 de 37

1

Where are kidney stones most likely to get stuck?

Selecione uma ou mais das seguintes:

  • 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

Explicação

Questão 15 de 37

1

Which of the following can cause kidney stones?

Selecione uma ou mais das seguintes:

  • Primary hyperparathyroidism

  • Primary hypoparathyroidism

  • Hypercalcaemia

  • Hypocalcaemia

  • Primary/secondary hyperoxaluria

  • Primary/secondary hypooxaluria

  • Renal tubular acidosis

  • Hypocitraturia

  • Hypercitraturia

Explicação

Questão 16 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 17 de 37

1

What is the most common composition of kidney stones?

Selecione uma das seguintes:

  • Calcium containing (calcium phosphate/oxalate)

  • Urate

  • Cysteine

  • Struvite

  • Mixed

Explicação

Questão 18 de 37

1

How thick should the kidney cortex be?

Selecione uma das seguintes:

  • 1-2 cm

  • 2-3 cm

  • 3-4 cm

  • 4-5 cm

Explicação

Questão 19 de 37

1

How much of the filtrate is reabsorbed by kidneys?

Selecione uma das seguintes:

  • 99% (180 L/day)

  • 95% (175 L/day)

  • 90% (165 L/day)

  • 80% (140 L/day)

Explicação

Questão 20 de 37

1

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

Selecione uma das seguintes:

  • Osmolality is temperature independent

  • Osmolality is easier to calculate

  • Osmolality is a more reliable measurement

  • Osmolality is recognised internationally

Explicação

Questão 21 de 37

1

How long is the PCT?

Selecione uma das seguintes:

  • 14mm

  • 10mm

  • 16mm

  • 18mm

  • 12mm

Explicação

Questão 22 de 37

1

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

Selecione uma das seguintes:

  • Na+/H+ exchanger

  • Na+ channel

  • Na+/HCO3- exchanger

  • Na+/Cl- exchanger

Explicação

Questão 23 de 37

1

How long is the DCT?

Selecione uma das seguintes:

  • 1mm

  • 2mm

  • 3mm

  • 4mm

Explicação

Questão 24 de 37

1

What proportion of total reabsorption happens in the DCT?

Selecione uma das seguintes:

  • 25%

  • 5%

  • 15%

  • 30%

  • 10%

Explicação

Questão 25 de 37

1

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

Selecione uma das seguintes:

  • 25%

  • 20%

  • 30%

  • 35%

Explicação

Questão 26 de 37

1

Preencha os espaços em branco para completar o texto.

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 )

Explicação

Questão 27 de 37

1

What proportion of creatinine is excreted via tubular secretion?

Selecione uma das seguintes:

  • 0.5%

  • 5%

  • 10%

  • 20%

Explicação

Questão 28 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 29 de 37

1

How much waste is excreted in the urine per day?

Selecione uma das seguintes:

  • 600 mosmol/day

  • 400 mosmol/day

  • 800 mosmol/day

  • 1000 mosmol/day

Explicação

Questão 30 de 37

1

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

Selecione uma das seguintes:

  • 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

Explicação

Questão 31 de 37

1

What can cause dysfunctional reabsorption in the PCT?

Selecione uma ou mais das seguintes:

  • Fanconi's syndrome

  • Acetzolamide

  • Bartter's syndrome

  • Gitelman's syndrome

  • Liddle's syndrome

  • Loop diuretics

  • Thiazide diuretics

  • K-sparing diuretics

Explicação

Questão 32 de 37

1

What can cause defective absorption through NKCC2 channels?

Selecione uma ou mais das seguintes:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explicação

Questão 33 de 37

1

What can cause dysfunctional absorption through NCC channels?

Selecione uma ou mais das seguintes:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explicação

Questão 34 de 37

1

What can cause dysfunctional reabsorption through ENaC channels?

Selecione uma ou mais das seguintes:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Explicação

Questão 35 de 37

1

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

Selecione uma das seguintes:

  • 0.8-2 L/day

  • 0.5-4 L/day

  • 0.4-12 L/day

  • 0.6-3 L/day

Explicação

Questão 36 de 37

1

What is used for the quantification of protein in urinalysis?

Selecione uma das seguintes:

  • Spot urinalysis for protein levels

  • Urinary protein:creatinine ratio

  • 24 hour urine collection and urinary protein levels

  • Consecutive spot urinalysis for protein levels

Explicação

Questão 37 de 37

1

Preencha os espaços em branco para completar o texto.

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

Explicação