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  • Question 1 - A 30-year-old man is brought to the emergency department suffering from extreme dehydration,...

    Incorrect

    • A 30-year-old man is brought to the emergency department suffering from extreme dehydration, and subsequent hypotension and tachycardia. Which part of the kidney will compensate for this loss?

      Your Answer: Distal convoluted tubule

      Correct Answer: Collecting ducts

      Explanation:

      The collecting duct system of the kidney consists of a series of tubules and ducts that physically connect nephrons to a minor calyx or directly to the renal pelvis. The collecting duct system is the last component of the kidney to influence the body’s electrolyte and fluid balance. In humans, the system accounts for 4–5% of the kidney’s reabsorption of sodium and 5% of the kidney’s reabsorption of water. At times of extreme dehydration, over 24% of the filtered water may be reabsorbed in the collecting duct system.

    • This question is part of the following fields:

      • Physiology
      • Renal
      24.3
      Seconds
  • Question 2 - A 55-year old lady underwent a major surgery for repair of an aortic...

    Incorrect

    • A 55-year old lady underwent a major surgery for repair of an aortic aneurysm. Her blood pressure was low throughout the intra-operative and the post-operative period, along with increasing serum creatinine and urea. Microscopic examination of her urine showed multiple granular and hyaline casts. What is the likely condition the patient is suffering from?

      Your Answer: Nodular glomerulosclerosis

      Correct Answer: Acute tubular necrosis

      Explanation:

      The most common predisposing factor leading to acute tubular necrosis is ischemia, typically seen in hospitalized patients with low blood pressure.

    • This question is part of the following fields:

      • Pathology
      • Renal
      39.7
      Seconds
  • Question 3 - A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains...

    Incorrect

    • A 45-year-old pregnant woman develops high blood pressure at 20 weeks. She complains of headaches and swollen feet, and a test reveals proteinuria (350 mg/day). Which of the following is the most likely diagnosis?

      Your Answer: Nephrotic syndrome

      Correct Answer: Pre-eclampsia

      Explanation:

      Pre-eclampsia (PE) is a disorder of pregnancy characterized by the onset of high blood pressure (two separate readings taken at least 6 h apart of 140/90 or more) and often a significant amount of protein in the urine (>300 mg of protein in a 24-h urine sample). While blood pressure elevation is the most visible sign of the disease, it involves generalised damage to the maternal endothelium of the kidneys and liver, with the release of vasopressive factors only secondary to the original damage. Pre-eclampsia may develop at varying times within pregnancy and its progress differs among patients; most cases present pre-term. It has no known cure apart from ending the pregnancy (induction of labour or abortion). It may also present up to 6 weeks post partum. Risk factors for pre-eclampsia include obesity, prior hypertension, older age, and diabetes mellitus.

    • This question is part of the following fields:

      • Physiology
      • Renal
      36.3
      Seconds
  • Question 4 - Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of...

    Correct

    • Nephrotic syndrome is a condition that causes proteinuria, hypoalbuminemia and oedema. Which of the following is the cause of the oedema in these patients?

      Your Answer: Decreased oncotic pressure

      Explanation:

      The glomeruli of the kidneys are the parts that normally filter the blood. They consist of capillaries that are fenestrated and allow fluid, salts and other small solutes to flow through, but normally not proteins. In nephrotic syndrome, the glomeruli become damaged allowing small proteins, such as albumin to pass through the kidneys into urine. Oedema usually occurs due to salt and water retention by the diseased kidneys as well as due to the reduced colloid oncotic pressure (because of reduced albumin in the plasma). Lower serum oncotic pressure causes fluid to accumulate in the interstitial tissues.

    • This question is part of the following fields:

      • Physiology
      • Renal
      16.3
      Seconds
  • Question 5 - A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes...

    Correct

    • A 25-year-old woman complains of generalised swelling and particularly puffiness around the eyes which is worst in the morning. Laboratory studies showed:

      Blood urea nitrogen (BUN) = 30 mg/dl

      Creatinine = 2. 8 mg/dl

      Albumin = 2. 0 mg/dl

      Alanine transaminase (ALT) = 25 U/l

      Bilirubin = 1 mg/dl

      Urine analysis shows 3+ albumin and no cells.

      Which of the following is the most likely diagnosis?

      Your Answer: Nephrotic syndrome

      Explanation:

      Nephrotic syndrome is a disorder in which the glomeruli have been damaged, characterized by:

      – Proteinuria (>3.5 g per 1.73 m2 body surface area per day, or > 40 mg per square meter body surface area per hour in children)

      – Hypoalbuminemia (< 2,5 g/dl) – Hyperlipidaemia, and oedema (generalized anasarca).

    • This question is part of the following fields:

      • Physiology
      • Renal
      81.1
      Seconds
  • Question 6 - A 59-year-old woman with hyperaldosteronism is prescribed a diuretic. Which of the following...

    Incorrect

    • A 59-year-old woman with hyperaldosteronism is prescribed a diuretic. Which of the following diuretics promotes diuresis by opposing the action of aldosterone?

      Your Answer: Thiazide

      Correct Answer: Potassium-sparing diuretic

      Explanation:

      The term potassium-sparing refers to an effect rather than a mechanism or location. Potassium-sparing diuretics act by either antagonising the action of aldosterone (spironolactone) or inhibiting Na+ reabsorption in the distal tubules (amiloride). This group of drugs is often used as adjunctive therapy, in combination with other drugs, for the management of chronic heart failure. Spironolactone, the first member of the class, is also used in the management of hyperaldosteronism (including Conn’s syndrome) and female hirsutism (due to additional antiandrogen actions).

    • This question is part of the following fields:

      • Physiology
      • Renal
      51.2
      Seconds
  • Question 7 - A 7-year-old boy with facial oedema was brought to the hospital by his...

    Correct

    • A 7-year-old boy with facial oedema was brought to the hospital by his parents. Renal function is normal and urinalysis revealed the presence of a profound proteinuria. Which of the following is the most probable cause of these findings?

      Your Answer: Minimal-change disease

      Explanation:

      Minimal-change disease (MCD) refers to a histopathologic glomerular lesion, typically found in children, that is almost always associated with nephrotic syndrome. The most noticeable symptom of MCD is oedema, which can develop very rapidly. Due to the renal loss of proteins muscle wasting and growth failure may be seen in children. Renal function is usually not affected and a proteinuria of more than 40 mg/h/m2 is the only abnormal finding in urinalysis.

    • This question is part of the following fields:

      • Pathology
      • Renal
      11.9
      Seconds
  • Question 8 - Renal function is an indication of the state of the kidney, measured by glomerular...

    Correct

    • Renal function is an indication of the state of the kidney, measured by glomerular filtration rate (GFR). In a healthy person, GFR would be greatly increased by: 

      Your Answer: Substantial increases in renal blood flow

      Explanation:

      An increase in the rate of renal blood flow (RBF) greatly increases the glomerular filtration rate (GFR). The more plasma available (from increased RBF), the more filtrate is formed. Glomerular filtration rate (GFR) is the volume of fluid filtered from the renal (kidney) glomerular capillaries into the Bowman’s capsule per unit time. Central to the physiologic maintenance of GFR is the differential basal tone of the afferent and efferent arterioles.

    • This question is part of the following fields:

      • Physiology
      • Renal
      155.6
      Seconds
  • Question 9 - Which part of the nephron would have to be damaged to stop the...

    Correct

    • Which part of the nephron would have to be damaged to stop the reabsorption of the majority of salt and water?

      Your Answer: Proximal tubule

      Explanation:

      The proximal tubule is the portion of the duct system of the nephron of the kidney which leads from Bowman’s capsule to the loop of Henle. It is conventionally divided into the proximal convoluted tubule (PCT) and the proximal straight tubule (PST). The proximal tubule reabsorbs the majority (about two-thirds) of filtered salt and water. This is done in an essentially iso-osmotic manner. Both the luminal salt concentration and the luminal osmolality remain constant (and equal to plasma values) along the entire length of the proximal tubule. Water and salt are reabsorbed proportionally because the water is dependent on and coupled with the active reabsorption of Na+. The water permeability of the proximal tubule is high and therefore a significant transepithelial osmotic gradient is not possible.

    • This question is part of the following fields:

      • Physiology
      • Renal
      17.6
      Seconds
  • Question 10 - Urine specific gravity allows the assessment of which of the following renal functions?...

    Correct

    • Urine specific gravity allows the assessment of which of the following renal functions?

      Your Answer: Concentration

      Explanation:

      Concentrating ability of kidneys is assessed by measuring the urine specific gravity. Normal values of urine specific gravity fall between 1.002 and 1.030 g/ml.

    • This question is part of the following fields:

      • Pathology
      • Renal
      8.1
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Physiology (4/7) 57%
Renal (6/10) 60%
Pathology (2/3) 67%
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