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  • Question 1 - In a 70 kg male, the approximate volumes (litres) of water in the...

    Incorrect

    • In a 70 kg male, the approximate volumes (litres) of water in the different compartments mentioned (intracellular, interstitial, vascular) are:

      Your Answer: 30l, 8l, 4l

      Correct Answer: 28l, 14l, 3.5l

      Explanation:

      In a 70kg male, approximately 60% (42 L) of the total body weight is composed of water divided proportionally in the following compartments:Intracellular fluid (ICF) – Around 67% (28 L) of total body water.Extracellular fluid (ECF) – Approximately 33% (14 L) of the total body fluid. The fluid in the intravascular compartment is about 3 L and is generally about 25% of the volume of ECF.

    • This question is part of the following fields:

      • Medicine
      • Renal
      37.4
      Seconds

  • Question 2 - Renin is secreted by which of the following cells? ...

    Correct

    • Renin is secreted by which of the following cells?

      Your Answer: Juxtaglomerular cells

      Explanation:

      The juxtaglomerular cells are cells in the kidney that synthesize, store, and secrete the enzyme renin. They are specialized smooth muscle cells mainly in the walls of the afferent arterioles, and some in the efferent arterioles, that deliver blood to the glomerulus.

    • This question is part of the following fields:

      • Medicine
      • Renal
      4.3
      Seconds

  • Question 3 - Using the Cockcroft-Gault formula, what will the estimated creatinine clearance be of a...

    Incorrect

    • Using the Cockcroft-Gault formula, what will the estimated creatinine clearance be of a 55 year old male who weighs 75kg and has a serum creatinine of 150mg/dL?

      Your Answer: 0.26ml/min

      Correct Answer: 0.59ml/min

      Explanation:

      A commonly used surrogate marker for estimate of creatinine clearance is the Cockcroft-Gault (CG) formula, which in turn estimates GFR in ml/min:CCr = [(140-age) x Mass(kg)]/[72 x serum creatinine (mg/dL)](multiply by 0.85 for women)Therefore CCr = (85 x 75)/(72 x 150) = 0.59

    • This question is part of the following fields:

      • Medicine
      • Renal
      21.5
      Seconds

  • Question 4 - What is the most important determinant of ECF volume? ...

    Incorrect

    • What is the most important determinant of ECF volume?

      Your Answer: The amount of chloride in the ECF

      Correct Answer: The amount of sodium in the ECF

      Explanation:

      The volume of the ECF is determined primarily by the total amount of osmotically active solute in the ECF. The composition of the ECF is discussed in Chapter 1. Because Na+ and Cl− are by far the most abundant osmotically active solutes in ECF, and because changes in Cl− are to a great extent secondary to changes in Na+, the amount of Na+ in the ECF is the most important determinant of ECF volume.

    • This question is part of the following fields:

      • Medicine
      • Renal
      38.9
      Seconds

  • Question 5 - The interstitium of the kidney is most hypertonic in the: ...

    Incorrect

    • The interstitium of the kidney is most hypertonic in the:

      Your Answer: Juxtaglomerular apparatus

      Correct Answer: Papillary tip of the medulla

      Explanation:

      The medullary interstitium is the tissue surrounding the loop of Henle in the renal medulla. It functions in renal water reabsorption by building up a high hypertonicity, which draws water out of the thin descending limb of the loop of Henle and the collecting duct system. This hypertonicity, in turn, is created by an efflux of urea from the inner medullary collecting duct.

    • This question is part of the following fields:

      • Medicine
      • Renal
      34.7
      Seconds

  • Question 6 - Which of the following stimulate the release of aldosterone from the adrenal cortex?...

    Correct

    • Which of the following stimulate the release of aldosterone from the adrenal cortex?

      Your Answer: Angiotensin 2

      Explanation:

      Angiotensin II also stimulates the secretion of the hormone aldosterone from the adrenal cortex. Aldosterone causes the renal tubules to increase the reabsorption of sodium and water into the blood, while at the same time causing the excretion of potassium (to maintain electrolyte balance).

    • This question is part of the following fields:

      • Medicine
      • Renal
      16.9
      Seconds

  • Question 7 - An effect of aging on the kidney includes? ...

    Correct

    • An effect of aging on the kidney includes?

      Your Answer: Decreased GFR

      Explanation:

      The normal range of GFR, adjusted for body surface area, is 100 to 130 mL/min/1.73m2 in men and 90 to 120 ml/min/1.73m2 in women younger than the age of 40. After age 40, GFR decreases progressively with age, by about 0.4 mL/min to 1.2 mL/min per year.

    • This question is part of the following fields:

      • Medicine
      • Renal
      18.7
      Seconds

  • Question 8 - Where is most of the filtered sodium reabsorbed? ...

    Correct

    • Where is most of the filtered sodium reabsorbed?

      Your Answer: Proximal tubule

      Explanation:

      Renal reabsorption of sodium (Na+) is a part of renal physiology. It uses Na-H antiport, Na-glucose symport, sodium ion channels (minor). It is stimulated by angiotensin II and aldosterone, and inhibited by atrial natriuretic peptide. Most of the reabsorption (65%) occurs in the proximal tubule.

    • This question is part of the following fields:

      • Medicine
      • Renal
      13.7
      Seconds

  • Question 9 - Where is the majority of Mg2+ absorbed? ...

    Incorrect

    • Where is the majority of Mg2+ absorbed?

      Your Answer: Distal convoluted tubule.

      Correct Answer: Thick ascending limb of loop of Henle.

      Explanation:

      Although the majority of the filtered magnesium is reabsorbed within the ascending loop of Henle, it is now recognized that the distal tubule also plays an important role in magnesium conservation.

    • This question is part of the following fields:

      • Medicine
      • Renal
      22.1
      Seconds

  • Question 10 - Where are the principal cells found in the kidney? ...

    Correct

    • Where are the principal cells found in the kidney?

      Your Answer: Collecting ducts

      Explanation:

      A kidney collecting duct cell can be of two different cell types:Principal cellsIntercalated cells

    • This question is part of the following fields:

      • Medicine
      • Renal
      11.2
      Seconds

  • Question 11 - An important enzyme in renal tissue responsible for the conversion of glutamine to...

    Incorrect

    • An important enzyme in renal tissue responsible for the conversion of glutamine to glutamate and the subsequent production of NH4 is called?

      Your Answer: Glutamic dehydrogenase

      Correct Answer: Glutaminase

      Explanation:

      Glutaminase catalyses the following reaction:Glutamine + H2O → Glutamate + NH3

    • This question is part of the following fields:

      • Medicine
      • Renal
      36.3
      Seconds

  • Question 12 - Which of the following is the correct way to calculate the anion gap?...

    Correct

    • Which of the following is the correct way to calculate the anion gap?

      Your Answer: (Na + K) – (HCO3 + Cl)

      Explanation:

      The anion gap is the difference between the measured cations (positively charged ions) and the measured anions (negatively charged ions) in serum, plasma, or urine. The magnitude of this difference in the serum is often calculated in medicine when attempting to identify the cause of metabolic acidosis. Anion Gap = ([Na+] + [K+]) − ([Cl−] + [HCO−3])

    • This question is part of the following fields:

      • Medicine
      • Renal
      12.7
      Seconds

  • Question 13 - What is the function of the macula densa, located in the wall of...

    Correct

    • What is the function of the macula densa, located in the wall of the thick ascending limb?

      Your Answer: Tubuloglomerular feedback.

      Explanation:

      Macula densa cells sense changes in sodium chloride level, and will trigger an autoregulatory response to increase or decrease reabsorption of ions and water to the blood (as needed) in order to alter blood volume and return blood pressure to normal. Tubuloglomerular feedback is one of several mechanisms the kidney uses to regulate glomerular filtration rate (GFR). It involves the concept of purinergic signalling, in which an increased distal tubular sodium chloride concentration causes a basolateral release of adenosine from the macula densa cells. This initiates a cascade of events that ultimately brings GFR to an appropriate level.

    • This question is part of the following fields:

      • Medicine
      • Renal
      16.2
      Seconds

  • Question 14 - ADH causes? ...

    Incorrect

    • ADH causes?

      Your Answer: Decreased permeability of the collecting ducts to water

      Correct Answer: Increased permeability of the collecting ducts to water

      Explanation:

      Vasopressin (ADH) has three main effects:1. Increasing the water permeability of distal convoluted tubule and collecting duct cells in the kidney, thus allowing water reabsorption and excretion of more concentrated urine.2. Increasing permeability of the inner medullary portion of the collecting duct to urea by regulating the cell surface expression of urea transporters.3. Acute increase of sodium absorption across the ascending loop of Henle.

    • This question is part of the following fields:

      • Medicine
      • Renal
      74.6
      Seconds

  • Question 15 - Erythropoietin is synthesized by which cells of the nephron? ...

    Correct

    • Erythropoietin is synthesized by which cells of the nephron?

      Your Answer: Tubular interstitial cells

      Explanation:

      Erythropoietin is produced by interstitial fibroblasts in the kidney in close association with peritubular capillary and proximal convoluted tubule. It is also produced in perisinusoidal cells in the liver. While liver production predominates in the fetal and perinatal period, renal production is predominant during adulthood.

    • This question is part of the following fields:

      • Medicine
      • Renal
      19.4
      Seconds

  • Question 16 - ANP and BNP in the circulation act on the kidney to? ...

    Incorrect

    • ANP and BNP in the circulation act on the kidney to?

      Your Answer: Decrease sodium excretion

      Correct Answer: Increase sodium excretion

      Explanation:

      The physiologic actions of BNP are similar to those of ANP and include decrease in systemic vascular resistance and central venous pressure as well as an increase in natriuresis (sodium excretion). The net effect of these peptides is a decrease in blood pressure due to the decrease in systemic vascular resistance and, thus, afterload.

    • This question is part of the following fields:

      • Medicine
      • Renal
      23.5
      Seconds

  • Question 17 - The Na-K-2Cl co-transporter occurs in which part of the renal tubule? ...

    Correct

    • The Na-K-2Cl co-transporter occurs in which part of the renal tubule?

      Your Answer: Apical surface of thick ascending limb

      Explanation:

      The Na-K-Cl cotransporter (NKCC) is a protein that aids in the active transport of sodium, potassium, and chloride into cells. In humans there are two isoforms of this membrane transport protein, NKCC1 and NKCC2. NKCC2 is specifically found in cells of the thick ascending limb of the loop of Henle and the macula densa in nephrons, the basic functional units of the kidney. Within these cells, NKCC2 resides in the apical membrane abutting the nephron’s lumen.

    • This question is part of the following fields:

      • Medicine
      • Renal
      27.3
      Seconds

  • Question 18 - Where is angiotensinogen produced? ...

    Incorrect

    • Where is angiotensinogen produced?

      Your Answer: Lungs

      Correct Answer: Liver

      Explanation:

      Angiotensin is a peptide hormone that causes vasoconstriction and a subsequent increase in blood pressure. Angiotensin also stimulates the release of aldosterone from the adrenal cortex. Aldosterone promotes sodium retention in the distal nephron, in the kidney, which also drives blood pressure up. It is derived from the precursor molecule angiotensinogen, a serum globulin produced in the liver.

    • This question is part of the following fields:

      • Medicine
      • Renal
      8.2
      Seconds

  • Question 19 - Amino acid reabsorption occurs most markedly in the? ...

    Correct

    • Amino acid reabsorption occurs most markedly in the?

      Your Answer: Proximal convoluted tubule

      Explanation:

      Renal protein reabsorption is the part of renal physiology that deals with the retrieval of filtered proteins, preventing them from disappearing from the body through the urine. Almost all reabsorption takes place in the proximal tubule. Only ,1% is left in the final urine.

    • This question is part of the following fields:

      • Medicine
      • Renal
      15.6
      Seconds

  • Question 20 - What effect does osmotic diuresis have on net Na+ excretion? ...

    Incorrect

    • What effect does osmotic diuresis have on net Na+ excretion?

      Your Answer: Markedly decreased Na+ excretion

      Correct Answer: Markedly increased Na+ excretion 

      Explanation:

      Osmotic diuresis is the increase of urination rate caused by the presence of certain substances in the small tubes of the kidneys. The excretion occurs when substances such as glucose enter the kidney tubules and cannot be reabsorbed (due to a pathological state or the normal nature of the substance). The substances cause an increase in the osmotic pressure within the tubule, causing retention of water within the lumen, and thus reduces the reabsorption of water, increasing urine output (i.e. diuresis). Sodium, chloride, potassium are markedly excreted in osmotic diuresis.

    • This question is part of the following fields:

      • Medicine
      • Renal
      35.2
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Medicine (10/20) 50%
Renal (10/20) 50%
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