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  • Question 1 - 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
      28.7
      Seconds

  • Question 2 - The interstitium of the kidney is most hypertonic in the: ...

    Incorrect

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

      Your Answer: Juxtamedullary cortex

      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
      30.8
      Seconds

  • Question 3 - 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: Constrict vascular smooth cells in arterioles and venules

      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
      11.3
      Seconds

  • Question 4 - The position of the kidneys besides the vertebral column retroperitoneally spans levels: ...

    Incorrect

    • The position of the kidneys besides the vertebral column retroperitoneally spans levels:

      Your Answer: T10 – L1

      Correct Answer: T12 – L3

      Explanation:

      The asymmetry within the abdominal cavity, caused by the position of the liver, typically results in the right kidney being slightly lower and smaller than the left, and being placed slightly more to the middle than the left kidney. The left kidney is approximately at the vertebral level T12 to L3, and the right is slightly lower.

    • This question is part of the following fields:

      • Medicine
      • Renal
      14.5
      Seconds

  • Question 5 - What effect does osmotic diuresis have on net Na+ excretion? ...

    Correct

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

      Your 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
      33.7
      Seconds

  • Question 6 - 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: 25l, 12l, 5l

      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
      9.1
      Seconds

  • Question 7 - Where is most of the filtered sodium reabsorbed? ...

    Incorrect

    • Where is most of the filtered sodium reabsorbed?

      Your Answer: Distal convoluted tubule

      Correct 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
      6.9
      Seconds

  • Question 8 - How does the proximal convoluted tubule excrete H+? ...

    Correct

    • How does the proximal convoluted tubule excrete H+?

      Your Answer: Via Na+/H+ antiporter.

      Explanation:

      H+ secretion from cells across the luminal membrane is mostly in exchange for Na+ ions, and to a small extent, through a proton ATPase. Secreted H+ react with filtered HC03- to form H2CO3.

    • This question is part of the following fields:

      • Medicine
      • Renal
      5.9
      Seconds

  • Question 9 - If UA = concentration of A in urine, V = urine flow per...

    Incorrect

    • If UA = concentration of A in urine, V = urine flow per unit time, and PA = arterial plasma level of A, renal clearance of A is equal to?

      Your Answer: PA/(UA x V)

      Correct Answer: (UA x V)/PA

      Explanation:

      Renal clearance = [Urine concentration (UA) x Urine flow (V)]/[Plasma concentration (PA)]

    • This question is part of the following fields:

      • Medicine
      • Renal
      14.3
      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
      7.6
      Seconds

  • Question 11 - What is the most important determinant of ECF volume? ...

    Correct

    • What is the most important determinant of ECF volume?

      Your 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
      9.4
      Seconds

  • Question 12 - 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: 0.44ml/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
      426.2
      Seconds

  • Question 13 - Which segment of the nephron is impermeable to water? ...

    Incorrect

    • Which segment of the nephron is impermeable to water?

      Your Answer: Descending limb of Henle

      Correct Answer: Ascending limb of Henle

      Explanation:

      Considerable differences aid in distinguishing the descending and ascending limbs of the loop of Henle. The descending limb is permeable to water and noticeably less permeable to salt, and thus only indirectly contributes to the concentration of the interstitium. Unlike the descending limb, the thin ascending limb is impermeable to water, a critical feature of the counter current exchange mechanism employed by the loop.

    • This question is part of the following fields:

      • Medicine
      • Renal
      4.5
      Seconds

  • Question 14 - Glucose is typically removed from the urine by…? ...

    Correct

    • Glucose is typically removed from the urine by…?

      Your Answer: Secondary active transport

      Explanation:

      Glucose, amino acids, inorganic phosphate, and some other solutes are resorbed via secondary active transport through co-transporters driven by the sodium gradient out of the nephron.

    • This question is part of the following fields:

      • Medicine
      • Renal
      17.7
      Seconds

  • Question 15 - 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
      8.1
      Seconds

  • Question 16 - 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: Glutamine reductase

      Correct Answer: Glutaminase

      Explanation:

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

    • This question is part of the following fields:

      • Medicine
      • Renal
      20.7
      Seconds

  • Question 17 - Which of the following stimulate the release of aldosterone from the adrenal cortex?...

    Incorrect

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

      Your Answer: Hyponatraemia

      Correct 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
      28.6
      Seconds

  • Question 18 - 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
      14
      Seconds

  • Question 19 - What is the function of the macula densa, located in the wall of...

    Incorrect

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

      Your Answer: Efferent arteriolar vasoconstriction.

      Correct 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
      14
      Seconds

  • Question 20 - 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
      12
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Medicine (8/20) 40%
Renal (8/20) 40%
Passmed
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