ILA 9 - Renal Flashcards

1
Q

Blood pressure is controlled in part by the renin-angiotensin-system.

Angiotensin I is converted by renin from which of the following?
A. Aldosterone
B. Angiotensin converting enzyme (ACE)
C. Angiotensin II
D. Angiotensinogen
E. Preangiotensin

A

D. Angiotensinogen

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2
Q

The ureter is a continuation of the renal pelvis.
Which type of cell lines the ureter?

A. Ciliated columnar epithelium
B. Podocytes
C. Squamous epithelium
D. Transitional epithelium
E. Urinary epithelium

A

D. Transitional epithelium

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3
Q

A 25-year-old patient awaiting a renal transplant is found to be anaemic.
Which of the following best describes the mechanism of anaemia in chronic renal failure?

A. Bone marrow suppression by uraemia
B. Excess loss of folate and B12 cofactors
C. Iron deficiency
D. Protein loss by the kidney, preventing globin formation
E. Reduced production of erythropoietin

A

E. Reduced production of erythropoietin
Chronic renal failure causes a reduction in the production of erythropoietin.
Erythropoietin is a glycoprotein cytokine that stimulates erythropoiesis in the bone marrow.

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4
Q

If the renal clearance of a substance X is 250ml/min.

Which best describes its method of clearance?

A. It must be freely filtered
B. It must be freely filtered and then reabsorbed by the nephron
C. It must be reabsorbed in the proximal tubule before being secreted in the distal tubule
D. It must be secreted by the nephron
E. It must undergo first-pass metabolism in the liver

A

D. It must be secreted by the nephron

Renal clearance of a molecule is ‘the volume of plasma cleared of that molecule per minute’
Clearance of molecule x (mls/min) is expressed as Cx = (Ux X V)/Px
Ux = concentration of x in the urine
Px = concentration of x in the plasma
V = volume of urine formed per minute
-A molecule that is filtered and passes unchanged into the urine e.g. inulin has a renal clearance of ~125 mls/min
-A molecule that is filtered and reabsorbed will have a lower renal clearance e.g. urea ~ 80 mls/min
-A molecule that is filtered and actively secreted will have a higher renal clearance e.g Para-amino hippuric acid (PAH) ~ 650-700 mls/min

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5
Q

A 78-year-old women presents with shortness of breath. On examination you find she has signs of heart failure.

Which of the following is true concerning Atrial Naturetic Peptides (ANPs)
A. Secretion is inhibited by cardiac failure.
B. They act on the renal collecting tubules to prevent Na+ excretion.
C.They act on the renal collecting tubules to promote Na+ excretion.
D. They act to raise blood pressure.
E. They are synthesised mainly in the cardiac ventricles.

A

C. They act on the renal collecting tubules to promote na+ excretion

ANP is released by the atrial myocytes in response to atrial stretch due to elevated atrial pressure and blood volume e.g cardiac failure
ANP causes
An increased glomerular filtration rate
Increased sodium excretion
Inhibition of release of vasoconstrictors e.g. angiotensin II, aldosterone and endothelin
A decrease in blood pressure

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6
Q

The kidneys play a key role in fluid balance.

Which of the following best describes the anatomical location of the kidneys?

A. Abdomen
B.Mediastinum
C. Pelvis
D. Peritoneal cavity
E. Retroperitoneal space

A

E. Retroperitoneal space

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7
Q

Urine production is a key function of the kidney.

Which of the following best describes urine production and flow?
A.The detrusor muscle is entirely under autonomic control
B. The proximal tubules of several nephrons join to form the collecting duct
C. Urine flows from the kidney to the bladder via the urethra
D. Urine is formed at a rate of 125mls per minute
E. Urine passes through the ureter by peristalsis

A

E. Urine passes through the ureter by peristalsis

Urine is produced at a variable rate and is transported to the bladder by the peristaltic action of the ureters.

The collecting duct is formed by the distal convoluted tubules

The detrusor is under the control of the autonomic system with some voluntary control

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8
Q

Filtration is a key process in the production of urine.

Which of the following is not found in the glomerular filtrate of a healthy individual?
A.Albumin
B. Creatinine
C. Glucose
D. Potassium
E. Uric acid

A

A. Albumin

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9
Q

A 63-year-old patient presents with an acute kidney injury.

Which of the following would not cause pre-renal acute kidney injury?
A.Benign prostatic hypertrophy
B. Cellulitis
C. Decompensated heart failure
D. Decompensated liver failure
E. Diarrhoea and vomiting

A

A. Benign prostatic hypertrophy

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10
Q

To function the kidney requires an adequate blood supply.

How much of the cardiac output passes through the kidneys?
A. 10%
B. 20%
C. 40%
D. 55%
E. 80%

A

B. 20%

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11
Q

Regarding the anatomy of the kidney.

What name is given to the outermost layer of the kidney?
A.Calyx
B. Capsule
C. Cortex
D. Medulla
E. Pelvis

A

B. Capsule

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12
Q

Blood pressure is controlled in part by the renin-angiotensin-system.
Which is of the following is not correct with regard to renin?
A. Drugs which inhibit renin can be used to control high blood pressure
B. Renin converts Angiotensinogen to Angiotensin I by adding a short amino acid chain
C. Renin is released in response to stimulation of beta adrenergic receptors on the JGC
D. Renin is secreted by the juxtaglomerular cells (JGC)
E. The macula densa stimulates renin release in response to changes in Na+ delivery to the distal tubules

A

B. Renin converts angiotensinogen to angiotensin 1 by adding a short amino acid chain

Renin is secreted by the juxtaglomerular cells (JGC)

Renin is released in response to stimulation of beta adrenergic receptors on the JGC

Renin converts Angiotensinogen to Angiotensin I by removing a short amino acid chain

The macula densa stimulates renin release in response to changes in Na+ delivery to the distal tubules

Drugs which inhibit renin can be used to control high blood pressure

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13
Q

Aldosterone plays a major role in the regulation of blood pressure.

Which of the following is not a function of Aldosterone?
A. It has a diurnal secretion rhythm
B. It is a steroid hormone with the chemical formula: C25H28O5
C. It is secreted by the adrenal cortex
D. Its main action is on the collecting duct to increase Na+ resorption
E. Its overall effect is to lower blood pressure

A

E. It’s overall effect is to lower BP

Aldosterone plays a major role in the regulation of blood pressure.

Which of the following is not a function of Aldosterone?
A. It has a diurnal secretion rhythm
B. It is a steroid hormone with the chemical formula: C25H28O5
C. It is secreted by the adrenal cortex
D. Its main action is on the collecting duct to increase Na+ resorption
E. Its overall effect is to lower blood pressure

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