2010 final

Question 1

Acid base info with everything normal, when you calculate PAG it was high

Answer 1

High plasma anion gap with decrease in unmeasured anion

Question 2

Histology showed lymphocytic &eosinophilic infiltration and edema, what is the pathology?

• Drug induced hypersensitivity
• Analgesics nephropathy

Answer 2

• Drug induced hypersensitivity

Question 3

If the CO = 5.5, Hematocrit = 45%, what is the RPF?

Answer 3

605

Question 4

Patient with previous history of Schistosomahematobium developed cancer of the renal pelvis. What type?

Answer 4

Squamous cell carcinoma of the kidney

Question 5

Main transporter in the TALH?

Answer 5

Na/K/2Cl

Question 6

Patient is taking thiazide diuretics, which drug is used to preserve K+ ?

Answer 6

Amiloride

Question 7

Patient with MI, what is increased in his serum?

Answer 7

Lactate

Question 8

Values showed metabolic acidosis with normal blood volume. What is the cause?

Answer 8

Renal tubular acidosis

Question 9

A patient with increased urine output was treated with ADH and he responded to the treatment. What is the cause?

Answer 9

Complete neurogenic diabetes insipidus

Question 10

(The same previous question) if the patient show no response to ADH?

Answer 10

Complete nephrogenic diabetes insipidus

Question 11

Remnant of the median umbilical ligament?

Answer 11

Urachus

Question 12

Forms the anterolateral boarder of the urogenital diaphragm?

Answer 12

Ischiopubic ramus

Question 13

Failure of union between the ureteric bud and the mesenchyme?

Answer 13

Kidney agenesis

Question 14

Cut section showed well defined mass with slit like spaces and whorled apperance?

Answer 14

Fibroadenoma

Question 15

Patient with HBV who have nephritic syndrome?

Answer 15

Membranous glomeriolonephritis

Question 16

Patient with dilated pelvis & severe cortical atrophy?

Answer 16

End stage hydronephrosis

Question 17

By which mechanism does diuretics increase K secretion?

Answer 17

?

Question 18

Which structure compresses the left renal vein and affects the testes?

Answer 18

Superior mesenteric artery

Question 19

A 4 years old child with protienuria& edema?

Answer 19

Minimal change disease

Question 20

Fused foot processes on electron microscope?

Answer 20

Minimal change disease

Question 21

What happens if nephrin decreases?

Answer 21

Clearance of albumin will increase

Question 22

How to estimate GFR?

• Creatinine clearance
• PAH plasma clearance

Answer 22

• Creatinine clearance

Question 23

If GFR decreased to double, what will happen to creatinine?

Answer 23

Decrease to less than double

Question 24

What separates the peri-renal fat from the para-renal fat?

Answer 24

Renal fascia

Question 25

DNA virus?

Answer 25

HBV

Question 26

Patient on dialysis?

Answer 26

HCV

Question 27

What is the first layer in the dorsal part to approach the kidney?

Answer 27

Thoracolumbar fascia

Question 28

Coarse stones that damage the parenchyma and the calyces?

Answer 28

Stag-horn

Question 29

During volume expansion, the decrease in Na reabsorption in collecting ducts is due to?

Answer 29

↓ aldosterone

Question 30

During volume expansion, the decrease in Na reabsorption in proximal tubules is due to?

Answer 30

↓ angiotensin II

Question 31

What is the main cause of metabolic alkalosis in a patient w/ hyperkalemia?

Answer 31

?

Question 32

What happens if a person is on high K diet?

Answer 32

Both receptors are expressed

Question 33

What is the effect of insulin?

Answer 33

Move K inside the cell

Question 34

What condition leads to increase the level of ADH in the body?

Answer 34

Being in the desert for 5 hrs without water

Question 35

Patient with normal PH, normal HCO3, but ↑ anion gap (not sure)

Answer 35

No acid base disorder (same concept as question 4, only unmeasured anion)

Question 36

Patient with normal PH, ↓ HCO3, ↓ CO2, normal anion gap (not sure)

Answer 36

Respiratory alkalosis + metabolic acidosis e.g. aspirin overdose

Question 37

Which part of the nephron is impermeable to solute?

Answer 37

Thin descending loop of Henle

Question 38

How can amakrin damage the kidney?

Answer 38

Acute tubular necrosis

Question 39

Loss of blood induces sympathetic activation and increase in RAAS. What is the effect on GFR, RPF, FF?

Answer 39

↓ GFR, ↓RPF , ↑ FF

Question 40

An old man with plasma Na=149, urine osmolarity was only 300. What is your diagnosis?

Answer 40

Diabetes insipidus

Question 41

Patient with RTA, ruptured spleen. What could be the consequences?

Answer 41

Acute pre-renal failure

Question 42

Post infectious glomerulonephritis would show?

Answer 42

Subepithelial humps

Question 43

Blood and urine analysis showed low PH, low HCO3 , low CO2 , normal Cl , urea is low. What was the compensatory mechanism?

Answer 43

Reabsorb all HCO3 (normally the kidney reabsorbs all HCO3) ü Make new HCO3

Question 44

Calculate free water clearance. | Urine volume = 700 ml ,Uosm = 1400 mg/l , Posm = 265 mg/l.

Answer 44

-3

Question 45

What is the most lobe affected in prostatic hyperplasia?

Answer 45

Posterior lobe

Question 46

A 50 years old male had enlarged prostate with difficulty urinating. What is the Diagnostic method?

Answer 46

Ultrasound

Question 47

Surgery of the posterior surface of the kidney may effect?

Answer 47

Ilioinguinal nerve

Question 48

What is true from the following? - The hilum is on the trans-pyloric plane 5 cm from midline on T12 (trans-pyloric is on L1?) - The posterior surface is related to the spinous process of T11 to L3

Answer 48

- The posterior surface is related to the spinous process of T11 to L3

Question 49

A male is diagnosed with UTI and his urine ph=8 (alkaline urine)?

Answer 49

Proteus mirabilis

Question 50

Renal inflammation, fibrosis, cortical atrophy and loss of renal medulla?

Answer 50

Chronic pyelonephritis

Question 51

What does fractional excretion above 1 indicate?

Answer 51

Substance is filtered and secreted

Question 52

What is the most common congenital anomaly in children?

Answer 52

Vesicoureteral reflux

Question 53

A 60 year old smoker with hemoptysis and rapidly progressive renal dysfunction?

Answer 53

Cresents