2010 module exam

Question 1

Which is true during S1?

Answer 1

Cl reabsorption is less than water reabsorption

Question 2

What stimulates the release of Renin?

1. Hypotension
2. Dilation of Afferant arteriole

Answer 2

1. Hypotension

Question 3

Which of the following increases the GFR?

1. Hypoalbuminemia
2. Hypotension

Answer 3

1. Hypoalbuminemia

Question 4

What is the rule of ADH in creating the interstial medullary gradiant?

1. Increase the permeability of urea in the collecting duct.
2. Activates the NaKCC co-transporter

Answer 4

1. Increase the permeability of urea in the collecting duct.

Question 5

How does ADH increase the single effect ?

Answer 5

Activation of NaKCC co-transporter in Thick ascending lope of henle

Question 6

A 4th year medical student in 2013 RRB examination was brought to the hospital with the following test results
Ph 7.47 Pco2 25 HCO3 16
What is the problem?

Answer 6

Acute respiratory alkalosis.

Question 7

What is true about K transport in the proximal tubule?

Answer 7

Paracellular

Question 8

Renal physiology question: if Px= 1mg/ml Renal plasma flow(RPF)= 550
creatinine clearance =100 Tm of secretion= 80
What is the excretion rate ?

• 180
• 100
• 360
• 420

Answer 8

• 180

Question 9

Renal physiology question (week 9): Na= 130 glucose= 7 urea=9
measured osmolarity =322
Calculate the osmolar gap?

Answer 9

46

Question 10

what stimulates the secretion of H in proximal tubule during Acidosis?

Answer 10

Endothelin-1

Question 11

Hypokalemia?

Answer 11

Low intracellular Ph

Question 12

Which of the following is a charachteristic of aquaporin 1?

Answer 12

Water reabsorption in the proximal tubule

Question 13

A 53 year old man had an accidental on the base of his skull, which of the following will occur?

• Urine osmolarity increase after administration of subcutaneous ADH (because he had developed neurogenic diabetes insipidus )
• No change in urine osmolarity after administration of subcutaneous ADH
• Increase in serum NA

Answer 13

• Urine osmolarity increase after administration of subcutaneous ADH (because he had developed neurogenic diabetes insipidus)

Question 14

A patient had developed protienuria, what would be the cause?

• Loss of nephrin in glomerular basement barrier
• Enlargement of pores
• Mesangial contraction

Answer 14

• Loss of nephrin in glomerular basement barrier

Question 15

What causes high potassium secretion?

Answer 15

Opening of both ROMK + BK channels

Question 16

Sympathetic stimulation to the kidney will lead to which of the following?

• Induce the release of Renin
• Lower the tone of the efferent arteriole

Answer 16

• Induce the release of Renin

Question 17

A patient with diarrhea had pH=Low, HCO3=low Co2=low, what is the compensation mechanism?

Answer 17

Decrease in HCO3 will increase CL reabsorption

Question 18

A study was done to divers to measure the Pco2 in blood after holding their breath for 4-5 minutes, before diving the Pco2 was (37 – 42), after diving the Pco2 (47 – 52), but there was no change in Blood pH, why?

Answer 18

Excess H is being buffered by hemoglobin

Question 19

In diuresis, medullary interstial osmolarity = 600, what is a contributing factor?

Answer 19

Increase blood flow to vasa recta

Question 20

Fetal tissue obtain sufficient O2 although pO2 gradient =30?

Answer 20

Because fetal hemoglobin shifts dissociation curve to the left

Question 21

What structure could be damaged during kidney resection?

Answer 21

Illioinguinal nerve

Question 22

Uretric bud will give us which of the following structure?

Answer 22

Collecting duct

Question 23

What supplies the middle aspect of the ureter?

Answer 23

Gonadal artery

Question 24

What supplies the prostate?

Answer 24

Inferior vesical artery (which gives us the prostatic artery)

Question 25

What could injured when you ligate uterine artery? - Tranverse cervical ligament - Uterovesical vien - Uterovaginal plexus (anatomy 1, slide 18)

Answer 25

Uterovaginal plexus (anatomy 1, slide 18)

Question 26

Union of major calyces

Answer 26

Renal pelvis

Question 27

Part of the cortex reaching the medulla

Answer 27

Renal columns

Question 28

What secretes renin?

Answer 28

Juxtaglomeruler cells

Question 29

What creates the hypertonicity in medullary interstiam?

Answer 29

Loop of henle

Question 30

Which nerve gives sympatahtic innervations for micturation?

Answer 30

Lumbar sphlencnic

Question 31

What is the origin of the median umbilical ligament?

Answer 31

Urachus

Question 32

A 10 year old boy presented with protienuria more than 6mg, he had periorbital edema, and the histological appearance was normal, what will you find in the ultra structure?

Answer 32

Diffuse effacement of foot processes

Question 33

What prevents asceinding of the kidney?

Answer 33

inferior mesenstric artery

Question 34

What is a characteristic of post-strep glomerulonephritis?

Answer 34

Neutrophil infiltration in the capillary loop

Question 35

45 year old male with disturbance in bowel motion and hypokalemia?( we will have hypokalemia in a,b,and c, but with purgative abuse the patient will have an increase in bowel motion) - Purgative abuse - Villous adenoma at the rectum - Cushing syndrome - Liver cirrhosis

Answer 35

- Purgative abuse

Question 36

Patient with ascites and hyponatremia?

Answer 36

Liver cirrhosis

Question 37

Histology slide shows a prostatic tissue near to the normal appearance , what is the gleason grade?

Answer 37

Grade 1

Question 38

A patient with gleason score= 10, what does it indicate?

Answer 38

Poorly differentiated prostatic tissue

Question 39

Damage to foot process?

Answer 39

Minimal change disease

Question 40

A case about a patient on analgesics for 10 years

Answer 40

Lymphocytic infiltration

Question 41

A patient had bacteria in his urine, which of the following is a typical finding?

Answer 41

Neutrophil infiltration

Question 42

Patient on antibiotic for 3 days, developed acute renal failure ?

Answer 42

ATN- Eisonophillic infiltration

Question 43

Bilateral clear cell carcinoma is associated with which syndrome?

Answer 43

Von hippel lindu

Question 44

Triphosphate stones are found in which type of stones?

Answer 44

Staghorn stones

Question 45

What lies in the level of L1?

Answer 45

Hilum

Question 46

What increases the cardiac output?

Answer 46

Increased stroke volume

Question 47

What is the characteristic of proximal renal tubular acidodsis ?

Answer 47

No reabsorption of HCO3

Question 48

What characterize a benign lesion and a cyst in the kidney?

Answer 48

Homogenous composition in Ultra sound

Question 49

A 45 year old Kuwaiti smoker with hypercholesterolemia and hypertension developed ESRF(end stage renal failure), which of the following risk factors highly predisposed this patient to develop end stage renal failure? - Hypertension - Smoking - Age

Answer 49

- Hypertension

Question 50

What is the most imp modifiable risk factor of ESRF?

Answer 50

Diabetes

Question 51

A patient developed acute renal failure because of alteration in intraglomerular hemodynamics?

Answer 51

Declonphic (NSAID)

Question 52

A patient developed acute interstial nephritis with crystal formation?

Answer 52

Acyclovir

Question 53

How do we evaluate urethral stricture?

Answer 53

Ascending urethrography

Question 54

What is the diagnostic way of taking a urine sample of mycobacterium tuberculosis?

Answer 54

Early morning urine 3 constitutive days

Question 55

A pregnant women on antenatal care appointment with normal urine analysis but culture of e.coli is positive

Answer 55

Asymptomatic UTI

Question 56

We took midstream urine for analysis which one is bacteruria significant? - ↑ 10^5 for e.coli only - ↑10^5 for e.coli + klebsiella

Answer 56

- ↑ 10^5 for e.coli only

Question 57

Mechanism of action of thiazide ?

Answer 57

Inhibit NaCl co-transporter(symporter)

Question 58

What drug causes hyperkalemia?

Answer 58

Spirolactone

Question 59

Best imaging for recurrent renal colic?

Answer 59

CT-KUB

Question 60

Patient with water retention and hyponatremia?

Answer 60

Nephrotic syndrome

Question 61

How would an inborn error in transport of bi-phasic amino acid manifest?

Answer 61

Cystinuria

Question 62

Microscopic examination showed hylanization of both afferent and efferent arteriols?

Answer 62

Diabetic neuropathy

Question 63

What is the most common zone for benign prostatic hyperplasia?

Answer 63

Periurethral

Question 64

Which drug causes testicular atrophy?

Answer 64

Spirolactone

Question 65

Bladder dilatation and muscular wall hypertrophy?

Answer 65

Bladder diverticulitis

Question 66

A patient with metabolic acidosis and have high osmolar urine gap?

Answer 66

Methanol poisoning

Question 67

If we have failure of fusion of the renal vesicles and the collecting system?

Answer 67

Polycystic kidney

Question 68

A 50 years old patient presented with linear deposition of ANTI GBM and hemoptysis ?

Answer 68

Goodpastue

Question 69

Which of the following diseases will have subepithelial deposit in ultrastructure?

Answer 69

Membrenous GN

Question 70

Organize the following substances according to their clearance from the lowest to the highest

Answer 70

Glucose, creatinine, and then PAH

Question 71

A patient presented with bladder wall and diverticuli, what most likely would be the cause?

Answer 71

Urethral block

Question 72

Which of the following is 50% inulin clearance?

Answer 72

Urea

Question 73

Which of the following is correct about RTA?

Answer 73

Distal RTA causes stone formation