Diuretics Quiz

Question 1

A drug that increases urine volume by inhibiting the renal actions of vasopressin to increse free water clearance is most accurately referred to as a(n);

Answer 1

aquaretic

Question 2

Substance that promotes the excretion of urine

Answer 2

diuretic

Question 3

substance that promotes renal excretion of Na

Answer 3

Natriuretic

Question 4

A nod to urologists, damage to any renal preglomerular blood vessel causes ischemia and death because these are lacking:

Answer 4

anastomoses

Question 5

mannitol acts where?

acetazolamide acts where?

Answer 5

• PT and thin descending loop
• PT

Question 6

Common reasons for administering a diuretic include all of the following EXCEPT:

• kidney failure
• heart failure
• primary (“essential”) hypertension
• central diabetes insipidus
• liver failure

Answer 6

• central diabetes insipidus

Question 7

Hypokalemia causes which of the following at the excitable tissue cell membrane level?

Answer 7

hyperpolarization

Question 8

Which of the following acid-base disturbances is associated with the use of loop and thiazide diuretics?

Answer 8

hypochloremic metabolic alkalosis

Question 9

which diuretics can be used for acute pulmonary edema and why?

Answer 9

loop diuretics

removes massive amounts of fluid quickly

Question 10

Diuretic class useful for treating HTN patients with low RBF and GFR (e.g., GFR < 30 ml/min):

Answer 10

loop diuretics

Question 11

The excretion of this divalent cation is increased by loop diuretics and decreased by thiazide diuretics.

Answer 11

calcium

Question 12

Besides contracting extracellular fluid volume, loop and thiazide diuretics inhibit organic anion transporters in the proximal tubule. This further increases the circulating level of a metabolic waste product, manifesting as:

Answer 12

hyperuricemia

Question 13

Which of the following diuretics is most likely to cause hyperkalemia with hyperchloremic metabolic acidosis?

Answer 13

K+ sparring drugs:

Question 14

Considering the mechanism of action of the following diuretics, which would be expected to take the longest for its effects to be observed?

Answer 14

spironolactone

Question 15

What is a major concern when spironolactone is used at the same time as ACE inhibitors or ARBs in the treatment of heart failure?

Answer 15

hyperkalemia

Question 16

Which of the following drugs is indicated if the goal is to hasten the elimination of toxic levels of a weak acid via urinary alkalinization?

Answer 16

acetazolamide

Question 17

Which is a feared consequence of correcting hyponatremia too rapidly?

Answer 17

osmotic demyelination

Question 18

what does licorice do?

What acid does it contain

Answer 18

1. potentiates aldosterone affects => increases systolic BP => HTN
2. glycyrrihizic

Question 19

what is used to tx

central diabetes insipidus

nephrogenic diabetes insipidus due to Li+ toxicity

Answer 19

-desmopressin

-amilodrone

Question 20

Na is less than 135 mEq; seen in 15-20% of hispitalized pts, most common electrolyte abnoralitiy seen in clinical practice

Answer 20

hyponatremia

Question 21

predictable consequence of vaptan administration

Answer 21

polyuria

Question 22

ability impaired in the kidney by loop diuretics, Bartter syndrome and hypokalemia (here presumably due to need for K+ by Na+-K+-2Cl- cotransporter) resulting in polyuria and nocturia (2 words)

Answer 22

concentrating

Question 23

caused by loop and thiazide diuretics, increase the risk of gout

Answer 23

hyperuricemia

Question 24

process employed by the TAL to make dilute tubular fluid and hypertonic medullary interstitium

Answer 24

countercurrent multiplier

Question 25

potential adverse effect of spiranolactone in W;

Answer 25

hirtuism amenorrhea

Question 26

diuretic class that is a **secondary choice for HTN** _unless GFR is low_ (e.g., GFR \< 30 ml/min) since it will still work then while thiazides become ineffective

Answer 26

loop

Question 27

first choice for HTN

Answer 27

**thiazides**

Question 28

similar to hydrochlorothiazide but **longer half-life,** favored by some hypertension specialists in part because it is the **only thiazide with proven cardiovascular benefits**; doesn't end in "thiazide"

Answer 28

**chlorthalidone**

Question 29

* its blockade of carbonic anhydrase causes a **Na/BICARB diuresis** with **hyperchloremic acidosis** * used for * urinary alkalization to hasten eliination of weak acid toxins (aspirin), * metabolic alkalosis, * acute mountain sickness * glaucoma

Answer 29

**acetazolamide**

Question 30

occurs in liver disease due to impaired synthesis of plasma proteins and increased portal venous pressure; a reason to give a **LOOP DIURETIC**

Answer 30

**ascites**

Question 31

selective **non-peptide V2 receptor antagonis**t that can be administered orally to patients with **hyponatermia** despite water restriction; use \> 30 days increases risk of **hepatotoxicity**

Answer 31

**tolvaptan**

Question 32

prototype for the **non-peptide V2 receptor antagonists** that can be used judiciously to treat **euvolemic** and **hypervolemic hyponatremia** that does NOT respond to fluid restriction; causes **water excretion** _without_ **solute excretion**

Answer 32

**conivaptan**

Question 33

more selective than spiranolactone and more expensive

Answer 33

eplenerone

Question 34

similar AE to foresemide; but better oral absorption

Answer 34

**bumetadine**

Question 35

do not use diuretics for \_\_\_\_\_

Answer 35

**lymphedema**

Question 36

**Ca2+ kidney stones** are more likely likely to develop due to which diuretics

Answer 36

**loop**, not thiazide

Question 37

swelling of this organ by **rapid onset hyponatremia** or **too-rapid correction of chronic hypernatremia** can have catastrophic consequences

Answer 37

**brain**

Question 38

best used to treat **pulmonary edema** due removal of exxcess extracellular fluid and in part by due to prostaglandin mediated vasodilation

Answer 38

loop diuiretics

Question 39

+ inotrope used in inotrope whose toxicity is increased when we use **loop diuretics d/t K+ loss**

Answer 39

**digoxin**