OS 206 E3 Samplex 2015 Flashcards Preview

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Flashcards in OS 206 E3 Samplex 2015 Deck (40)
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1

You have a patient with a stab wound at the right
flank, with depth just enough to lacerate the dorsal
convex border of the kidney. Assuming the kidney
bled slowly, in what direction would blood
preferentially dissect in the retroperitoneum?

A. Anteriorly towards peritoneal cavity
B. Posterior into fascia of Zuckerland
C. Laterally towards lateral abdominal wall fascia
D. Medially towards midline
E. Superiorly towards hepatorenal fascia and
subdiaphragmatic area

D

2

If you were stabbed in the epigastric area, which
organ will be least likely damaged?

A. Jejunum
B. Pancreas
C. Duodenum
D. NOTA

A

3

A 4-mm stone migrated from calyx to ureter.
Where will it lodge?

A. L1-L2
B. L3-L4
C. Pelvic Brim
D. Level of sacral promontory
E. Pelvic cavity

A

4

During a left nephrectomy, ligating near the IVC
would affect which of the following organs?

A. pancreas
B. spleen
C. left colon
D. stomach
E. a portion of the jejunum

B

5

Developmental anomalies do sometime develop
in both the intestinal and urinary tracts. When both
tracts develop common drainage cavity, this
is referred as:

A. Cloaca
B. Urachus
C. Urogenital sinus
D. Extrophy
E. Sinus bifidus

A

6

The ureteral orifices are minute openings that are
not readily seen from within the bladder wall. Which
are guides to see these orifices?

A. Apex of trigone
B. Interureteral ridge
C. Superolateral angles of trigone
D. Uvula
E. ABC

E

7

What normally stimulates micturition?

A. Contraction of the detrusor muscle
B. Stretching of the bladder wall
C. Relaxation of the sphincter urethra
D. Urine filling the trigone

B

8

In the renal medulla, to maintain osmotic gradient,
which of the following is true?

A. the descending loop of Henle is selectively permeable to water
B. counter current flow of the urine is opposite the renal blood flow
C. only 20% of renal blood flow through medulla
D. the thick ascending limb of loop of Henle
actively transports salt and water
E. all of the above

A

9

The membranous urethra is lined by

A. transitional epithelium
B. stratified squamous epithelium
C. pseudostratified or stratified columnar
epithelium
D. simple squamous epithelium
E. NOTA

C

10

Common to renal pelvis, ureter and bladder

A. lined by thick transitional epithelium
B. covered by serosa
C. contains muscle layers involuntarily controlled
D. contains muscle layers in horizontal orientation
E. all of the above

C

11

Reabsorbed electrolytes from PCT go back to
circulation through

A. vasa recta
B. arcuate arteries
C. peritubular capillaries
D. arcuate veins
E. all of the above

C

12

Component of the nephron with phagocytic
properties

A. macula densa
B. JG cells
C. mesangial cells
D. principal cells
E. intercalated cells

C

13

Blood volume decreases as it passes through
which structures?

A. afferent arteriole
B. efferent arteriole
C. peritubular capillaries
D. glomerular capillaries
E. all of the above

D

14

Region of the kidney with the least blood supply

A. cortex
B. outer medulla
C. papilla
D. renal columns
E. NOTA

C

15

Which anatomical part is not seen in a noncontrast plain film?

A. Stomach
B. Psoas
C. Ureter
D. Bladder

C

16

In the adult human, the kidneys lie at the level of

A. L1-L4
B. T11-L3
C. T12-L2
D. L3-L4

B

17

Which statement is not true about phleboliths?

A. vascular structures on the face
B. have radioluscent center area surrounded by
radiodense periphery
C. may be mistaken for calculi
D. are calcified arteries

D

18

The renal shadow is visible in the plain x-ray film
in the abdomen because of

A. the low density perineal fat
B. the uptake of contrast by the kidneys
C. the soft tissue low density psoas
D. the presence of gas bowel surrounding the
kidneys

A

19

The isotope used commonly for visualization of
the urinary tract

A. Calcium
B. Strontium
C. Iodine
D. Technetium

C

20

Common findings on an intravenous pyelogram
in patients with hydronephrosis are the following
except:

A. Flattening of the normal concavity of the calyx
B. Reversal of the convexity of the renal pelvis
C. Atrophy of the renal pelvis
D. Enlarged calyces

C

21

A patient presents with massive pedal edema and
ascites due to nephritic syndrome. His sodium
concentration is 136 mEq/l, Posm 277 mOsm/kg H20. Urinalysis reveals Uosm 300 mOsm/kg H20, sodium 5 mEq/l, and potassium 60 mEq/l. Urine volume is 2L/day.

His free water clearance is

A. 0.17 liter/day
B. 1.7 liters/day
C. 17 liters/day
D. Not enough data to calculate the CH20

A

22

A patient presents with massive pedal edema and
ascites due to nephritic syndrome. His sodium
concentration is 136 mEq/l, Posm 277 mOsm/kg H20. Urinalysis reveals Uosm 300 mOsm/kg H20, sodium 5 mEq/l, and potassium 60 mEq/l. Urine volume is 2L/day.

If he drinks a liter of water a day, will he develop
hyponatremia?

A. Yes, because his CH20 1 liter.
C. Yes, because his electrolyte-free water
clearance 1L.

D

23

A patient with congestive heart failure may retain
more fluid because of:

A. AVP release
B. Decreased effective arterial blood volume
C. RAAS Activity
D. SNS Activity

B

24

A falsely low urine specific gravity using the
reagent strip indicates

A. acidic urine
B. glucosuria
C. ketonuria
D. proteinuria

B

25

Which of the following requirements is essential
for counter-current multiplier?

A. flow against concentration gradient.
B. difference in permeability of tubules carrying fluid in the same direction
C. Na/Cl pump activation
D. source of energy

B

26

Which of the following is true for the collecting
duct?

A. There are 2 cell types: principal cell and
dark staining intercalated cell.
B. It is lined mostly by intercalated cells that
regulate sodium reabsorption.
C. It has aquaporin 3 responsible for urea
reabsorption due to solvent drag.
D. It is affected by SIADH, which presents
inappropriately low vasopressin levels, causing
water retention.

A

27

A 30-year old male was found unconscious in a
highway, probably a victim of hit and run. He was
brought to the emergency room of the Philippine
General Hospital and was found to have a systolic
BP if 70 mmHg and feeble pulses. He was noted to
be probably in shock. How will this affect Na
reabsorption in the PCT?

A. Decreased Na reabsorption due to increased
sympathetic nerve activity
B. Increased Na absorption secondary to
increased renin-angiotensin-aldosterone system
C. Increased Na reabsorption secondary to
increased renal interstitium
D. All except B
E. All except C

C

28

80 year old woman found in her bed
unconscious with an empty bottle of salicylic acid on the nearby table. Obviously a victim of accidental salicylate poisoning, she was brought to the ER. If you were the intern who initially saw the victim, you would treat her with

A. sodium bicarbonate
B. ammonium chloride
C. BOTA
D. NOTA

Your objective in doing the above intervention is
to

a. increase the amount of salicylic acid (ASA)
which is lipid soluble
b. increase the amount of the anionic form
(ASA-) of salicylic acid
c. BOTA
d. NOTA

A, b

29

Which of the following will result in the lowest
FF?

A. EA dilate, AA dilate
B. EA dilate, AA constrict
C. EA constrict, AA constrict
D. EA constrict, AA dilate

B

30

If cardiac output is 6.0L, what is RBF?

A. 1.0-1.25 L/min
B. 1.25-1.50L/min
C. 1.50-2.0L/min
D. 2.0-2.50L/min

B

31

In decreased blood pH, to determine if
bicarbonate loss is through diarrhea and not
impaired kidney function, one must test for
increased levels of which of the following in the
urine?

A. bicarbonate
B. H+
C. NH4+
D. H2PO3-

A

32

What differentiates the distal tubule from
the proximal convoluted tubule?

A. presence of Na-K ATPase pump at the
basolateral membrane
B. Ca reabsorption at this site is enhanced
by the the parathyroid hormone
C. reabsorbed Na diffuses to the peritubular
capillaries
D. presence of brush border at the luminal side

B

33

Water reabsorption from interstitial space to
peritubular capillaries is by

A. interstitial hydrostatic pressure
B. interstitial oncotic pressure
C. peritubular capillary hydrostatic pressure
D. peritubular oncotic pressure

A

34

In the absence of ADH, at the same level of the
medulla, which has more concentrated tubular fluid?

A. descending loop of henle
B. ascending loop of henle
C. medullary interstitium
D. collecting tubule

A

35

Compared to plasma, interstitial fluid has more:

A. K+
B. Na+
C. Mg2+
D. Cl-

D

36

How many tablets of NaCl (1 tablet = 1 gram
NaCl) will you give a patient who has an estimated
Na+ deficit of 102 mmoles?

A. 2
B. 4
C. 6
D. 10

C

37

Which of the following will stimulate renin
release?

A. aldosterone
B. antidiuretic hormone
C. increased salt intake
D. increased sympathetic activity

D

38

In kidney failure, edema is secondary to

A. Increased capillary hydrostatic pressure
B. Decreased plasma oncotic pressure
C. Increased capillary permeability
D. Lymphatic obstruction

B

39

Bladder compliance is essential because

A. allows slow rise in detrusor pressure as
volume rises
B. maintains pressure despite increase in volume
C. allows complete emptying of bladder during voiding
D. prevents reflux of urine to the ureter

A

40

The Brush Border Microvilli in the apical
membrane is a distinct characteristic of:

A. glomerulus
B. bowman's capsule
C. PCT
D. DCT
E. NOTA

C