Melissa Denker
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Kidney function and anatomy

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Melissa Denker
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REPRO/NEPHRO BLOCK: Week 4 - More Kidneys

Frage 1 von 37

1

What is the correct order of blood vessels in the kidney?

Wähle eine der folgenden:

  • Renal artery
    Segmental arteries
    Lobar arteries
    Interlobar arteries
    Arcuate arteries
    Cortical radiate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Segmental arteries
    Lobar arteries
    Interlobar arteries
    Cortical radiate arteries
    Arcuate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Lobar arteries
    Interlobar arteries
    Segmental arteries
    Cortical radiate arteries
    Arcuate arteries
    Afferent arterioles
    Glomerulus

  • Renal artery
    Interlobar arteries
    Lobar arteries
    Arcuate arteries
    Cortical radiate arteries
    Segmental arteries
    Afferent arterioles
    Glomerulus

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Frage 2 von 37

1

What is the correct order of veins in the kidney?

Wähle eine der folgenden:

  • Glomerulus
    Efferent arterioles
    Cortical radiate veins
    Arcuate veins
    Interlobar veins
    Lobar veins
    Segmental veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Arcuate veins
    Cortical radiate veins
    Interlobar veins
    Lobar veins
    Segmental veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Segmental veins
    Lobar veins
    Interlobar veins
    Arcuate veins
    Cortical radiate veins
    Renal vein

  • Glomerulus
    Efferent arterioles
    Cortical radiate veins
    Arcuate veins
    Lobar veins
    Interlobar veins
    Segmental veins
    Renal vein

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Frage 3 von 37

1

What is the lymphatic drainage of the kidneys?

Wähle eine der folgenden:

  • Para-aortic/lumbar lymph nodes

  • Deep inguinal lymph nodes

  • Superficial inguinal lymph nodes

  • Groin lymph nodes

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Frage 4 von 37

1

Fülle die Lücken, um den Text zu vervollständigen.

Describe the process of bicarbonate reabsorption.
1. Bicarbonate is filtered by the glomerulus
---Inside the tubule it associates with to form
2. catalyses the of carbonic acid into
---These can then be into the tubular cells
3. Inside the cell, catalyses the reaction between H2O and CO2 to form again
4. The carbonic acid then into again
5. ensures that the ions are transported in the right directions:
---H+ is , as H+ channels are only found on the side
---Bicarbonate is , as bicarbonate channels are only found on the side

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Frage 5 von 37

1

Fülle die Lücken, um den Text zu vervollständigen.

Describe the process of H+ excretion via titration with phosphate.
1. react to form inside tubular cells, catalysed by
---NOTE: the H2O and CO2 is , i.e. produced inside the cell and not reabsorbed from the filtrate
2. Carbonic acid dissociates to form
3. is absorbed into the capillary from the side (via selective permeability)
4. is secreted back into the (via selective permeability)
5. Some H+ associates with to form
---This is then excreted in the urine

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Frage 6 von 37

1

How much H+ is excreted via titration with phosphate per day?

Wähle eine der folgenden:

  • 40 mmol/day

  • 50 mmol/day

  • 60 mmol/day

  • 70 mmol/day

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Frage 7 von 37

1

Fülle die Lücken, um den Text zu vervollständigen.

Describe the excretion of H+ via titration with ammonia.
1. is produced in the :
--- is reabsorbed from the filtrate
---Inside the tubular cell, catalyses the breakdown of glutamine into
--- is reabsorbed into the capillary
--- is secreted into the lumen
---NH4+ is converted to
2. react to form carbonic acid inside tubular cells, catalysed by
---NOTE: the H2O and CO2 is new, i.e. produced inside the cell and not reabsorbed from the filtrate
3. Carbonic acid dissociates to form
4. is absorbed into the capillary from the side (via selective permeability)
5. is secreted back into the (via selective permeability)
6. Some H+ associates with to form
7.NH4+ is then excreted in the urine

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Frage 8 von 37

1

How much H+ is excreted per day via titration with ammonia?

Wähle eine der folgenden:

  • 10-50 mmol/day

  • 50-100 mmol/day

  • 70-100 mmol/day

  • 80-130 mmol/day

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Frage 9 von 37

1

How is the amount of H+ excretion in the urine increased when there are high levels of H+ in the blood?

Wähle eine der folgenden:

  • Upregulation of glutaminase, leading to increased H+ excretion via titration with ammonia

  • Increased phosphate excretion, leading to more phosphate in the tubules and increased H+ excretion via titration with phosphate

  • Increased bicarbonate production in the tubular cells, leading to increased buffering in the blood to decrease H+ levels

  • Down-regulation of H2O and CO2 transport into tubular cells, leading to increased H+ excretion in carbonic acid

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Frage 10 von 37

1

What is the function of the mesangial cells in the juxtaglomerular apparatus?

Wähle eine der folgenden:

  • Unknown

  • Unclear: possibly erythropoietin or smooth muscle-like functions

  • Constriction of the efferent arteriole to maintain GFR

  • Vasodilation of the afferent arteriole to maintain GFR

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Frage 11 von 37

1

What is the function of juxtaglomerular cells?

Wähle eine der folgenden:

  • Secretion of renin

  • Secretion of adenosine

  • Detection of tubular flow

  • Vasodilation of the afferent arteriole to maintain GFR

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Frage 12 von 37

1

What is the function of the macula densa?

Wähle eine oder mehr der folgenden:

  • Detect tubular flow

  • Adenosine secretion

  • Renin secretion

  • Vasodilation of the afferent artiole to maintain GFR

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Frage 13 von 37

1

How big are the ureters?

Wähle eine der folgenden:

  • Length: 25-30 cm
    Diameter: 3-4 mm

  • Length: 30-35 cm
    Diameter: 4-5 mm

  • Length: 20-25 cm
    Diameter: 2-3 mm

  • Length: 35-40 cm
    Diameter: 3-4 mm

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Frage 14 von 37

1

Where are kidney stones most likely to get stuck?

Wähle eine oder mehr der folgenden:

  • Uteropelvic junction

  • Crossing over the common iliac arteries at the pelvic brim

  • Where ureters enter the bladder

  • Medial aspect of the psoas major muscle

  • Point at which it enters the retroperitoneum

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Frage 15 von 37

1

Which of the following can cause kidney stones?

Wähle eine oder mehr der folgenden:

  • Primary hyperparathyroidism

  • Primary hypoparathyroidism

  • Hypercalcaemia

  • Hypocalcaemia

  • Primary/secondary hyperoxaluria

  • Primary/secondary hypooxaluria

  • Renal tubular acidosis

  • Hypocitraturia

  • Hypercitraturia

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Frage 16 von 37

1

What is the correct order for the proportions of different types of kidney stones, from most common to least common?

Wähle eine der folgenden:

  • Calcium containing (calcium phosphate/oxalate)
    Magnesium ammonium phosphate (Struvite)
    Urate
    Cysteine
    Mixed

  • Mixed
    Calcium containing (calcium phosphate/oxalate)
    Magnesium ammonium phosphate (Struvite)
    Urate
    Cysteine

  • Mixed
    Magnesium ammonium phosphate (Struvite)
    Calcium containing (calcium phosphate/oxalate)
    Cysteine
    Urate

  • Magnesium ammonium phosphate (Struvite)
    Calcium containing (calcium phosphate/oxalate)
    Mixed
    Cysteine
    Urate

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Frage 17 von 37

1

What is the most common composition of kidney stones?

Wähle eine der folgenden:

  • Calcium containing (calcium phosphate/oxalate)

  • Urate

  • Cysteine

  • Struvite

  • Mixed

Erklärung

Frage 18 von 37

1

How thick should the kidney cortex be?

Wähle eine der folgenden:

  • 1-2 cm

  • 2-3 cm

  • 3-4 cm

  • 4-5 cm

Erklärung

Frage 19 von 37

1

How much of the filtrate is reabsorbed by kidneys?

Wähle eine der folgenden:

  • 99% (180 L/day)

  • 95% (175 L/day)

  • 90% (165 L/day)

  • 80% (140 L/day)

Erklärung

Frage 20 von 37

1

Why is osmolality used to measure electrolyte concentrations, not osmolarity?

Wähle eine der folgenden:

  • Osmolality is temperature independent

  • Osmolality is easier to calculate

  • Osmolality is a more reliable measurement

  • Osmolality is recognised internationally

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Frage 21 von 37

1

How long is the PCT?

Wähle eine der folgenden:

  • 14mm

  • 10mm

  • 16mm

  • 18mm

  • 12mm

Erklärung

Frage 22 von 37

1

How is sodium reabsorbed in the PCT? NOTE: not the co-transporters, just sodium on its own!

Wähle eine der folgenden:

  • Na+/H+ exchanger

  • Na+ channel

  • Na+/HCO3- exchanger

  • Na+/Cl- exchanger

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Frage 23 von 37

1

How long is the DCT?

Wähle eine der folgenden:

  • 1mm

  • 2mm

  • 3mm

  • 4mm

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Frage 24 von 37

1

What proportion of total reabsorption happens in the DCT?

Wähle eine der folgenden:

  • 25%

  • 5%

  • 15%

  • 30%

  • 10%

Erklärung

Frage 25 von 37

1

What proportion of total reabsorption happens in the thick ascending loop of Henle?

Wähle eine der folgenden:

  • 25%

  • 20%

  • 30%

  • 35%

Erklärung

Frage 26 von 37

1

Fülle die Lücken, um den Text zu vervollständigen.

Describe the action of aldosterone.
1. binds to the intracellular
2. Aldosterone-receptor complex binds to and acts as a transcription factor, causing:
---
--- (therefore more potassium )
--- (therefore more sodium )

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Frage 27 von 37

1

What proportion of creatinine is excreted via tubular secretion?

Wähle eine der folgenden:

  • 0.5%

  • 5%

  • 10%

  • 20%

Erklärung

Frage 28 von 37

1

What are the correct values of minimum and maximum urine osmolality?

Wähle eine der folgenden:

  • Minimum osmolality: 50 mosm/Kg
    Maximum osmolality: 1400 mosm/Kg

  • Minimum osmolality: 100 mosm/Kg
    Maximum osmolality: 2000 mosm/Kg

  • Minimum osmolality: 60 mosm/Kg
    Maximum osmolality: 1400 mosm/Kg

  • Minimum osmolality: 50 mosm/Kg
    Maximum osmolality: 1200 mosm/Kg

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Frage 29 von 37

1

How much waste is excreted in the urine per day?

Wähle eine der folgenden:

  • 600 mosmol/day

  • 400 mosmol/day

  • 800 mosmol/day

  • 1000 mosmol/day

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Frage 30 von 37

1

What are the correct values for minimum and maximum daily urine output?

Wähle eine der folgenden:

  • Minimum urine output: 0.4 L/day
    Maximum urine output: 12 L/day

  • Minimum urine output: 0.3 L/day
    Maximum urine output: 14L/day

  • Minimum urine output: 0.5 L/day
    Maximum urine output: 12 L/day

  • Minimum urine output: 0.6 L/day
    Maximum urine output: 14 L/day

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Frage 31 von 37

1

What can cause dysfunctional reabsorption in the PCT?

Wähle eine oder mehr der folgenden:

  • Fanconi's syndrome

  • Acetzolamide

  • Bartter's syndrome

  • Gitelman's syndrome

  • Liddle's syndrome

  • Loop diuretics

  • Thiazide diuretics

  • K-sparing diuretics

Erklärung

Frage 32 von 37

1

What can cause defective absorption through NKCC2 channels?

Wähle eine oder mehr der folgenden:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Erklärung

Frage 33 von 37

1

What can cause dysfunctional absorption through NCC channels?

Wähle eine oder mehr der folgenden:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Erklärung

Frage 34 von 37

1

What can cause dysfunctional reabsorption through ENaC channels?

Wähle eine oder mehr der folgenden:

  • Fanconi's syndrome

  • Acetazolamide

  • Bartter's syndrome

  • Loop diuretics

  • Gitelman's syndrome

  • Thiazide diuretics

  • Liddle's syndrome

  • K-sparing diuretics

Erklärung

Frage 35 von 37

1

What is the normal (healthy) range of urine output per day?

Wähle eine der folgenden:

  • 0.8-2 L/day

  • 0.5-4 L/day

  • 0.4-12 L/day

  • 0.6-3 L/day

Erklärung

Frage 36 von 37

1

What is used for the quantification of protein in urinalysis?

Wähle eine der folgenden:

  • Spot urinalysis for protein levels

  • Urinary protein:creatinine ratio

  • 24 hour urine collection and urinary protein levels

  • Consecutive spot urinalysis for protein levels

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Frage 37 von 37

1

Fülle die Lücken, um den Text zu vervollständigen.

What are the main causes of acute kidney injury or chronic kidney disease?
1.
2.
3.
4.

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