REPRO/NEPHRO BLOCK: Week 4 - More Kidneys

Description

Kidney function and anatomy
Melissa Denker
Quiz by Melissa Denker, updated more than 1 year ago
Melissa Denker
Created by Melissa Denker over 8 years ago
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Resource summary

Question 1

Question
What is the correct order of blood vessels in the kidney?
Answer
  • 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

Question 2

Question
What is the correct order of veins in the kidney?
Answer
  • 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

Question 3

Question
What is the lymphatic drainage of the kidneys?
Answer
  • Para-aortic/lumbar lymph nodes
  • Deep inguinal lymph nodes
  • Superficial inguinal lymph nodes
  • Groin lymph nodes

Question 4

Question
Describe the process of bicarbonate reabsorption. 1. Bicarbonate is filtered by the glomerulus ---Inside the tubule it associates with [blank_start]H+[blank_end] to form [blank_start]carbonic acid[blank_end] 2. [blank_start]Carbonic anhydrase[blank_end] catalyses the [blank_start]dissociation[blank_end] of carbonic acid into [blank_start]H2O and CO2[blank_end] ---These can then be [blank_start]absorbed[blank_end] into the tubular cells 3. Inside the cell, [blank_start]carbonic anhydrase[blank_end] catalyses the reaction between H2O and CO2 to form [blank_start]carbonic acid[blank_end] again 4. The carbonic acid then [blank_start]dissociates[blank_end] into [blank_start]H+ and bicarbonate[blank_end] again 5. [blank_start]Selective permeability[blank_end] ensures that the ions are transported in the right directions: ---H+ is [blank_start]secreted back into the lumen[blank_end], as H+ channels are only found on the [blank_start]luminal[blank_end] side ---Bicarbonate is [blank_start]absorbed into the capillaries[blank_end], as bicarbonate channels are only found on the [blank_start]basolateral[blank_end] side
Answer
  • H+
  • carbonic acid
  • Carbonic anhydrase
  • dissociation
  • H2O and CO2
  • absorbed
  • carbonic anhydrase
  • carbonic acid
  • dissociates
  • H+ and bicarbonate
  • Selective permeability
  • secreted back into the lumen
  • luminal
  • absorbed into the capillaries
  • basolateral

Question 5

Question
Describe the process of H+ excretion via titration with phosphate. 1. [blank_start]H2O and CO2[blank_end] react to form [blank_start]carbonic acid[blank_end] inside tubular cells, catalysed by [blank_start]carbonic anhydrase[blank_end] ---NOTE: the H2O and CO2 is [blank_start]new[blank_end], i.e. produced inside the cell and not reabsorbed from the filtrate 2. Carbonic acid dissociates to form [blank_start]H+ and a new bicarbonate ion[blank_end] 3. [blank_start]Bicarbonate[blank_end] is absorbed into the capillary from the [blank_start]basolateral[blank_end] side (via selective permeability) 4. [blank_start]H+[blank_end] is secreted back into the [blank_start]lumen[blank_end] (via selective permeability) 5. Some H+ associates with [blank_start]phosphate ions[blank_end] to form [blank_start]H2PO4[blank_end] ---This is then excreted in the urine
Answer
  • H2O and CO2
  • carbonic acid
  • carbonic anhydrase
  • new
  • H+ and a new bicarbonate ion
  • Bicarbonate
  • basolateral
  • H+
  • lumen
  • phosphate ions
  • H2PO4

Question 6

Question
How much H+ is excreted via titration with phosphate per day?
Answer
  • 40 mmol/day
  • 50 mmol/day
  • 60 mmol/day
  • 70 mmol/day

Question 7

Question
Describe the excretion of H+ via titration with ammonia. 1. [blank_start]Ammonia[blank_end] is produced in the [blank_start]PCT[blank_end]: ---[blank_start]Glutamine[blank_end] is reabsorbed from the filtrate ---Inside the tubular cell, [blank_start]glutaminase[blank_end] catalyses the breakdown of glutamine into [blank_start]NH4+ and bicarbonate[blank_end] ---[blank_start]Bicarbonate[blank_end] is reabsorbed into the capillary ---[blank_start]NH4+[blank_end] is secreted into the lumen ---NH4+ is converted to [blank_start]NH3[blank_end] 2. [blank_start]H2O and CO2[blank_end] react to form carbonic acid inside tubular cells, catalysed by [blank_start]carbonic anhydrase[blank_end] ---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 [blank_start]H+ and a new bicarbonate ion[blank_end] 4. [blank_start]Bicarbonate[blank_end] is absorbed into the capillary from the [blank_start]basolateral[blank_end] side (via selective permeability) 5. [blank_start]H+[blank_end] is secreted back into the [blank_start]lumen[blank_end] (via selective permeability) 6. Some H+ associates with [blank_start]NH3[blank_end] to form [blank_start]NH4+[blank_end] 7.NH4+ is then excreted in the urine
Answer
  • Ammonia
  • PCT
  • Glutamine
  • glutaminase
  • NH4+ and bicarbonate
  • Bicarbonate
  • NH4+
  • NH3
  • H2O and CO2
  • carbonic anhydrase
  • H+ and a new bicarbonate ion
  • Bicarbonate
  • basolateral
  • H+
  • lumen
  • NH3
  • NH4+

Question 8

Question
How much H+ is excreted per day via titration with ammonia?
Answer
  • 10-50 mmol/day
  • 50-100 mmol/day
  • 70-100 mmol/day
  • 80-130 mmol/day

Question 9

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

Question 10

Question
What is the function of the mesangial cells in the juxtaglomerular apparatus?
Answer
  • 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

Question 11

Question
What is the function of juxtaglomerular cells?
Answer
  • Secretion of renin
  • Secretion of adenosine
  • Detection of tubular flow
  • Vasodilation of the afferent arteriole to maintain GFR

Question 12

Question
What is the function of the macula densa?
Answer
  • Detect tubular flow
  • Adenosine secretion
  • Renin secretion
  • Vasodilation of the afferent artiole to maintain GFR

Question 13

Question
How big are the ureters?
Answer
  • 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

Question 14

Question
Where are kidney stones most likely to get stuck?
Answer
  • 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

Question 15

Question
Which of the following can cause kidney stones?
Answer
  • Primary hyperparathyroidism
  • Primary hypoparathyroidism
  • Hypercalcaemia
  • Hypocalcaemia
  • Primary/secondary hyperoxaluria
  • Primary/secondary hypooxaluria
  • Renal tubular acidosis
  • Hypocitraturia
  • Hypercitraturia

Question 16

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

Question 17

Question
What is the most common composition of kidney stones?
Answer
  • Calcium containing (calcium phosphate/oxalate)
  • Urate
  • Cysteine
  • Struvite
  • Mixed

Question 18

Question
How thick should the kidney cortex be?
Answer
  • 1-2 cm
  • 2-3 cm
  • 3-4 cm
  • 4-5 cm

Question 19

Question
How much of the filtrate is reabsorbed by kidneys?
Answer
  • 99% (180 L/day)
  • 95% (175 L/day)
  • 90% (165 L/day)
  • 80% (140 L/day)

Question 20

Question
Why is osmolality used to measure electrolyte concentrations, not osmolarity?
Answer
  • Osmolality is temperature independent
  • Osmolality is easier to calculate
  • Osmolality is a more reliable measurement
  • Osmolality is recognised internationally

Question 21

Question
How long is the PCT?
Answer
  • 14mm
  • 10mm
  • 16mm
  • 18mm
  • 12mm

Question 22

Question
How is sodium reabsorbed in the PCT? NOTE: not the co-transporters, just sodium on its own!
Answer
  • Na+/H+ exchanger
  • Na+ channel
  • Na+/HCO3- exchanger
  • Na+/Cl- exchanger

Question 23

Question
How long is the DCT?
Answer
  • 1mm
  • 2mm
  • 3mm
  • 4mm

Question 24

Question
What proportion of total reabsorption happens in the DCT?
Answer
  • 25%
  • 5%
  • 15%
  • 30%
  • 10%

Question 25

Question
What proportion of total reabsorption happens in the thick ascending loop of Henle?
Answer
  • 25%
  • 20%
  • 30%
  • 35%

Question 26

Question
Describe the action of aldosterone. 1. [blank_start]Aldosterone[blank_end] binds to the intracellular [blank_start]mineralocorticoid receptor[blank_end] 2. Aldosterone-receptor complex binds to [blank_start]nucleus[blank_end] and acts as a transcription factor, causing: ---[blank_start]Stimulation of Na+/K+ ATPase[blank_end] ---[blank_start]Increased expression of K+ channels[blank_end] (therefore more potassium [blank_start]excretion[blank_end]) ---[blank_start]Increased expression of Na+ channels[blank_end] (therefore more sodium [blank_start]reabsorption[blank_end])
Answer
  • Aldosterone
  • mineralocorticoid receptor
  • nucleus
  • Stimulation of Na+/K+ ATPase
  • Increased expression of K+ channels
  • excretion
  • Increased expression of Na+ channels
  • reabsorption

Question 27

Question
What proportion of creatinine is excreted via tubular secretion?
Answer
  • 0.5%
  • 5%
  • 10%
  • 20%

Question 28

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

Question 29

Question
How much waste is excreted in the urine per day?
Answer
  • 600 mosmol/day
  • 400 mosmol/day
  • 800 mosmol/day
  • 1000 mosmol/day

Question 30

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

Question 31

Question
What can cause dysfunctional reabsorption in the PCT?
Answer
  • Fanconi's syndrome
  • Acetzolamide
  • Bartter's syndrome
  • Gitelman's syndrome
  • Liddle's syndrome
  • Loop diuretics
  • Thiazide diuretics
  • K-sparing diuretics

Question 32

Question
What can cause defective absorption through NKCC2 channels?
Answer
  • Fanconi's syndrome
  • Acetazolamide
  • Bartter's syndrome
  • Loop diuretics
  • Gitelman's syndrome
  • Thiazide diuretics
  • Liddle's syndrome
  • K-sparing diuretics

Question 33

Question
What can cause dysfunctional absorption through NCC channels?
Answer
  • Fanconi's syndrome
  • Acetazolamide
  • Bartter's syndrome
  • Loop diuretics
  • Gitelman's syndrome
  • Thiazide diuretics
  • Liddle's syndrome
  • K-sparing diuretics

Question 34

Question
What can cause dysfunctional reabsorption through ENaC channels?
Answer
  • Fanconi's syndrome
  • Acetazolamide
  • Bartter's syndrome
  • Loop diuretics
  • Gitelman's syndrome
  • Thiazide diuretics
  • Liddle's syndrome
  • K-sparing diuretics

Question 35

Question
What is the normal (healthy) range of urine output per day?
Answer
  • 0.8-2 L/day
  • 0.5-4 L/day
  • 0.4-12 L/day
  • 0.6-3 L/day

Question 36

Question
What is used for the quantification of protein in urinalysis?
Answer
  • Spot urinalysis for protein levels
  • Urinary protein:creatinine ratio
  • 24 hour urine collection and urinary protein levels
  • Consecutive spot urinalysis for protein levels

Question 37

Question
What are the main causes of acute kidney injury or chronic kidney disease? 1. [blank_start]Ineffective blood supply[blank_end] 2. [blank_start]Glomerular disease[blank_end] 3. [blank_start]Tubulo-interstitial disease[blank_end] 4. [blank_start]Obstructive uropathy[blank_end]
Answer
  • Ineffective blood supply
  • Glomerular disease
  • Tubulo-interstitial disease
  • Obstructive uropathy
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