Usmle Step 1 Dit: Renal

Front 1

The kidney in a fetus of 4 weeks is called...

Back 1

Pronephros

Front 2

Functions as kidney for first trimester, later contributes to male genital system

Back 2

Mesonephros

Front 3

First appears in 5th week of gestation, nephrogenesis continues through 32-36 weeks of gestation

Back 3

Metanephros

Front 4

Potter syndrome is due to failure of the _________________ to form, causing bilateral agenesis

Back 4

Failure of the uretic buds to form

Front 5

What are the common symptoms of potters syndrome?

Back 5

POTTER

Pulmonary hypoplasia

Oligohydramnios

Twisted face

Twisted skin (wrinkled)

Extremity defects

Renal failure (in utero)

Front 6

Horseshoe kidneys get trapped under ___________________ and remain low in the abdomen

Back 6

Inferior mesenteric artery

Front 7

Horseshoe kidney is associated to __________ syndrome

Back 7

Turner syndrome

Front 8

What composes the glomerular filtration barrier?

Back 8

- Capillary endothelium

- Basement membrane

- Podocyte foot process

Front 9

Angiotensinogen is cleaved into angiotensin I by ____________

Back 9

Renin

Front 10

Angiotensin I converts into angiotensin II thanks to ___________

Back 10

ACE

Front 11

Main functions of ACE are:

Back 11

- Vasoconstrictor that increases BP

- Stimulates aldosterone (which in turn increases Na+ and h20 retention)

Front 12

JG stimulation

Back 12

- B adrenergic stimulation

- Low Na+ in the DCT (sensed by macula densa cells)

- Low pressure in the afferent arteriole

Front 13

JG apparatus is composed of

Back 13

HG cells and macula densa

Front 14

Ureters pass ____________ in women and _____________ in men

Back 14

- Under the uterine artery in women

- Under ductus deferens in men

Front 15

Common site for renal stones

Back 15

Ureterovesicular junction

Front 16

Renal clearance formula

Back 16

UV/P

Front 17

_________clearance is an approximate measure of glomerular filtration rate

Back 17

Creatinine

Front 18

________ clearance can be used to calculate glomerular filtration rate because it is so freely filtered and is neither reabsorbed nor secreted

Back 18

Inulin

Front 19

____________________________ can be estimated using para-aminohippuric acid

Back 19

Effective renal plasma flow

Front 20

Normal filtration fraction

Back 20

20%

Front 21

At plasma glucose of _____mg/dL, glucosuria begins

Back 21

200

Front 22

At plasma glucose of _____mg/dL, all transporters are fully saturated

Back 22

375

Front 23

Glucose at ______ plasma level is completly reabsorbed in proximal tubule by Na+/glucose cotranport

Back 23

Normal plasma level

Front 24

______________ transporters in proximal tubule reabsorb amino acids.

Back 24

Sodium dependent transporters

Front 25

_________ disease where there is a deficiency of neutral amino acid (tryptophan=> inability to make niacin), which results in pellagra-like symptoms.

Back 25

Hartnup disease

Front 26

Potassium sparing diuretics

Back 26

Aldosterone antagonists: spironolactone, eplerenone

Inhibit epithelial Na+ channels: Triamterene, amiloride

Front 27

What class of diuretic directly affects principal cells?

Back 27

Potassium sparing diuretics

Front 28

What effect does aldosterone have on principal cells of the collecting duct?

Back 28

Principal cells: reabsorption of Na and secretion of K

Intercalated cells: stimulate secretion of H ions

Front 29

Reabsorbs 67% of the fluid and electrolytes filtered by the glomerulus

Back 29

Proximal tubule

Front 30

Site of secretion of organic anions and cations

Back 30

Proximal tubule

Front 31

Nephron area always impermeable to H20

Back 31

Thick ascending limb

Front 32

Area of nephron permeable to water only in the presence of ADH

Back 32

Late distal tubule (also the collecting duct)

Front 33

Site of the Na/2Cl-/K+ co-transporter

Back 33

Thick ascending limb

Front 34

Site of isotonic fluid reabsorption

Back 34

Proximal tubule

Front 35

Site responsible for diltuting urine

Back 35

Thick ascending limb

Front 36

Only site where glucose and amino acids are reabsorbed

Back 36

Proximal tubule

Front 37

Water reabsorption in the loop of henle

Back 37

Descending limb

Front 38

What drug should you use on acute pulmonary edema?

Back 38

Loop diuretic

Front 39

What drug should you use on idiopathic hypercalciuria

Back 39

Thiazide diuretic

Front 40

What drug should you use to treat glaucoma

Back 40

Acetazolamide or mannitol

Front 41

How do you treat mild to moderate CHF with expanded ECV?

Back 41

Loop diuretic

Front 42

How do you treat CHF in conjunction with loop or thiazide diuretics to retain calcium?

Back 42

Potassium-sparing diuretic

Front 43

How do you treat edema associated with nephrotic syndrome?

Back 43

Loop diuretic

Front 44

For increased intracranial pressure, you can give...

Back 44

Mannitol

Front 45

How do you treat mild to moderate HTN?

Back 45

Thiazide diuretic

Front 46

How do you treat HTN with hypercalcemia?

Back 46

Loop diuretic

Front 47

Diuretic used to treat altitude sickness?

Back 47

Acetazolamide

Front 48

Diuretic used to treat hyperaldosteronism?

Back 48

Spironolactone or eplerenone

Front 49

Reabsorbs Na in exchange for secreting K+ and H+

Back 49

Collecting tubule

Front 50

Actively reabsorbs Na+, K+ and Cl-. Induces reabsorption of Mg2+ and Ca2+. Impermeable to H20

Back 50

Thick ascending loop of henle

Front 51

Same action as furosemide but does not cause allergy to sulfa drugs

Back 51

Ethacrynic acid

Front 52

Major toxicities seen in hydrochlorothiazide

Back 52

HyperGLUC

HyperGlycemia, hyperLipidemia, hyperUricemia, hyperCalcemia

Front 53

Urine NaCl increases with all diuretics except....

Back 53

acetazolamide

Front 54

Urine K+ increases with all diuretics except...

Back 54

k-SPARING

Front 55

Toxicities seen in ACE inibitors

Back 55

Cough, Angioedema, Teratogen, increasted Creatinine, Hyperkalemia, Hypotension

CATCHH

Front 56

What hormones act on the kidney?

Back 56

Angiotensin II, atrial natriuretic peptide, parathyroid hormone, ADH (vasopressin), aldosterone

Front 57

What hormones are produced by the kidney. (endocrine functions)

Back 57

Erythropoietin, vitamin D, renin, prostaglandins

Front 58

Syndrome of inappropiate antidiuretic hormone secretion, excessive water retention, hyponatremia with continued urinary Na+ excretion

Back 58

SIADH

Front 59

Very low serum levels of _________ can lead to cerebral edema.

Back 59

SIADH

Front 60

Causes of SIADH include:

Back 60

Ectopic ADH, CNS disorders, pulmonary disease, drugs