Week 6 - Renal Function

Glomerulonephritis is the damage and inflammation of the filtration system of the kidneys and that can cause a)Acute kidney failure b)Acute/chronic kidney c)Chronic kidney failure

b)Acute/chronic kidney

Uremia is usually happening in case of a)Acute renal failure b)Chronic renal failure

b)Chronic renal failure

In the kidneys, reabsorbed substances known as tubular fluid (e.g. inulin) go directly to the urine. a)True b)False

b)False

The kidney filters 60 L/day of plasma and reabsorb more than 95.5% of the amount filtered. a)True b)False

b)False - 180L/day

Each nephron produces ~100 µL of urine per day. a)True b)False

b)False - Each nephron filters ~100 µL of urine per day

BUN test is a measure of the amount of nitrogen in the urine in the form of urea, and a measurement of renal function. a)True b)False

b)False - it is a measure of the amount of nitrogen in the 'blood' in the form of urea.

Measurement of the urine sodium concentration (FENa) provides information on the integrity of Tubular secretion function. a)True b)False

b)False - percentage of the sodium filtered by the kidney and is excreted in the urine

The liver produces the active form of Vit D. a)True b)False

b)False - produced in kidney

When does glucose appear in the urine? When its concentration exceeds the renal threshold of 15 mmol/L. a)True b)False

b)False - renal threshold is 11mmol/L

------- has an essential role as a buffer in blood. a)HCl b)HCO3- c)H2SO4 d)PO4--- e)SO3--

b)HCO3-

The increase in blood volume in the body is termed---------- a)Hyperglycemia b)Hypervolemia c)Hypovolemia d)Hypoglycemia

b)Hypervolemia

Renal calculi is also called-------------- a)Kidney functions b)Kidney stones c)Liver functions d)Prostate stones

b)Kidney stones

In a healthy person, do you expect to see creatinine in blood? a)Yes b)No

b)No

In a healthy person, do you expect to see glucose in urine? a)Yes b)No

b)No - glucose should not pass the filtration membrane

Abnormally low urine volume < 400 mL / 24 hour is called: a)Anuria b)Oliguria c)Polyuria d)Urea

b)Oliguria

----- is a measure of the osmoles (Osm) of solute per kilogram of solvent (osmol/kg or Osm/kg), ----is defined as the number of osmoles of solute per liter (L) of solution (osmol/L or Osm/L). a)Osmolarity b)Osmolality

b)Osmolality a)Osmolarity

What is the reference range for creatinine clearance? a)60 - 80 µmol/L b)60 - 120 µmol/L c)80 - 120 µmol/L d)80 - 140 µmol/L

c)80 - 120 µmol/L

What is the reference range for GFR? a)60 - 80 mL/min b)80 - 120 mL/min c)80 - 140 mL/min d)60 - 120 mL/min

c)80 - 140 mL/min

Most of the blood acids are coming from: a)HCl b)H2SO4 c)CO2 d)PO4--- e)SO3--

c)CO2

Analgesics are safe to use. However, using analgesics over a long period of time may cause ------ a)Cough b)Cancer c)Chronic kidney disease d)Diarrhoea

c)Chronic kidney disease

In the kidney, the tubular secretion of -------- from the blood into the tubular fluid helps the blood to keep its pH in the normal level? a)Calcium b)Creatinine c)H+ and NH4+ d)Na+ and K+

c)H+ and NH4+

In Acute renal failure, renal stones and enlarged prostate are considered: a)Pre-renal uraemia b)Intrinsic renal damage c)Post-renal obstruction

c)Post-renal obstruction

The reabsorption process is taking place in the a)Glomerulus b)Heart c)Proximal tubules d)Spleen

c)Proximal tubules

What is the best terminology to describe the abnormalities here? Ref Interval Sodium 140 mmol/L 135-145 Potassium 6.0 mmol/L 3.0-5.0 Bicarbonate 16 mmol/L 22-32 Urea 40 mmol/L 3-8 Creatinine 400 µmol/L 50-120 a)Dehydration and acidosis b)Dehydration and alkalosis c)Renal failure and acidosis d)Renal failure and alkalosis

c)Renal failure and acidosis

The actual glomerular filtration rate (GFR) or creatinine clearance test took into account: a)The volume of creatinine b)The volume of plasma c)The time for urine collection d)The time for creatinine collection e)The concentration of creatinine

c)The time for urine collection

White/yellow crystals of urate on skin is called a)Hyperkalemia b)Metabolic acidosis c)Uremic frost d)Uremia

c)Uremic frost

The actual glomerular filtration rate (GFR) or creatinine clearance test main difficulty is the large errors in the collection of: a)Volume of creatinine b)Volume of urea c)Volume of urine d)Volume of plasma

c)Volume of urine

The typical pH of the blood is -------, whereas that of urine is -----. a)4.5-6.0 b)6.0 c)3.5-5.5 d)7.35-7.45 e)More than 11

d)7.35-7.45 b)6.0

Rhabdomyolysis is the breakdown of a)Brain fibers b)Kidney fibers c)Liver fibers d)Muscle fibers

d)Muscle fibers

BUN test is a measure of the amount of -----------in the blood in the form of urea, and a measurement of renal function. a)Ammonia b)Albumin c)Oxygen d)Nitrogen e)Urine

d)Nitrogen

The osmolarity of plasma is higher than that of urine. a)True b)False

a) True

Desmopressin is a drug that is used as a)ADH analogue b)Anticoagulant c)Antidepressant d)Diuretic hormone analogue

a)ADH analogue

A useful test for detecting risk of diabetic nephropathy is: a)Albumin creatinine ratio b)Creatinine c)HbA1C

a)Albumin creatinine ratio

What is the responsible hormone for concentrating urine and increasing osmolality / osmolarity? a)Anti-diuretic hormone b)Epinephrine c)Glucagon d)Insulin

a)Anti-diuretic hormone

Abnormally low urine volume < 100 mL / 24 hour is called: a)Anuria b)Oliguria c)Polyuria d)Urea

a)Anuria

Renal Tubular Acidosis is a syndrome due to either a defect in proximal tubule ------, or a defect in distal tubule ------. As a result there is -------. a)Bicarbonate reabsorption b)Hydrogen ion secretion c)Metabolic acidosis d)Respiratory acidosis

a)Bicarbonate reabsorption b)Hydrogen ion secretion c)Metabolic acidosis

The following are expected to be seen in a healthy person's urine, however, in case of glomerulonephritis, we are more likely to see -------- in urine. a)Blood and protein b)Water and sodium c)Calcium and potassium d)Creatinine and urea

a)Blood and protein

The glomerular capillary membrane could filter the following EXCEPT a)Blood cells b)Creatinine c)Glucose d)Urea e)Water

a)Blood cells

In healthy person, the kidney tubules reabsorb completely or most of all of the following EXCEPT a)Creatinine b)Glucose c)Sodium d)Water

a)Creatinine

In chronic renal failure, the end stage of renal disease (ESRD) requires: a)Dialysis or transplant b)Increase fluid c)IV sodium d)IV potassium

a)Dialysis or transplant

Liver is an organ of the ----system while kidneys are the organs of the ----system. a)Digestive b)Urinary

a)Digestive b)Urinary

The filtration process is taking place in the a)Glomerulus b)Heart c)Proximal tubules d)Spleen

a)Glomerulus

Glomerular capillary membrane consists of three layers which allows some the blood to pass though but not all, blood cells and ----molecular weight proteins are ----and ----pass. a)High b)Low c)large d)Small can e)Can't

a)High e)Can't

During acute renal failure, all the following are correct EXCEPT a)Metabolic alkalosis b)Hyperkalemia c)Increase in waste products d)Hypervolemia e)Hyponatremia

a)Metabolic alkalosis - this is not part of renal failure - Metabolic acidosis (low excretion of H+/or low reabsorption of HCO3-) can occur.

Renal functions test include all the followings EXCEPT a)Production of bilirubin b)Excretion of metabolic waste and by-products c)Endocrine function d)Regulation of plasma electrolytes, fluid/water balance, blood pressure

a)Production of bilirubin

Desmopressin could be used in case of low urine osmolality. a)True b)False

a)True

The estimated glomerular filtration rate (eGFR) could be calculated using the Cockcroft-Gault equation, which took into consideration the body weight, sex and age. a)True b)False

a)True

The estimated glomerular filtration rate (eGFR) could be calculated using the Modified Diet in Renal Disease (MDRD) equation, which took into consideration the sex and ethnicity and not the body weight. a)True b)False

a)True

The plasma concentration above which the substance appears in the urine is known as renal threshold. a)True b)False

a)True

In a healthy person, do you expect to see creatinine in urine? a)Yes b)No

a)Yes

In a healthy person, do you expect to see glucose in blood? a)Yes b)No

a)Yes

Which test is highly recommended to assess tubular function specifically for renal transplant patients as it is relatively intact molecule? a)β2-microglobulin b)Creatinine c)Myoglobin d)Microalbuminuria

a)β2-microglobulin

Which test is highly recommended to assess tubular functions? a)β2-microglobulin b)Creatinine c)Myoglobin d)Microalbuminuria

a)β2-microglobulin

Normally, low MW proteins (e.g. Cystatin C) are filtered by the GFR, reabsorbed by the kidney tubular cells and been catabolized. Whereas, high MW proteins (e.g. blood cells) won't be filtered and they will remain in the blood too. In case of kidney diseases, we will find proteins in urine, which are probably due to EXCEPT: a)Glomerulus dysfunction, thus high MW proteins, e.g. albumin, were filtered. ● b)Renal tubular cells dysfunction, thus can't reabsorb low MW proteins and thus they were excreted in urine. ● c)Overflow or excessive filtration rate exceeded reabsorption capacity (Bence-Jones) ● d)Overflow or excessive reabsorption rate exceeded filtration capacity

d)Overflow or excessive reabsorption rate exceeded filtration capacity

There are reabsorbed substances and non reabsorbed substances known as --------- such as inulin, which go directly to the urine. a)Capsule fluid b)Renin fluid c)Nephron fluid d)Tubular fluid

d)Tubular fluid

In chronic renal failure, the patient smells like ------ a)Blood b)Citric acid c)Glucose d)Urine/ammonia

d)Urine/ammonia

Renal threshold is the plasma concentration above which the substance appears in the urine. Glucose can be seen in urine if its concentration is above------- mmol/L: a) 3 b) 6 c) 8 d) 9 e) 11

e) 11

The golden marker for GFR is -----, as it is completely filtered by the glomerulus and being ---- excreted in urine. a) 0% b)100% c)Creatinine d)Glucose e)Inulin

e)Inulin b)100%