Download 2025 RENAL MEDICINE MUST KNOW QUIZ and more Exams Nursing in PDF only on Docsity!
2025 RENAL MEDICINE MUST KNOW QUIZ
1. What is the functional unit of the kidney? The nephron Explanation: The nephron is the microscopic structural and functional unit of the kidney responsible for filtering blood, reabsorbing needed substances, and forming urine. 2. Which cells form the juxtaglomerular apparatus? Macula densa cells, juxtaglomerular cells, and extra glomerular mesangial cells Explanation: This apparatus regulates renal blood flow and glomerular filtration rate via the renin-angiotensin system. 3. What is the main function of podocytes? They form part of the glomerular filtration barrier and prevent protein loss Explanation: Podocytes have foot processes that create slit diaphragms, critical for selective filtration. 4. How does the kidney regulate acid-base balance? By reabsorbing bicarbonate and secreting hydrogen ions in the renal tubules Explanation: This maintains blood pH within a narrow range by adjusting acid and base excretion. 5. What is the role of the loop of Henle in urine concentration? It creates a medullary osmotic gradient via counter-current multiplication Explanation: This gradient enables water reabsorption from the collecting ducts, concentrating urine.
6. What hormone primarily controls water reabsorption in the collecting duct? Antidiuretic hormone (ADH) or vasopressin Explanation: ADH increases aquaporin channels, allowing water to be reabsorbed and urine to be concentrated. 7. What is the significance of the glomerular filtration rate (GFR)? It measures kidney function and filtration capacity Explanation: GFR indicates how well the kidneys filter blood; decreased GFR suggests renal impairment. 8. How is GFR commonly estimated clinically? Using equations based on serum creatinine, such as the MDRD or CKD- EPI formulas Explanation: These formulas adjust for age, sex, and race to estimate kidney filtration without invasive testing. 9. What is proteinuria and why is it clinically important? The presence of excess protein in urine, indicating glomerular damage Explanation: Proteinuria suggests kidney disease and is a marker for progression risk. 10. What is the primary cause of nephrotic syndrome? Damage to the glomerular filtration barrier leading to heavy proteinuria Explanation: This results in hypoalbuminemia, edema, and hyperlipidemia. 11. What is the main pathophysiological mechanism in acute tubular necrosis (ATN)? Ischemic or toxic injury to tubular epithelial cells causing cell death Explanation: ATN leads to acute kidney injury with impaired tubular function and decreased urine output.
urinary tract infections and kidney stones Explanation: Produced by tubular cells, it forms part of the urinary defense system.
19. What causes renal tubular acidosis (RTA)? Defects in tubular acid secretion or bicarbonate reabsorption leading to metabolic acidosis Explanation: Different types of RTA affect proximal or distal tubule function. 20. What is the counter-current exchange mechanism in the kidney? It maintains the osmotic gradient in the medulla by exchanging solutes and water between vasa recta and interstitium Explanation: This preserves the concentration gradient essential for urine concentration. 21. What is the role of organic anion transporters (OATs) in the kidney? They mediate secretion of endogenous and exogenous organic anions into the tubular lumen Explanation: OATs help eliminate drugs and toxins. 22. How does aging affect renal function? There is a gradual decline in GFR and reduced ability to concentrate urine Explanation: Structural changes and nephron loss reduce renal reserve. 23. What is the pathophysiology of chyluria? Lymphatic fistulae cause leakage of chyle into urine, leading to milky urine Explanation: Often due to filarial infection or lymphatic obstruction. 24. What is the clinical significance of podocyte injury? Podocyte damage leads to proteinuria and progression of glomerular
diseases Explanation: Podocytes are critical for filtration barrier integrity.
25. How is acute interstitial nephritis typically caused? By hypersensitivity reactions to drugs, infections, or autoimmune diseases Explanation: It causes inflammation of the renal interstitium with impaired function. 26. What is the effect of high protein diet on GFR? It causes hyper filtration and increased GFR Explanation: Protein intake increases renal workload and glomerular pressure. 27. What is the role of aquaporins in the kidney? Aquaporins facilitate water reabsorption across tubular epithelial cells Explanation: Aquaporin-2 is regulated by ADH in the collecting duct. 28. What is the primary cause of nephrogenic diabetes insipidus? Resistance of renal tubules to ADH action Explanation: It results in inability to concentrate urine despite normal or high ADH levels. 29. What is the significance of free water clearance? It indicates the kidney’s ability to excrete or retain free water independent of solutes Explanation: Positive free water clearance means water excretion; negative means water retention. 30. How does pressure natriuresis contribute to blood pressure regulation? Increased renal perfusion pressure leads to enhanced sodium excretion, lowering blood volume and pressure Explanation: It is a key mechanism in long-term blood pressure control.
Explanation: Cortical nephrons mainly perform filtration and reabsorption.
37. What is the role of prostaglandins in renal physiology? They regulate renal blood flow and sodium excretion, often causing vasodilation Explanation: NSAIDs inhibit prostaglandin synthesis, potentially reducing renal perfusion. 38. How does the kidney handle uric acid? It filters, reabsorbs, and secretes uric acid via proximal tubular transporters Explanation: Impaired handling can lead to hyperuricemia and gout. 39. What is the pathophysiology of acute glomerulonephritis? Immune-mediated inflammation of glomeruli causing hematuria and renal impairment Explanation: Often post-infectious or autoimmune in origin. 40. What is the role of complement system in renal disease? Activation leads to inflammation and tissue injury in diseases like lupus nephritis and membranoproliferative glomerulonephritis Explanation: Complement components can be therapeutic targets. 41. How is renal plasma flow measured clinically? Using para-aminohippurate (PAH) clearance test Explanation: PAH is almost completely cleared from plasma in one pass through the kidneys. 42. What is the clinical relevance of cystatin C? It is an alternative marker of GFR, less affected by muscle mass than creatinine Explanation: Useful in patients where creatinine may be unreliable.
43. What causes nephrotic range proteinuria? Damage to the glomerular filtration barrier allowing >3.5 g/day protein loss in urine Explanation: Seen in diseases like minimal change disease and focal segmental glomerulosclerosis. 44. What is the typical presentation of polycystic kidney disease (PKD)? Hypertension, flank pain, hematuria, and enlarged cystic kidneys Explanation: It is a genetic disorder causing cyst formation and progressive renal failure. 45. What is the role of vasopressin receptor antagonists in renal medicine? They block ADH action to treat hyponatremia and polycystic kidney disease Explanation: By inhibiting water reabsorption, they help correct fluid overload. 46. What is the mechanism of action of sodium-glucose cotransporter 2 (SGLT2) inhibitors? They block glucose reabsorption in the proximal tubule, promoting glycosuria Explanation: Used in diabetes management and have renal protective effects. 47. How does renal artery stenosis cause hypertension? Reduced renal perfusion stimulates renin release, activating RAAS and increasing blood pressure Explanation: This is a form of secondary hypertension. 48. What is the significance of casts in urine sediment? They indicate renal tubular or glomerular pathology depending on type
