QUESTION 1
1. The main driving pressure creating nephron tubule filtrate from blood in the glomerulus is the oncotic pressure exerted by the proteins in blood.
True
False
1 points
QUESTION 2
1. Atrial natriuretic peptide is secreted by the kidneys in response to high blood pressure
True
False
QUESTION 3
1. Insulin stimulates potassium absorption into cells.
True
False
QUESTION 4
1. Which of the following is TRUE regarding hyponatraemia
a. osmolality of blood will probably be decreased
b. the term refers to low levels of calcium in blood
c. it can occur as a result of dehydration
d. it is not significant as potassium is the main cation in extracellular fluid
e. it means there is ‘too little water’ in blood
1 points
QUESTION 5
1. Infusion of hypertonic saline will:
A. Decrease interstitial fluid volume
B. Draw water out of plasma into interstitial fluid
C. Draw water out of interstitial fluid into plasma
D. Decrease intracellular fluid volume
E. Decrease plasma volume
1 points
QUESTION 6
1. A hypertonic albumin infusion (i.e. 25% albumin solution) will:
a. Increase plasma volume but decrease both intracellular and interstitial fluid volumes
b. Increase interstitial fluid and intracellular fluid volumes
c. Increase interstitial fluid and plasma volumes
d. Increase intracellular fluid volume and decrease plasma volume
e. Decrease interstitial fluid volume but increase intracellular fluid volume
1 points
QUESTION 7
1.
Value Normal range Patient 3
Blood pCO2 35-45 mmHg 56
Plasma Bicarbonate 22-26 mM 31
Arterial blood pH 7.35-7.45 7.29
2.
3. From the information in the table above, patient 3 has
4.
a. A partially compensated metabolic acidosis
b. A partially compensated respiratory acidosis
c. An uncompensated respiratory alkalosis
d. An uncompensated metabolic alkalosis
e. A partially compensated metabolic alkalosis
1 points
QUESTION 8
1.
Value Normal range Patient 1
Blood pCO2 35-45 mmHg 51
Plasma Bicarbonate 22-26 mM 31
Arterial blood pH 7.35-7.45 7.52
2.
3. From the information in the table above, patient 1 has
4.
a. A partially compensated metabolic alkalosis
b. A partially compensated respiratory alkalosis
c. A partially compensated metabolic acidosis
d. A partially compensated respiratory acidosis
e. An uncompensated metabolic acidosis
1 points
QUESTION 9
1.
Value Normal range Patient 1
Blood pCO2 35-45 mmHg 44
Plasma Bicarbonate 22-26 mM 29
Arterial blood pH 7.35-7.45 7.48
2.
3. From the data above above, this patient has:
a. A partially compensated respiratory alkalosis
b. A partially compensated metabolic acidosis
c. A partially compensated respiratory acidosis
d. An uncompensated metabolic alkalosis
e. A partially compensated metabolic alkalosis
1 points
QUESTION 10
1. Glomerular filtration rates are increased by which of the following effects?
a. Vasodilation of the afferent arteriole feeding the glomerulus
b. Vasoconstriction of the efferent arteriole draining the glomerulus
c. Increased cardiac output
d. Angiotensin II
e. All of the above
1 points
QUESTION 11
1. Which of the following DOES NOT reduce glomerular filtration rates?
a. Angiotensin receptor antagonists
b. Non-steroidal anti-inflammatories
c. Angiotensin converting enzyme (ACE) inhibitors
d. Heart failure
e. Nitrate medications
1 points
QUESTION 12
1. Which of the following is the MOST LIKELY treatment for anaemia associated with chronic kidney disease?
a. Insulin infusion
b. Bicarbonate infusion
c. Parenteral erythropoietin
d. Calcimimetics
e. Diuretic therapy
1 points
QUESTION 13
1. 3.
Based on the results in the table below, which of the following renal conditions does patient 3 probably have?
Parameter Normal range Patient 3
Plasma
Albumin 35-50 g/L 42
Urea (BUN) 2.5-7.1 mM 18.1
Creatinine 61-107 uM 283
Potassium 3.5-5.0 mM 4.8
pH 7.35-7.45 7.41
osmolality 275-299 mOsMol/kg 306
Urine
Protein Negative Negative
Glucose Negative Negative
Osmolality 50-1200 (>500 if excretion rate lower than normal) 1100
Urine: plasma osmolality ratio >1.3 3.59
Urine sodium <10 mM 10.3
Fractional clearance sodium >1% 0.93
Urine output >0.5 ml/kg per hour 0.36 ml
a. Intra-renal failure
b. Pre-renal injury
c. Intra-renal injury
d. Risk of pre-renal injury
e. Pre-renal failure
1 points
QUESTION 14
1. Patient 2 has been in ICU for several days in a critical condition. He had previously been diagnosed with pre-renal injury which is now suspected to have developed to acute tubular necrosis. From the results below, what condition is this patient likely to have?
Parameter Normal range Patient 2 results
Plasma
Albumin 35-50 g/L 36
Urea (BUN) 2.5-7.1 mM 18.2
Creatinine 61-107 uM 339
Potassium 3.5-5 mM 6.2
pH 7.35-7.45 7.28
osmolality 275-299 mOsMol/kg 318
Urine
Protein Negative +
Glucose Negative negative
Osmolality 50-1200 (>500 if excretion rate lower than normal) 390
Urine:plasma osmolality >1.3 1.25
Sodium clearance < 1% 1.2 %
Urine output >0.5 ml/kg per hour 0.13 ml
a. Nephrotic syndrome
b. The oliguric phase of acute tubular necrosis
c. The post-oliguric phase of acute tubular necrosis
d. The prodromal phase of acute tubular necrosis
e. Continuing pre-renal injury
1 points
QUESTION 15
1. A patient with reduced glomerular filtration rate exhibiting polyuria but no other signs of renal injury (i.e. blood and urine analysis results come back as normal) is MOST LIKELY suffering from:
a. Stage 2 chronic kidney disease
b. Stage 1 chronic kidney disease
c. No persistent renal injury
d. Stage 4 chronic kidney disease
e. Stage 5 chronic kidney disease
1 points
QUESTION 16
1. The following patient is thought to have chronic kidney disease. Based on their results below, which stage would their chronic kidney disease be classified as?
Parameter Normal range Results
Plasma
Albumin 35-50 g/L 48
Urea (BUN) 2.5-7.1 mM 7.9
Creatinine 61-107 uM 159
Potassium 3.5-5.0 mM 5.2
pH 7.35-7.45 7.32
osmolality 275-299 mOsMol/kg 308
Urine
Protein Negative Positive
Glucose Negative Negative
Glomerular filtration rate >90ml/min/1.72m2 19
Urine output >0.5 mL/kg/hr 0.5
2.
3.
a. Stage 1 chronic kidney disease
b. Stage 3a chronic kidney disease
c. Stage 5 chronic kidney disease
d. No persistent renal injury
e. Stage 4 chronic kidney disease
1 points
QUESTION 17
1. Mrs Jones (70 years old) has high blood pressure and heart failure. What is the correct rationale for her diuresis treatment, that will reduce blood pressure and aid in the management of heart failure?
a. Spironolactone, taken with potassium supplements to prevent hypokalaemia
b. Amiloride, taken in the morning after breakfast
c. Indapamide, taken at night to avoid dizziness and falling
d. Frusemide, taken in the morning after breakfast
e. Hydrochlorothiazide, prescribed at a high dose because of her age
1 points
QUESTION 18
1. Select the statement that is TRUE
a. Spironolactone causes potent diuresis
b. Thiazide diuretics are recommended for patients under 40 years old
c. Gout can be a side effect of thiazide and loop diuretics
d. Aldosterone is a potassium-sparing diuretic
e. Spironolactone causes the loss of potassium
1 points
QUESTION 19
1. Select the statement that is FALSE
a. Osmotic diuretics may result in hypovolaemia
b. Diuretics cause hypotension
c. Frusemide is a potassium-sparing diuretic
d. Loop diuretics are used in the management of congestive heart failure
e. Hydrochlorothiazide is used at low dose to manage hypertension
1 points
QUESTION 20
1. Complete the following to make a CORRECT statement. Diuretics are agents that…
a. Result in hypernatremia
b. Produce excess urine
c. Cause oedema
d. Promote the formation of extracellular fluid
e. Have a hypertensive effect
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