Order Renal System Discussion Questions

Order Renal System Discussion Questions
Order 5993290
Order Renal System Discussion Questions
1. What is the approximate glomerular filtration rate (GFR) in a patient with
normal renal function?
A. 10 mL/min
B. 125 mL/min
C. 500 mL/min
D. 1000 mL/min
2. Which of the following tissues has the highest oxygen extraction ratio in the
body?
A. Renal medulla
B. Cardiac myocytes
C. Neurons
D. Hepatocytes
3. Which of the following factors will increase sodium resorption in the proximal
tubule?
A. Increased blood pressure
B. Increased extracellular volume
C. High salt intake
D. Angiotensin II
Order Renal System Discussion Questions
4. Sodium reabsorption in the distal nephron (connecting the segment and
collecting duct) is mediated directly by which substance?
A. Aldosterone
B. Angiotensin II
C. Vasopressin
D. Renin
5. An increase in which of the following will decrease the GFR?
A. Renal blood flow (RBF)
B. Afferent arteriolar pressure
C. Efferent arteriolar pressure
D. Plasma osmotic pressure
6. 6. Sympathetic stimulation increases sodium and water retention through which
of the following mechanisms?
A. Increased Na

/H2O reabsorption in the nephron
B. Vasoconstriction leading to decreased net filtration
C. Activation of the renin-angiotensin-aldosterone system (RAAS)
D. All of the above
7. Which of the following statements is true of renal function and aging?
A. Production of vitamin D is preserved in the aging kidney.
B. Progressive decline in renal function begins to occur at 30-40 years of age.
C. Serum creatinine tends to rise with age.
D. GFR is preserved in healthy adults at the age of 80 years.
8. Which of the following situations meets criteria for stage 3 acute kidney injury
(AKI) according to the Acute Kidney Injury Network (AKIN) classifications?
A. Creatinine rise from 0.8 to 1.5
B. Creatinine rise from 4.1 to 4.3
C. Commencement of renal replacement therapy
D. Urine output of 40 mL/h for a 70-kg man
9. RBF represents what fraction of cardiac output?
A. 10%
B. 25%
C. 40%
D. 50%
Order Renal System Discussion Questions
10. Which of the following classes of drugs is known to raise serum creatinine by
decreasing tubular secretion?
A. Cimetidine
B. Cephalosporins
C. Vitamin D
D. Aminoglycosides
11. A patient is admitted to the surgical ICU following a motor vehicle accident and
is now status post an open splenectomy with massive hemorrhage. Which of the
following sets of laboratory indices is most consistent with a diagnosis of
prerenal AKI, assuming a serum sodium of 140 mEq/L and a urine creatinine of
50 mg/dL?
Cr
(mg/dL)
BLOOD UREA NITROGEN
(mg/dL)
Urine
Na

(mEq/L)
URINE OSMOLALITY
(mOsm/L)
A. 2.1 30 40 300
B. 2.1 45 40 200
C. 2.1 30 14 400
D. 2.1 45 14 800
12. 12. What percentage of the kidney’s nephrons must be affected to see a rise in
serum creatinine?
A. 25%
B. 50%
C. 75%
D. 90%
13. Where is angiotensinogen produced?
A. Kidney
B. Lung
C. Liver
D. Muscle
14. Which of the following substances is principally responsible for renal
vasodilation in the face of surgical stress?
A. Nitric oxide
B. Prostaglandins
C. Endothelial-derived hyperpolarizing factor
D. Atrial natriuretic peptide (ANP)
15. Release of which of the following substances is most likely to lead to
postoperative hyponatremia?
A. Angiotensin II
B. Aldosterone
C. Renin
D. Vasopressin
16. What is the net effect of angiotensin II on the glomerular arterioles and RBF?
AFFERENT ARTERIOLE EFFERENT ARTERIOLE RENAL BLOOD FLOW
A. Vasodilation Vasodilation Increased
B. Vasodilation Vasoconstriction Increased
C. Vasoconstriction Vasodilation Decreased
D. Vasoconstriction Vasoconstriction Decreased
17. What is the net effect of ANP on the glomerular arterioles, RBF, and GFR?
AFFERENT ARTERIOLE EFFERENT ARTERIOLE RENAL BLOOD FLOW GFR
A. Vasodilation Vasodilation Increased Unchanged
B. Vasodilation Vasoconstriction Increased Increased
C. Vasoconstriction Vasodilation Decreased Decreased
D. Vasoconstriction Vasoconstriction Decreased Unchanged
18. 18. Which of the following is the treatment of choice for a patient who has
acutely developed hypernatremia with a urine output of 600 cc/h in the
postanesthesia care unit following transphenoidal resection of a pituitary
adenoma?
A. Normal saline
B. Desmopressin
C. Spironolactone
D. Hydrocortisone
19. Which of the following mechanisms primarily accounts for the normalization of
arterial pH after prolonged hyperventilation in a patient with head injury?
A. Increased renal excretion of bicarbonate ions
B. Decreased RBF
C. Decreased renal absorption of hydrogen ions
D. Increased renal resorption of bicarbonate ions
20. The following laboratory values are most consistent with which of the following
acid-base disturbances?
pH 7.29
PaCO2 35 mm Hg
PaO2 112 mm Hg
Sodium 139 mEq/L
Potassium 4.3 mEq/L
Chloride 105 mEq/L
Bicarbonate 17 mEq/L
Albumin 4.6 g/dL
A. Anion gap acidosis
B. Respiratory alkalosis with metabolic compensation
C. Mixed anion gap and nonanion gap metabolic acidosis
D. Combined metabolic and respiratory acidosis
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