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Renal

Renal

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Published by MedSchoolStuff
First Aid for the USMLE Step 1
2011 EXPRESS Workbook
First Aid for the USMLE Step 1
2011 EXPRESS Workbook

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Published by: MedSchoolStuff on Dec 10, 2013
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First Aid for the
® 
 USMLE Step 1 2011 EXPRESS workbook
page 165
Copyright © 2011 by MedIQ Learning, LLC All rights reserved
Renal
ANATOMY
1. Why is the left kidney harvested for transplantation rather than the right?
(p. 458)
 _____________  ______________________________________________________________________________ 
 
2. Ureters pass __________ (over/under) the uterine artery and the ductus deferens.
(p. 458)
 
PHYSIOLOGY
3. Extracellular fluid consists of __________ (high/low) sodium chloride and __________ (high/low) potassium, whereas intracellular fluid consists of __________ (high/low) sodium chloride and  __________ (high/low) potassium.
(p. 459)
 4. What is the 60-40-20 rule of total body weight?
(p. 459)
 __________________________________   ______________________________________________________________________________ 
 
5. The fenestrated capillary endothelium of the glomerular filtration barrier is responsible for the filtration of plasma by which characteristic: size or charge?
(p. 459)
 _________________________ 6. The fused basement membrane of the glomerulus containing heparan sulfate is responsible for the filtration of plasma molecules by which characteristic, size or charge?
(p. 459)
 ________________ 7. The epithelial layer of the glomerular filtration barrier is formed by which cells?
(p. 459)
 _________  ______________________________________________________________________________ 
 
8. What is the formula for calculating the clearance of substance X, the volume of plasma from which the substance is cleared completely per unit of time?
(p. 459)
 _____________________________ 9. If renal clearance is greater than the glomerular filtration rate (GFR) of substance X, then there is a net tubular __________ (reabsorption/secretion) of substance X.
(p. 459)
 10. Creatinine clearance slightly __________ (overestimates/underestimates) the GFR rate because creatinine is __________ (secreted/reabsorbed) by the renal tubules.
(p. 459)
 11. What is the formula for estimating renal blood flow if renal plasma flow is known?
(p. 459)
 ______  ______________________________________________________________________________ 
 
12. What are the effects of prostaglandins on the glomerulus?
(p. 460)
 ________________________  ______________________________________________________________________________ 
 
Questions
 
page 166
First Aid for the
® 
 USMLE Step 1 2011 EXPRESS workbook 
 
Copyright © 2011 by MedIQ Learning, LLC All rights reserved
13. What are the effects of angiotensin II on the glomerulus?
(p. 460)
 __________________________  ______________________________________________________________________________ 
 
14. Decreased plasma protein concentration causes __________ (decrease/increase/no change) in renal plasma flow and __________ (decrease/increase/no change) in GFR, which in turn results in  __________ (decrease/increase/no change) in the filtration fraction.
(p. 460)
 15. Constriction of the afferent arteriole causes __________ (decrease/increase/no change) in renal plasma flow and __________ (decrease/increase/no change) in GFR, which in turn results in  __________ (decrease/increase/no change) in the filtration fraction.
(p. 460)
 16. What is the formula for excretion rate?
(p. 460)
 _________________________________________ 17. In the nephron, glucose at normal plasma concentrations is reabsorbed in which structure? And by which transporter?
(p. 460)
 ________________________________________________________ 18. At what plasma glucose concentration is the transport mechanism of the proximal tubule completely saturated, leading to glucose spilling into the urine?
(p. 460)
 _____________________ 19. How and where are amino acids reabsorbed in the kidney?
(p. 460)
 ________________________  ______________________________________________________________________________ 
 
20. What substance is secreted into the lumen of the early proximal convoluted tubule and acts as a buffer for hydrogen ions?
(p. 461)
 ___________________________________________________ 21. Which two ions are actively reabsorbed in the thick ascending loop of Henle?
(p. 461)
 _________  ______________________________________________________________________________ 
 
22. Which three ions are indirectly reabsorbed in the thick ascending loop of Henle?
(p. 461)
 ________  ______________________________________________________________________________ 
 
23. Which hormone controls the reabsorption of calcium in the early distal convoluted tubule?
(p. 461)
  ______________________________________________________________________________ 24. On which segment of the nephron does the hormone aldosterone act?
(p. 461)
 _______________ 25. 
 ADH’s effect
at V
2
 receptors results in what action?
(p. 461)
 _______________________________ 26. The ratio of solute concentration in the tubular fluid versus plasma (TF/P) can indicate the level of secretion or reabsorption of that solute along the proximal renal tubule. If the TF/P ratio of that solute is less than that of inulin, there is net __________ (reabsorption/secretion) along the proximal tubule.
(p. 462)
 27. Along the length of the proximal tubule, does the relative concentration of chloride increase, decrease, or stay the same?
(p. 462)
 _________________________________________________ 28. Which five actions of angiotensin II serve to increase intravascular volume and blood pressure?
(p. 462)
 __________________________________________________________________________  ______________________________________________________________________________ 
 
 ______________________________________________________________________________ 
 
 
First Aid for the
® 
 USMLE Step 1 2011 EXPRESS workbook
page 167
Copyright © 2011 by MedIQ Learning, LLC All rights reserved
29. What is the site of action of angiotensin-converting enzyme?
(p. 462)
 _______________________ 30. When blood pressure falls, the kidneys release which proteolytic enzyme?
(p. 462)
 ____________ 31. ADH primarily regulates __________ (osmolarity/blood volume), whereas aldosterone primarily regulates __________ (osmolarity/blood volume). However, in __________ (low/high) volume states, both ADH and aldosterone act to protect __________ (osmolarity/blood volume).
(p. 462)
 32. What are the effects of aldosterone secretion?
(p. 462)
 __________________________________   ______________________________________________________________________________ 
 
 ______________________________________________________________________________ 33. Atrial natriuretic peptide __________ (decreases/increases) renin secretion and __________ (decreases/increases) the GFR.
(p. 462)
 34. Which cells produce renin in the kidney?
(p. 463)
 _______________________________________ 35. Which hormone is released by the endothelial cells of renal peritubular capillaries in response to hypoxia?
(p. 463)
 ________________________________________________________________ 36. Which enzyme from the kidney is activated by PTH, and what is the function of that enzyme?
(p. 463)
 __________________________________________________________________________ 37. In the chart below, checkmark the effect that each condition has on the potassium shift.
(p. 464)
 
Effect Shifts K
+
 Into Cell Hypokalemia Shifts K
+
 Out of Cell Hyperkalemia
 Acidosis  Alkalosis
β
-Adrenergic agonists
β
-Adrenergic antagonists Cell lysis Digitalis Hyperosmolarity Hypo-osmolarity Insulin Insulin deficiency 38. By which mechanism does digitalis cause hyperkalemia?
(p. 464)
 __________________________ 39. What is the primary electrolyte disturbance in metabolic acidosis?
(p. 465)
 ___________________ 40. What is the compensatory respiratory response to metabolic acidosis, and does P
CO
2
 increase or decrease?
(p. 465)
 _______________________________________________________________ 41. What are the ten causes of increased anion gap metabolic acidosis?
(p. 465)
 ________________
 ______________________________________________________________________________  ______________________________________________________________________________

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