What percentage of erythropoietin (EPO) is produced by the liver?
10%.
What percentage of EPO is produced by the peritubular cells of the kidney?
90%.
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p.1
Erythropoietin Production and Function

What percentage of erythropoietin (EPO) is produced by the liver?

10%.

p.1
Erythropoietin Production and Function

What percentage of EPO is produced by the peritubular cells of the kidney?

90%.

p.1
Anaemia of Chronic Disease

What is the characteristic of anaemia of chronic disease?

It is normocytic normochromic anaemia.

p.1
Erythropoietin Production and Function

What can cause the overproduction of EPO?

Polycystic renal disease.

p.1
Erythropoietin Production and Function

What medication is given to prevent deep vein thrombosis in patients with polycythemia?

Clexane.

p.1
Erythropoietin Production and Function

What condition can cause the liberation of EPO?

Hypoxia.

p.1
Types of Hydroxycholecalciferol

What is the function of 1-hydroxycholecalciferol (Alfacalcidol)?

It is used in renal impairment.

p.1
Types of Hydroxycholecalciferol

What is the use of 25-hydroxycholecalciferol (Calci fedi ol)?

It is used in liver impairment.

p.1
Anaemia of Chronic Disease

What type of anaemia occurs in kidney impairment?

Anaemia of chronic disease.

p.1
Types of Hydroxycholecalciferol

What is the role of 1,25-dihydroxycholecalciferol (Calcitriol)?

It is used in both liver and renal impairment.

p.4
Kidney Functions and Hormone Production

What is creatinine and how is it produced?

Creatinine is produced by the muscles and excreted via the kidneys.

p.6
Chronic Kidney Disease (CKD) Classification

What does the Cockcroft-Gault formula calculate?

It calculates kidney function based on age, weight, and sex.

p.6
Chronic Kidney Disease (CKD) Classification

What is the factor 'F' in the Cockcroft-Gault formula for females?

F = 1.04.

p.6
Chronic Kidney Disease (CKD) Classification

Why is smoking considered a risk factor for CKD?

Because nicotine causes vasoconstriction, leading to increased blood pressure that can damage the kidneys.

p.3
Urinalysis and Dipstick Tests

What can urinary casts be made up of?

White blood cells, red blood cells, kidney cells, or substances like protein or fat.

p.5
Chronic Kidney Disease (CKD) Classification

How is the severity of CKD classified?

By the GFR from stage 1 to 5.

p.3
Chronic Kidney Disease (CKD) Classification

What are the key parameters for investigating kidney disease?

Creatinine and urea.

p.10
Management of Hyperkalemia

What are some side effects of lactulose?

Diarrhea, bloating, wind, nausea and vomiting, stomach pain.

p.19
Acute Kidney Injury (AKI) Types and Causes

How can dehydration lead to Prerenal AKI?

It reduces blood volume, leading to decreased perfusion of the kidneys.

p.4
Chronic Kidney Disease (CKD) Classification

What can high creatinine levels indicate?

High creatinine levels can indicate renal impairment or dehydration.

p.18
Acute Kidney Injury (AKI) Types and Causes

Give examples of conditions that can cause post-renal AKI.

Kidney stones, calculi, tumors, or cancer.

p.6
Chronic Kidney Disease (CKD) Classification

What is the factor 'F' in the Cockcroft-Gault formula for males?

F = 1.23.

p.6
Chronic Kidney Disease (CKD) Classification

What are some risk factors for Chronic Kidney Disease (CKD)?

Hypertension, smoking, dyslipidemia, obesity, and family history.

p.18
Acute Kidney Injury (AKI) Types and Causes

Why are aminoglycosides considered nephrotoxic?

They accumulate in renal tubules, interfere with cellular processes, and can lead to cellular death.

p.5
Chronic Kidney Disease (CKD) Classification

What is the commonest form of renal condition?

Chronic Kidney Disease (CKD).

p.4
Chronic Kidney Disease (CKD) Classification

What does high levels of urea indicate?

High levels of urea can indicate renal impairment.

p.2
Urinalysis and Dipstick Tests

What does the presence of ketones in urine indicate?

Poor diabetes control.

p.3
Anaemia of Chronic Disease

What does the presence of urinary casts often indicate?

A complication of nephrotic syndrome.

p.2
Urinalysis and Dipstick Tests

Where do nitrites in urine come from?

Nitrates from food (as preservatives).

p.14
Management of Hyperkalemia

What is a common clinical presentation associated with peripheral edema?

Peripheral edema itself.

p.3
Chronic Kidney Disease (CKD) Classification

What does a reduction in kidney size indicate?

Suspicion of chronic kidney disease.

p.5
Chronic Kidney Disease (CKD) Classification

What are the two main characteristics of CKD?

Decline in the GFR and urinary or structural abnormalities.

p.26
Kidney Functions and Hormone Production

What is the functional unit of the kidney?

The nephron.

p.4
Kidney Functions and Hormone Production

How is urea produced in the body?

Urea is produced from the breakdown of proteins or amino acids, converted from ammonia by the liver.

p.3
Urinalysis and Dipstick Tests

What are urinary casts?

Tiny tube-shaped particles found in urine during urinalysis.

p.6
Chronic Kidney Disease (CKD) Classification

What are some causes of Chronic Kidney Disease (CKD)?

Hypertension, diabetes, autoimmune conditions, Alport syndrome, unknown causes, acute kidney injury, and kidney stones.

p.4
Urinalysis and Dipstick Tests

What does urinary specific gravity measure?

It measures the concentration of solutes in urine and indicates the kidney's ability to concentrate urine.

p.5
Chronic Kidney Disease (CKD) Classification

How is renal function determined in CKD?

Using the GFR.

p.5
Chronic Kidney Disease (CKD) Classification

What is used to determine GFR?

Creatinine clearance.

p.5
Chronic Kidney Disease (CKD) Classification

What GFR level indicates end-stage kidney disease?

Below 15 mL/min.

p.3
Chronic Kidney Disease (CKD) Classification

What do red blood cell casts indicate?

There is a microscopic amount of bleeding from the kidney.

p.16
Management of Hyperkalemia

What are the contraindications for Furosemide?

Anuria, comatose states associated with liver cirrhosis, renal failure due to nephrotoxic or hepatotoxic drugs, severe hypokalaemia, severe hyponatraemia, agranulocytosis, aplastic anaemia, auditory disorder, diabetes mellitus, eosinophilia, fever, gout, haemolytic anaemia, malaise, mucosal reaction, nephritis tubulointerstitial, pancreatitis acute shock, skin eruption, tetany, and vasculitis.

p.2
Urinalysis and Dipstick Tests

Why might the absence of nitrites not indicate the absence of UTIs?

Not all organisms can convert nitrates to nitrites.

p.9
Management of Hyperkalemia

How should kayexalate be reconstituted for administration?

Each dose should be suspended in a small quantity of water or syrup, typically ranging from 20 mL to 100 mL.

p.2
Urinalysis and Dipstick Tests

What enzyme do WBCs release that indicates UTIs?

Leucocyte esterase.

p.4
Urinalysis and Dipstick Tests

What are normal ranges for urine specific gravity?

Normal urine specific gravity results fall between 1.002 and 1.030.

p.14
Management of Hyperkalemia

What is the elemental calcium content in 1250g of calcium carbonate powder?

500mg of elemental Ca2+.

p.18
Acute Kidney Injury (AKI) Types and Causes

What percentage of renal AKI is due to acute tubular necrosis (ATN)?

About 80%.

p.4
Chronic Kidney Disease (CKD) Classification

What is the significance of the BUN/Cr ratio?

The BUN/Cr ratio helps determine if a patient is hydrated or has acute kidney injury.

p.5
Chronic Kidney Disease (CKD) Classification

What GFR level is considered normal?

Above 90 mL/min.

p.4
Urinalysis and Dipstick Tests

What does urine osmolality measure?

Urine osmolality measures the concentration of particles in urine.

p.2
Urinalysis and Dipstick Tests

What do nitrites in urine indicate?

Urinary Tract Infections (UTIs).

p.16
Management of Hyperkalemia

What are the contraindications for Metolazone?

Anuria, hypersensitivity to metolazone, hepatic coma or precoma.

p.3
Chronic Kidney Disease (CKD) Classification

What do granular casts signify?

They are a sign of many types of kidney diseases.

p.5
Chronic Kidney Disease (CKD) Classification

What factors does the creatinine clearance equation depend on?

Age, weight, and sex of the individual.

p.14
Management of Hyperkalemia

What type of diuretics are used in the management of peripheral edema?

Diuretics, specifically thiazides and loop diuretics.

p.7
Chronic Kidney Disease (CKD) Classification

What is the number one cause of Chronic Kidney Disease (CKD)?

Hypertension.

p.4
Urinalysis and Dipstick Tests

What are normal results for urine osmolality?

Normal results for urine osmolality are typically between 500 to 850 mOsm/kg.

p.4
Chronic Kidney Disease (CKD) Classification

What can elevated urine osmolality indicate?

Elevated urine osmolality may indicate conditions such as Addison disease, congestive heart failure, or shock.

p.14
Management of Hyperkalemia

What should be done if Lasix (Furosemide) alone is not effective for resistant edema?

Combine loop diuretics with thiazide diuretics.

p.5
Chronic Kidney Disease (CKD) Classification

What is the formula for creatinine clearance (CrCl)?

CrCl = F (140 x Age x Weight) / Serum Creatinine (μmol/L).

p.16
Management of Hyperkalemia

What are the side effects of Furosemide?

Agranulocytosis, aplastic anaemia, auditory disorder, diabetes mellitus, eosinophilia, fever, gout, haemolytic anaemia, malaise, mucosal reaction, nephritis tubulointerstitial, pancreatitis acute shock, skin eruption, tetany, and vasculitis.

p.14
Management of Hyperkalemia

Which diuretic is more effective for peripheral edema, thiazides or loop diuretics?

Loop diuretics are more effective than thiazides.

p.14
Management of Hyperkalemia

What is the high ceiling effect in relation to loop diuretics?

An increase in the dose results in a corresponding increase in effect.

p.15
Management of Hyperkalemia

What is the primary thiazide diuretic mentioned?

Metolazone.

p.7
Chronic Kidney Disease (CKD) Classification

Why are diabetic patients prone to CKD?

Because diabetes causes nephropathy.

p.15
Management of Hyperkalemia

What is the role of calcium gluconate in hyperkalemia management?

It is used as an adjunct to stabilize myocytes, not specifically to manage hyperkalemia.

p.10
Management of Hyperkalemia

What are the contraindications for nebulization using salbutamol?

Hypersensitivity to salbutamol, hemodynamically significant tachycardia, hypertension, hypokalemia.

p.7
Metabolic Acidosis in CKD

What do the proximal convoluted tubules produce to neutralize H+ ions?

Bicarbonate ions (HCO3-).

p.22
Kidney Functions and Hormone Production

Which two organs are responsible for producing active vitamin D3?

The kidney and the liver.

p.21
Acute Kidney Injury (AKI) Types and Causes

What happens in the Recovery phase of ATN?

Regeneration of the tubule occurs, but the patient may not return to baseline.

p.2
Urinalysis and Dipstick Tests

What do white blood cells (WBCs) in urine indicate?

Possible urinary tract infections (UTIs).

p.9
Management of Hyperkalemia

What are the contraindications for using dextrose in hyperkalemia management?

Dextrose is contraindicated in diabetes, hyperglycemia, hypokalemia, peripheral edema, and pulmonary conditions.

p.9
Management of Hyperkalemia

What are the side effects of insulin?

Side effects include sweating, trembling or shaking, palpitations, and tingling lips.

p.18
Acute Kidney Injury (AKI) Types and Causes

What condition leads to prerenal AKI due to reduced plasma volume?

Hypovolemia.

p.14
Management of Hyperkalemia

Where do thiazide diuretics act in the nephron?

At the distal convoluted tubule.

p.22
Types of Hydroxycholecalciferol

What is the active form of vitamin D3 produced in the body?

Calcitriol (1,25-dihydroxycholecalciferol).

p.7
Metabolic Acidosis in CKD

What happens to H+ ions in CKD?

The kidneys fail to produce HCO3- ions, leading to an excess of H+ ions.

p.9
Management of Hyperkalemia

What is the sodium content in one gram of kayexalate?

One gram of kayexalate contains 4.1 mEq of sodium.

p.16
Management of Hyperkalemia

What are the side effects of Metolazone?

Decreased appetite, arthralgia, asthenia, chest discomfort, chills, drowsiness, gastrointestinal discomfort, glycosuria, aggravated gout, haemoconcentration, hepatic disorders, hypoplastic anaemia, hypovolaemia, palpitations, peripheral neuropathy, psychotic depression, syncope, venous thrombosis, vertigo, and blurred vision.

p.9
Management of Hyperkalemia

What are the contraindications for sodium bicarbonate?

Contraindicated in hypertension, congestive heart failure, hypokalemia, chloride loss, and metabolic alkalosis.

p.9
Management of Hyperkalemia

What are the side effects of dextrose?

Side effects include bluish color, blurred vision, changes in skin color, fast or slow heartbeat, and weight gain.

p.19
Acute Kidney Injury (AKI) Types and Causes

What are the three main classes of Acute Kidney Injury (AKI)?

Prerenal, Intrarenal, and Postrenal.

p.2
Urinalysis and Dipstick Tests

What is the normal range of proteins found in urine?

About 30 - 150 mg.

p.10
Management of Hyperkalemia

What are some side effects of salbutamol?

Palpitation, tachycardia, tremor, headache, muscle cramps.

p.19
Acute Kidney Injury (AKI) Types and Causes

What typically causes Intrarenal AKI?

Direct damage to the kidneys, such as from toxins, infections, or inflammation.

p.9
Management of Hyperkalemia

How can kayexalate be administered?

It can be administered orally or rectally as an enema.

p.7
Chronic Kidney Disease (CKD) Classification

What type of hypertension is associated with CKD?

Salt sensitive hypertension.

p.2
Urinalysis and Dipstick Tests

Which organisms can convert nitrates to nitrites?

Escherichia coli, Lactobacillus plantarum, Neisseria gonorrhoeae, among others.

p.29
Chronic Kidney Disease (CKD) Classification

What is the urine output in kidney failure?

Less than 1.5L/day.

p.26
Kidney Functions and Hormone Production

Where are the kidneys located?

In the retroperitoneal region, behind the peritoneum.

p.2
Urinalysis and Dipstick Tests

What type of proteins are normally found in urine?

Tamm-Horsfall proteins.

p.14
Management of Hyperkalemia

Why can loop and thiazide diuretics be combined in therapy?

They act at different portions of the nephron and have a synergistic effect.

p.10
Anaemia of Chronic Disease

What tests must be conducted to confirm anaemia in CKD patients?

Full Blood Count (FBC) to check MCV and MCH.

p.7
Chronic Kidney Disease (CKD) Classification

What are some clinical presentations of CKD?

Peripheral oedema, anaemia, osteoporosis, oliguria or anuria, metabolic acidosis, uremic encephalopathy, uremic gastritis, hyperphosphatemia.

p.25
Kidney Functions and Hormone Production

What do NSAIDs block to prevent the production of prostaglandins?

COX enzymes.

p.25
Kidney Functions and Hormone Production

What effect do NSAIDs have on blood pressure in the kidneys?

They cause vasoconstriction, leading to high blood pressure and worsening kidney impairment.

p.2
Urinalysis and Dipstick Tests

What does the presence of large proteins like albumin in urine indicate?

Renal damage (nephropathy).

p.15
Management of Hyperkalemia

What is the rate of administration for Lasix?

4 mg/min.

p.18
Acute Kidney Injury (AKI) Types and Causes

Name a few conditions that can cause hypovolemia.

Heart failure, burns, dehydration, vomiting, diarrhea, internal bleeding, excessive sweating.

p.18
Acute Kidney Injury (AKI) Types and Causes

What is the relationship between hypotension and prerenal AKI?

Hypotension reduces perfusion to the kidneys, leading to prerenal AKI.

p.15
Management of Hyperkalemia

How much calcium gluconate is typically administered?

10 - 15 mL of 10% calcium gluconate for 10 - 15 minutes.

p.14
Management of Hyperkalemia

Why should thiazide diuretics be given before loop diuretics?

To inhibit distal sodium reabsorption while loop diuretics block proximal sodium reabsorption.

p.10
Management of Hyperkalemia

What are the contraindications for using Kayexalate?

Hypokalemia, hypersensitivity to polystyrene sulfonate resins, obstructive bowel disease, reduced gut motility.

p.7
Metabolic Acidosis in CKD

What can metabolic acidosis lead to?

Hyperkalemia, which can cause arrhythmia, embolism, and thrombosis leading to death.

p.18
Kidney Functions and Hormone Production

What are the two main parts of the kidney?

Cortex and medulla.

p.10
Management of Hyperkalemia

What are the contraindications for using lactulose?

Galactosemia, diabetes, GI obstructions.

p.25
Urinalysis and Dipstick Tests

What are the main parameters investigated in a urinalysis for kidney problems?

Urea and creatinine.

p.25
Kidney Functions and Hormone Production

What happens when there is too much endothelin in the kidneys?

It worsens renal impairment.

p.23
Metabolic Acidosis in CKD

What complication can arise in patients with kidney problems related to acid-base balance?

Metabolic acidosis.

p.21
Acute Kidney Injury (AKI) Types and Causes

What is a common treatment for severe Acute Kidney Injury?

Dialysis.

p.17
Acute Kidney Injury (AKI) Types and Causes

What are the three classifications of AKI?

Prerenal AKI, Renal AKI (Intrinsic), and Post-renal AKI.

p.28
Kidney Functions and Hormone Production

What is the formula for calculating net filtration pressure?

Net filtration pressure = Capillary pressure - (Bowman’s capsule pressure + Oncotic pressure).

p.12
Erythropoietin Production and Function

What conditions can lead to high production of EPO?

Renal cell carcinoma and polycystic kidney disease.

p.10
Anaemia of Chronic Disease

What type of anaemia do about 99% of CKD patients present with?

Normocytic normochromic anaemia.

p.19
Acute Kidney Injury (AKI) Types and Causes

What is a common cause of Prerenal AKI?

Decreased blood flow to the kidneys, often due to dehydration or heart failure.

p.29
Chronic Kidney Disease (CKD) Classification

What happens when HPG is less than 10 mmHg?

There is kidney failure.

p.18
Acute Kidney Injury (AKI) Types and Causes

What can cause necrosis in the kidney medulla?

Hypoperfusion leading to ischemia.

p.18
Acute Kidney Injury (AKI) Types and Causes

What causes post-renal AKI?

Acute obstruction to urinary flow.

p.25
Urinalysis and Dipstick Tests

What other parameters are included in a urinalysis?

Protein in urine and RBCs in urine.

p.23
Metabolic Acidosis in CKD

What does the kidney produce at the proximal convoluted tubule to neutralize H+ ions?

Bicarbonate.

p.20
Acute Kidney Injury (AKI) Types and Causes

What does F eNa > 1% indicate?

Renal AKI.

p.24
Urinalysis and Dipstick Tests

What is the normal color of urine?

Pale yellow or straw colored.

p.28
Kidney Functions and Hormone Production

What is oncotic pressure in the context of the Bowman’s capsule?

It is the pressure due to proteins within the Bowman’s capsule, which are negatively charged and repel the negatively charged endothelium.

p.2
Urinalysis and Dipstick Tests

What condition is characterized by leaking ≥ 3.5g of proteins or albumin per day?

Nephrotic syndrome.

p.9
Management of Hyperkalemia

What are some side effects of sodium bicarbonate?

Side effects include headache, muscle pain and twitching, nausea or vomiting, bradypnea, nervousness, unpleasant taste, increased frequency in urination, and increased thirst.

p.15
Kidney Functions and Hormone Production

What can cause muscle weakness or pain in renal patients?

Build-up of urea or electrolyte imbalance.

p.15
Kidney Functions and Hormone Production

What are some clinical manifestations of neurological changes in renal patients?

Epilepsy, poor concentration, and pruritus (itching).

p.10
Management of Hyperkalemia

What are some side effects of Kayexalate?

Constipation, hypertension, colitis, stomach pain, nausea and vomiting.

p.15
Kidney Functions and Hormone Production

How can pruritus be managed in renal patients?

By administering antihistamines, preferably sedative antihistamines at night.

p.26
Kidney Functions and Hormone Production

What are the dimensions of a kidney?

About 11-14 cm in length, 5-6 cm in width, and 3-4 cm in depth.

p.26
Kidney Functions and Hormone Production

Why is kidney size important?

It is key in the diagnosis of kidney disease as acute or chronic.

p.14
Management of Hyperkalemia

Where do loop diuretics act in the nephron?

At the thick ascending limb of the loop of Henle.

p.18
Acute Kidney Injury (AKI) Types and Causes

What is the primary cause of renal AKI?

Destruction to the kidneys themselves.

p.22
Types of Hydroxycholecalciferol

How does the body receive vitamin D3?

From sunlight or food.

p.7
Metabolic Acidosis in CKD

What is the reference range for K+ ions in the body?

3.5 - 5.5 mmol/L.

p.25
Kidney Functions and Hormone Production

What are the types of endothelin produced by the kidneys?

ET-1, ET-2, ET-3.

p.22
Types of Hydroxycholecalciferol

What should be avoided in patients with liver or kidney problems regarding vitamin D3?

Inactive vitamin D3.

p.22
Types of Hydroxycholecalciferol

What are the preferred forms of vitamin D3 for patients with liver or kidney issues?

Calcitriol, Alfacalcidol (1α-hydroxycholecalciferol), and Eldecalcitol.

p.29
Chronic Kidney Disease (CKD) Classification

What is anuria?

The absence of urine production, defined as less than 100 mL daily.

p.20
Acute Kidney Injury (AKI) Types and Causes

What happens in fluid overload related to AKI?

Small urine production leads to fluid accumulation in the system.

p.17
Acute Kidney Injury (AKI) Types and Causes

What can cause renal ischemia in Prerenal AKI?

Low oxygen perfusion to the kidney.

p.11
Anaemia of Chronic Disease

What type of anemia is commonly seen in patients with chronic kidney disease (CKD)?

Normocytic normochromic anemia.

p.24
Urinalysis and Dipstick Tests

What condition is indicated by a musty smell in urine?

Liver disease.

p.27
Kidney Functions and Hormone Production

Where are the thick loops of the proximal convoluted tubule primarily located?

In the cortex, with some descending into the medulla.

p.27
Kidney Functions and Hormone Production

What is the role of the thin loops in the medulla?

Facilitating water exchange.

p.29
Kidney Functions and Hormone Production

What causes resistance to decrease in the efferent artery?

Small lumen size and the presence of more angiotensin II receptors.

p.25
Kidney Functions and Hormone Production

What is the role of endothelin in the kidneys?

Endothelin causes vasoconstriction, which raises pressure and ensures high blood flow.

p.29
Kidney Functions and Hormone Production

What is autocrine signaling?

A form of cell signaling where a cell secretes a hormone that binds to its own surface receptors.

p.7
Chronic Kidney Disease (CKD) Classification

What are the characteristic symptoms of Alport syndrome?

Kidney disease, hearing loss, and eye abnormalities.

p.20
Acute Kidney Injury (AKI) Types and Causes

What does a high sodium level in urine indicate?

Renal AKI.

p.17
Acute Kidney Injury (AKI) Types and Causes

What happens to urine production in AKI?

It can suddenly drop, which is alarming.

p.26
Kidney Functions and Hormone Production

How is blood supplied to the glomerulus?

By the afferent artery.

p.20
Acute Kidney Injury (AKI) Types and Causes

What clinical presentations are associated with hypovolemia?

Skin turgor, palpitation, dry oral membranes.

p.24
Urinalysis and Dipstick Tests

What color change occurs in urine during liver disease?

The urine becomes yellowish.

p.12
Erythropoietin Production and Function

What happens if the Hb level exceeds 12 g/dL?

It can cause cardiac issues.

p.12
Erythropoietin Production and Function

How much does 1 pint of blood increase Hb levels?

By 1 - 1.5 g/dL.

p.17
Acute Kidney Injury (AKI) Types and Causes

What happens to kidney function after developing AKI?

It cannot return to normal.

p.11
Anaemia of Chronic Disease

What are two management options for anemia in CKD?

Iron supplements and exogenous EPO.

p.11
Erythropoietin Production and Function

What is the ideal route for administering EPO to CKD patients?

Subcutaneous (SC).

p.22
Types of Hydroxycholecalciferol

What is produced when vitamin D3 is hydroxylated at C-25 in the liver?

25-hydroxycholecalciferol.

p.29
Kidney Functions and Hormone Production

What are the three categories of kidney function?

Tubular function, Endocrine function, Autocrine function.

p.7
Chronic Kidney Disease (CKD) Classification

What is Alport syndrome?

An inherited form of kidney inflammation (nephritis) caused by a defect in a gene for collagen.

p.15
Chronic Kidney Disease (CKD) Classification

Do all nephrotic syndrome patients respond to steroids?

No, not all nephrotic syndrome patients respond to steroids.

p.23
Kidney Functions and Hormone Production

What is reabsorbed in the collecting duct of the kidney?

Water.

p.21
Acute Kidney Injury (AKI) Types and Causes

What occurs during the Diuretic phase of ATN?

There is an improvement in urine output.

p.23
Kidney Functions and Hormone Production

What is the role of renin produced by the kidney?

It converts angiotensinogen to angiotensin I.

p.21
Acute Kidney Injury (AKI) Types and Causes

What is the age and gender of the patient AK?

45 years old male.

p.24
Urinalysis and Dipstick Tests

What is the purpose of a dipstick test in urinalysis?

To make a quick analysis of the urine.

p.28
Chronic Kidney Disease (CKD) Classification

What is the normal estimated Glomerular Filtration Rate (eGFR)?

Normal eGFR is ≥ 90 mL/min/1.73m².

p.23
Kidney Functions and Hormone Production

What is the role of Vitamin D in the kidneys?

Synthesis of Vitamin D.

p.11
Erythropoietin Production and Function

What is the main cause of anemia in CKD?

Erythropoietin (EPO) deficiency.

p.24
Urinalysis and Dipstick Tests

What is the significance of blood in urine during urination?

The timing of blood indicates the source: urethra, bladder, or prostate.

p.12
Chronic Kidney Disease (CKD) Classification

How are H2 receptor antagonists adjusted for patients with renal impairment?

Their doses are halved to prevent renal problems.

p.15
Kidney Functions and Hormone Production

What is a potential cause of pruritus in renal patients?

Uremia, high levels of PTH, high levels of phosphate, and accumulation of divalent ions.

p.10
Management of Hyperkalemia

What are the contraindications for magnesium preparations?

Myasthenia gravis, severe renal failure, cardiac ischemia, heart block, pulmonary edema.

p.10
Management of Hyperkalemia

What are some side effects of magnesium preparations?

Diarrhea, nausea and vomiting, stomach cramps.

p.7
Chronic Kidney Disease (CKD) Classification

What indicates abnormal functioning of the kidneys in Alport syndrome?

Blood in the urine (hematuria).

p.23
Kidney Functions and Hormone Production

What is the function of aldosterone?

Causes water and salt retention, regulating blood pressure.

p.21
Acute Kidney Injury (AKI) Types and Causes

What physical findings were noted in the patient AK?

Multiple ulcers at the ankle area with hyperpigmentation and pitting bipedal edema up to the shin.

p.27
Kidney Functions and Hormone Production

What is the primary function of the proximal convoluted tubule (PCT)?

Reabsorption of about 80% of the filtrate, including glucose, Na+, amino acids, and other substances.

p.12
Phosphate Management in CKD

What is the consequence of phosphate buildup in CKD?

It combines with serum calcium to form calcium phosphate, reducing calcium levels and causing osteodystrophy.

p.11
Anaemia of Chronic Disease

How do iron sucrose and iron dextran differ?

Iron sucrose is complexed with sucrose, while iron dextran is complexed with a carbohydrate polymer derived from dextran.

p.7
Metabolic Acidosis in CKD

What happens to K+ ions during metabolic acidosis?

H+ ions move into the intracellular space, displacing K+ ions into the blood, resulting in hyperkalemia.

p.15
Chronic Kidney Disease (CKD) Classification

Why are steroids not given to CKD patients?

They can cause a build-up of fluids, worsening the condition.

p.20
Acute Kidney Injury (AKI) Types and Causes

What is a key indicator to differentiate between renal and prerenal AKI?

The fractional excretion of sodium (F eNa).

p.26
Kidney Functions and Hormone Production

What are the two main parts of the kidney?

The cortex (outer portion) and the medulla (conical region).

p.20
Acute Kidney Injury (AKI) Types and Causes

What is the formula for calculating fractional excretion of sodium (F eNa)?

F eNa = (Urine Na / Serum Na x Serum Cr / Urine Cr) x 100%.

p.17
Acute Kidney Injury (AKI) Types and Causes

What compounds build up in the body during AKI?

Nitrogenous compounds and other toxins.

p.26
Kidney Functions and Hormone Production

What is the role of the juxtaglomerular apparatus?

It is attached to the afferent artery and plays a role in regulating blood pressure and filtration.

p.26
Kidney Functions and Hormone Production

Why should ACE inhibitors (ACEIs) be avoided in renal patients?

They can cause renal dysfunction due to a drop in renal perfusion pressure and decrease in glomerular filtration.

p.21
Acute Kidney Injury (AKI) Types and Causes

What condition is the patient AK being managed for?

Acute Kidney Injury (Septic ATN) from UTI and CKD secondary to chronic Glomerular Nephritis.

p.23
Kidney Functions and Hormone Production

What triggers the production of renin in the kidneys?

Oxygen depletion or fluid depletion.

p.11
Anaemia of Chronic Disease

What are common symptoms of anemia in CKD patients?

Dizziness, nausea, and weakness.

p.12
Chronic Kidney Disease (CKD) Classification

What is uremic gastritis and what causes it?

It is caused by the buildup of urea in CKD patients, leading to ulceration and bleeding.

p.1
Kidney Functions and Hormone Production

What does renal natriuretic peptide do?

It causes natriuresis and allows renal blood flow.

p.1
Kidney Functions and Hormone Production

What is the first prostaglandin produced by COX enzymes?

Prostaglandin H2 (PGH2).

p.27
Kidney Functions and Hormone Production

What is reabsorbed at the distal convoluted tubule (DCT)?

The remaining 20% of the filtrate.

p.22
Types of Hydroxycholecalciferol

What enzyme is responsible for hydroxylation at C-1?

1α hydroxylase.

p.29
Chronic Kidney Disease (CKD) Classification

What is the definition of oliguria?

Low urine output, less than 400 mL per day or 20 mL per hour.

p.17
Acute Kidney Injury (AKI) Types and Causes

What is Acute Kidney Injury (AKI)?

A sudden reduction in kidney function within 48 hours.

p.24
Urinalysis and Dipstick Tests

What can change the color of urine?

Food, medications, and other conditions.

p.28
Kidney Functions and Hormone Production

What happens when Bowman’s capsule pressure and oncotic pressure exceed capillary pressure?

It results in a deficit in hydrostatic pressure gradient (HPG), indicating reduced kidney function or filtration.

p.17
Acute Kidney Injury (AKI) Types and Causes

What is the major cause of Prerenal AKI?

Impairment of perfusion.

p.12
Chronic Kidney Disease (CKD) Classification

What is the management for uremic gastritis?

Proton pump inhibitors (PPIs) are typically used.

p.1
Kidney Functions and Hormone Production

What is the effect of prostaglandins produced by the kidneys?

They cause vasodilatation and ensure renal blood flow.

p.27
Kidney Functions and Hormone Production

What happens to the concentration of electrolytes in the medulla during urinary incontinence?

It becomes lesser than that of the filtrate, causing water to move in the reverse direction.

p.19
Acute Kidney Injury (AKI) Types and Causes

What is a common cause of Postrenal AKI?

Obstruction of urine flow, such as from kidney stones or enlarged prostate.

p.25
Kidney Functions and Hormone Production

What are the endothelin receptors found in the kidneys?

Endothelin receptor A (ET A) and B (ET B).

p.19
Acute Kidney Injury (AKI) Types and Causes

What role do nephrotoxins play in Intrarenal AKI?

They cause direct injury to the renal tubules, impairing kidney function.

p.22
Types of Hydroxycholecalciferol

What happens to cholecalciferol in the kidney?

It can be hydroxylated at C-1 before reaching the liver.

p.26
Kidney Functions and Hormone Production

What structures make up a nephron?

The Bowman’s capsule and the glomerulus.

p.20
Acute Kidney Injury (AKI) Types and Causes

What are the two basic conditions leading to clinical presentations of AKI?

Hypovolemia and fluid overload.

p.23
Kidney Functions and Hormone Production

What system maintains blood flow and ultrafiltration in the kidneys?

Renin-Angiotensin-Aldosterone System (RAAS).

p.24
Urinalysis and Dipstick Tests

What does a sweet smell in urine suggest?

Diabetes mellitus.

p.11
Anaemia of Chronic Disease

Which form of iron is preferred for managing anemia in CKD patients?

Parenteral iron, such as iron sucrose or iron dextran.

p.27
Kidney Functions and Hormone Production

What is the hydrostatic pressure gradient (HPG) in the glomerulus?

Always 10 mmHg, which contributes to ultrafiltration.

p.21
Acute Kidney Injury (AKI) Types and Causes

What is the first phase of Acute Tubular Necrosis (ATN)?

Oliguria phase, characterized by a reduction in urine output.

p.21
Acute Kidney Injury (AKI) Types and Causes

How long can the Oliguria phase last in ATN?

About 7 to 14 days.

p.29
Kidney Functions and Hormone Production

What are the functions of the kidney related to tubular function?

Reabsorption of nutrients, excretion of waste, fluid balance, and pH regulation.

p.23
Metabolic Acidosis in CKD

Why is it called 'metabolic' acidosis?

Because H+ ions come from all metabolic activities in the body.

p.21
Acute Kidney Injury (AKI) Types and Causes

What are the complications associated with the patient AK?

Hyperkalemia, severe normocytic anemia, and hypertension.

p.17
Acute Kidney Injury (AKI) Types and Causes

What is Prerenal AKI?

A condition that causes injury before reaching the kidney, often due to reduced blood flow.

p.24
Urinalysis and Dipstick Tests

What does dimorphic RBCs indicate?

It implies glomerular damage.

p.24
Urinalysis and Dipstick Tests

What does an ammonia smell in urine indicate?

Dehydration.

p.28
Kidney Functions and Hormone Production

What is the effect of ACE inhibitors (ACEIs) on the efferent artery?

They cause pronounced vessel dilation in the efferent artery compared to the afferent artery.

p.12
Phosphate Management in CKD

What is hyperphosphatemia and what causes it in CKD?

It is the buildup of phosphate due to impaired excretion by the kidneys.

p.1
Kidney Functions and Hormone Production

What does PGH2 produce?

Other prostaglandins such as PGE2, which causes diuresis.

p.17
Acute Kidney Injury (AKI) Types and Causes

What percentage of AKI cases occur in hospitalized patients?

99%.

p.23
Kidney Functions and Hormone Production

What does angiotensin II do?

Causes vasoconstriction and the release of aldosterone.

p.12
Erythropoietin Production and Function

What can cause elevation of blood pressure when administering EPO?

Increased production of RBCs, which raises blood viscosity.

p.17
Acute Kidney Injury (AKI) Types and Causes

What is Nephrotic syndrome?

A condition where large proteins leak into urine due to podocyte damage.

p.28
Kidney Functions and Hormone Production

Why does the afferent artery have a larger lumen than the efferent artery?

To cause increased pressure and allow enough time for filtration.

p.11
Anaemia of Chronic Disease

How does high PTH affect red blood cells (RBCs) in CKD?

High PTH suppresses RBC production.

p.27
Kidney Functions and Hormone Production

What occurs at the thick loops of the proximal convoluted tubule?

Exchange of electrolytes, but no water exchange.

p.11
Anaemia of Chronic Disease

What is the administration method for iron sucrose?

Typically administered as a slow IV infusion.

p.12
Erythropoietin Production and Function

What is the target hemoglobin (Hb) level when administering EPO?

10 - 12 g/dL, or 10 - 13 g/dL for patients with diabetes.

p.26
Kidney Functions and Hormone Production

What effect do ACEIs have on the renal efferent arteriole?

They cause preferential vasodilation, impairing the kidney's ability to compensate for low perfusion states.

p.23
Erythropoietin Production and Function

What is erythropoietin and where is it produced?

A hormone produced by the kidneys that stimulates red blood cell production.

p.12
Chronic Kidney Disease (CKD) Classification

What renal impairment can PPIs cause?

Acute interstitial nephritis, potentially leading to acute kidney injury.

p.11
Anaemia of Chronic Disease

Why is parenteral iron preferred over oral iron in CKD patients?

Due to edema around the GIT, which reduces iron absorption.

p.20
Acute Kidney Injury (AKI) Types and Causes

What are some clinical manifestations of fluid overload?

Peripheral edema, ascites, hypertension, congestive heart failure, uremia, encephalopathy, hyperphosphatemia.

p.24
Urinalysis and Dipstick Tests

What is a disadvantage of the dipstick test?

It cannot differentiate between RBCs and Hb/myoglobin.

p.28
Chronic Kidney Disease (CKD) Classification

What does an eGFR of ≤ 10 mL/min/1.73m² indicate?

It indicates that the kidney is in end-stage disease.

p.28
Kidney Functions and Hormone Production

What is the significance of angiotensin II receptors in the efferent artery?

The efferent artery has more angiotensin II receptors than the afferent artery, influencing pressure and filtration.

p.1
Kidney Functions and Hormone Production

What are the two COX isoenzymes?

COX-1 (constitutive) and COX-2 (inducible).

p.27
Kidney Functions and Hormone Production

What is the consequence of more water in the thin loops?

Increased volume of urine.

p.17
Acute Kidney Injury (AKI) Types and Causes

What two parameters affect perfusion in Prerenal AKI?

Intravascular volume and intravascular pressure.

p.11
Anaemia of Chronic Disease

What condition can uremia cause in CKD patients?

Encephalopathy.

p.27
Kidney Functions and Hormone Production

What is the glomerular filtration rate (GFR)?

The amount of filtrate that leaves the glomerulus per unit time.

p.11
Erythropoietin Production and Function

What happens if EPO-α is given subcutaneously?

The patient may develop antibodies leading to pure red blood cell aplasia.

p.11
Anaemia of Chronic Disease

What is a key safety consideration when using iron sucrose versus iron dextran?

Iron sucrose has a lower risk of severe allergic reactions compared to iron dextran.

p.23
Metabolic Acidosis and Its Management

What is the primary function of bicarbonate produced in the proximal convoluted tubule?
A) To increase H+ ions
B) To neutralize H+ ions
C) To promote water reabsorption
D) To produce erythropoietin
E) To synthesize Vitamin D

B) To neutralize H+ ions
Explanation: The bicarbonate produced in the proximal convoluted tubule serves to neutralize H+ ions, which helps maintain acid-base balance in the body, particularly in patients with kidney problems.

p.23
Metabolic Acidosis and Its Management

What complication arises in patients with kidney problems related to acid-base balance?
A) Respiratory acidosis
B) Metabolic acidosis
C) Hypertension
D) Hyperkalemia
E) Hypocalcemia

B) Metabolic acidosis
Explanation: Patients with kidney problems often experience metabolic acidosis due to the kidneys' inability to produce sufficient bicarbonates, leading to an excess of H+ ions from metabolic activities.

p.3
Chronic Kidney Disease (CKD) and Its Classification

What does a reduction in kidney size indicate during imaging scans?
A) Acute kidney injury
B) Chronic kidney disease
C) Kidney stones
D) Urinary tract infection
E) Normal kidney function

B) Chronic kidney disease
Explanation: A reduction in kidney size observed in imaging scans raises suspicion of chronic kidney disease, as it indicates nephron destruction and the chronicity of the disease.

p.15
Management of Hyperkalemia in CKD

Which thiazide diuretic is primarily considered for use?
A) Hydrochlorothiazide (HCTZ)
B) Metolazone
C) Chlorthalidone
D) Indapamide
E) Furosemide

B) Metolazone
Explanation: Metolazone is specifically mentioned as the thiazide diuretic that is primarily considered, although other thiazide diuretics can also be used.

p.5
Chronic Kidney Disease (CKD) and Its Classification

What does a decline in GFR indicate in CKD?
A) Improvement in kidney function
B) Normal kidney function
C) Worsening kidney function
D) Acute kidney injury
E) No change in kidney function

C) Worsening kidney function
Explanation: A decline in the Glomerular Filtration Rate (GFR) is a key characteristic of chronic kidney disease, indicating a deterioration in kidney function.

p.7
Chronic Kidney Disease (CKD) and Its Classification

What is the primary cause of Chronic Kidney Disease (CKD)?
A) Diabetes
B) Hypertension
C) Obesity
D) Smoking
E) High cholesterol

B) Hypertension
Explanation: Hypertension is identified as the number one cause of CKD, specifically referred to as salt-sensitive hypertension, which significantly impacts kidney health.

p.6
Chronic Kidney Disease (CKD) and Its Classification

What is one of the causes of Chronic Kidney Disease (CKD)?
A) High protein diet
B) Hypertension
C) Excessive hydration
D) Low sodium intake
E) Regular check-ups

B) Hypertension
Explanation: Hypertension is identified as one of the primary causes of Chronic Kidney Disease (CKD), contributing to kidney damage over time.

p.8
Metabolic Acidosis and Its Management

How is sodium bicarbonate administered in the ward?
A) Once daily
B) T.I.D (three times a day)
C) Every hour
D) Twice a week
E) Only when symptoms occur

B) T.I.D (three times a day)
Explanation: Sodium bicarbonate is administered T.I.D in the ward, indicating a regular schedule for its use in managing metabolic acidosis.

p.25
Erythropoietin Production and Its Role in Anemia

What is the role of endothelin in the kidneys?
A) It promotes vasodilation
B) It causes vasoconstriction
C) It decreases blood flow
D) It reduces blood pressure
E) It enhances urine production

B) It causes vasoconstriction
Explanation: Endothelin, produced by the kidneys, causes vasoconstriction, which increases pressure and ensures high blood flow, but excessive endothelin can worsen renal impairment.

p.26
Erythropoietin Production and Its Role in Anemia

What is the functional unit of the kidney?
A) Glomerulus
B) Nephron
C) Bowman’s capsule
D) Juxtaglomerular apparatus
E) Renal tubule

B) Nephron
Explanation: The nephron is the functional unit of the kidney, consisting of various structures including the Bowman’s capsule and glomerulus, essential for filtration and urine formation.

p.23
Erythropoietin Production and Its Role in Anemia

What system maintains blood flow and ultrafiltration in the kidneys?
A) Respiratory system
B) Renin-Angiotensin-Aldosterone System (RAAS)
C) Endocrine system
D) Nervous system
E) Lymphatic system

B) Renin-Angiotensin-Aldosterone System (RAAS)
Explanation: The RAAS is crucial for maintaining blood flow and ultrafiltration in the kidneys, regulating blood pressure and fluid balance through various hormonal actions.

p.19
Acute Kidney Injury (AKI) and Its Types

What is a typical cause of intrarenal AKI?
A) Severe blood loss
B) Urinary obstruction
C) Acute tubular necrosis
D) Heart failure
E) Hypotension

C) Acute tubular necrosis
Explanation: Intrarenal AKI is frequently caused by acute tubular necrosis, which results from damage to the kidney tubules, often due to ischemia or nephrotoxins.

p.2
Urinalysis and Its Diagnostic Importance

Which of the following organisms is known to convert nitrates to nitrites?
A) Staphylococcus aureus
B) Escherichia coli
C) Streptococcus pneumoniae
D) Clostridium botulinum
E) Salmonella enterica

B) Escherichia coli
Explanation: Escherichia coli is one of the organisms that can convert nitrates to nitrites, which is significant in diagnosing urinary tract infections.

p.7
Clinical Presentations and Complications of CKD

Which of the following is NOT a clinical presentation of CKD?
A) Peripheral edema
B) Osteoporosis
C) Hyperkalemia
D) Uremic gastritis
E) Hypertension

E) Hypertension
Explanation: While hypertension is a cause of CKD, it is not a clinical presentation of the disease itself. The other options are recognized clinical manifestations of CKD.

p.6
Chronic Kidney Disease (CKD) and Its Classification

Which of the following is a risk factor for CKD due to its effect on blood pressure?
A) Alcohol consumption
B) Nicotine from smoking
C) High fiber diet
D) Regular hydration
E) Low cholesterol intake

B) Nicotine from smoking
Explanation: Nicotine from smoking causes vasoconstriction, leading to increased blood pressure, which is a significant risk factor for kidney damage and CKD.

p.9
Management of Hyperkalemia in CKD

Which side effect is associated with dextrose?
A) Tingling lips
B) Fast or slow heartbeat
C) Trembling
D) Increased thirst
E) Sweating

B) Fast or slow heartbeat
Explanation: Changes in heart rate, such as fast or slow heartbeat, are noted as side effects of dextrose, indicating potential cardiovascular effects.

p.25
Management of Hyperkalemia in CKD

What is the primary effect of NSAIDs on COX enzymes in the kidneys?
A) Increase prostaglandin production
B) Prevent prostaglandin production
C) Enhance blood flow
D) Decrease blood pressure
E) Promote vasodilation

B) Prevent prostaglandin production
Explanation: NSAIDs block COX enzymes, which prevents the production of prostaglandins, leading to vasoconstriction and potentially causing high blood pressure in the kidneys.

p.16
Furosemide and Metolazone Side Effects and Contraindications

What side effect is associated with Metolazone?
A) Increased energy
B) Chest discomfort
C) Improved vision
D) Decreased thirst
E) Enhanced appetite

B) Chest discomfort
Explanation: Chest discomfort is one of the side effects associated with Metolazone, indicating potential cardiovascular effects.

p.23
Erythropoietin Production and Its Role in Anemia

What triggers the production of renin in the kidneys?
A) Increased oxygen levels
B) Fluid depletion
C) High blood pressure
D) Excess bicarbonate
E) Decreased aldosterone

B) Fluid depletion
Explanation: Renin is produced by the juxtaglomerular complex in response to oxygen or fluid depletion, initiating the Renin-Angiotensin-Aldosterone System (RAAS) to regulate blood pressure.

p.19
Acute Kidney Injury (AKI) and Its Types

What is the primary classification of Acute Kidney Injury (AKI)?
A) Prerenal, Intrarenal, Postrenal
B) Chronic, Acute, Subacute
C) Mild, Moderate, Severe
D) Primary, Secondary, Tertiary
E) Functional, Structural, Metabolic

A) Prerenal, Intrarenal, Postrenal
Explanation: AKI is primarily classified into three categories: prerenal (caused by factors affecting blood flow to the kidneys), intrarenal (caused by damage to the kidney tissue), and postrenal (caused by obstruction of urine flow).

p.2
Urinalysis and Its Diagnostic Importance

What do nitrites in urine typically indicate?
A) Good hydration
B) Urinary tract infections (UTIs)
C) Kidney stones
D) Diabetes
E) Liver disease

B) Urinary tract infections (UTIs)
Explanation: The detection of nitrites in urine is commonly associated with urinary tract infections, as certain organisms convert nitrates to nitrites.

p.2
Urinalysis and Its Diagnostic Importance

What is the significance of leucocyte esterase in urine?
A) Indicates kidney stones
B) Indicates the absence of UTIs
C) Indicates the presence of WBCs and potential UTIs
D) Indicates dehydration
E) Indicates liver damage

C) Indicates the presence of WBCs and potential UTIs
Explanation: Leucocyte esterase is an enzyme released by white blood cells (WBCs) that indicates the presence of WBCs in urine, suggesting a urinary tract infection.

p.24
Urinalysis and Its Diagnostic Importance

Which medication is known to alter the color of urine?
A) Aspirin
B) Rifampicin
C) Ibuprofen
D) Paracetamol
E) Amoxicillin

B) Rifampicin
Explanation: Rifampicin is one of the medications mentioned that can change the color of urine, indicating how certain drugs can affect urine appearance.

p.6
Chronic Kidney Disease (CKD) and Its Classification

What factor (F) is used in the Cockcroft-Gault formula for males?
A) 1.0
B) 1.23
C) 1.04
D) 1.5
E) 2.0

B) 1.23
Explanation: In the Cockcroft-Gault formula, the factor (F) for males is 1.23, while for females it is 1.04, reflecting differences in body composition.

p.24
Urinalysis and Its Diagnostic Importance

What does the presence of dimorphic red blood cells in urine indicate?
A) Normal kidney function
B) Glomerular damage
C) Urinary tract infection
D) Dehydration
E) Liver disease

B) Glomerular damage
Explanation: The presence of dimorphic red blood cells in urine suggests glomerular damage, as it indicates two distinct populations of red blood cells, one of which has morphological changes.

p.16
Furosemide and Metolazone Side Effects and Contraindications

Which of the following is a contraindication for Furosemide?
A) Hypertension
B) Anuria
C) Mild hypokalemia
D) Diabetes mellitus
E) Hyperlipidemia

B) Anuria
Explanation: Furosemide is contraindicated in patients with anuria, which means the absence of urine production, as it can lead to serious complications.

p.26
Autocrine Functions of the Kidney

What are the two main regions of the kidney?
A) Cortex and medulla
B) Afferent and efferent
C) Glomerulus and Bowman’s capsule
D) Renal pelvis and ureter
E) Nephron and collecting duct

A) Cortex and medulla
Explanation: The kidney is divided into two main regions: the cortex (outer portion) and the medulla (conical region), which play distinct roles in kidney function.

p.25
Urinalysis and Its Diagnostic Importance

Which of the following is NOT a parameter included in a urinalysis for kidney issues?
A) Urea
B) Creatinine
C) Protein in urine
D) RBCs in urine
E) Blood glucose

E) Blood glucose
Explanation: Blood glucose is not a parameter typically included in a urinalysis for kidney issues; the main parameters focus on urea, creatinine, protein, and RBCs.

p.3
Chronic Kidney Disease (CKD) and Its Classification

Which two parameters are key indicators in the investigation of kidney disease?
A) Sodium and potassium
B) Creatinine and urea
C) Glucose and cholesterol
D) Calcium and magnesium
E) Bilirubin and albumin

B) Creatinine and urea
Explanation: Creatinine and urea are the main parameters used to investigate kidney disease, as their levels indicate kidney function and potential dysfunction.

p.24
Urinalysis and Its Diagnostic Importance

What is the normal color of urine?
A) Dark brown
B) Pale yellow or straw colored
C) Bright red
D) Clear
E) Green

B) Pale yellow or straw colored
Explanation: Normal urine is typically pale yellow or straw colored, and this appearance can change due to various factors such as food, medications, and medical conditions.

p.9
Management of Hyperkalemia in CKD

What is a contraindication for administering dextrose?
A) Hypokalemia
B) Diabetes
C) Hypertension
D) Hyperkalemia
E) Heart failure

B) Diabetes
Explanation: Dextrose is contraindicated in patients with diabetes, as it can exacerbate hyperglycemia and lead to complications.

p.4
Acute Kidney Injury (AKI) and Its Types

What does a high BUN/Cr ratio indicate?
A) Liver function
B) Dehydration or acute kidney injury
C) Normal kidney function
D) Chronic liver disease
E) Diabetes insipidus

B) Dehydration or acute kidney injury
Explanation: A high BUN/Cr (Blood Urea Nitrogen/Creatinine) ratio suggests dehydration or acute kidney injury, helping to assess a patient's hydration status.

p.18
Acute Kidney Injury (AKI) and Its Types

What condition can lead to prerenal AKI due to reduced plasma volume?
A) Hypertension
B) Heart failure
C) Hypervolemia
D) Chronic kidney disease
E) Diabetes mellitus

B) Heart failure
Explanation: Heart failure is one of the conditions that can reduce plasma volume, leading to decreased blood flow to the kidneys, which can result in prerenal acute kidney injury (AKI).

p.5
Chronic Kidney Disease (CKD) and Its Classification

What is the formula used to calculate creatinine clearance (CrCl)?
A) CrCl = (140 x Age x Weight) / Serum Creatinine
B) CrCl = (140 x Age) / (Weight x Serum Creatinine)
C) CrCl = (Weight x Serum Creatinine) / (140 x Age)
D) CrCl = (Age x Serum Creatinine) / (Weight)
E) CrCl = (140 x Weight) / (Age x Serum Creatinine)

A) CrCl = (140 x Age x Weight) / Serum Creatinine
Explanation: The formula for calculating creatinine clearance (CrCl) incorporates age, weight, and serum creatinine levels, providing a measure of renal function.

p.26
Clinical Presentations and Complications of CKD

Where are the kidneys located in the human body?
A) In the abdominal cavity
B) In the thoracic cavity
C) In the retroperitoneal region
D) In the pelvic cavity
E) In the cranial cavity

C) In the retroperitoneal region
Explanation: The kidneys are paired organs situated in the retroperitoneal region, which means they are located behind the peritoneum, distinguishing their anatomical position.

p.16
Furosemide and Metolazone Side Effects and Contraindications

Which of the following is a contraindication for both Furosemide and Metolazone?
A) Hypertension
B) Anuria
C) Diabetes mellitus
D) Hyperlipidemia
E) Asthma

B) Anuria
Explanation: Anuria is a contraindication for both Furosemide and Metolazone, as it indicates a serious condition that can complicate treatment.

p.26
Management of Hyperkalemia in CKD

Why should ACE inhibitors (ACEIs) be avoided in renal patients?
A) They increase renal perfusion pressure
B) They cause renal dysfunction due to drop in renal perfusion pressure
C) They enhance glomerular filtration
D) They have no effect on the kidneys
E) They decrease blood pressure without side effects

B) They cause renal dysfunction due to drop in renal perfusion pressure
Explanation: ACE inhibitors can lead to renal dysfunction by causing a drop in renal perfusion pressure and decreasing glomerular filtration, particularly due to their effect on the renal efferent arteriole.

p.19
Acute Kidney Injury (AKI) and Its Types

Which of the following is a common cause of prerenal AKI?
A) Acute tubular necrosis
B) Urinary tract obstruction
C) Dehydration
D) Glomerulonephritis
E) Nephrotoxic drugs

C) Dehydration
Explanation: Prerenal AKI is often caused by factors that reduce blood flow to the kidneys, with dehydration being a common cause that leads to decreased renal perfusion.

p.9
Management of Hyperkalemia in CKD

What is the recommended fluid amount for reconstituting kayexalate?
A) 5 mL to 10 mL
B) 10 mL to 20 mL
C) 20 mL to 100 mL
D) 100 mL to 200 mL
E) 200 mL to 300 mL

C) 20 mL to 100 mL
Explanation: The amount of fluid used to suspend kayexalate usually ranges from 20 mL to 100 mL, depending on the dose, ensuring proper administration.

p.3
Urinalysis and Its Diagnostic Importance

What are urinary casts?
A) Large kidney stones
B) Tiny tube-shaped particles in urine
C) Blood clots in urine
D) Bacteria in urine
E) Crystals formed from minerals

B) Tiny tube-shaped particles in urine
Explanation: Urinary casts are tiny tube-shaped particles found in urine during microscopic examination, and they can be composed of various substances, indicating different kidney conditions.

p.5
Chronic Kidney Disease (CKD) and Its Classification

At what GFR level is end-stage kidney disease classified?
A) Above 90 mL/min
B) Between 60-89 mL/min
C) Between 30-59 mL/min
D) Below 15 mL/min
E) Between 15-29 mL/min

D) Below 15 mL/min
Explanation: End-stage kidney disease is classified when the GFR falls below 15 mL/min, indicating severe kidney dysfunction.

p.7
Chronic Kidney Disease (CKD) and Its Classification

Which condition is commonly associated with CKD in diabetic patients?
A) Osteoporosis
B) Nephropathy
C) Hypertension
D) Hyperkalemia
E) Anemia

B) Nephropathy
Explanation: Diabetic patients are prone to CKD primarily because diabetes can lead to nephropathy, which is a significant complication affecting kidney function.

p.19
Acute Kidney Injury (AKI) and Its Types

Which of the following is NOT a cause of AKI?
A) Nephrotoxic medications
B) Severe dehydration
C) Chronic kidney disease
D) Urinary tract infection
E) Heart failure

C) Chronic kidney disease
Explanation: Chronic kidney disease is a long-term condition that leads to gradual loss of kidney function, whereas AKI refers to a sudden decline in kidney function, often due to acute causes.

p.25
Urinalysis and Its Diagnostic Importance

What are the main parameters investigated in a urinalysis for kidney problems?
A) Glucose and electrolytes
B) Urea and creatinine
C) Sodium and potassium
D) Calcium and magnesium
E) Bilirubin and ketones

B) Urea and creatinine
Explanation: The main parameters in a urinalysis for kidney problems include urea and creatinine, which are critical indicators of kidney function.

p.5
Chronic Kidney Disease (CKD) and Its Classification

What is the most common type of kidney condition?
A) Acute kidney injury
B) Chronic kidney disease (CKD)
C) Nephrotic syndrome
D) Glomerulonephritis
E) Renal failure

B) Chronic kidney disease (CKD)
Explanation: Chronic kidney disease (CKD) is identified as the most common renal condition, distinguishing it from other types of kidney issues.

p.4
Chronic Kidney Disease (CKD) and Its Classification

What can cause high creatinine levels besides renal impairment?
A) Liver failure
B) Dehydration
C) Heart disease
D) Diabetes
E) High protein diet

B) Dehydration
Explanation: High creatinine levels can also result from dehydration, so it is important not to conclude renal impairment solely based on elevated creatinine levels.

p.19
Acute Kidney Injury (AKI) and Its Types

Which condition is associated with postrenal AKI?
A) Dehydration
B) Acute glomerulonephritis
C) Kidney stones
D) Sepsis
E) Hypertension

C) Kidney stones
Explanation: Postrenal AKI is typically caused by obstruction of urine flow, with kidney stones being a common condition that can lead to such obstruction.

p.9
Management of Hyperkalemia in CKD

Which of the following is a side effect of insulin?
A) Weight gain
B) Nausea
C) Sweating
D) Blurred vision
E) Muscle pain

C) Sweating
Explanation: Sweating is listed as a side effect of insulin, indicating potential reactions that patients may experience during treatment.

p.3
Urinalysis and Its Diagnostic Importance

What type of casts are often associated with nephrotic syndrome?
A) Granular casts
B) Hyaline casts
C) Red blood cell casts
D) White blood cell casts
E) Fatty casts

A) Granular casts
Explanation: Granular casts are commonly associated with various types of kidney diseases, including nephrotic syndrome, and their presence can indicate significant kidney pathology.

p.15
Clinical Presentations and Complications of CKD

What is a potential cause of pruritus in renal patients?
A) Low calcium levels
B) Uremia
C) High sodium levels
D) Dehydration
E) Hyperglycemia

B) Uremia
Explanation: Uremia is identified as one potential cause of pruritus in renal patients, along with other factors such as high levels of PTH and phosphate.

p.22
Types of Hydroxycholecalciferol and Their Uses

What is the active form of vitamin D3 produced in the body?
A) Cholecalciferol
B) 25-hydroxycholecalciferol
C) Calcitriol
D) Ergocalciferol
E) 1α-hydroxycholecalciferol

C) Calcitriol
Explanation: Calcitriol, also known as 1,25-dihydroxycholecalciferol, is the active form of vitamin D3 produced in the body through hydroxylation processes in the liver and kidneys.

p.11
Erythropoietin Production and Its Role in Anemia

What type of anemia is commonly associated with chronic kidney disease (CKD)?
A) Microcytic hypochromic anemia
B) Normocytic normochromic anemia
C) Macrocytic anemia
D) Hemolytic anemia
E) Sideroblastic anemia

B) Normocytic normochromic anemia
Explanation: Normocytic normochromic anemia is frequently observed in patients with CKD, characterized by symptoms such as dizziness, nausea, and weakness due to insufficient red blood cells (RBCs) to transport oxygen.

p.24
Urinalysis and Its Diagnostic Importance

If blood appears before urine during urination, where is the source of the blood likely from?
A) Kidney
B) Bladder
C) Urethra
D) Prostate
E) Base of the bladder

C) Urethra
Explanation: If blood is observed before urine is passed, it indicates that the source of the blood is likely from the urethra, which is important for diagnosing urinary tract issues.

p.17
Acute Kidney Injury (AKI) and Its Types

What happens when there is a sudden drop in urine output in AKI?
A) Increased hydration
B) Buildup of nitrogenous compounds and toxins
C) Improved kidney function
D) Decreased blood pressure
E) Increased urine production

B) Buildup of nitrogenous compounds and toxins
Explanation: A sudden drop in urine output leads to the accumulation of nitrogenous waste and other toxins in the body, which can be harmful.

p.16
Furosemide and Metolazone Side Effects and Contraindications

Which condition contraindicates the use of Metolazone?
A) Mild dehydration
B) Hypersensitivity to metolazone
C) Controlled hypertension
D) Chronic kidney disease
E) Hyperthyroidism

B) Hypersensitivity to metolazone
Explanation: Metolazone is contraindicated in individuals with hypersensitivity to the drug, as it can lead to severe allergic reactions.

p.25
Chronic Kidney Disease (CKD) and Its Classification

Which endothelin receptors are found in the kidneys?
A) ET-1 and ET-2
B) ET-A and ET-B
C) ET-3 and ET-4
D) ET-X and ET-Y
E) ET-5 and ET-6

B) ET-A and ET-B
Explanation: The kidneys have endothelin receptors known as ET-A and ET-B, which mediate the effects of endothelin in the renal system.

p.2
Urinalysis and Its Diagnostic Importance

What does the presence of ketones in urine indicate?
A) Good diabetes control
B) Poor diabetes control
C) Normal kidney function
D) Urinary tract infection
E) Dehydration

B) Poor diabetes control
Explanation: The presence of ketones in urine is a sign of poor diabetes control, indicating that the body is not effectively using glucose for energy and is instead breaking down fats.

p.9
Management of Hyperkalemia in CKD

How should kayexalate be administered for better palatability?
A) In juice
B) In syrup
C) In milk
D) In soda
E) In plain water

B) In syrup
Explanation: For greater palatability, kayexalate can be suspended in syrup, making it more acceptable for patients when administered orally.

p.6
Chronic Kidney Disease (CKD) and Its Classification

Which of the following is NOT a risk factor for Chronic Kidney Disease (CKD)?
A) Hypertension
B) Smoking
C) Regular exercise
D) Dyslipidemia
E) Obesity

C) Regular exercise
Explanation: Regular exercise is generally considered beneficial for health and is not listed as a risk factor for CKD, unlike hypertension, smoking, dyslipidemia, and obesity.

p.27
Autocrine Functions of the Kidney

Where are the thick loops of the proximal convoluted tubule primarily located?
A) In the medulla
B) In the cortex
C) In the renal pelvis
D) In the ureter
E) In the bladder

B) In the cortex
Explanation: The thick loops of the proximal convoluted tubule are primarily found in the cortex, while the thinner loops are located in the medulla, indicating the structural organization of the nephron.

p.2
Chronic Kidney Disease (CKD) and Its Classification

What condition is characterized by the leakage of ≥ 3.5g of protein or albumin per day?
A) Acute kidney injury
B) Chronic kidney disease
C) Nephrotic syndrome
D) Urinary tract infection
E) Diabetes mellitus

C) Nephrotic syndrome
Explanation: Nephrotic syndrome is defined by the excessive leakage of proteins or albumin in urine, specifically ≥ 3.5g/day, indicating significant renal damage.

p.27
Chronic Kidney Disease (CKD) and Its Classification

What is the glomerular filtration rate (GFR)?
A) The amount of urine produced per day
B) The amount of filtrate leaving the glomerulus per unit time
C) The total volume of blood in the kidneys
D) The rate of electrolyte exchange in the nephron
E) The pressure in the Bowman’s capsule

B) The amount of filtrate leaving the glomerulus per unit time
Explanation: The GFR refers to the volume of filtrate that is produced by the glomerulus per unit time, which is a crucial measure of kidney function.

p.5
Chronic Kidney Disease (CKD) and Its Classification

How is renal function determined in CKD?
A) Blood pressure measurement
B) Urinalysis
C) GFR
D) Imaging studies
E) Biopsy

C) GFR
Explanation: Renal function in chronic kidney disease is primarily determined using the Glomerular Filtration Rate (GFR), which reflects the kidneys' filtering capacity.

p.4
Urinalysis and Its Diagnostic Importance

What is the normal range for urine specific gravity?
A) 1.000 to 1.002
B) 1.002 to 1.030
C) 1.030 to 1.050
D) 1.050 to 1.100
E) 1.100 to 1.200

B) 1.002 to 1.030
Explanation: Ideally, urine specific gravity results should fall between 1.002 and 1.030 if the kidneys are functioning normally, indicating their ability to concentrate urine.

p.16
Furosemide and Metolazone Side Effects and Contraindications

What is a common side effect of Furosemide?
A) Increased appetite
B) Fever
C) Weight gain
D) Insomnia
E) Hypertension

B) Fever
Explanation: Fever is listed as a side effect of Furosemide, indicating potential adverse reactions that patients may experience.

p.26
Chronic Kidney Disease (CKD) and Its Classification

What is the average length of a kidney?
A) 5-6 cm
B) 7-10 cm
C) 11-14 cm
D) 15-20 cm
E) 20-25 cm

C) 11-14 cm
Explanation: The kidneys are approximately 11-14 cm in length, which is important for diagnosing kidney diseases as size can indicate acute or chronic conditions.

p.23
Chronic Kidney Disease (CKD) and Its Classification

What is the role of angiotensin II in the body?
A) It decreases blood pressure
B) It promotes vasodilation
C) It causes vasoconstriction
D) It inhibits aldosterone release
E) It increases bicarbonate production

C) It causes vasoconstriction
Explanation: Angiotensin II causes vasoconstriction and stimulates the release of aldosterone, which helps regulate blood pressure and fluid balance.

p.6
Chronic Kidney Disease (CKD) and Its Classification

What does the Cockcroft-Gault formula calculate?
A) Body temperature
B) Kidney function
C) Blood pressure
D) Weight loss
E) Age in years

B) Kidney function
Explanation: The Cockcroft-Gault formula is used to estimate kidney function, specifically the glomerular filtration rate (GFR), which is crucial for assessing renal health.

p.4
Erythropoietin Production and Its Role in Anemia

What is the primary source of creatinine in the body?
A) Liver
B) Kidneys
C) Muscles
D) Fat cells
E) Blood plasma

C) Muscles
Explanation: Creatinine is produced by the muscles as a byproduct of muscle metabolism, which is why its levels can indicate renal impairment when excreted via the kidneys.

p.15
Management of Hyperkalemia in CKD

What is the rate of administration for Lasix?
A) 2 mg/min
B) 4 mg/min
C) 6 mg/min
D) 8 mg/min
E) 10 mg/min

B) 4 mg/min
Explanation: The rate of administration for Lasix is specified as 4 mg/min, which is important for proper dosing in clinical settings.

p.8
Metabolic Acidosis and Its Management

What is the primary medication used to manage metabolic acidosis?
A) Sodium chloride
B) Sodium bicarbonate (NaHCO3)
C) Potassium chloride
D) Calcium carbonate
E) Magnesium sulfate

B) Sodium bicarbonate (NaHCO3)
Explanation: Sodium bicarbonate is specifically mentioned as the primary treatment for metabolic acidosis, available in both powder and capsule forms.

p.15
Management of Hyperkalemia in CKD

What is the primary role of calcium gluconate in the management of hyperkalemia?
A) To directly lower potassium levels
B) To stabilize myocytes
C) To replace lost electrolytes
D) To increase urine output
E) To treat muscle weakness

B) To stabilize myocytes
Explanation: Calcium gluconate is used as an adjunct to stabilize myocytes when potassium levels rise, rather than being used specifically to manage hyperkalemia.

p.3
Urinalysis and Its Diagnostic Importance

What does the presence of red blood cell casts in urine indicate?
A) Normal kidney function
B) Infection in the urinary tract
C) Microscopic bleeding from the kidney
D) Dehydration
E) High blood pressure

C) Microscopic bleeding from the kidney
Explanation: The presence of red blood cell casts in urine suggests that there is a microscopic amount of bleeding occurring from the kidney, which can be indicative of underlying kidney issues.

p.27
Erythropoietin Production and Its Role in Anemia

What percentage of filtrate is reabsorbed in the proximal convoluted tubule (PCT)?
A) 50%
B) 20%
C) 80%
D) 100%
E) 10%

C) 80%
Explanation: Approximately 80% of the filtrate, including vital nutrients like glucose and electrolytes, is reabsorbed in the proximal convoluted tubule, which is essential for maintaining homeostasis.

p.8
Management of Hyperkalemia in CKD

Which of the following is NOT a temporary method for managing hyperkalemia?
A) Regular insulin in dextrose
B) Sodium bicarbonate
C) Nebulization using salbutamol
D) Kayexalate
E) None of the above

D) Kayexalate
Explanation: Kayexalate is identified as a permanent method for managing hyperkalemia, while the other options are temporary methods.

p.24
Urinalysis and Its Diagnostic Importance

What does a foul smell in urine typically indicate?
A) Dehydration
B) Liver disease
C) Bladder infection
D) Diabetes mellitus
E) Ketosis

C) Bladder infection
Explanation: A foul smell in urine is commonly associated with a bladder infection, highlighting the importance of odor in diagnosing urinary conditions.

p.14
Management of Hyperkalemia in CKD

Which diuretic is considered more effective for severe edema?
A) Thiazides
B) Potassium-sparing diuretics
C) Loop diuretics
D) Carbonic anhydrase inhibitors
E) Osmotic diuretics

C) Loop diuretics
Explanation: Loop diuretics, such as Lasix (Furosemide), are more effective for severe edema due to their high ceiling effect, allowing for greater fluid removal compared to thiazides.

p.15
Clinical Presentations and Complications of CKD

What is a common clinical manifestation of neurological changes in renal patients?
A) Hypertension
B) Epilepsy
C) Hyperkalemia
D) Muscle cramps
E) Edema

B) Epilepsy
Explanation: Neurological changes in renal patients can manifest as epilepsy, poor concentration, and pruritus, indicating the impact of renal dysfunction on the nervous system.

p.9
Management of Hyperkalemia in CKD

What is a contraindication for sodium bicarbonate?
A) Hyperglycemia
B) Congestive heart failure
C) Hypoglycemia
D) Peripheral edema
E) Weight gain

B) Congestive heart failure
Explanation: Sodium bicarbonate is contraindicated in patients with congestive heart failure, as it can exacerbate fluid retention and other complications.

p.14
Management of Hyperkalemia in CKD

What is the primary use of diuretics in the management of peripheral edema?
A) To increase blood pressure
B) To reduce fluid retention
C) To increase calcium levels
D) To enhance potassium absorption
E) To decrease heart rate

B) To reduce fluid retention
Explanation: Diuretics are primarily used in the management of peripheral edema to help reduce fluid retention in the body, thereby alleviating swelling.

p.15
Chronic Kidney Disease (CKD) and Its Classification

Why are steroids not typically given to CKD patients?
A) They cause muscle weakness
B) They worsen fluid retention
C) They increase potassium levels
D) They lead to electrolyte imbalance
E) They are ineffective

B) They worsen fluid retention
Explanation: Steroids can cause a build-up of fluids in CKD patients, which can exacerbate their condition, making them unsuitable for this patient population.

p.17
Acute Kidney Injury (AKI) and Its Types

What characterizes Acute Kidney Injury (AKI)?
A) Gradual reduction in kidney function
B) Sudden reduction in kidney function within 48 hours
C) Permanent kidney failure
D) Increased urine output
E) Normal kidney function

B) Sudden reduction in kidney function within 48 hours
Explanation: AKI is defined by a sudden decrease in kidney function, typically occurring within a 48-hour period, which can lead to serious complications.

p.18
Acute Kidney Injury (AKI) and Its Types

What percentage of renal AKI cases is attributed to acute tubular necrosis (ATN)?
A) 50%
B) 60%
C) 70%
D) 80%
E) 90%

D) 80%
Explanation: About 80% of renal AKI cases are due to acute tubular necrosis (ATN), indicating its significant role in the development of renal AKI.

p.8
Management of Hyperkalemia in CKD

What is the function of Kayexalate in the body?
A) It absorbs potassium
B) It moves sodium into the system and potassium into the GIT
C) It increases potassium levels
D) It acts as a diuretic
E) It is a source of magnesium

B) It moves sodium into the system and potassium into the GIT
Explanation: Kayexalate works by exchanging sodium for potassium, effectively removing potassium from the body through the gastrointestinal tract.

p.17
Acute Kidney Injury (AKI) and Its Types

What is a major cause of prerenal AKI?
A) Direct kidney damage
B) Impairment of perfusion
C) Urinary obstruction
D) Infection in the kidney
E) Genetic disorders

B) Impairment of perfusion
Explanation: Prerenal AKI is primarily caused by reduced blood flow to the kidneys, leading to impaired perfusion and subsequent kidney injury.

p.18
Erythropoietin Production and Its Role in Anemia

Why are aminoglycosides considered nephrotoxic?
A) They increase blood flow to the kidneys
B) They accumulate in renal tubules and interfere with cellular processes
C) They enhance kidney function
D) They are used to treat kidney infections
E) They decrease urine output

B) They accumulate in renal tubules and interfere with cellular processes
Explanation: Aminoglycosides can accumulate in the renal tubules, particularly in the proximal tubules, leading to cellular death and impaired kidney function, contributing to nephrotoxicity.

p.20
Clinical Presentations and Complications of CKD

Which of the following conditions can lead to clinical presentations of AKI?
A) Hypervolemia
B) Hypovolemia
C) Dehydration
D) Hypernatremia
E) Hypokalemia

B) Hypovolemia
Explanation: Hypovolemia leads to reduced plasma volume and hypoperfusion to the kidneys, contributing to the clinical presentations of AKI.

p.17
Acute Kidney Injury (AKI) and Its Types

What can severe AKI affect besides the kidneys?
A) Only the lungs
B) The brain and liver
C) The skin
D) The heart only
E) No other organs

B) The brain and liver
Explanation: In severe cases of AKI, low perfusion can lead to complications affecting other organs, including the brain and liver, which is referred to as organ AKI.

p.29
Acute Kidney Injury (AKI) and Its Types

What is anuria?
A) Urine output of less than 400mL/day
B) Normal urine production
C) Absence of urine production
D) Urine output of more than 100mL/day
E) Urine output of less than 1L/day

C) Absence of urine production
Explanation: Anuria is defined as the absence of urine production, characterized by a urine output of fewer than 100 mL daily.

p.29
Autocrine Functions of the Kidney

What is the difference between autocrine and paracrine signaling?
A) Autocrine signaling affects distant cells, while paracrine affects nearby cells.
B) Autocrine signaling involves the same cell, while paracrine affects nearby cells.
C) Both affect the same cell type.
D) Paracrine signaling uses the circulatory system, while autocrine does not.
E) There is no difference.

B) Autocrine signaling involves the same cell, while paracrine affects nearby cells.
Explanation: Autocrine signaling is when a cell secretes a messenger that binds to its own receptors, while paracrine signaling involves messengers that act on nearby cells.

p.28
Chronic Kidney Disease (CKD) and Its Classification

What is the normal estimated Glomerular Filtration Rate (eGFR) for healthy kidney function?
A) ≥ 60 mL/min/1.73m²
B) ≥ 90 mL/min/1.73m²
C) ≤ 30 mL/min/1.73m²
D) ≤ 10 mL/min/1.73m²
E) 45 mL/min/1.73m²

B) ≥ 90 mL/min/1.73m²
Explanation: A normal estimated Glomerular Filtration Rate (eGFR) is defined as being greater than or equal to 90 mL/min/1.73m², indicating healthy kidney function.

p.2
Urinalysis and Its Diagnostic Importance

What is the normal range of smaller proteins found in urine?
A) 10-20 mg
B) 30-150 mg
C) 200-300 mg
D) 400-500 mg
E) 600-700 mg

B) 30-150 mg
Explanation: The normal proteins found in urine, known as Tamm-Horsfall proteins, typically range from 30 to 150 mg, indicating normal kidney function.

p.7
Metabolic Acidosis and Its Management

What ion do the proximal convoluted tubules produce to neutralize H+ ions?
A) Sodium (Na+)
B) Calcium (Ca2+)
C) Bicarbonate (HCO3-)
D) Potassium (K+)
E) Chloride (Cl-)

C) Bicarbonate (HCO3-)
Explanation: The proximal convoluted tubules produce bicarbonate ions (HCO3-) to neutralize excess H+ ions, which is crucial for maintaining acid-base balance in the body.

p.21
Acute Kidney Injury (AKI) and Its Types

What is the first phase of Acute Tubular Necrosis (ATN)?
A) Recovery phase
B) Diuretic phase
C) Oliguria phase
D) Renal failure phase
E) Maintenance phase

C) Oliguria phase
Explanation: The first phase of Acute Tubular Necrosis (ATN) is the Oliguria phase, characterized by a reduction in urine output, which can last about 7 to 14 days.

p.22
Types of Hydroxycholecalciferol and Their Uses

Which organs are primarily responsible for producing active vitamin D3?
A) Heart and lungs
B) Brain and pancreas
C) Kidney and liver
D) Stomach and intestines
E) Spleen and gallbladder

C) Kidney and liver
Explanation: The kidney and liver are the two organs that produce active vitamin D3 (Calcitriol) in the body through specific hydroxylation processes.

p.11
Erythropoietin Production and Its Role in Anemia

What is the main cause of anemia in CKD?
A) Iron deficiency
B) Vitamin B12 deficiency
C) Erythropoietin (EPO) deficiency
D) Folate deficiency
E) Hemolysis

C) Erythropoietin (EPO) deficiency
Explanation: EPO is the primary factor contributing to anemia in CKD, as the kidneys are unable to produce sufficient amounts of this hormone, which is essential for RBC production.

p.13
Phosphate Management in CKD

Which medication is considered the best phosphate binder?
A) Calcium carbonate
B) Sevelamer
C) Aluminum hydroxide
D) Calcium acetate
E) Lanthanum carbonate

C) Aluminum hydroxide
Explanation: Aluminum hydroxide [Al(OH)3] is noted as the best phosphate binder, although it is not commonly used due to the risk of aluminum buildup in CKD patients.

p.22
Types of Hydroxycholecalciferol and Their Uses

What enzyme is responsible for hydroxylation at C-1 to produce active vitamin D3?
A) 25-hydroxylase
B) 1α-hydroxylase
C) 24-hydroxylase
D) 1β-hydroxylase
E) 27-hydroxylase

B) 1α-hydroxylase
Explanation: The enzyme responsible for hydroxylation at C-1, which converts 25-hydroxycholecalciferol to the active form of vitamin D3 (Calcitriol), is called 1α-hydroxylase.

p.11
Erythropoietin Production and Its Role in Anemia

What is the preferred route for administering EPO-β in CKD patients?
A) Oral
B) Intravenous (IV)
C) Subcutaneous (SC)
D) Intramuscular (IM)
E) Topical

C) Subcutaneous (SC)
Explanation: EPO-β is ideally administered via the subcutaneous route, while EPO-α should be given intravenously to avoid the development of antibodies that can lead to pure red blood cell aplasia.

p.13
Clinical Presentations and Complications of CKD

What is the mainstay treatment for dialysis dementia?
A) Calcium carbonate
B) Sevelamer
C) Dexferrioxamine
D) Aluminum hydroxide
E) Lanthanum carbonate

C) Dexferrioxamine
Explanation: Dexferrioxamine infusions are the mainstay treatment for dialysis dementia, as it effectively binds aluminum in the body.

p.17
Acute Kidney Injury (AKI) and Its Types

What is a common consequence of reduced intravascular volume in prerenal AKI?
A) Increased kidney function
B) Hypovolemia
C) Hypervolemia
D) Normal perfusion
E) Decreased urine output

B) Hypovolemia
Explanation: A reduction in intravascular volume leads to hypovolemia, which results in decreased perfusion to the kidneys and can cause AKI.

p.12
Uremic Gastritis in CKD and Its Management

What complication can arise from the use of PPIs?
A) Hypertension
B) Acute interstitial nephritis
C) Osteoporosis
D) Diabetes
E) Hyperkalemia

B) Acute interstitial nephritis
Explanation: PPIs can trigger acute interstitial nephritis, a serious adverse event that is commonly associated with acute kidney injury.

p.28
Autocrine Functions of the Kidney

Why does the afferent artery have a larger lumen than the efferent artery?
A) To decrease blood flow
B) To increase pressure and allow time for filtration
C) To reduce filtration rate
D) To enhance oxygen delivery
E) To facilitate waste removal

B) To increase pressure and allow time for filtration
Explanation: The larger lumen of the afferent artery compared to the efferent artery is designed to increase pressure and provide sufficient time for filtration in the kidneys.

p.18
Acute Kidney Injury (AKI) and Its Types

Which of the following conditions is associated with hypotension that can lead to prerenal AKI?
A) Dehydration
B) Hyperglycemia
C) Chronic hypertension
D) Anemia
E) Hyperlipidemia

A) Dehydration
Explanation: Dehydration can cause hypotension, which reduces perfusion to the kidneys and can result in prerenal AKI.

p.13
Phosphate Management in CKD

What condition can reduce calcium levels in the body?
A) High vitamin D
B) Low vitamin D
C) High phosphate
D) Low phosphate
E) High calcium

B) Low vitamin D
Explanation: Low vitamin D is identified as a condition that can reduce calcium levels in the body, which is crucial for maintaining various physiological functions.

p.1
Types of Hydroxycholecalciferol and Their Uses

Which form of hydroxycholecalciferol is used in liver impairment?
A) 1-hydroxycholecalciferol (Alfacalcidol)
B) 25-hydroxycholecalciferol (Calcifediol)
C) 1,25-dihydroxycholecalciferol (Calcitriol)
D) 10-hydroxycholecalciferol
E) None of the above

B) 25-hydroxycholecalciferol (Calcifediol)
Explanation: 25-hydroxycholecalciferol (Calcifediol) is specifically indicated for use in liver impairment, while other forms are used for renal impairment or both.

p.8
Management of Hyperkalemia in CKD

What is the permanent method for managing hyperkalemia?
A) Regular insulin
B) Sodium bicarbonate
C) Nebulization with salbutamol
D) Kayexalate
E) Calcium gluconate

D) Kayexalate
Explanation: Kayexalate is the permanent method for managing hyperkalemia as it removes potassium from the body rather than just redistributing it.

p.7
Chronic Kidney Disease (CKD) and Its Classification

What is Alport syndrome primarily characterized by?
A) High blood pressure
B) Kidney inflammation, hearing loss, and eye abnormalities
C) Diabetes and obesity
D) Osteoporosis and anemia
E) Hyperkalemia and metabolic acidosis

B) Kidney inflammation, hearing loss, and eye abnormalities
Explanation: Alport syndrome is an inherited condition characterized by kidney inflammation (nephritis), hearing loss, and eye abnormalities, indicating a systemic impact on health.

p.29
Autocrine Functions of the Kidney

What is the primary consequence of having a small lumen size and more angiotensin II receptors in the efferent artery?
A) Increased filtration time
B) Decreased blood flow
C) Decreased resistance and easier blood flow
D) Increased urine output
E) Increased kidney size

C) Decreased resistance and easier blood flow
Explanation: The small lumen size and presence of more angiotensin II receptors lead to decreased resistance, allowing blood to flow more easily through the efferent artery, which affects filtration time.

p.13
Clinical Presentations and Complications of CKD

What is a common side effect of dexferrioxamine?
A) Increased appetite
B) Hives
C) Weight gain
D) Improved vision
E) Enhanced kidney function

B) Hives
Explanation: Hives is one of the side effects associated with dexferrioxamine, which is used in the treatment of dialysis dementia by binding aluminum.

p.22
Types of Hydroxycholecalciferol and Their Uses

Why is vitamin D3 not advisable for patients with liver or kidney problems?
A) It is too expensive
B) It is ineffective
C) It can lead to toxicity
D) It is inactive and cannot be converted
E) It causes allergic reactions

D) It is inactive and cannot be converted
Explanation: Vitamin D3 (inactive form) is not advisable for patients with liver or kidney problems because their bodies may not effectively convert it to the active form (Calcitriol), which is essential for calcium metabolism.

p.29
Acute Kidney Injury (AKI) and Its Types

What is oliguria defined as?
A) Urine output of less than 1.5L/day
B) Urine output of less than 400mL/day
C) Absence of urine production
D) Normal urine output
E) Urine output of more than 1L/day

B) Urine output of less than 400mL/day
Explanation: Oliguria is defined as low urine output, specifically when urine output is less than 400mL per day.

p.13
Phosphate Management in CKD

Which medication is commonly used to manage high levels of phosphate?
A) Aluminum hydroxide
B) Calcium carbonate
C) Dexferrioxamine
D) Sevelamer
E) Lanthanum carbonate

B) Calcium carbonate
Explanation: Calcium carbonate (CaCO3) is the most commonly used medication to manage high phosphate levels, as it also replenishes calcium and binds phosphate.

p.29
Functions of the Kidney

Which of the following is NOT a function of the kidney?
A) Reabsorption of nutrients
B) Excretion of waste
C) Fluid balance
D) Hormone production
E) pH regulation

D) Hormone production
Explanation: While the kidneys have endocrine functions, the primary functions listed here focus on tubular functions such as reabsorption, excretion, fluid balance, and pH regulation.

p.12
Uremic Gastritis in CKD and Its Management

What is the recommended dose adjustment for H2 receptor antagonists in patients with renal impairment?
A) Full dose
B) Double the dose
C) Half the dose
D) No adjustment needed
E) Increase by 25%

C) Half the dose
Explanation: In patients with renal impairment, H2 receptor antagonists should be given at half the usual dose to minimize the risk of renal problems.

p.10
Management of Hyperkalemia in CKD

What is a potential side effect of magnesium preparations?
A) Constipation
B) Diarrhea
C) Hypertension
D) Tachycardia
E) Palpitations

B) Diarrhea
Explanation: Magnesium preparations can lead to diarrhea as a side effect, which is important to consider when prescribing these medications.

p.27
Management of Hyperkalemia in CKD

Where does water exchange occur in the nephron?
A) At the thick loops
B) At the glomerulus
C) At the Bowman’s capsule
D) At the thin loops
E) At the distal convoluted tubule

D) At the thin loops
Explanation: Water exchange occurs at the thin loops of the nephron, while the thick loops are primarily involved in electrolyte exchange, highlighting the functional specialization of these structures.

p.8
Management of Hyperkalemia in CKD

What is the role of regular insulin in managing hyperkalemia?
A) It increases potassium levels
B) It pushes K+ ions back into the cells
C) It decreases sodium levels
D) It acts as a diuretic
E) It is used to treat metabolic acidosis

B) It pushes K+ ions back into the cells
Explanation: Regular insulin is used to help push potassium ions back into the cells, which is crucial in the temporary management of hyperkalemia.

p.21
Acute Kidney Injury (AKI) and Its Types

During which phase of ATN does urine output improve?
A) Recovery phase
B) Oliguria phase
C) Diuretic phase
D) Initial phase
E) Maintenance phase

C) Diuretic phase
Explanation: The Diuretic phase of ATN is marked by an improvement in urine output, indicating a positive response in kidney function.

p.20
Acute Kidney Injury (AKI) and Its Types

What is a key indicator of renal AKI when using fractional excretion of sodium (F eNa)?
A) F eNa < 1%
B) F eNa = 1%
C) F eNa > 1%
D) F eNa = 0%
E) F eNa < 0%

C) F eNa > 1%
Explanation: A fractional excretion of sodium (F eNa) greater than 1% indicates renal AKI, as it suggests that the kidneys are unable to retain sodium due to tubular damage.

p.14
Management of Hyperkalemia in CKD

Why are thiazide diuretics administered before loop diuretics in combination therapy?
A) To enhance the effect of loop diuretics
B) To prevent dehydration
C) To inhibit distal sodium reabsorption
D) To increase potassium levels
E) To reduce side effects

C) To inhibit distal sodium reabsorption
Explanation: Thiazide diuretics are given before loop diuretics to inhibit distal sodium reabsorption, allowing loop diuretics to block proximal sodium reabsorption more effectively.

p.21
Acute Kidney Injury (AKI) and Its Types

What is a common requirement for patients with severe Acute Kidney Injury (AKI)?
A) Increased fluid intake
B) Dialysis
C) Antibiotics
D) Blood transfusion
E) Surgery

B) Dialysis
Explanation: Patients with severe AKI often require dialysis to manage their condition and support kidney function.

p.12
Erythropoietin Production and Its Role in Anemia

What condition can lead to high production of EPO?
A) Diabetes
B) Renal cell carcinoma
C) Hypertension
D) Asthma
E) Osteoporosis

B) Renal cell carcinoma
Explanation: Conditions such as renal cell carcinoma and polycystic kidney disease can cause an increased production of EPO, which is important to monitor in patients.

p.1
Autocrine Functions of the Kidney

Which COX isoenzyme is constitutive and always present in the system?
A) COX-1
B) COX-2
C) COX-3
D) COX-4
E) None of the above

A) COX-1
Explanation: COX-1 is the constitutive isoenzyme that is always present in the system, while COX-2 is inducible and produced during injury.

p.12
Uremic Gastritis in CKD and Its Management

What is the management for uremic gastritis in CKD?
A) Antibiotics
B) Proton pump inhibitors (PPIs)
C) Antidepressants
D) Corticosteroids
E) Antihistamines

B) Proton pump inhibitors (PPIs)
Explanation: Proton pump inhibitors (PPIs) are commonly used to manage uremic gastritis, although they can cause renal impairment in some cases.

p.28
Chronic Kidney Disease (CKD) and Its Classification

What happens when the sum of Bowman’s capsule pressure and Oncotic pressure exceeds capillary pressure?
A) Increased filtration
B) Decreased filtration
C) Normal kidney function
D) Increased blood flow
E) Enhanced urine output

B) Decreased filtration
Explanation: When the sum of Bowman’s capsule pressure and Oncotic pressure becomes greater than capillary pressure, it results in a negative net filtration pressure, indicating reduced kidney function or filtration.

p.10
Management of Hyperkalemia in CKD

Which condition contraindicates the use of lactulose?
A) Hypertension
B) Diabetes
C) Hypokalemia
D) Heart block
E) Myasthenia gravis

B) Diabetes
Explanation: Lactulose is contraindicated in patients with diabetes, as it can affect blood sugar levels, necessitating caution in its use.

p.4
Urinalysis and Its Diagnostic Importance

What does urine osmolality measure?
A) The pH of urine
B) The concentration of particles in urine
C) The volume of urine produced
D) The presence of glucose in urine
E) The color of urine

B) The concentration of particles in urine
Explanation: Urine osmolality measures the concentration of particles in urine, providing important information about kidney function and hydration status.

p.18
Acute Kidney Injury (AKI) and Its Types

What is the primary cause of renal AKI?
A) Dehydration
B) Obstruction of urinary flow
C) Damage to kidney tissue
D) Low blood pressure
E) Excessive fluid intake

C) Damage to kidney tissue
Explanation: Renal AKI is primarily caused by conditions that damage the kidney itself, such as acute tubular necrosis, interstitial nephritis, and glomerular nephritis.

p.7
Metabolic Acidosis and Its Management

What condition can result from metabolic acidosis due to CKD?
A) Hypokalemia
B) Hyperkalemia
C) Hypertension
D) Osteoporosis
E) Anemia

B) Hyperkalemia
Explanation: Metabolic acidosis in CKD leads to an excess of H+ ions, which can cause hyperkalemia, a condition characterized by elevated potassium levels in the blood.

p.14
Management of Hyperkalemia in CKD

What does the term 'high ceiling effect' refer to in loop diuretics?
A) The maximum dose that can be given
B) The ability to increase effect with higher doses
C) The minimum effective dose
D) The duration of action
E) The side effects associated with high doses

B) The ability to increase effect with higher doses
Explanation: The 'high ceiling effect' means that as the dose of a loop diuretic is increased, the effect also increases correspondingly, allowing for more effective management of edema.

p.21
Acute Kidney Injury (AKI) and Its Types

What occurs during the Recovery phase of ATN?
A) Complete return to baseline function
B) Regeneration of the tubule
C) Decrease in urine output
D) Onset of dialysis
E) Development of chronic kidney disease

B) Regeneration of the tubule
Explanation: The Recovery phase involves the regeneration of the tubules, although patients may not return to baseline kidney function.

p.12
Erythropoietin Production and Its Role in Anemia

What is the target hemoglobin (Hb) level when administering EPO?
A) 8 - 10 g/dL
B) 10 - 12 g/dL
C) 12 - 14 g/dL
D) 14 - 16 g/dL
E) 15 - 17 g/dL

B) 10 - 12 g/dL
Explanation: The target hemoglobin level when administering EPO is set between 10 - 12 g/dL to ensure effective treatment without causing complications such as cardiac issues.

p.1
Erythropoietin Production and Its Role in Anemia

What condition can lead to the overproduction of EPO?
A) Liver failure
B) Polycystic renal disease
C) Hypertension
D) Diabetes mellitus
E) Hyperthyroidism

B) Polycystic renal disease
Explanation: Overproduction of EPO can occur in conditions like polycystic renal disease, leading to polycythemia, which increases blood viscosity and hypercoagulability.

p.21
Chronic Kidney Disease (CKD) and Its Classification

What is one of the complications associated with the patient's condition in the case study?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypocalcemia
E) Hyperglycemia

A) Hyperkalemia
Explanation: The patient in the case study is noted to have hyperkalemia as one of the complications associated with their condition.

p.12
Erythropoietin Production and Its Role in Anemia

How long does it take for fersolate to raise hemoglobin by 1 g/dL?
A) 1 week
B) 2 - 3 weeks
C) 4 - 5 weeks
D) 1 month
E) 6 weeks

B) 2 - 3 weeks
Explanation: Fersolate takes approximately 2 - 3 weeks to raise hemoglobin levels by 1 g/dL, indicating the time required for iron supplementation to affect hemoglobin production.

p.12
Hyperphosphatemia in CKD and Its Management

What condition leads to hyperphosphatemia in CKD?
A) Excessive calcium intake
B) Buildup of phosphate
C) Low vitamin D levels
D) Increased potassium levels
E) Decreased sodium levels

B) Buildup of phosphate
Explanation: In chronic kidney disease (CKD), the kidneys are unable to excrete phosphate effectively, leading to its buildup and resulting in hyperphosphatemia.

p.28
Management of Hyperkalemia in CKD

What effect do ACE inhibitors (ACEIs) have on the efferent artery compared to the afferent artery?
A) They constrict both arteries equally
B) They cause pronounced vessel dilation in the efferent artery
C) They have no effect on either artery
D) They constrict the efferent artery more
E) They dilate the afferent artery more

B) They cause pronounced vessel dilation in the efferent artery
Explanation: ACE inhibitors cause more significant dilation in the efferent artery compared to the afferent artery, which can affect glomerular filtration rate (GFR).

p.10
Erythropoietin Production and Its Role in Anemia

What type of anemia is most commonly found in CKD patients?
A) Microcytic hypochromic anemia
B) Normocytic normochromic anemia
C) Macrocytic anemia
D) Sideroblastic anemia
E) Hemolytic anemia

B) Normocytic normochromic anemia
Explanation: About 99% of CKD patients present with normocytic normochromic anemia, which is a key characteristic of anemia in chronic kidney disease.

p.27
Acute Kidney Injury (AKI) and Its Types

What happens if there is a problem with the medulla in a patient with urinary incontinence?
A) Increased electrolyte concentration in the medulla
B) Decreased water volume in the thin loops
C) Electrolytes fail to filter into the medulla
D) Increased GFR
E) Decreased urine volume

C) Electrolytes fail to filter into the medulla
Explanation: In urinary incontinence, a problem in the medulla leads to a failure of electrolytes to filter into the medulla, causing water to move in the reverse direction and increasing urine volume.

p.4
Metabolic Acidosis and Its Management

What is the role of lactulose in treating high ammonia levels?
A) It increases ammonia production
B) It neutralizes ammonia
C) It promotes dehydration
D) It enhances kidney function
E) It decreases urine output

B) It neutralizes ammonia
Explanation: Lactulose is given to neutralize ammonia by breaking down into weak acids, which helps to manage high ammonia levels that can lead to hepatic encephalopathy.

p.1
Erythropoietin Production and Its Role in Anemia

What is the primary source of erythropoietin (EPO) production in the body?
A) Bone marrow
B) Liver
C) Kidney
D) Spleen
E) Pancreas

B) Liver
Explanation: 10% of erythropoietin (EPO) is produced by the liver, while the remaining 90% is produced by peritubular cells of the kidney, highlighting the liver's role in EPO production.

p.18
Acute Kidney Injury (AKI) and Its Types

What can cause post-renal AKI?
A) Dehydration
B) Kidney stones
C) Heart failure
D) Sepsis
E) Hypotension

B) Kidney stones
Explanation: Post-renal AKI occurs due to acute obstruction of urinary flow, and kidney stones are a common example of conditions that can cause such obstruction.

p.7
Chronic Kidney Disease (CKD) and Its Classification

What is a common symptom of Alport syndrome?
A) Hematuria
B) Hypertension
C) Oliguria
D) Osteoporosis
E) Peripheral edema

A) Hematuria
Explanation: Almost all individuals affected by Alport syndrome experience hematuria, which indicates abnormal kidney function and is a key symptom of the condition.

p.29
Chronic Kidney Disease (CKD) and Its Classification

What happens when HPG is less than 10 mmHg?
A) Increased urine output
B) Kidney failure
C) Normal kidney function
D) Increased filtration rate
E) Decreased blood pressure

B) Kidney failure
Explanation: When HPG (Hydrostatic Pressure Gradient) is less than 10 mmHg, it indicates kidney failure, which is characterized by significantly reduced filtration capability.

p.12
Erythropoietin Production and Its Role in Anemia

What happens when the hemoglobin level exceeds 12 g/dL?
A) It improves kidney function
B) It can cause cardiac issues
C) It leads to increased blood flow
D) It reduces blood viscosity
E) It enhances oxygen delivery

B) It can cause cardiac issues
Explanation: Exceeding a hemoglobin level of 12 g/dL can lead to complications such as cardiac issues due to increased blood viscosity.

p.20
Acute Kidney Injury (AKI) and Its Types

What is the formula for calculating fractional excretion of sodium (F eNa)?
A) (Urine Na / Serum Na) x 100%
B) (Urine Cr / Serum Cr) x 100%
C) (Urine Na / Serum Na x Serum Cr / Urine Cr) x 100%
D) (Serum Na / Urine Na) x 100%
E) (Serum Cr / Urine Cr) x 100%

C) (Urine Na / Serum Na x Serum Cr / Urine Cr) x 100%
Explanation: The formula for F eNa incorporates both sodium and creatinine concentrations in urine and serum to assess kidney function.

p.28
Autocrine Functions of the Kidney

What is the primary factor opposing the hydrostatic pressure gradient (HPG) in the Bowman’s capsule?
A) High temperature
B) Oncotic pressure due to proteins
C) Blood flow rate
D) Low pH levels
E) Increased oxygen levels

B) Oncotic pressure due to proteins
Explanation: Oncotic pressure, which is caused by proteins within the Bowman’s capsule, opposes the hydrostatic pressure gradient (HPG) due to the negative charges of both the proteins and the endothelium, leading to a repulsive effect.

p.10
Erythropoietin Production and Its Role in Anemia

What is the purpose of conducting a Full Blood Count (FBC) in CKD patients?
A) To check for infections
B) To confirm MCV and MCH
C) To assess liver function
D) To evaluate kidney size
E) To measure blood glucose levels

B) To confirm MCV and MCH
Explanation: The FBC is conducted to check the Mean Cell Volume (MCV) and Mean Cell Hemoglobin (MCH) to confirm the type of anemia present in CKD patients.

p.13
Phosphate Management in CKD

What can high phosphate levels in the body lead to?
A) Increased calcium absorption
B) Formation of kidney stones
C) Decreased blood pressure
D) Enhanced kidney function
E) Improved metabolic rate

B) Formation of kidney stones
Explanation: High phosphate levels can crystallize and form kidney stones, which can block smaller capillaries, leading to low perfusion and potential damage.

p.22
Types of Hydroxycholecalciferol and Their Uses

What is the first step in the conversion of vitamin D3 to its active form?
A) Hydroxylation at C-1
B) Hydroxylation at C-25
C) Conversion to ergocalciferol
D) Conversion to calcidiol
E) Hydroxylation at C-24

B) Hydroxylation at C-25
Explanation: The first step in converting vitamin D3 (Cholecalciferol) to its active form involves hydroxylation at C-25 in the liver, producing 25-hydroxycholecalciferol.

p.1
Erythropoietin Production and Its Role in Anemia

What type of anemia is associated with kidney impairment?
A) Iron deficiency anemia
B) Anemia of chronic disease
C) Hemolytic anemia
D) Sickle cell anemia
E) Aplastic anemia

B) Anemia of chronic disease
Explanation: In kidney impairment, patients suffer from anemia of chronic disease, which is characterized by normal quality but reduced quantity of red blood cells.

p.8
Management of Hyperkalemia in CKD

What can be given to prevent colitis caused by prolonged retention of Kayexalate in the GIT?
A) Regular insulin
B) Sodium bicarbonate
C) Lactulose
D) Magnesium sulfate
E) Calcium carbonate

C) Lactulose
Explanation: Lactulose is sometimes given to help push out Kayexalate and prevent colitis, which can occur if Kayexalate is retained in the GIT for too long.

p.17
Acute Kidney Injury (AKI) and Its Types

Which of the following is a classification of AKI?
A) Chronic AKI
B) Prerenal AKI
C) Genetic AKI
D) Infectious AKI
E) Autoimmune AKI

B) Prerenal AKI
Explanation: AKI is classified into three types: prerenal, renal (intrinsic), and post-renal, with prerenal AKI being related to factors affecting blood flow to the kidneys.

p.1
Autocrine Functions of the Kidney

What is the role of renal natriuretic peptide?
A) Increases water reabsorption
B) Causes natriuresis and inhibits ADH
C) Stimulates erythropoiesis
D) Causes vasoconstriction
E) Increases blood pressure

B) Causes natriuresis and inhibits ADH
Explanation: Renal natriuretic peptide promotes natriuresis, allowing renal blood flow, and inhibits ADH, preventing water reabsorption and promoting diuresis.

p.1
Autocrine Functions of the Kidney

What is the first prostaglandin produced by COX enzymes?
A) PGE1
B) PGH2
C) PGF2
D) PGE2
E) PGD2

B) PGH2
Explanation: Prostaglandin H2 (PGH2) is the first prostaglandin produced by the COX enzymes, which then leads to the production of other prostaglandins like PGE2.

p.28
Autocrine Functions of the Kidney

What is the net filtration pressure in the kidney given the following values: Capillary pressure = 45 mmHg, Bowman’s capsule pressure = 10 mmHg, and Oncotic pressure = 25 mmHg?
A) 20 mmHg
B) 5 mmHg
C) 10 mmHg
D) 15 mmHg
E) 30 mmHg

C) 10 mmHg
Explanation: The net filtration pressure is calculated as Capillary pressure - (Bowman’s capsule pressure + Oncotic pressure), which equals 45 mmHg - (10 mmHg + 25 mmHg) = 10 mmHg.

p.10
Management of Hyperkalemia in CKD

What is a common side effect of Kayexalate?
A) Hypokalemia
B) Muscle cramps
C) Nausea and vomiting
D) Tachycardia
E) Headache

C) Nausea and vomiting
Explanation: Kayexalate can cause several side effects, with nausea and vomiting being among the common ones, indicating the need for careful monitoring during treatment.

p.11
Chronic Kidney Disease (CKD) and Its Classification

What condition can uremia cause in CKD patients?
A) Hypertension
B) Encephalopathy
C) Diabetes
D) Hyperthyroidism
E) Asthma

B) Encephalopathy
Explanation: Uremia, which is the buildup of toxins in the body due to kidney failure, can lead to encephalopathy, affecting brain function and contributing to symptoms like dizziness.

p.20
Acute Kidney Injury (AKI) and Its Types

What does a high sodium level in urine indicate in the context of AKI?
A) Prerenal AKI
B) Renal AKI
C) Normal kidney function
D) Chronic kidney disease
E) Urinary tract infection

B) Renal AKI
Explanation: High sodium levels in urine suggest renal AKI, as the damaged tubules cannot retain sodium, leading to its increased excretion.

p.14
Management of Hyperkalemia in CKD

What should be confirmed with the physician before dispensing calcium carbonate?
A) The patient's age
B) The need for elemental calcium or the salt
C) The patient's weight
D) The dosage form
E) The duration of treatment

B) The need for elemental calcium or the salt
Explanation: It is important to confirm whether the physician requires 2g of elemental calcium or the calcium carbonate salt, as this will affect the dispensing instructions.

p.11
Management of Hyperkalemia in CKD

What is a significant difference between iron sucrose and iron dextran?
A) Iron sucrose is given orally, while iron dextran is given IV
B) Iron sucrose has a higher risk of allergic reactions than iron dextran
C) Iron sucrose is composed of iron complexed with sucrose, while iron dextran is complexed with dextran
D) Iron sucrose is only for children, while iron dextran is for adults
E) Iron sucrose is administered as a deep IM injection, while iron dextran is given as a slow IV infusion

C) Iron sucrose is composed of iron complexed with sucrose, while iron dextran is complexed with dextran
Explanation: The primary difference lies in their composition; iron sucrose is complexed with sucrose, while iron dextran is complexed with a carbohydrate polymer derived from dextran, influencing their administration and safety profiles.

p.20
Clinical Presentations and Complications of CKD

What is a common clinical manifestation of fluid overload in AKI?
A) Increased urine output
B) Peripheral edema
C) Hypernatremia
D) Dehydration
E) Hypotension

B) Peripheral edema
Explanation: Fluid overload in AKI results in small urine production, leading to fluid accumulation and clinical manifestations such as peripheral edema.

p.13
Phosphate Management in CKD

What is a potential risk when using calcium carbonate for phosphate management?
A) Formation of calcium phosphate crystals
B) Increased calcium levels
C) Decreased phosphate levels
D) Improved kidney function
E) Enhanced metabolic rate

A) Formation of calcium phosphate crystals
Explanation: The use of calcium carbonate can lead to the formation of calcium phosphate, which can crystallize and cause complications.

p.12
Hyperphosphatemia in CKD and Its Management

What can hyperphosphatemia cause in the body?
A) Increased calcium levels
B) Osteodystrophy
C) Improved bone density
D) Enhanced kidney function
E) Decreased blood pressure

B) Osteodystrophy
Explanation: Hyperphosphatemia can lead to osteodystrophy, which causes bone deformities due to the combination of phosphate with serum calcium.

p.10
Management of Hyperkalemia in CKD

Which drug is contraindicated in patients with hypersensitivity to salbutamol?
A) Kayexalate
B) Lactulose
C) Magnesium preparations
D) Salbutamol nebulization
E) Erythropoietin

D) Salbutamol nebulization
Explanation: Salbutamol nebulization is contraindicated in patients with hypersensitivity to salbutamol, highlighting the importance of assessing patient history before administration.

p.3
Chronic Kidney Disease (CKD) Classification

What imaging techniques can be used to check for kidney necrosis?

Scanning, imaging, or biopsy.

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Study Smarter, Not Harder