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Pharmacology - Problem Drill 10: Diuretics

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Pharmacology - Problem Drill 10: Diuretics Pharmacology - Problem Drill 10: Diuretics Question No. 1 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 1. The _______ is the functional unit of the kidney where blood is filtered and concentrated to form urine. (A) Glomerulus Question #01 (B) GFR (C) Nephron (D) Cortex (E) Medulla Incorrect! The glomerulus is a specialized capillary bed at the beginning of each nephron. B. Incorrect! GFR is the glomerular filtration rate. C. Correct! Feedback on Then nephron is the functional unit of the kidney where blood is filtered Each Answer and concentrated to form urine. Choice D. Incorrect! The cortex is not considered to be the functional unit of the kidney. E. Incorrect! The medulla is not considered to be the functional unit of the kidney. The nephron is the functional unit of the kidney. Each kidney contains approximately 1 million nephrons that are virtually identical. The nephron is divided into the proximal tubule, the loop of Henle, the distal tubule, and the collecting duct. The glomerular portion of all nephrons is located in the cortex, but while the tubules of some nephrons are found Solution only in the cortex, the tubules of other nephrons (those located deep within the cortex) extend into the medulla. The correct answer is (C). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 2 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 2. ____________ receives 90% of the incoming kidney blood flow via the renal artery. (A) Bowman’s capsule Question (B) Cortex #02 (C) Medulla (D) Papilla (E) Proximal distal tubule A. Incorrect! Bowman's capsule is a specialized capillary bed located inside a layer of epithelial cells in the kidney. B. Correct! The cortex is the part of the kidney which receives 90% of the incoming kidney blood flow via the renal artery. Feedback on Each C. Incorrect! Answer Think of another section of the kidney. Choice D. Incorrect! Think of another section of the kidney. E. Incorrect! The proximal distal tubule is a section of the nephron. Each kidney as an identical structure that can be divided into three sections: the outer cortex, the central medulla, and the inner papilla. The cortex receives approximately 90% of the incoming blood flow from the renal artery. Once it enters the kidney, the renal artery branches into smaller arterioles that supply smaller structures called glomeruli. Blood then leaves the kidney by the renal vein. Solution The correct answer is (B). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 3 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 3. The ________ restricts the passage of molecules based on charge, by allowing neutral or cationic molecules to freely pass, while anionic molecules are restricted. Question #03 (A) Bowman’s capsule (B) Glomerulus (C) Proximal tubule (D) loop of Henle (E) Distal tubule A. Incorrect! Bowman's capsule is a specialized capillary bed located inside a layer of epithelial cells in the kidney. B. Correct! The glomerulus restricts the passage of molecules based on charge, by allowing neutral or cationic molecules to freely pass, while anionic molecules are restricted. Feedback on Each Answer C. Incorrect! Choice The proximal tubule is located after this barrier. D. Incorrect! The loop of Henle is located after this barrier. E. Incorrect! The distal tubule is located after this barrier. The glomerulus restricts the passage of molecules into the nephron by preventing large molecules from passing through the capillary wall. The glomerular wall also restricts the passage of molecules based on charge, by allowing neutral or cationic molecules to freely pass, while anionic molecules are restricted. The correct answer is (B). Solution RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 4 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 4. Loop diuretics are useful for treating patients with salt and water overload due to: (A) Acute pulmonary edema Question #04 (B) Chronic heart failure (C) Nephritic syndrome (D) Renal failure (E) All of the above A. Incorrect! Loop diuretics are useful for treating patients with salt and water overload due to acute pulmonary edema, but this is not their only use. B. Incorrect! Loop diuretics are useful for treating patients with salt and water overload due to chronic heart failure, but this is not their only use. C. Incorrect! Loop diuretics are useful for treating patients with salt and water overload Feedback on due to nephritic syndrome, but this is not their only use. Each Answer Choice D. Incorrect! Loop diuretics are useful for treating patients with salt and water overload due to renal failure, but this is not their only use. E. Correct! Loop diuretics are useful for treating patients with salt and water overload due to acute pulmonary edema, chronic heart failure, nephritic syndrome and renal failure. Loop diuretics are useful in patients with salt and water overload due to: •Acute pulmonary edema •Chronic heart failure •Hepatic cirrhosis complicated by ascites •Nephrotic syndrome •Renal failure They are also used in patients with hypertension and the acute treatment Solution of hypercalcemia. The correct answer is (E). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 5 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 5. Furosemide is an example of a(n): (A) Thiazide diuretic (B) Loop diuretic Question #05 (C) Indirect acting diuretic (D) Osmotic diuretic (E) Potassium-sparing diuretic A. Incorrect! Furosemide acts at the Loop of Henle. B. Correct! Furosemide is an example of a loop diuretic. C. Incorrect! Furosemide is a direct-acting diuretic. Feedback on Each Answer Choice D. Incorrect! R Furosemide acts at the Loop of Henle. E. Incorrect! Furosemide acts at the Loop of Henle. Loop diuretics inhibit the Na+/K+/Cl- pump in the thick ascending loop and thereby cause more of the filtered sodium to be excreted. Loop diuretics are perhaps the most powerful diuretics since they can cause 15-25% of filtered sodium to be excreted. Additionally, they cause K and Ca loss resulting in hypokalemia, metabolic alkalosis and hypovolemia. Examples include furosemide, bumetanide, torasemide and pirentanide. Solution The correct answer is (B). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 6 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 6. Mannitol is an example of a(n): (A) Thiazide diuretic (B) Loop diuretic Question #06 (C) Direct acting diuretic (D) Osmotic diuretic (E) Potassium-sparing diuretic A. Incorrect! Mannitol is not a thiazide drug. B. Incorrect! Mannitol acts at the proximal tubule and descending limb, not the Loop of Henle. C. Incorrect! Feedback on Mannitol is an indirect, not direct, acting diuretic. Each Answer Choice D. Correct! Mannitol is an example of an osmotic diuretic. E. Incorrect! Mannitol is not a potassium-sparing drug. Osmotic diuretics are pharmacologically inert substances that are filtered in the glomerulus but are incompletely reabsorbed or not reabsorbed at all by the nephron. Their main effects are seen in the proximal tubule and the descending limb that are freely permeable to water. The presence of the non-reabsorbable solute reduces passive water reabsorption. An example of an osmotic diuretic is mannitol. Solution The correct answer is (D). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 7 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 7. Thiazide diuretics inhibit the _______________ in the distal convoluted tubule. (A) Glomerulus Question #07 (B) Nephron (C) Proximal tubule (D) Carbonic anhydrase (E) Na+/Cl- co-transporter A. Incorrect! The Glomerulus is not a part of the distal convoluted tubule. B. Incorrect! The distal convoluted tubule is part of the nephron. C. Incorrect! Feedback on The proximal tubule is part of the nephron. Each Answer Choice D. Incorrect! Thiazide diuretics inhibit a different protein. E. Correct! Thiazide diuretics inhibit the Na+/Cl- co-transporter in the distal convoluted tubule. Thiazide diurectics mediate their effects by inhibiting the Na/Cl co- transporter in the distal convoluted tubule. They increase the loss of potassium and magnesium, but excretion of uric acid and calcium is decreased. Potassium loss is significant and can be serious. Examples include hydrochlorthiazide and bendrofluazide. Solution The correct answer is (E). RapidLearningCenter.com © Rapid Learning Inc. All Rights Reserved Question No. 8 of 10 Instructions: (1) Read the problem and answer choices carefully (2) Work the problems on paper as needed (3) Pick the answer (4) Go back to review the core concept tutorial as needed. 8. Carbonic anhydrase inhibitors: (A) Increase urine volume. (B) Decrease urine volume Question #08 (C) Increase GFR (D) Decrease GFR (E) Increase cellular bicarbonate A. Correct! Carbonic anhydrase inhibitors increase urine volume. B.
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