How to Use the Workbook with the Videos
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First Aid Express 2016 workbook: RENAL page 1 Renal How to Use the Workbook with the Videos Using this table as a guide, read the Facts in First Aid for the USMLE Step 1 2016, watch the corresponding First Aid Express 2016 videos, and then answer the workbook questions. Facts in First Aid for Corresponding First Aid Workbook the USMLE Step 1 2016 Express 2016 video questions 530.1–531.5 Embryology (1 video) 1–3 532.1 Anatomy (1 video) 4–5 533.1–544.1 Physiology (5 videos) 6–43 544.2–555.1 Pathology (4 videos) 44–66 556.1–559.3 Pharmacology (1 video) 67–73 Copyright © 2016 by MedIQ Learning, LLC All rights reserved v1.0 page 2 First Aid Express 2016 workbook: RENAL Questions EMBRYOLOGY 1. What are the three causes of Potter sequence? (p 530) _________________________________ 2. Which genetic disease is associated with horseshoe kidney? (p 531) _______________________ 3. What error in development occurs that results in unilateral renal agenesis? (p 531) ____________ ______________________________________________________________________________ ANATOMY 4. Why is the left kidney harvested for transplantation rather than the right? (p 532) _____________ ______________________________________________________________________________ 5. Ureters pass ______________ (over/under) the uterine artery and the ductus deferens. (p 532) PHYSIOLOGY 6. Extracellular fluid consists of __________ (high/low) sodium chloride and ___________ (high/low) potassium, whereas intracellular fluid consists of ___________ (high/low) sodium chloride and ___________ (high/low) potassium. (p 533) 7. What is the 60-40-20 rule of total body weight? (p 533) __________________________________ ______________________________________________________________________________ 8. The fenestrated capillary endothelium of the glomerular filtration barrier is responsible for the filtration of plasma by which characteristic: size or charge? (p 533) ________________________________ ______________________________________________________________________________ 9. The epithelial layer of the glomerular filtration barrier is formed by which cells? (p 533) ______________________________________________________________________________ 10. What is the formula for calculating the clearance of substance X, the volume of plasma from which the substance is cleared completely per unit of time? (p 533) _____________________________ ______________________________________________________________________________ 11. If renal clearance is greater than the glomerular filtration rate (GFR) of substance X, then there is a net tubular ________________________ (reabsorption/secretion) of substance X. (p 533) 12. Creatinine clearance slightly ________________ (overestimates/underestimates) the GFR rate because creatinine is ___________________ (secreted/reabsorbed) by the renal tubules. (p 533) Copyright © 2016 by MedIQ Learning, LLC All rights reserved v1.0 First Aid Express 2016 workbook: RENAL page 3 13. What is the formula for estimating renal blood flow if renal plasma flow is known? (p 534) _____________________________________________________________________________ 14. What are the effects of prostaglandins on the glomerulus? (p 535) ________________________ _____________________________________________________________________________ 15. What are the effects of angiotensin II on the glomerulus? (p 535) __________________________ ______________________________________________________________________________ 16. Decreased plasma protein concentration causes ____________ (decrease/increase/no change) in renal plasma flow and ____________ (decrease/increase/no change) in GFR, which in turn results in ____________ (decrease/increase/no change) in the filtration fraction. (p 535) 17. Constriction of the afferent arteriole causes ____________ (decrease/increase/no change) in renal plasma flow and ____________ (decrease/increase/no change) in GFR, which in turn results in ____________ (decrease/increase/no change) in the filtration fraction. (p 535) 18. What is the formula for excretion rate? (p 535) _________________________________________ ______________________________________________________________________________ 19. In the nephron, glucose at normal plasma concentrations is reabsorbed in which structure? And by which transporter? (p 537) _________________________________________________________ 20. At what plasma glucose concentration is the transport mechanism of the proximal tubule completely saturated, leading to glucose spilling into the urine? (p 537) _______________________________ 21. ________________________develops due to a deficiency of tryptophan, an amino acid that is normally reabsorbed in the ___________________ of the kidney. (p 537) ___________________ ______________________________________________________________________________ 22. What ion is secreted into the lumen of the early proximal convoluted tubule and acts to reabsorb bicarbonate? (p 537) _____________________________________________________________ 23. Which three ions are actively reabsorbed in the thick ascending loop of Henle? (p 537) _________ ______________________________________________________________________________ 24. Which two ions are indirectly reabsorbed in the thick ascending loop of Henle? (p 537) ______________________________________________________________________________ 25. Which hormone controls the reabsorption of calcium in the early distal convoluted tubule? (p 537) ______________________________________________________________________________ 26. On which segment of the nephron does the hormone aldosterone act? (p 537) _______________ ______________________________________________________________________________ 27. ADH’s effect at V2 receptors results in what action? (p 537) ______________________________ ______________________________________________________________________________ Copyright © 2016 by MedIQ Learning, LLC All rights reserved v1.0 page 4 First Aid Express 2016 workbook: RENAL 28. The ratio of solute concentration in the tubular fluid versus plasma (TF/P) can indicate the level of secretion or reabsorption of that solute along the proximal renal tubule. If the TF/P ratio of that solute is less than that of inulin, there is net ___________________ (reabsorption/secretion) along the proximal tubule. (p 539) 29. Along the length of the proximal tubule, does the relative concentration of chloride increase, decrease, or stay the same? (p 539) _________________________________________________ 30. Which five actions of angiotensin II serve to increase intravascular volume and blood pressure? (p 540) __________________________________________________________________________ ______________________________________________________________________________ 31. What is the site of action of angiotensin-converting enzyme? (p 540) _______________________ 32. When blood pressure falls, the kidneys release which proteolytic enzyme? (p 540) ____________ 33. ADH primarily regulates __________ (osmolarity/blood volume), whereas aldosterone primarily regulates __________ (osmolarity/blood volume). However, in __________ (low/high) volume states, both ADH and aldosterone act to protect __________ (osmolarity/blood volume). (p 540) 34. What are the effects of aldosterone secretion? (p 540) ___________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 35. Atrial natriuretic peptide ____________ (decreases/increases) renin secretion and ____________ (decreases/increases) the GFR. (p 540) 36. Which cells in the kidney secrete renin? (p 540) ________________________________________ 37. Which hormone is released by the endothelial cells of renal peritubular capillaries in response to hypoxia? (p 541) _________________________________________________________________ 38. Which enzyme from the kidney is activated by PTH, and what is the function of that enzyme? (p 541) ______________________________________________________________________________ 39. In the chart below, check the effect that each condition has on the potassium shift. (p 542) Shifts K+ into Cell Shifts K+ out of Cell Effect Hypokalemia Hyperkalemia Acidosis Alkalosis β-adrenergic agonists β-blocker Cell lysis Digitalis Hyperosmolarity Hypo-osmolarity Insulin Copyright © 2016 by MedIQ Learning, LLC All rights reserved v1.0 First Aid Express 2016 workbook: RENAL page 5 Insulin deficiency 40. By what mechanism does insulin cause hypokalemia? (p 542) ____________________________ ______________________________________________________________________________ 41. What is the primary electrolyte disturbance in metabolic acidosis? (p 543) ___________________ 42. What is the compensatory respiratory response to metabolic acidosis, and does PCO2 increase or decrease? (p 543) _______________________________________________________________ 43. What are the ten causes of increased anion gap metabolic acidosis? (p 543) _________________ ______________________________________________________________________________ PATHOLOGY 44 What glomerular diseases can be considered both nephritic and nephrotic syndromes? (p 544) ______________________________________________________________________________ 45. What four clinical findings are associated with nephritic syndrome? (p 545) __________________ ______________________________________________________________________________