265 Questions
What is the major physiological regulator of GFR that is a powerful vasoconstrictor of efferent arterioles?
Angiotensin II
Which cells sense changes in NaCl in the distal tubule as part of autoregulation mechanisms?
Macula densa cells
What is the effect of strong activation of the sympathetic nervous system on renal blood flow and GFR?
Cause renal vasoconstriction, decrease renal blood flow, decrease GFR
Which component of the juxtaglomerular complex releases Renin and causes vasoconstriction?
Juxtaglomerular cells
What would happen to urine flow if there was a significant decrease in arterial pressure according to the autoregulation principle?
Urine flow would increase
Which plasma protein plays a role in maintaining the oncotic pressure within the glomerular capillaries?
Albumin
Which system helps maintain GFR during changing arterial pressure by causing vasoconstriction?
$\alpha$-Renin system
Which of the following best describes the composition of glomerular filtrate?
Devoid of proteins and similar in solute concentrations to plasma
How does the glomerular capillary filtration coefficient (Kf) contribute to the high rate of filtration in the kidneys?
By increasing the rate of filtration due to high permeability and surface area
Which factor plays a significant role in determining the Glomerular Filtration Rate (GFR)?
The balance of hydrostatic and colloid osmotic forces
Why do glomerular capillaries have a much higher rate of filtration compared to most other capillaries?
High glomerular hydrostatic pressure and large Kf
In urine formation, approximately how many liters are filtered into Bowman's capsule each day?
~180 liters
What happens to the number of nephrons in the kidney after the age of 40?
Decrease by approximately 10% each year
Which statement best represents the relationship between Glomerular Filtration Rate (GFR) and Renal Plasma Flow?
GFR is higher than renal plasma flow
What characterizes nephrons as the functional units of the kidney?
~800,000 to 1,000,000 nephrons per kidney with no regeneration ability
Which of the following is true about the relationship between increased glomerular capillary colloid osmotic pressure and GFR?
Increased glomerular colloid osmotic pressure decreases GFR.
How does an increase in arterial colloid osmotic pressure affect GFR?
Decreases GFR
What determines the normal glomerular capillary hydrostatic pressure?
Arterial pressure, afferent arteriolar resistance, and efferent arteriolar resistance
What happens when there is a severe efferent arteriolar constriction on GFR?
Decreases GFR
How does increased efferent arteriolar pressure affect glomerular capillary hydrostatic pressure and GFR?
Increases both hydrostatic pressure and GFR
Which of the following statements is correct about increased glomerular capillary hydrostatic pressure?
It increases GFR.
What effect does increased afferent arteriolar pressure have on renal blood flow?
Decreases renal blood flow
What occurs when there is moderate efferent arteriolar constriction on the hydrostatic pressure and GFR?
Hydrostatic pressure increases causing mild increase in GFR
What role does increased glomerular capillary hydrostatic pressure play in renal plasma flow?
Increases renal plasma flow
What is the main reason that negatively charged large molecules, such as plasma proteins, are not easily filtered through the glomerular capillary membrane?
The strong negative charge of the capillary endothelium
Which layer of the glomerular capillary membrane is responsible for having slit pores that contribute to its high permeability?
Epithelial cells (podocytes)
What effect does an increased Bowman’s capsule hydrostatic pressure have on the glomerular filtration rate?
Decreases GFR
In the glomerular capillary membrane, which of the following forces determines the net filtration pressure?
Interaction between hydrostatic and colloid osmotic pressures
What happens to glomerular filtration rate when there is an obstruction in the urinary tract?
GFR decreases
Which disease condition is associated with an increase in basement membrane thickness, potentially lowering the glomerular filtration co-efficient Kf?
Uncontrolled hypertension
How does an increase in Kf affect the glomerular filtration rate?
Increases GFR
What is the normal pressure within Bowman’s capsule that keeps the glomerular filtration rate stable?
18 mm Hg
Which transporter is inhibited by thiazide diuretics in the early distal tubule?
Sodium chloride cotransporter
Which cell type in the late distal tubule and cortical collecting duct maintains acid/base balance?
Intercalated cells
Where is Na+-K+ ATPase located in the nephron?
Basolateral membrane
Which cells are the primary site of action for potassium sparing diuretics?
Principal cells
What do mineralocorticoid receptor antagonists like spironolactone and eplerenone compete with in principal cells?
Aldosterone
Which diuretic directly inhibits the entry of sodium into sodium channels on luminal membranes?
Sodium channel blockers
Where does ATPase activity primarily result in the secretion of potassium?
Into lumen by specialized channels
What is the primary role of principal cells in the nephron?
Reabsorb sodium and water; secrete potassium
Which type of cell in the late distal tubule and cortical collecting duct secretes potassium?
Principal cells
In tubular reabsorption, the entry of glucose into the tubular cell from the lumen is coupled with the entry of which ion down the concentration gradient?
Sodium
During secondary active transport of protons in tubular reabsorption, the movement of Na ions is coupled with the movement of protons in which direction?
Opposite direction
Which segment of the nephron reabsorbs approximately 65% of the filtered load of sodium and water?
Proximal tubule
Tubular reabsorption involving primary active transport couples the movement of glucose with the movement of which ion?
Sodium
In tubular reabsorption, what is coupled to the downhill movement of Na ions during secondary active transport of protons?
Proton movement
Glucose exits the tubular cell from the basolateral aspect down its own concentration gradient. What exit pathway does glucose use in this process?
Facilitated diffusion
Which ion is coupled with the entry of glucose into the tubular cell from the lumen during tubular reabsorption involving primary active transport?
$Na^+$ (Sodium)
Which substance is reabsorbed by the proximal tubule as an important site for secretion, along with sodium and water?
$H^+$ (Protons)
$Na^+$ ions move down their concentration gradient during entry into the tubular cell. What type of transport allows this to occur?
$Na^+$/glucose symporter
Which segment of the Loop of Henle is highly permeable to water but not so permeable to sodium chloride?
Thin descending
What makes the tubular fluid dilute in the Loop of Henle?
Impermeability to water in the thin ascending segment
Which transporter mediates the movement of sodium across the luminal membrane in the thick ascending Loop of Henle?
1-sodium, 2-chloride, 1-potassium cotransporter
What is the primary effect of loop diuretics like furosemide on the thick ascending Loop of Henle?
Inhibit the sodium-chloride transporter
Which nephron segment has reabsorptive properties similar to the thick ascending Loop of Henle?
Distal tubule
What ions are reabsorbed by the thick ascending segment besides sodium and chloride?
Calcium and magnesium
What is the main reason for making urine very dilute by the time it reaches the distal tubule?
Reabsorption of sodium chloride in thick ascending segment
Which nephron segment is impermeable to water but reabsorbs some sodium chloride?
Thin ascending segment
What is the main renal action of ADH in terms of water permeability?
Increasing water permeability
Which cells release ADH in response to changes in extracellular fluid osmolarity?
Osmoreceptor cells in the hypothalamus
Which of the following disorders can result in the inability to concentrate urine appropriately?
Impairment of the countercurrent mechanism
Central diabetes insipidus can be caused by all of the following EXCEPT:
Overactive nephrons
In which segment of the nephron does Nephrogenic diabetes insipidus primarily affect water reabsorption?
Collecting duct
Which condition is associated with the absence of aldosterone, marked loss of sodium from the body, and accumulation of potassium?
Addison's disease
What stimulates the release of aldosterone in response to increased extracellular potassium concentration?
High angiotensin II levels
In which disorder does excess aldosterone secretion lead to sodium retention and decreased plasma potassium concentration?
Conn's disease
What is the primary cause of central diabetes insipidus?
Hypothalamic damage impairing ADH release
Nephrogenic diabetes insipidus is primarily characterized by:
Impaired renal response to ADH
What is the primary action of ADH in the nephron?
Decrease permeability of collecting ducts to water
Which disorder is characterized by the inability to concentrate urine due to a deficiency of ADH secretion?
Central diabetes insipidus
In nephrogenic diabetes insipidus, where is the defect located that causes the kidneys to be unresponsive to ADH?
Collecting ducts
What is the main difference between central diabetes insipidus and nephrogenic diabetes insipidus?
Central diabetes insipidus is due to a lack of ADH secretion, while nephrogenic diabetes insipidus is due to kidneys not responding to ADH
Which of the following is not a main effect of angiotensin II on restoring blood pressure and extracellular fluid volume?
Inhibits potassium reabsorption in the loop of Henle
Which hormone plays a crucial role in regulating water reabsorption and urine concentration by acting on the kidneys?
Antidiuretic hormone (ADH)
Which transporter is directly stimulated by angiotensin II in the proximal tubules and the loops of Henle for sodium reabsorption?
Na+-HCO3- cotransporter
Which of the following is a potential consequence of increased formation of angiotensin II in the kidneys?
Reduced potassium excretion
What is the primary mechanism of action for vasoconstriction by angiotensin II to maintain normal excretion of metabolic waste products?
Constricting efferent arterioles
Which statement accurately describes the effect of angiotensin II on sodium reabsorption in the kidneys?
Indirectly stimulates sodium reabsorption in the proximal tubules
In Nephrogenic diabetes insipidus, why does the individual not respond to desmopressin?
Failure of the distal and collecting tubules to respond to ADH
What is the main treatment approach for Nephrogenic diabetes insipidus?
Correction of underlying renal disorder
Which renal condition is characterized by the presence of normal or elevated levels of ADH but inability of renal tubular segments to respond appropriately?
Nephrogenic diabetes insipidus
Which drug, used to treat manic-depressive disorders, can impair the ability of distal nephron segments to respond to ADH?
Lithium
What is the primary difference between Central diabetes insipidus and Nephrogenic diabetes insipidus in terms of ADH responsiveness?
Central diabetes insipidus involves a deficiency in ADH production while Nephrogenic diabetes insipidus involves an inability to respond to ADH
What is the primary mechanism through which Antidiuretic Hormone (ADH) acts to increase water reabsorption in the collecting ducts?
Inducing the expression of aquaporins on the luminal membrane of the collecting duct cells
Which condition is characterized by a deficiency of Antidiuretic Hormone (ADH) secretion from the posterior pituitary gland, leading to polyuria and polydipsia?
Central diabetes insipidus
What is the primary defect seen in individuals with Nephrogenic Diabetes Insipidus, leading to an inability to concentrate urine despite normal ADH levels?
Impaired response of collecting duct cells to ADH
Which disorder is associated with a lack of responsiveness of the kidneys to circulating Antidiuretic Hormone (ADH), leading to an inability to concentrate urine?
Nephrogenic diabetes insipidus
Which hormone is primarily responsible for regulating the reabsorption of water in the renal collecting ducts under normal physiological conditions?
Antidiuretic Hormone (ADH)
What is the primary cause of central diabetes insipidus?
Deficiency of ADH production
Which condition is characterized by the kidneys failing to respond to ADH, leading to the inability to concentrate urine?
Nephrogenic diabetes insipidus
In the context of water reabsorption in the nephron, what role does ADH play?
Stimulates reabsorption of water in the distal convoluted tubule
What is a characteristic feature of nephrogenic diabetes insipidus?
Resistance of kidneys to ADH
Which disorder results from a defect in the genes responsible for the synthesis or functioning of aquaporin-2 channels?
Nephrogenic diabetes insipidus
What is the underlying cause of excessive dilute urine production in central diabetes insipidus?
Impaired water reabsorption in the collecting ducts
Which mechanism is impaired in nephrogenic diabetes insipidus, leading to an inability to concentrate urine?
Response of the kidneys to ADH
In central diabetes insipidus, what effect does a deficiency in ADH production have on urine concentration?
Decreases urine concentration
"If a substance is completely cleared from the plasma, it must be excreted by both glomerular filtration and tubular secretion" - This statement is most relevant when discussing:
"Clearance"
Given equal amounts of PAH clearance and GFR, what approximation can be made about renal plasma flow?
Renal plasma flow equals glomerular filtration rate
What is a common presenting symptom of malignant hypertension in the kidneys?
Oliguria
Which of the following is a characteristic feature of acute post-infectious glomerulonephritis?
Proteinuria
In chronic pyelonephritis, what is the common histological finding associated with the renal tubules?
Tubular atrophy and interstitial fibrosis
Which causative organism is commonly associated with acute pyelonephritis?
Escherichia coli
What is a key feature differentiating tubulointerstitial nephritis from acute pyelonephritis?
Rash
What is the likely mechanism of drug-induced interstitial nephritis?
Immune-mediated reaction
Which type of renal lesion is a hallmark of chronic pyelonephritis?
Scarring involving the pelvis or calyces
What congenital anomaly can lead to bilateral chronic pyelonephritis and fatal renal insufficiency if not corrected?
Posterior urethral valves
Which condition can result in unilateral chronic pyelonephritis?
Unilateral obstructive lesions
What type of infections can lead to repeated bouts of renal inflammation in chronic pyelonephritis?
Recurrent infections superimposed on obstructive lesions
Which of the following is a principal causative organism of acute pyelonephritis?
Escherichia coli
What is the main manifestation that differentiates acute pyelonephritis from lower urinary tract infections?
Costovertebral angle pain
Chronic pyelonephritis is most likely to result from recurrent infections with which of the following organisms?
Proteus mirabilis
In the context of kidney vascular diseases, which condition is characterized by a malignant form of hypertension?
Malignant hypertension
Which type of nephritis is associated with drug-induced kidney damage?
Interstitial nephritis
What is a characteristic feature of interstitial nephritis?
Affects interstitium and tubules with sparing of glomeruli
Which vessel changes are commonly seen in malignant hypertension?
Renal atherosclerosis and arteriolosclerosis
What is a common causative organism of acute pyelonephritis?
Escherichia coli
Which condition is characterized by the presence of renal atherosclerosis?
Diabetic nephropathy
What distinguishes chronic pyelonephritis from acute pyelonephritis?
Long-term interstitial inflammation
What is the most common causative organism of acute pyelonephritis?
Escherichia coli
Which of the following conditions is associated with the development of chronic pyelonephritis?
Recurrent urinary tract infections
Which of the following best describes the characteristic feature of tubulointerstitial nephritis?
Inflammation affecting the renal tubules and interstitium
Which vascular disease is known to cause malignant hypertension affecting the kidneys?
Polyarteritis nodosa
What is a key distinguishing feature between acute pyelonephritis and chronic pyelonephritis?
Hyaline arteriolosclerosis
What is the typical presentation of acute postinfectious glomerulonephritis in a child?
Within 1 to 4 weeks post-infection
Which of the following cellular changes is characteristic of acute poststreptococcal glomerulonephritis?
Proliferation of endothelial and mesangial cells
Which of the following organisms is not commonly associated with causing acute postinfectious glomerulonephritis?
Haemophilus influenzae
What is the prototypic agent that leads to acute postinfectious glomerulonephritis?
Streptococcus
What is a common clinical manifestation of reduced glomerular filtration rate in nephritic syndrome?
Azotemia
Which clinical complex includes massive proteinuria, hypoalbuminemia, generalized edema, hyperlipidemia, and lipiduria?
Nephrotic syndrome
What is the main difference between nephritic and nephrotic syndromes based on the provided text?
Amount of proteinuria
Which type of glomerular injury is characterized by acute post-infectious glomerulonephritis according to the text?
Nephritic syndrome
What are the dominant clinical features of acute post-infectious glomerulonephritis as mentioned in the text?
Grossly visible hematuria and red cell casts in urine
What group of disorders includes malignant hypertension and diabetic nephropathy as examples as per the text?
Vascular diseases
What is a causative organism often associated with acute pyelonephritis?
Escherichia coli
Which type of nephritis involves immune mechanisms underlying most primary glomerular diseases?
Nephritic syndrome
'Materials from Robins Basic Pathology, 9th' were used to describe which condition involving massive proteinuria, hypoalbuminemia, and generalized edema?
'Nephrotic syndrome'
'Antigens may be planted in the basement membrane; or be endogenous glomerular proteins.' This statement aligns with the pathogenesis of which condition?
'Nephritic syndrome'
'What are the Principles of glomerular injury according to the text?' Which condition's pathophysiology would you refer to for this information?
'Nephritic syndrome'
What effect do diuretics have on the bicarbonate buffer system?
Decrease bicarbonate reabsorption in the distal tubule/collecting ducts
How do lungs regulate acid-base balance in response to metabolic alkalosis?
Retain CO2 to decrease pH
What is the primary mechanism by which kidneys regulate acid-base balance?
Secretion of hydrogen ions
Which condition is likely to result from an increased anion gap?
Metabolic acidosis
In the context of acidosis and alkalosis, what does a normal 'anion gap' imply?
Balance between anions and cations
Which system regulates the removal of CO2 from the extracellular fluid within minutes?
Respiratory center
What is formed by the reaction of CO2 with H2O in the body?
H2CO3
What ionizes weakly to form small amounts of H+ and HCO3− in the bicarbonate buffer system?
H2CO3
Which condition refers to a state where the pH of arterial blood is below 7.35?
Acidosis
What is the primary function of the anion gap in acid-base balance?
Indirectly assess unmeasured ions in plasma
What is the primary cation measured in the clinical laboratory?
Sodium (Na+)
Which anions are usually measured in the clinical laboratory along with Na+?
Chloride (Cl-) and Bicarbonate (HCO3-)
What is the diagnostic concept that represents the difference between primary measured cations and anions?
Anion Gap
In hyper-chloremic metabolic acidosis, what is the relationship between plasma HCO3- and Cl-?
Both increase proportionally
What characterizes metabolic acidosis caused by excess nonvolatile acids like lactic acid or ketoacids in terms of the anion gap?
Anion gap increases due to increased unmeasured anions
What is the primary response of the kidneys to correct respiratory acidosis?
Secrete more H+
Which of the following conditions can cause a decrease in plasma HCO3- concentration, leading to metabolic acidosis?
Diarrhea
What is the primary role of the lungs in regulating acid-base balance?
Maintaining a constant pCO2
In the context of acidosis and alkalosis, what is the significance of the anion gap?
It helps differentiate the cause of metabolic acidosis
How does hyperventilation lead to respiratory alkalosis?
Increases extracellular fluid pH and decreases H+ concentration
In acidosis, where does much of the buffering of excess H+ occur?
Ammonia buffer system
Where does the concentration of H+ increase approximately 900-fold, decreasing the pH of tubular fluid to about 4.5?
Collecting tubules
Which type of intercalated cells secrete protons by hydrogen-ATPase transporter and hydrogen-potassium ATPase transporter?
Type A intercalated cells
Which system is particularly important for the formation of maximally acidic urine in the kidneys?
Ammonia buffer system
What accounts for only about 5 percent of the total H+ secreted but is crucial in forming maximally acidic urine?
Secretion of H in late distal urine + tubule
What is the daily requirement for H+ secretion in order to reabsorb the filtered HCO3−, as mentioned in the text?
4320 mEq
How is excess H+ excreted when it is secreted in amounts greater than the HCO3− filtered into the tubular fluid, according to the text?
Combines with ammonia and phosphate buffers
How does the presence or absence of HCO3- affect the fate of H+ in the lumen of the renal tubules, as described in the text?
H+ combines with ammonia and phosphate buffers
What is the maximum amount of free H+ that can be excreted in a liter of urine, as mentioned in the text?
~0.03 mEq
How would the lack of bicarbonate buffer affect the excretion of H+ in the urine, based on the text?
Increased excretion as free H+
What is the main response of the bicarbonate buffer system to acidosis?
Excess H+ excretion by the kidneys
How does the bicarbonate buffer system respond to alkalosis?
H2CO3 dissociation decreases
What happens to blood CO2 levels during acidosis according to the bicarbonate buffer system?
Stimulate respiration
How does the bicarbonate buffer system regulate acid-base balance in response to alkalosis?
Excretes more HCO3-
What is one of the responses of the bicarbonate buffer system to base?
Increased CO2 production
How does acidosis affect the bicarbonate buffer system?
Stimulates respiration for CO2 elimination
Which component of the bicarbonate buffer system increases in response to base?
NaHCO3 formation
What is the significance of the low intracellular PO2 of 23 mm Hg?
It provides a large safety factor for oxygen utilization in cells.
What determines tissue PO2 in the context of oxygen delivery and metabolism?
Increase in blood flow increases tissue PO2.
How does a higher intracellular PCO2 affect the movement of gases between cells and the blood?
Increases the diffusion of CO2 from cells to interstitial fluid.
What happens when tissue PCO2 is influenced by decreasing blood flow?
Tissue PCO2 increases.
Why is ~3% of O2 transported in a dissolved state in the water of plasma and blood cells?
To provide a reserve source of oxygen during emergencies.
What is the impact on the quantity of oxygen binding with hemoglobin, when the hemoglobin passes through tissues?
Increases to about 14.4 ml
What effect does the Bohr effect have on the oxygen-hemoglobin dissociation curve?
Shifts it to the right in the tissues
Which gas has a 250-times stronger interaction with hemoglobin compared to oxygen?
Carbon monoxide
What is the significance of high pCO2 and low pH in tissues for oxygen binding to hemoglobin?
Reduces oxygen binding to hemoglobin
What is the characteristic of the CO-Hb dissociation curve compared to the O2-Hb dissociation curve?
CO partial pressures are 1/250 of O2 partial pressures
How does an increase in 2,3-biphosphoglycerate (BPG) concentration affect oxygen transport in blood?
Decreases oxygen binding to hemoglobin
At what CO partial pressure in the alveoli does CO compete equally with O2 for combination with hemoglobin?
0.4 mm Hg
How does a reduction in partial pressure of oxygen in the alveoli impact the oxygenation of blood?
Reduces oxygenation of blood
What happens when the blood is exposed to a CO pressure of 0.6 mm Hg?
Half of the hemoglobin binds with CO instead of O2
What level of CO pressure in the alveoli can be lethal due to its effect on oxygen transport?
0.4 mm Hg
What is the total surface area of the respiratory membrane?
70 m2
What is the average diameter of pulmonary capillaries?
5 µm
What is the partial pressure of oxygen in the alveoli after the addition of water vapor and carbon dioxide?
~104 mmHg
How much blood is in the capillaries of the lungs at any given instant?
60 to 140 milliliters
What is the partial pressure of oxygen in inspired air at atmospheric pressure of 760 mmHg?
~160 mmHg
What happens to adjacent blood vessels in the pulmonary capillaries when the concentration of O2 in the alveoli decreases below normal levels?
They constrict to decrease blood flow
What is the effect of extremely low O2 levels on the vascular resistance of pulmonary capillaries?
Vascular resistance increases more than fivefold
How do systemic vessels respond to low O2 levels?
They dilate
What is the general effect on local alveolar blood flow when there is decreased alveolar oxygen?
Local alveolar blood flow decreases
What happens to the pulmonary interstitial spaces and alveoli when factors increase fluid filtration from pulmonary capillaries?
They fill with large amounts of free fluid
What is the main factor that influences the oxygenation of blood in the pulmonary capillaries?
Diameter of the pulmonary capillaries
How does the partial pressure of oxygen in the alveoli impact the oxygen transport in blood?
Leads to more oxygen binding with hemoglobin
Which phenomenon is primarily responsible for displacing CO2 from hemoglobin and promoting oxygen transport in blood?
Haldane effect
What is the reversible reaction that occurs with a loose bond allowing easy release of CO2 into the alveoli?
Formation of carbamino compounds
How does the chloride shift affect the oxygen transport in blood between venous and arterial red blood cells?
Enhances oxygen binding with hemoglobin
What happens if the pulmonary capillary pressure rises slightly above the safety factor level?
Lethal pulmonary edema can occur within hours
What is the consequence of a rise in pulmonary capillary pressure to 50 mm Hg in acute left-sided heart failure?
Death in less than 30 minutes
How does diffusion between the gas phase of alveoli and liquid phase of blood occur?
In a manner similar to diffusion through water
What determines the direction of diffusion between the gas phase of alveoli and the liquid phase of blood?
The difference in partial pressure of gases in air and blood
What is the total pressure of the air mixture at sea level?
$760$ mm Hg
In the air mixture, what percentage of nitrogen contributes to the total pressure at sea level?
$79%$
Which gas has a partial pressure of $160$ mm Hg in the air mixture at sea level?
$O_2$ (oxygen)
What happens if the partial pressure of oxygen in the alveoli decreases significantly?
$CO_2$ levels increase due to reduced oxygenation
How does diffusion of CO2 and O2 through tissues compare to diffusion through water?
Faster due to higher solubility in tissues
What happens when pulmonary capillary pressures reach 40 to 45 mm Hg?
Lethal pulmonary edema does not develop
What is a common characteristic of obstructive lung diseases?
Normal total lung capacity
Which lung disease is characterized by a triad of chronic cough, sputum production, and airflow limitation?
Chronic bronchitis
What is the primary issue in obstructive lung diseases?
Partial or complete air flow obstruction
What parameter is usually abnormal in obstructive lung diseases?
Forced Expiratory Volume in 1 second (FEV1)
Which statement is true regarding the total lung capacity in obstructive lung diseases?
It may be normal or decreased
What is the defining characteristic of obstructive lung diseases such as asthma and COPD?
Partial or complete airway obstruction leading to increased resistance
Which lung disease is NOT classified as an obstructive lung disease?
Pulmonary fibrosis
In obstructive lung diseases, what is the typical ratio of FEV1/FVC?
< 0.7
Which of the following is a common symptom observed in patients with obstructive lung diseases?
Hypoxemia (low blood oxygen)
What is the primary pathological feature of cystic fibrosis among the listed obstructive lung diseases?
Increased mucus production and impaired clearance
Which mechanism of microbial evasion of host immunity involves the production of molecules that actively inhibit cytokines and other mediators of innate immunity?
Resistance to innate immune defenses
What type of mutation in the Spike protein of SARS CoV-2 from the U.K. variant is likely to increase its transmissibility?
N501Y
Which viral mutation is associated with the Mink farms outbreak in Denmark/Netherlands and may increase binding affinity to ACE2 receptors?
Y453F
Which type of genetic mutation in SARS CoV-2 is least likely to be adaptive according to the text?
D614G
What is a common mechanism utilized by viruses to evade host immune responses by decreasing recognition of infected cells by specific T cell populations?
Antigenic variation
Which type of T-cells are expected to be activated by mRNA vaccines according to the text?
CD8+ cytotoxic T-cells
What is the main component of the ChAdOx1 nCoV-19 vaccine (AZD1222) mentioned in the text?
Replication-deficient adenoviral vector
Which type of vaccine uses a lipid nanoparticle to encapsulate the antigen?
Gene-based viral vector vaccine
Why was a chimpanzee adenovirus used in the ChAdOx1 nCoV-19 vaccine according to the text?
To enhance immune response by pre-existing antibodies to human adenovirus
What aspect sets viral vector vaccines apart from mRNA vaccines based on the information provided?
They have been in use longer than mRNA vaccines
What was a key factor that led to the low dose/standard dose arm in the AZD1222 vaccine trial?
Dose miscalculation
Which adverse event was NOT reported in the BNT162b2 vaccine trial mentioned in the text?
Transverse myelitis
Why was AZD1222 not approved in the US according to the text?
Changes in dosing and safety concerns
In the BNT162b2 mRNA vaccine trial, how many serious adverse events were reported among placebo patients?
Two
What distinguishes the dosing schedule of AZD1222 from BNT162b2 mRNA vaccines as per the text?
Variable timing between doses
Which cells are primarily targeted by HIV to compromise their function?
CD4+ T cells
What is the determining factor of efficacy for vaccine antibodies?
Avidity
Which type of vaccines generally activate cytotoxic T-cells?
Live-attenuated vaccines
What is the primary role of T-cells in the immune response to vaccination?
Activation of B-cells
Which type of vaccines confer early protective efficacy primarily through antigen-specific antibodies?
Live-attenuated vaccines
How do viruses damage or kill cells, according to the text?
Direct cytopathic effects
What is the primary mechanism of injury caused by SARS-CoV2, as discussed in the text?
Cytokine storm
In the context of viral infections, what is the role of CD4+ T cells?
Regulating the immune response
How does HIV primarily cause immunodeficiency in the body?
By targeting and destroying CD4+ T cells
What is a common outcome of microbial evasion of host immunity, as mentioned in the text?
Tissue damage without viral replication
What is a hallmark of T-dependent responses in the immune system?
Activating memory B-cells
Which type of vaccines lead to a T-cell dependent antibody response?
Toxoids
What is the mechanism by which capsular polysaccharides (PS) elicit B cell responses?
T-cell independent activation
What leads to a slower decline in antibody levels post-vaccination?
Long-lived plasma cells in survival niches
Which type of vaccines are known to generate both high-affinity antibodies and immune memory?
Live attenuated viral vaccines
What is the primary function of CD4+ helper T cells in response to protein antigen vaccines?
Aid in migration of B-cells to the germinal center
Where do some plasma cells migrate and survive after the germinal center reaction?
Bone marrow
What is a key characteristic of memory B-cells?
Rapidly differentiate into plasma cells upon subsequent antigen exposure
Which type of vaccines induce an additional activation of CD8+ T cells?
Live attenuated vaccines
What is a crucial requirement for antigens to activate CD8+ cytotoxic T-cells?
Production in the cytosol of dendritic cells
Where do some B-cells differentiate into memory B-cells in response to protein antigen vaccines?
Extrafollicular region
What happens to B-cells in the germinal center during response to protein antigen vaccines?
Undergo clonal proliferation and differentiation
Which cell type undergoes clonal proliferation and affinity maturation during response to protein antigen vaccines?
B-cells
What is the primary role of plasma cells in immune response to protein antigen vaccines?
Produce large amounts of antibody
Which type of vaccines require antigens presented through MHC I to stimulate CD8+ cytotoxic T-cells?
Live attenuated vaccines
Test your knowledge on the three major layers of the glomerular capillary membrane: capillary endothelium, basement membrane, and a layer of epithelial cells (podocytes). Explore the high permeability, filterability of solutes, and determinants of glomerular filtration.
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