Renal Physiology Quiz

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In renal physiology, which of the following is the most important driving force for filtration in the glomerulus?

Osmotic pressure in Bowman’s capsule

Hydrostatic pressure in glomerular capillaries (correct)

Oncotic pressure in glomerular capillaries

Hydrostatic pressure in the renal tubules

A patient presents with chronic diarrhoea and steatorrhea. Which of the following is most consistent with malabsorption in the small intestines?

Decreased bile salt production

Increased pancreatic enzyme secretion

Decreased villous surface area (correct)

Increased secretion of gastric acid

Which of the following is a common feature of obstructive lung disease?

Increased FEV1/FVC ratio

Decreased residual volume

Increased total lung capacity (correct)

Decreased functional residual capacity

Regarding GFR regulation, which of the following would increase GFR?

Increasing systemic blood pressure Signup and view all the answers

Which hormone is primarily responsible for water reabsorption in the collecting ducts?

ADH Signup and view all the answers

What vitamin is essential for calcium absorption in the gastrointestinal tract?

Vitamin D Signup and view all the answers

Which is NOT one of the primary roles of the juxtaglomerular apparatus in the kidney?

Regulation of sodium excretion Signup and view all the answers

A patient with elevated ferritin and transferrin saturation, but no clinical symptoms, is likely in which stage of hereditary hemochromatosis?

Biochemical Signup and view all the answers

Which type of gastric cell produces hydrochloric acid?

Parietal cells Signup and view all the answers

Which of the following electrolyte abnormalities is common in Addison's disease?

Hyperkalaemia Signup and view all the answers

In respiratory physiology, what does an increase in the V/Q ratio indicate?

Dead space ventilation Signup and view all the answers

Which genetic disorder is diagnosed by detecting the C282Y mutation in the HFE gene?

Hereditary haemochromatosis Signup and view all the answers

Which neurotransmitter is primarily involved in the retrograde signal in peristalsis?

Nitric oxide Signup and view all the answers

Which condition is most associated with elevated levels of alkaline phosphatase (ALP) without elevated GGT?

Bone metastasis Signup and view all the answers

Which of the following is NOT a feature of nephrotic syndrome?

Haematuria Signup and view all the answers

Which enzyme is responsible for the conversion of angiotensin I to angiotensin II?

ACE Signup and view all the answers

What is the major function of bile acids in digestion?

Emulsification of fats Signup and view all the answers

In liver function, which of the following tests is most indicative of synthetic function?

Albumin Signup and view all the answers

A patient with primary biliary cholangitis will most likely have which of the following antibodies?

Anti-mitochondrial antibodies Signup and view all the answers

Which of the following is true regarding the cephalic phase of digestion?

It is mediated by the parasympathetic nervous system Signup and view all the answers

What is the effect of aldosterone on the kidneys?

Sodium reabsorption Signup and view all the answers

Which of the following is characteristic of respiratory acidosis?

Increased PaCO2 Signup and view all the answers

The primary defect in coeliac disease is due to:

An autoimmune response to gluten Signup and view all the answers

Which of the following laboratory values would most suggest acute liver failure?

Elevated bilirubin with decreased albumin Signup and view all the answers

In renal clearance, what is a primary function of the proximal tubule?

Reabsorption of glucose Signup and view all the answers

Which structure separates the functional left and right lobes of the liver?

Principal plane Signup and view all the answers

Which of the following is involved in gastric acid secretion regulation?

Somatostatin from D cells Signup and view all the answers

Which is a common early sign of chronic kidney disease?

Proteinuria Signup and view all the answers

Which of the following conditions is likely to cause high anion gap metabolic acidosis?

Diabetic ketoacidosis Signup and view all the answers

A common mutation in hereditary haemochromatosis is:

C282Y Signup and view all the answers

Which vitamin is crucial in preventing neural tube defects?

Folic acid Signup and view all the answers

Which of the following drugs is most likely to cause renal toxicity?

Ibuprofen Signup and view all the answers

The bicarbonate buffer system is crucial in maintaining blood pH. What is the normal plasma bicarbonate concentration?

22-26 mEq/L Signup and view all the answers

Which cell type produces insulin in the pancreas?

Beta cells Signup and view all the answers

In acute pancreatitis, which of the following enzymes is typically elevated?

Amylase Signup and view all the answers

The intrinsic factor required for vitamin B12 absorption is produced by which type of gastric cell?

Parietal cells Signup and view all the answers

Which of the following is considered a risk factor for the development of gastric adenocarcinoma?

H. pylori infection Signup and view all the answers

Which of the following conditions is most likely associated with prolonged use of NSAIDs?

Peptic ulcer disease Signup and view all the answers

In which part of the nephron is most sodium reabsorbed?

Proximal convoluted tubule Signup and view all the answers

Which of the following is the primary mechanism of aldosterone’s effect on sodium?

It increases sodium reabsorption in the DCT Signup and view all the answers

Which of the following is the characteristic abnormality seen in Wilson's disease?

Increased urinary copper excretion Signup and view all the answers

Which hormone promotes calcium absorption from the small intestines?

Vitamin D Signup and view all the answers

What is the most likely complication of untreated coeliac disease?

Osteoporosis Signup and view all the answers

Which of the following factors most directly stimulates insulin secretion from beta cells in the pancreas?

High blood glucose Signup and view all the answers

A patient presents with respiratory distress and cyanosis. Blood gas analysis reveals: pH: 7.31 PaCO2: 50 mmHg HCO3-: 26 mEq/L. What is the most likely diagnosis?

Respiratory acidosis Signup and view all the answers

In the liver, what is the primary function of Kupffer cells?

Phagocytosis of bacteria and debris Signup and view all the answers

Which of the following conditions results in hyperbilirubinaemia due to excessive red blood cell destruction?

Haemolytic anaemia Signup and view all the answers

In renal physiology, what does the term 'renal clearance' refer to?

The amount of plasma cleared of a substance per minute Signup and view all the answers

In which organ does the urea cycle primarily take place?

Liver Signup and view all the answers

A patient presents with pruritus and jaundice. Which of the following conditions is most likely the cause?

Primary sclerosing cholangitis Signup and view all the answers

Which of the following is a major site of bicarbonate reabsorption in the kidney?

Proximal convoluted tubule Signup and view all the answers

Which of the following is a feature of metabolic acidosis with compensation?

Decreased PaCO2 Signup and view all the answers

What is the role of glucocorticoids in inflammation?

To suppress the immune response Signup and view all the answers

In the gastrointestinal tract, which of the following hormones stimulates the release of bile from the gallbladder?

Cholecystokinin (CCK) Signup and view all the answers

Which of the following is NOT typically a symptom of nephritic syndrome?

Hyperlipidaemia Signup and view all the answers

Which of the following electrolyte disturbances is commonly seen in patients with chronic kidney disease?

Hyperkalaemia Signup and view all the answers

Which of the following is TRUE regarding hereditary haemochromatosis?

It leads to increased serum ferritin and transferrin saturation Signup and view all the answers

Coeliac disease risk is associated with which genetic factors?

DQ2 and DQ8 alleles Signup and view all the answers

Which of the following enzymes plays a key role in ammonia conversion in the liver?

Glutaminase Signup and view all the answers

In the presence of H. pylori, triple therapy includes all EXCEPT:

Doxycycline Signup and view all the answers

The secretion of HCl in the stomach is primarily regulated by which hormone?

Gastrin Signup and view all the answers

In liver pathology, elevated levels of ALP and GGT with a normal ALT suggest?

Biliary obstruction Signup and view all the answers

Which of the following neurotransmitters is primarily responsible for stimulating peristalsis?

Acetylcholine (ACh) Signup and view all the answers

Which of the following drugs is most likely to cause hyperkalaemia in patients with renal impairment?

Lisinopril Signup and view all the answers

The most likely diagnosis for a patient presenting with episodic blood diarrhoea, fever, and abdominal pain, with granulomatous inflammation seen on colonoscopy is:

Crohn’s disease Signup and view all the answers

Which test is considered the most reliable for diagnosing hereditary haemochromatosis?

Genetic testing for C282Y and H63D mutations Signup and view all the answers

Which of the following electrolyte imbalances is expected in metabolic acidosis?

Hyperkalaemia Signup and view all the answers

What electrolyte disturbance is most likely in a patient with severe diarrhoea?

Hypokalaemia Signup and view all the answers

Which of the following conditions is characterized by a raised AST/ALT ratio and increased GGT?

Alcoholic hepatitis Signup and view all the answers

Secretin primarily stimulates the secretion of:

Bicarbonate from the pancreas Signup and view all the answers

In a patient with hereditary haemochromatosis, what is the primary treatment?

Phlebotomy Signup and view all the answers

Which substance catalyzes the conversion of angiotensinogen to angiotensin I?

Renin Signup and view all the answers

Which of the following is a hallmark feature of Crohn’s disease as opposed to ulcerative colitis?

Transmural inflammation with skip lesions Signup and view all the answers

The liver deaminates amino acids to form:

Urea Signup and view all the answers

What is the most common cause of primary bile acid malabsorption?

Ileal resection Signup and view all the answers

Which liver enzyme is primarily elevated in cholestasis?

ALP Signup and view all the answers

Which of the following is NOT a common cause of metabolic acidosis?

Nephritic syndrome Signup and view all the answers

Which of the following is NOT a renal condition associated with nephritic syndrome?

Membranous nephropathy Signup and view all the answers

Patients presenting with weight loss, jaundice, and elevated bilirubin with a palpable mass in the right upper quadrant likely has:

Pancreatic cancer Signup and view all the answers

Which of the following is most likely to cause toxicity in a patient with impaired renal function, given a conventional treatment dose?

Lithium Signup and view all the answers

A patient with chronic liver disease presents with confusion, and their plasma shows a raised concentration of ammonia. Which organ is primarily responsible for ammonia conversion into a less toxic form for excretion?

Liver Signup and view all the answers

In respiratory alkalosis, what is the compensatory mechanism?

Decreased bicarbonate reabsorption Signup and view all the answers

Cholecystokinin (CCK) primarily acts on which pancreatic cells?

Acinar cells Signup and view all the answers

During which phase of digestion is hydrochloric acid predominantly secreted?

Gastric Signup and view all the answers

In which segment of the renal tubule is the majority of water reabsorbed?

Proximal convoluted tubule Signup and view all the answers

A patient presents with low pH, high PCO2, and elevated bicarbonate levels. What is the most likely condition?

Respiratory acidosis with metabolic compensation Signup and view all the answers

A deficiency in which of the following enzymes results in jaundice and bilirubin accumulation in the liver?

Glucuronyl transferase Signup and view all the answers

The liver plays a major role in deaminating amino acids. What is the fate of the ammonia produced in this process?

It is excreted as urea Signup and view all the answers

Which vitamin deficiency leads to pernicious anemia by impairing the absorption of vitamin B12?

Vitamin B12 Signup and view all the answers

Hepatocellular carcinoma most commonly arises in which of the following conditions?

Cirrhosis Signup and view all the answers

The bile canaliculi in the liver are lined by which type of epithelium?

Simple cuboidal Signup and view all the answers

A 60 year old male presents with RUQ pain and jaundice. His liver function tests show increased ALT and AST levels, with a normal ALP.

a) Suggest three possible causes of his condition (3 marks)

b) List two further investigations that would help narrow down the diagnosis (2 marks)

a) Viral hepatitis, alcoholic liver disease, autoimmune hepatitis b) Hepatitis viral serology (Hep A,B,C), Autoimmune markers (ANA, ASMA) Signup and view all the answers

Describe the regulation of aldosterone secretion in response to hypovolaemia (5 marks).

Aldosterone secretion is primarily regulated by the renin-angiotensin-aldosterone system (RAAS), which is activated in response to hypovolaemia. When blood volume decreases it is detected by baroreceptors in the juxtaglomerular apparatus, leading to the secretion of renin, which converts angiotensinogen to angiotensin I. This is further converted to angiotensin II by ACE in the lungs. Angiotensin II stimulates aldosterone secretion from the adrenal cortex, promoting sodium and water retention to increase blood volume. Signup and view all the answers

A patient presents with a blood gas analysis showing a pH of 7.48, PCO2 of 50 mmHg, HCO3- of 30 mEq/L. a) What is the primary acid-base disorder? (2 marks) b) Is compensation present, if so, what type? (2 marks)

a) Metabolic alkalosis b) Yes, Respiratory compensation Signup and view all the answers

Outline the genetic basis of coeliac disease, including the role of HLA alleles? (4 marks)

Coeliac disease is strongly associated with the presence of HLA-DQ2 and HLA-DQ8 alleles, which encode proteins involved in presenting gluten peptides to T-cells. In genetically predisposed individuals, ingestion of gluten triggers an immune response, leading to intestinal inflammation and villous atrophy Signup and view all the answers

Renal Physiology Quiz

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Questions and Answers

In renal physiology, which of the following is the most important driving force for filtration in the glomerulus?

A patient presents with chronic diarrhoea and steatorrhea. Which of the following is most consistent with malabsorption in the small intestines?

Which of the following is a common feature of obstructive lung disease?

Regarding GFR regulation, which of the following would increase GFR?

Which hormone is primarily responsible for water reabsorption in the collecting ducts?

What vitamin is essential for calcium absorption in the gastrointestinal tract?

Which is NOT one of the primary roles of the juxtaglomerular apparatus in the kidney?

A patient with elevated ferritin and transferrin saturation, but no clinical symptoms, is likely in which stage of hereditary hemochromatosis?

Which type of gastric cell produces hydrochloric acid?

Which of the following electrolyte abnormalities is common in Addison's disease?

In respiratory physiology, what does an increase in the V/Q ratio indicate?

Which genetic disorder is diagnosed by detecting the C282Y mutation in the HFE gene?

Which neurotransmitter is primarily involved in the retrograde signal in peristalsis?

Which condition is most associated with elevated levels of alkaline phosphatase (ALP) without elevated GGT?

Which of the following is NOT a feature of nephrotic syndrome?

Which enzyme is responsible for the conversion of angiotensin I to angiotensin II?

What is the major function of bile acids in digestion?

In liver function, which of the following tests is most indicative of synthetic function?

A patient with primary biliary cholangitis will most likely have which of the following antibodies?

Which of the following is true regarding the cephalic phase of digestion?

What is the effect of aldosterone on the kidneys?

Which of the following is characteristic of respiratory acidosis?

The primary defect in coeliac disease is due to:

Which of the following laboratory values would most suggest acute liver failure?

In renal clearance, what is a primary function of the proximal tubule?

Which structure separates the functional left and right lobes of the liver?

Which of the following is involved in gastric acid secretion regulation?

Which is a common early sign of chronic kidney disease?

Which of the following conditions is likely to cause high anion gap metabolic acidosis?

A common mutation in hereditary haemochromatosis is:

Which vitamin is crucial in preventing neural tube defects?

Which of the following drugs is most likely to cause renal toxicity?

The bicarbonate buffer system is crucial in maintaining blood pH. What is the normal plasma bicarbonate concentration?

Which cell type produces insulin in the pancreas?

In acute pancreatitis, which of the following enzymes is typically elevated?

The intrinsic factor required for vitamin B12 absorption is produced by which type of gastric cell?

Which of the following is considered a risk factor for the development of gastric adenocarcinoma?

Which of the following conditions is most likely associated with prolonged use of NSAIDs?

In which part of the nephron is most sodium reabsorbed?

Which of the following is the primary mechanism of aldosterone’s effect on sodium?

Which of the following is the characteristic abnormality seen in Wilson's disease?

Which hormone promotes calcium absorption from the small intestines?

What is the most likely complication of untreated coeliac disease?

Which of the following factors most directly stimulates insulin secretion from beta cells in the pancreas?

A patient presents with respiratory distress and cyanosis. Blood gas analysis reveals: pH: 7.31 PaCO2: 50 mmHg HCO3-: 26 mEq/L. What is the most likely diagnosis?

In the liver, what is the primary function of Kupffer cells?

Which of the following conditions results in hyperbilirubinaemia due to excessive red blood cell destruction?

In renal physiology, what does the term 'renal clearance' refer to?

In which organ does the urea cycle primarily take place?

A patient presents with pruritus and jaundice. Which of the following conditions is most likely the cause?

Which of the following is a major site of bicarbonate reabsorption in the kidney?

Which of the following is a feature of metabolic acidosis with compensation?

What is the role of glucocorticoids in inflammation?

In the gastrointestinal tract, which of the following hormones stimulates the release of bile from the gallbladder?

Which of the following is NOT typically a symptom of nephritic syndrome?

Which of the following electrolyte disturbances is commonly seen in patients with chronic kidney disease?

Which of the following is TRUE regarding hereditary haemochromatosis?

Coeliac disease risk is associated with which genetic factors?

Which of the following enzymes plays a key role in ammonia conversion in the liver?

In the presence of H. pylori, triple therapy includes all EXCEPT:

The secretion of HCl in the stomach is primarily regulated by which hormone?

In liver pathology, elevated levels of ALP and GGT with a normal ALT suggest?

Which of the following neurotransmitters is primarily responsible for stimulating peristalsis?

Which of the following drugs is most likely to cause hyperkalaemia in patients with renal impairment?

The most likely diagnosis for a patient presenting with episodic blood diarrhoea, fever, and abdominal pain, with granulomatous inflammation seen on colonoscopy is:

Which test is considered the most reliable for diagnosing hereditary haemochromatosis?

Which of the following electrolyte imbalances is expected in metabolic acidosis?

What electrolyte disturbance is most likely in a patient with severe diarrhoea?

Which of the following conditions is characterized by a raised AST/ALT ratio and increased GGT?

Secretin primarily stimulates the secretion of:

In a patient with hereditary haemochromatosis, what is the primary treatment?

Which substance catalyzes the conversion of angiotensinogen to angiotensin I?

Which of the following is a hallmark feature of Crohn’s disease as opposed to ulcerative colitis?

The liver deaminates amino acids to form:

What is the most common cause of primary bile acid malabsorption?

Which liver enzyme is primarily elevated in cholestasis?

Which of the following is NOT a common cause of metabolic acidosis?

A 60 year old male presents with RUQ pain and jaundice. His liver function tests show increased ALT and AST levels, with a normal ALP.

a) Suggest three possible causes of his condition (3 marks)

b) List two further investigations that would help narrow down the diagnosis (2 marks)