Please note that questions 1-5 go together!

1. Ms. Gagas evaluation reveals albuminuria of 4g/day. There is no hematuria. Her blood
pressure is 160/90 mmHg. She complains of fatigue. She has a plasma [K] of 5.0 mM.
Given the following information, calculate her GFR:
Plasma [creatinine] is 375 micromoles/L, urine [creatinine] is 13 millimoles/L and urine
flow rate is 1.2 ml/min

a) 84 ml/min
b) 125 ml/min
c) 22 ml/min
d) 42 ml/min
e) insufficient information to permit the calculation

2. The level of urine protein excretion in Ms. Gaga may indicate the existence of:

a) glomerular nephritis
b) glomerular hypertension
c) nephrotic syndrome
d) proximal tubular abnormality
e) normal renal function

3. The most probable cause of Ms. Gagas fatigue is:

a) hyperkalemia
b) anemia
c) hypertension
d) uremia
e) acidosis
4. Ms. Gagas glomerular filtration barrier restricts the passage of molecules based upon
which of the following:

a) First come, first served

b) concentration
c) charge
d) pH
e) nothing

5. It is likely that Ms. Gaga has:

a) post-renal failure/injury
b) pre-renal failure/injury
c) chronic kidney disease
d) a metabolic disorder of a non-renal cause
e) chronic fatigue syndrome

6. One of the principal strategies in reducing the rate of nephron destruction in chronic
renal disease is:

a) increase dietary protein intake

b) administer erythropoietin
c) administer vitamin D
d) constrict the afferent arteriole
e) dilate the efferent arteriole

7. Which of the following is/are FALSE about uremia?

a) associated with increased blood urea nitrogen (BUN)

b) urea is non-toxic
c) BUN is more reliable than creatinine as a reflection of GFR
d) severe itching is due to other substances
e) none of the above
 8. Which of the following is/are TRUE about Acute Renal Failure?

a) frequently caused by reduced blood flow to the kidney

b) GFR never returns to normal after treatment
c) can cause hypokalemia
d) is not caused by obstruction of urine flow
e) changes in urine [creatinine] can be used to estimate GFR

9. A useful marker for the calculation of GFR must:

a) be degraded by the glomerulus

b) not be secreted or reabsorbed by the nephron
c) regulate the dilatation of the afferent arteriole
d) be synthesized or metabolized by the kidney
e) be larger than albumin

10. Which of the following are an example(s) of an acute cause of intrinsic renal failure?

a) prostate cancer
b) kidney stone obstruction
c) bladder obstruction
d) mercury poisoning
e) all of the above

11. The leading cause of chronic kidney disease is:

a) Hypertension
b) Diabetes
c) IgA nephropathy
d) HIV
e) High salt diet
12. A biopsy performed on Ms. Gaga reveals areas of scarring in some, but not all glomeruli.
This would be consistent with which one of the following:
a) Diabetic nephropathy
b) Membranous nephropathy
c) Prostatic enlargement
d) Focal and segmental glomerulosclerosis
e) Minimal change disease
13. In CKD, the final stage of disease progression requires:
a) Dialysis
b) Increased doses of ACE inhibitors
c) Changes to the amount of protein in the diet
d) More exercise
e) Removal of a kidney
Answers:

1-d; 2-c;3-b;4-c; 5-c;6-e;7-c; 8-a;9-b; 10-d; 11-b;12-d; 13-a