bme403-renalex-2008

bme403-renalex-2008 - 0 NAME Jr 1 e h 5 Ms BME 403 Renal...

Info icon This preview shows pages 1–5. Sign up to view the full content.

View Full Document Right Arrow Icon
Image of page 1

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 2
Image of page 3

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full Document Right Arrow Icon
Image of page 4
Image of page 5
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: 0. \ NAME: Jr- 1 e h 5 Ms BME 403 Renal Section Exam Fall 2008 1. (15 )Mark True(T) or False(F)-one point each ( T ) 1.1 In the mammalian kidney all water movement is via a passive mechanism due to an osmolality difference not considering how this difference is created. ( 1' l 1.2 Increasing the hydrostatic pressure in Bowman’s space from the normal value is expected to increase gomerular filtration rate. ( F: ) 1.3 When perfusion pressure to the kidneys is reduced, renin secretion is inhibited. ( T ) 1.4 Effective circulating volume refers to the volume of fluid contained within the ECF (extracellular fluid volume) which is sensed by the volume sensors of the vascular system. ( I“ ) 1.5 Renin acting alone does not have a physiologic function; it fianctions solely as an enzyme which whose substrate is a circulating protein produced by the lungs. ( T- ) 1.6 A 0.9 % NaCl solution contains 154 mmoles/L of NaCl and an osmolality of 290 mOsmxkg H20. ( (Ti ') 1.? A change in plasma creatinine concentration from 1 to 2 mg/dL is consistent with a fall in glomcrular filtration rate from 120 to 60 mlfmin. ( T ) 1.8 Since a kidney transplant typically involves a single kidney the renal clearance of ereatinine should be approximately half that of what is tabulated for a normal person. ( F’ ) 1.9 Renal excretion rate ofa substance can never exceed the filtration rate. ( T ) 1.10 Total body water (TBW) can be further divided into intracellular fluid, interstitial fluid, and plasma. f" ( f' ) 1.11 The neural centers involved in thirst are located in the medulla. ( F- ) 1.12 ADH decreases the permeability of the collecting duct to water. ( T ) 1.13 In the normal kidney the amount of creatinine excreted in the urine per minute exceeds the amount filtered at the glomerulus each minute by about 10%.. ( Til ) 1.14 Inhibition of carbonic anhydrase will lead to diminished sodium ion reabsorption in the proximal tubule. ( Tr ) 1.15 Occlusion of the urinary tract with a kidney stone in a ureter should lead to increased hydrostatic pressure in Bowman’s space and a decrease in glomerular filtration rate. @ Fill in the blanks (20 points total—2 points each) S tr“ 0 (6'1” 2.1 The substance glucose is transported by a mechanism in the proxiEal tgule . 2.2 U is produced by atrial myocylcs, relaxes smooth muscle, and prornotes NaCl and water excretion by the kidney. ‘ 2.3 Antidiuretic hormone(ADH) also called 343 asap PCSfirr'l acts on the kidneys to regulate water excretion. 2.4 The portion of the nephron located just fter the glomerulus and before the descending thin limb is the - {2 Ma. tubule. 2.5 The process by which the h erosmotic medul ary interstial gradient is created is called Coum'léf‘cuv/‘V‘C Whi— LVIQl, Flimh C‘ "‘* 2.6 The [fl-fl? rl‘l— arteriole is the kidney vascular segment which proceeds the glomerular ea ’llaries. 2.7 The loop of 14. if.- is made up of the descending thin limb and the thick ascending limb of the nephron. 2.8 T? llalllflill' grflefid/fl’feedback is a mechanism where GFR is regulated according 0 NaCl concentration of tubular fluid. l . 2.9 Glomerular filtration rate is commonly estimated by [V1 0 l I' '4 clearance because this substance while not naturally produced is freely filtered by the glomerulus and not reabsorbed by the kidney. 2.10 Coupled transport of two or more solutes in opposite directions is called an (2 [fl] pa r" rmechanism. 3. Multiple Choice—Pick all that applies. (15 points total) 3.1 Glomerulotubular balance involves the following: ()4) An increase in GP R results in an increase in filtered load ot'glucose and amino acids. ( ) An increase in GFR due to a feedback loop in which NaCl concentration of tubular fluid is sensed. ( X} An increase in GP R raises the oneotic pressure in peritubular capillaries. ( ) An increase in OF R due to renal sympathetic nerve stimulation. ( ) An increase in GFR leading to increased ADH(antidiuretic hormone) secretion. 3.2 An increase in ECWeffective circulating volume) results in: ( )Q Decreased renal sympathetic nerve activity. ( )Q’ Decreased secretion of renin. ( ) Inhibition of urodilatin seeretiou ( ) Stimulation of ADH secretion. ( ) Increased secretion of aldosterone. 3.3 In NaCl and water reabsortion along the proximal tubule the following are involved: ( K) The proximal tubule reabsorbs 67% of the filtered water and NaCl. ( ) Active transport of sodium and potassium promote low apical cell intracellular sod um concentration in the proximal tubule. ( %) Reabsorption of sodium is coupled to that of bicarbonate ion in the first half of the proximal tubule. (X) Chloride ion concentration in tubular fluid 15 high in the second half of the proximal tubule. ( ) Of the total reabsorbed NaCl in the proximal tubule two-thirds is reabsorbed Via the paracellular pathway. Equations: Cx = Ux’l‘vi’PX Vx dPxfidt = l-CXPX Px=Px(0)+(I/Cx-PX(O))(I -exp(-t*W€-x)) Cir/v; t|Q=.693*VX!{CX 91 0) Versed is a common drug used during surgery as a CNS depressant( promotes ort term memory loss) . The plasma clearance rate is 10 leminx’Kg and the half time is 2 hrs. a) For a 70 Kg subject and assuming first order kinetics calculate the irolume of distribution for this drug. b) If an i. v. injection is made at a dose of0.15 mg/Kg at time 0, what will the drug concentration (mg/liter) be one houmfier .H W injection. __________ , . ‘- ' ”—g :2: ("0 3k 70 - "7&9 "‘4 Q7/"’t"‘ V‘s . “7'5 LC A”; wast 77.53:} ________ _ __ "2’27 3/; ........ Z‘fIt/L:iéQM-V‘F*Q ’57 (1/ ‘1 ._ “’ i7eo _____ __ _-_-_-_-:j+--- (7VLE770M1‘90) .__.. / :2/ :1/0 .2 mid (/JIQ f. k 77> l "i ' 7MB ...... ' (577:1 + ““61"” I6) "‘3: 3“}! law! ....... 7.43m ,. L ..... . ....... BJJf/‘L (2:0 / :73. 3: 04- {‘7 {if}; ___..._..__._...._.——.—M. .. ___ ....... ___-l . 7 JH‘ ‘ 3 49 .(a) g; (as? 7777... 7:: 057“ __Zet J __________ ...____._... _H 5.(20) A dialysis patient with no kidney function has: a constant urea production rate of 20 mg/min, urea clearance rate of 100 ml/min during dialysis, urea volume of distribution of 40 liters. The patient had a urea level of 0.4 [mg/ml at the end of the last dialysis which was 2 days ago. Assume complete equilibration was reached in the 40 liter volume. A) Assmning negligible loss of urea out of the volume of distribution, what will the urea concentration be at the start of dialysis. B) How long must the patient remain on dialysis to reach a level of 0.5 rug/ml? Assume first order kinetics. 52¢? mfg/gal 14 t'c-C '15:”; 7* 2‘! king/4""5”: 53660 M?" hv” a) l3..,m*’€"t‘r‘+ 47W T. (34139; mic-Kw WC (20) Drug X distributes in ECF=14 liters, the half life(T1f2) is 2 hours, and dose rate is 1 gmfday. (a) Calculate drug clearance rate in ml/min (b) Starting with the steady state concentration at time 0 to the given dose rate, what is the ECF concentration 1 hour after the drug administration is stopped. . ,. h '~‘ k {‘20 M‘” :_ (90 v-U\.il ex fivz- :3 j Y 5 KW «r— l K: ”QB; 0663 M\v‘l 120 . W _________________ W- _ W _____ ._ _ W) _W_ T5: "“C \4fié LWKL/mo “3%.0038 fijxg‘m’K/M (‘- 1—- F-fl ,_ ..................... t :1 _____ 21W ____________ _____ . . _ L - v, awn-x1 R _ (1 ELL-{r 394/1") ‘0 thffitfijfi _ _ ______ _ — — ~—-_——-___.. W _! .WumJfiZJ VL “VJ; f , cW‘r/ ,_. 50.55% ’5‘“ S” “W ”“63: “ES” ’ if “M'- - - - " :éaO £1155}ng r) (gown): ‘50955‘12’ ,3: ( Ocfléé¥ ...
View Full Document

{[ snackBarMessage ]}

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern