MODIFIED TRUE OR FALSE 1. Asymptomatic Bacteriuria a. Diagnosis involves both microbiologic and clinical criteria b.

Microbiologic criterion is usually >/= 10 x 5 bacterial cfu/ml in catheter associated disease c. Patient may have fever and chills d. Patient has no signs or symptoms referable to UTI e. Patient has dysuria but with no fever 2. Uncomplicated cystitis in women a. Acute onset of dysuria, fever and urgency b. Dysuria in an otherwise healthy pregnant patient c. Does not always warrant urinalysis d. There is no longer a single best agent for it e. First line agent involves TMP-SMX and nitrofurantoin 3. Complicated UTI a. Must be guided by urine culture result b. Xanthogranulomatous pyelonephritis is treated with percutaneous drainage c. Emphysematous pyelonephritis is treated with nephrectomy ASAP. d. Papillary necrosis with obstruction requires intervention to relieve the obstruction and to preserve renal function e. Drug of choice is a quinolone 4. Results in autoregulation of glomerular filtration a. Autonomous vasoactive reflex in the efferent arteriole b. Tubuloglomerular feedback c. Angiotensin II mediated vasoconstriction of the afferent arteriole d. Myogenic reflex in the afferent arteriole e. Increase blood pressure 5. Renal Membrane Transport a. Active transport involving channels requires metabolic energy generated by the hydrolysis of ATP b. Pumps are often electrogenic meaning they can create symmetric distribution of electrostatic charges across the membrane and establish a voltage or membrane potential c. The movement of solutes through a membrane protein by simple diffusion is called passive transport d. Facilitated diffusion is a specialized type of active transport mediated by simple transporters called carriers or uniporters e. Cell membranes are composed of hydrophobic lipids that repel water and aqueous solutes 6. The proximal tubule of the kidney

7.

8.

9.

10.

a. Is responsible for reabsorbing 60 % of filtered NaCl and water as well as 90 % of filtered bicarbonate,glucose and amino acids b. Utilizes both the cellular and paracellular transport mechanisms c. Bulk fluid reabsorption is driven by low oncotic pressure and high hydrostatic pressure within the peritubular pericapillaries d. Reclaim bicarbonate by a mechanism dependent on carbonic anhydrases e. Chloride is poorly reabsorbed throughout the 3rd segment of the proximal tubule Sodium Balance a. The rennin-angiotensin aldosterone system is the poorly understood hormonal system modulating it b. Stimulation of the proximal tubular Na/H exchange by Angiotensin II directly increases Na reabsorption c. Angiotensin II promotes sodium reabsorption along the collecting duct by stimulating secretion of aldosterone by the adrenal cortex d. The balance between Na intake and excretion is under the influence of baroreceptors in regional blood vessels and vascular hormone sensors modulated by ANP. e. Chronic exposure to aldosterone causes a decrease in urinary sodium excretion lasting only a few days, after which Na excretion returns to previous levels. Common mechanism of progressive renal disease a. When there is reduction in the number of the nephrons caused by a sentinel event, the kidney adapts by enlarging and increasing its glomerular filtration rate b. Hyperfiltration during pregnancy or in humans born with one kidney or who lose one to trauma or transplantation produces significant consequences c. Persistent glomerular injury produces local hypertension in capillary tufts, dcreases their single nephron filtration rate and engenders protein leak into the tubular fluid d. There is a high correlation between worsening glomerular proteinuria with renal progression in that severe proteinuria triggers a downstream inflammatory cascade in tubular epithelial cells producing intertstitial nephritis, fibrosis and tubular atrophy e. Significant ablation of renal mass results in hyperfiltration The cause of intrinsic acute kidney injury a. Sepsis b. AGN c. Vasculitis d. Cyclosporine e. Bladder outlet obstruction In ischemic Acute renal failure, there is decreased vasodilation in the glomerular and medullary vasculature in response to a. Nitric oxide b. PGE2 c. Acetylcholine d. Bradikinin e. Adenosine

11.