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Exam 2 Nephrology - Khan

Total questions: 55

Worksheet time: 2hrs 50mins

Name
Class
Date
1.

What are the functions of the kidneys

a)

Regulate blood pressure

b)

Regulate volume of ECF

c)

Regulate osmotic pressure of body fluids by excreting urine

d)

Add drugs and instill foreign compounds

2.

Diuretics...

a)

Increase urine output

b)

Decrease electrolytes

c)

Increase electrolytes

d)

Decrease urine output

3.

Diuretics are indicated for which complications?

a)

Edema

b)

Chronic Heart Failure

c)

Prevention of renal damage

d)

Hypotension

4.

Carrier mediated transport of two ions in the same direction is what type of transport mechanisms

a)

Symport/Cotransport

b)

Antiport

c)

Na+/K+ Transporter

d)

Ca2+/Na+ Transporter

5.

Carrier mediated transport of two ions in the opposite direction

a)

Na+/Cl- transport

b)

Symport/Co-transport

c)

Antiport

d)

Ca2+ transport

6.

Diuretics are orally efficacious

a)

True

b)

False

7.

Where is the site of action for thiazides?

a)

Loop of Henle

b)

Collecting Duct

c)

Proximal convoluted tubule (PCT)

d)

Distal convoluted tubule (DCT)

8.

Which position of chlorothiazide is highly reactive and required?

a)

8

b)

5

c)

1

d)

6

9.

Which position in chlorothiazide when added an electron donating group decreases activity

a)

8

b)

1

c)

6

d)

5

10.

Which position in chlorothiazide is essential for activity and when removed or replaced will result in little to no activity

a)

3

b)

7

c)

4

d)

1

11.

Which position on thiazides increases the duration of action with an alkyl substitution

a)

6

b)

2

c)

7

d)

8

12.

Which position on thiazide would increase potency and duration with a hydrophobic substitution

a)

3

b)

8

c)

7

d)

6

13.

At which position would saturation lead to an increase in potency of the compound

a)

1-2

b)

3-4

c)

5-6

d)

7-8

14.

What is the MOA for thiazides?

a)

Allows for the reabsorption Na+ and Cl- through co-transporter

b)

inhibit NaCl co-transporter from luminal side

c)

Decrease Na+, Cl-, and water excretion

d)

Increase Na+, Cl-, and water excretion

15.

How does an accumulation of volume occur in diabetes?

a)

increase in abnormal secretion of ADH

b)

decrease in abnormal secretion of ADH

c)

increase in abnormal secretion of PTH

d)

increase in abnormal secretion of aldosterone

16.

Thiazides increase urinary excretion of calcium

a)

True

b)

False

17.

Thiazides produce additive or synergistic effects when combined with...?

a)

Aminoglycoside

b)

NSAIDs

c)

Thyroid Medications

d)

Antihypertensive agents

18.

Which of these are considered acute effects for antihypertensive effects in thiazides

a)

Increase in blood pressure

b)

Increase Na+ excretion

c)

Decrease CO

d)

Increase intravascular volume

19.

Which of these is NOT a chronic effect in antihypertensive effects of thiazides

a)

Thiazides decrease vascular resistance

b)

Volume increases

c)

Increase in CO

d)

Increase Na absorption

20.

Which of these is an adverse effect to thiazides?

a)

Hypernatremia

b)

Hyper-magnesium

c)

Hypercalcemia

d)

Hypokalemia

21.

Where in the nephron do thiazides work?

a)

Proximal Tubule

b)

Late Distal Tubule

c)

Collecting Duct

d)

Loop of Henle

22.

How do thiazides cause hypokalemia?

a)

Increase Na and K resorption

b)

Decrease K and Na resorption

c)

Increase K resorption and Increase Na secretion

d)

Increase delivery of Na and Increase K secretion

23.

Which of these is a metabolic change of thiazides?

a)

Hyperlipidemia

b)

Hypoglycemia

c)

Hypouricemia

d)

Hyperkalemia

24.

The sulfonamide moiety in the structure of thiazide causes what adverse reaction?

a)

Headache and body aches

b)

Abdominal Discomfort

c)

Photosensitivity or rash

d)

Yellowing of the skin

25.

Which of these medications produce synergistic effects with loop diuretics?

a)

Antihypertensive Drugs

b)

Thiazides

c)

NSAIDs

d)

Dofetilide

26.

Which medications do you not wanna pair thiazides with?

a)

Lithium

b)

NSAIDs

c)

Dofetilide

d)

Loop diuretics

27.

Where do loop diuretics work in the nephron?

a)

Proximal Tubule

b)

Convoluted Distal Tubule

c)

Ascending limb of Loop of Henle

d)

Cortical Collecting Duct

28.

What is the amino benzoic acid derivative of this structure?

a)

Para-amino benzoic acid

b)

Meta-amino benzoic acid

c)

Ortho-amino benzoic acid

29.

What is the amino benzoic acid derivative of this structure?

a)

Meta-amino benzoic acid

b)

Ortho-amino benzoic acid

c)

Para-amino benzoic acid

30.

What is the MOA for loop diuretics?

a)

Inhibit NKCC2 transporter which increases Na excretion

b)

Inhibits CLC-K2 transporter which increase Cl excretion

c)

Helps the NKCC2 transporter which increases Na resorption

d)

Helps the CLC-K2 transporter which increases Cl resorption

31.

What is an adverse effect of loop diuretics?

a)

Hypolipidemia

b)

Hypercalcemia

c)

Hypokalemic Metabolic Alkalosis

d)

Hypermagnesemia

32.

What is another adverse effect of loop diuretics?

a)

Hypercalcemia

b)

Hypocalcemia

c)

Hypermagnesemia

d)

Hyperchloremia

33.

What occurs in hypokalemic alkalosis?

a)

Increased Na and K exchange

b)

Increased K excretion which leads to hypokalemia

c)

Increased H loss which results in alkalosis

d)

Cl channels are blocked therefore leading to Hypochloremia

34.

The metabolic changes in loop diuretics are similar to thiazides

a)

True

b)

False

35.

Loop diuretics cause hearing impairment which is not reversable under any circumstance

a)

True

b)

False

36.

A patient that has a sulfa allergy would have a contraindication with a loop diuretic

a)

True

b)

False

37.

Why are loop diuretics infrequently prescribed for those with hypertension

a)

They cause hypotension instead

b)

Increased risk of Edema

c)

Increase risk of renal failure

d)

Short duration of action

38.

Potassium-sparing diuretics are the strongest diuretic

a)

True

b)

False

39.

Which of these are aldosterone antagonists?

a)

Spironolactone

b)

Triamterene

c)

Eplerenone

d)

Amiloride

40.

Which of these are Inhibitors of epithelial sodium channels

a)

Eplerenone

b)

Spironolactone

c)

Amiloride

d)

Triamterene

41.

What is the site of action for potassium sparing diuretics?

a)

Medullary collecting duct

b)

Cortical collecting tubule

c)

Proximal tubule

d)

Glomerulus

42.

What are the physiological effects of aldosterone?

a)

K excretion

b)

Na excretion

c)

K retention

d)

Na retention

43.

Which part of spironolactone gets removed by first pass metabolism and creates the active metabolite Canrenone

a)

Lactone

b)

Thio-acetyl

c)

Carboxylic acid

d)

Ketone

44.

What is the MOA of spironolactone?

a)

Inhibit the ENaC channel from allowing sodium to enter the principal cell

b)

Competitively inhibit the interaction of aldosterone to the mineralocorticoid receptors

c)

Increase the expression of the ENaC and Na/K ATPase gene

d)

Promote water retention

45.

Spironolactone works as a treatment for female hirsutism but not Eplerenone

a)

True

b)

False

46.

What are some indications for aldosterone antagonist?

a)

Hypertension

b)

Primary aldosteronism

c)

Hypokalemia

d)

Hyperkalemia

47.

Which one of these is contraindicated for aldosterone antagonist

a)

Hypokalemia

b)

Edema

c)

Decreased renal function

d)

CHF (Congestive Heart Faliure)

48.

Inhibitors of epithelial sodium channels can also work to inhibit aldosterone

a)

True

b)

False

49.

Triamterene and Amiloride do not contain a steroid backbone

a)

True

b)

False

50.

Which of these are adverse effects of Triamterene

a)

Hyperkalemia

b)

Edema

c)

Metabolic acidosis

d)

Hypokalemia

51.

How is mannitol commonly administered?

a)

Rectally

b)

IM

c)

Orally

d)

IV

52.

What part of the nephron does an osmotic diuretic effect

a)

Cortical collecting duct

b)

Descending loop of Henle

c)

Proximal convoluted tubule

d)

Distal convoluted tubule

53.

What is the MOA of mannitol?

a)

Increase water retention by decreasing amount of NaCl channels

b)

Retain water by increasing osmotic pressure therefore increasing urine output

c)

Increasing the actions of the NKCC2 transporter

d)

Increase transports of Cl

54.

Which of these is an adverse effect of Osmotic diuretics?

a)

Hyperkalemia

b)

Hypokalemia

c)

Hyponatremia

d)

Hypernatremia

55.

Which of these is NOT an indication of mannitol

a)

Reduces intracranial pressure

b)

Hypertension

c)

Acute renal failure

d)

Reduce increased intraocular pressure

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