Font size
S
M
L
XL
WorksheetsNeph Exam 2 - Diuretics
Total questions: 83
Worksheet time: 42mins
Name
Class
Date
1.
What are some functions of the kidney
a)
regulate volume of ECF
b)
regulate osmotic pressure of body fluids by excreting urine
c)
regulate concentration of electrolytes
d)
regulate volume of ICF
e)
filter toxins from blood
2.
Within 24 hours, how much do the kidneys filter on average
a)
50 mL
b)
50 L
c)
180 mL
d)
180 L
3.
What do diuretics do in the body
a)
increase urine output
b)
decrease urine output
c)
increase electrolytes
d)
decrease electrolytes
4.
What are some examples of anionic electrolytes
a)
bicarbonate
b)
chloride
c)
calcium
d)
sodium
e)
potassium
5.
What are some examples of cationic electrolytes
a)
bicarbonate
b)
chloride
c)
calcium
d)
sodium
e)
potassium
6.
Where is the primary site of diuretic action
a)
liver
b)
bladder
c)
nephron
d)
adrenal cortex
7.
What are some indications for diuretics to be administered
a)
edema
b)
HTN
c)
CHF
d)
prevention of renal damage
8.
What are some different types of diuretics
a)
thiazides
b)
loop diuretics
c)
potassium-sparing diuretics
d)
osmotic diuretics
e)
carbonic anhydrase inhibitors
9.
What are the target for diuretics
a)
membrane transport protein
b)
osmosis
c)
enzymes
d)
nuclear hormone receptors
10.
What is it called when a carrier mediated transport of two ions move in the same direction
a)
symport
b)
co-transport
c)
antiport
11.
What is it called when a carrier mediated transport of two ions move in opposite directions
a)
symport
b)
co-transport
c)
antiport
12.
What is structurally different about chlorthalidone compared to thiazide diuretics
a)
has a benzothiadiazine backbone
b)
benzothiadiazine backbone is absent
c)
has an extra thiadiazine
d)
missing a thiadiazine
13.
Where is the site of action for thiazides
a)
proximal convoluted tubule
b)
thin descending limb of the Loop of Henle
c)
thick ascending limb of the Loop of Henle<br />
d)
distal convoluted tubule
e)
collecting duct
14.
What agents are considered thiazide or thiazide-like
a)
chlorothiazide
b)
hydrochlorothiazide
c)
chlorthalidone
15.
What are the SAR of thiazides
a)
electron withdrawing group at position 6
b)
electron withdrawing group at position 5
c)
Cl or CF3 at position 6 is highly reactive
d)
electron donating group CH3 and OCH3 at position 6 decreases activity
e)
Cl or CF3 at position 5 is highly reactive
16.
What position is the sulfonamide group essential for activity
a)
1
b)
3
c)
5
d)
7
17.
The removal or replacement of the sulfonamide group on a thiazide will result in little or no activity<br />
a)
true
b)
false
18.
An alkyl substitution with CH3 on the 2-N position of a thiazide would ___ the duration of action
a)
increase
b)
decrease
c)
not change
19.
A hydrophobic substitution at position 3 of a thiazide would __ the potency and duration
a)
increase
b)
decrease
c)
not change
20.
Saturation of the 3-4 bond of a thiazide ___ the potency of the compound
a)
increase
b)
decrease
c)
not change
21.
The distal convoluted tubule cells reabsorb Na and Cl through<br />
a)
an apical membrane NaCl co-transporter
b)
a basolateral membrane NaCl co-transporter
c)
an apical membrane NaCl anitport
d)
a basolateral membrane NaCl antiport
22.
Once the Na enters the apical membrane of the distal convoluted tubule, it is then transported through the basolateral membrane through
a)
Na/K ATPase
b)
NaCl co-transporter
c)
diffusion
d)
Cl channels
23.
Once the Cl enters the apical membrane of the distal convoluted tubule, it is then transproted through the basolateral memebrane through
a)
Cl channels
b)
NaCl co-transporter
c)
diffusion
d)
Na/K ATPase
24.
Which transporter do thiazides inhibit and where
a)
Na/K ATPase
b)
NaCl co-transporter
c)
Cl channels
d)
luminal side
e)
basolateral side
25.
When thiazides inhibit the NaCl co-transporters, what happens to Na, Cl, and water
a)
Na increases, Cl increase
b)
Na decreases, Cl decreases
c)
Na increase, Cl decrease
d)
water is retained
e)
water is excreted
26.
How does thiazides help with hypertension and heart failure
a)
produce additive or synergistic effects when combined with other classes of antihypertensive agents
b)
decrease the accumulation of salt and water
c)
reduce urinary excretion of calcium
d)
reduce urine volume by 50%
27.
How do thiazides help with nephrolithiasis due to idiopathic calciuria
a)
produce additive or synergistic effects when combined with other classes of antihypertensive agents
b)
decrease the accumulation of salt and water
c)
reduce urinary excretion of calcium
d)
reduce urine volume by 50%
28.
How do thiazides help with nephrogenic diabetes insipidus
a)
produce additive or synergistic effects when combined with other classes of antihypertensive agents
b)
decrease the accumulation of salt and water
c)
reduce urinary excretion of calcium
d)
reduce urine volume by 50%
29.
What are some acute antihypertensive effects of thiazides
a)
increase Na excretion
b)
decrease intravascular volume
c)
decrease carbon monoxide
d)
decrease blood pressure
e)
increase carbon monoxide
30.
What are some chronic antihypertensive effects of thiazides
a)
volume returns to normal
b)
decreased vascular resistance
c)
carbon monoxide returns to pretreatment levels
31.
What are some adverse effects of thiazides on electrolytes in the body
a)
hypomagnesemia
b)
hypercalcemia
c)
hyponatremia
d)
hypokalemia
e)
hypocalcemia
32.
Thiazides increase delivery of Na in the ___ and ___ which increases the exchange of Na and K, causing ___
a)
proximal convoluted tubule
b)
late distal convoluted tubule
c)
collecting duct
d)
hypokalemia
e)
hyperkalemia
33.
What are some metabolic adverse effects of thiazides
a)
hyperuricemia
b)
hyperglycemia
c)
hyperlipidemia
d)
hypouricemia
e)
hypoglycemia
34.
What are some general adverse effects of thiazides
a)
photosensitivity, rash (from sulfonamide moiety)
b)
weakness
c)
parasthesia
d)
fatigue
e)
hypokalemia
35.
What are some drug interactions of thiazides
a)
decrease lithium excretion, increases lithium levels, cause tremor and seizure
b)
thiazides + antihypertensive drugs, additive effects
c)
NSAIDs blunt thiazide response
d)
thiazide + dofetilide, severe arrhythmia, can cause hypokalemia<br />
36.
Which class of diuretics is the most effective
a)
loop diuretics
b)
potassium-sparing diuretics
c)
aldosterone antagonists
d)
epitheliual sodium channel inhibitors
e)
osmotic diuretic
37.
What are some characteristics of loop diuretics
a)
high-ceiling diuretics
b)
peak diuresis >> other diuretics
c)
works at the loop of Henle
d)
works at the distal tubule
e)
most effective class
38.
What are some loop diuretic agents
a)
furosemide (Lasix)
b)
bumetanide (Bumex)
c)
torsemide (Demadex)
d)
ethacrynic acid
39.
Where is the site of action for loop diuretics
a)
thick ascending limb of Loop of Henle
b)
thick descending limb of Loop of Henle
c)
thin descending limb of Loop of Henle<br />
d)
thin ascending limb of Loop of Henle<br />
40.
About how much Na is absorbed in the thick ascending limb of Loop of Henle
a)
0.1
b)
0.2
c)
0.3
d)
0.4
41.
Loop diuretics inhibit which transporter in the thick ascending limb of the Loop of Henle
a)
NKCC2
b)
Na/K ATPase
c)
CLC-K2
d)
ROMK
e)
ENaC
42.
Loop diuretics increase __ excretion
a)
urine
b)
Na
c)
K
d)
Cl
e)
Ca
43.
What is transported through the CLC-K2 transporter into the basolateral side
a)
urine
b)
Na
c)
K
d)
Cl
e)
Ca
44.
Where are Na/K ATPase pumps located in the thick ascending limb of the Loop of Henle
a)
luminal side
b)
basolateral side
c)
apical membrane
45.
What is transported through the ROMK channel
a)
urine
b)
Na
c)
K
d)
Cl
e)
Ca
46.
What are some adverse effects of loop diuretics on the electrolytes in the body
a)
hypokalemic metabolic alkalosis (excretion of K and H)
b)
hypomagnesemia
c)
hypocalcemia
d)
hypercalcemia
e)
hyperkalemia
47.
What are some metabolic adverse effects of loop diuretics
a)
hyperuricemia
b)
hyperglycemia
c)
hyperlipidemia
d)
hypouricemia
e)
hypoglycemia
48.
One adverse effect of loop diuretics, ototoxicity, can occur
a)
through IV administration
b)
in patients with renal dysfunction
c)
in patients receiving other ototoxic agents
d)
with ethacrynic acid
e)
and hearing impairment is usually reversible
49.
What are some contraindications of loop diuretics
a)
patients who are sensitive to other sulfonamides (except ethacrynic acid, not a sulfonamide)
b)
severe Na and volume depletion
c)
anuria unresponsive to a trial dose of loop diuretics
d)
fatigue
e)
hyperkalemia
50.
What are some potential drug interactions with loop diuretics
a)
potentiate digoxin toxicity in CHF
b)
aminoglycoside (may induce hearing loss)
c)
synergistic effects with thiazides; antihypertensive drugs - hypotension
d)
increase Li concentration
e)
NSAIDs
51.
What are therapeutic indications of loop diuretics
a)
acute pulmonary edema; edema of hepatic, cardiac, or renal origin
b)
hypertension (less frequent due to short duration of action)
c)
acute renal failure
d)
hypercalcemia
e)
hyperkalemia
52.
What are some common characteristics of potassium-sparing diuretics
a)
inhibit potassium excretion (offsets the effects of other diuretics)
b)
diuretic action is weak
c)
Na reabsorption is about 3%
d)
encourage potassium excretion
e)
diuretic action is strong
53.
What are some aldosterone antagonist potassium-sparing diuretics
a)
spironolactone (Aldactone)
b)
eplerenone (Inspra)
c)
triamterene (Dyrenium)
d)
amiloride
54.
What are some potassium-sparing diuretic epithelial sodium channel inhibitors
a)
spironolactone (Aldactone)
b)
eplerenone (Inspra)
c)
triamterene (Dyrenium)
d)
amiloride
55.
Where is the site of action for potassium-sparing diuretics
a)
proximal convoluted tubule
b)
thin descending limb of the Loop of Henle
c)
thick ascending limb of Loop of Henle<br />
d)
cortical collecting tubule and duct
e)
glomerulus
56.
What are the physiological effects of aldosterone on the kidney
a)
Na retention
b)
Na excretion
c)
K retention
d)
K excretion
57.
What effect do aldosterone antagonists have
a)
decrease aldosterone
b)
decrease Na reabsorption
c)
increase K levels
d)
increase Na reabsorption
e)
decrease K levels
58.
What adverse effects do aldosterone antagonists have
a)
hyperkalemia
b)
metabolic acidosis
c)
gynecomastia (spironolactone)
59.
What are some indications for aldosterone antagonists
a)
HTN, CHF
b)
edema (cardiac, hepatic)
c)
hypokalemia
d)
primary aldosteronism
e)
female hirsutism
60.
What are some contraindications of aldosterone antagonists
a)
potassium supplements
b)
K-sparing diuretics
c)
hyperkalemia
d)
decreased renal function
e)
HTN, CHF
61.
What are some characteristics of epithelial sodium channels
a)
structures do not contain steroid backbone
b)
structures contain steroid backbone
c)
actions unrelated to aldosterone inhibition
d)
actions related to aldosterone inhibition
62.
What channel does amiloride and triamterene inhibit
a)
NKCC2
b)
Na/K ATPase
c)
CLC-K2
d)
ROMK
e)
ENaC
63.
What are characteristics of Amiloride
a)
not bound to plasma protein
b)
excreted unchanged in the urine
c)
plasma protein binding 60%
d)
extensive metabolism in liver
64.
What are characteristics of Triamterene
a)
not bound to plasma protein
b)
excreted unchanged in the urine
c)
plasma protein binding 60%
d)
extensive metabolism in liver
65.
What are some common adverse effects of epithelial sodium channel inhibitors
a)
hyperkalemia
b)
metabolic acidosis
c)
nausea/vomiting
d)
headache
e)
hypokalemia
66.
What are some indications for epithelial sodium channel inhibitors
a)
combination with other diuretics for CHF and HTN
b)
hypokalemia
c)
hyperkalemia
d)
metabolic acidosis
67.
What are some properties of osmotic diuretics
a)
free glomerular filtration
b)
limited tubular reabsorption
c)
pharmacologically inert, non-toxic
d)
resistance to metabolic alterations
e)
no receptor is involved and is not administered orally
68.
Where is the site of action for osmotic diuretics
a)
proximal convoluted tubule
b)
descending limb of the Loop of Henle
c)
ascending limb of the Loop of Henle
d)
distal convoluted tubule
e)
collecting duct
69.
Osmotic diuretics have no receptor and involves physicochemical properties for its method of action
a)
true
b)
false
70.
Osmotic diuretics retain water by increasing osmotic pressure as mannitol moves through the nephron causing the urine output to
a)
increase
b)
decrease
c)
remain unchanged
71.
A decreased tubular Na concentration gradient between the luminal fluid and tubular cells will retard the absorption of Na causing Na to
a)
increase
b)
decrease
c)
remain unchanged
72.
What are some adverse effects of osmotic diuretics
a)
dehydration
b)
hyperkalemia
c)
nausea/vomiting/headache
d)
hypernatremia
e)
hypokalemia
73.
What are some contraindications of osmotic diuretics
a)
anuria due to severe renal disease
b)
severe dehydration
c)
hyperkalemia
d)
hypernatremia
74.
What are some indications for osmotic diuretics
a)
acute renal failure
b)
reduce intracranial pressure
c)
reduce increases intraocular pressure
d)
severe renal disease
e)
increase intracranial pressure
75.
What drug is this
a)
chlorothiazide
b)
hydrochlorothiazide
c)
chlorthalidone
76.
What drug is this
a)
chlorothiazide
b)
hydrochlorothiazide
c)
chlorthalidone
77.
What drug is this
a)
chlorothiazide
b)
hydrochlorothiazide
c)
chlorthalidone
78.
What drug is this
a)
furosemide
b)
bumetanide
c)
spironolactone
d)
eplerenone
79.
What drug is this
a)
furosemide
b)
bumetanide
c)
spironolactone
d)
eplerenone
80.
What drug is this
a)
furosemide
b)
bumetanide
c)
spironolactone
d)
eplerenone
81.
What drug is this
a)
triamterene
b)
amiloride
c)
spironolactone
d)
eplerenone
82.
What drug is this
a)
triamterene
b)
amiloride
c)
spironolactone
d)
eplerenone
83.
What drug is this
a)
triamterene
b)
amiloride
c)
spironolactone
d)
eplerenone
Reset
