N5315 Advanced Pathophysiology Renal
Exam Questions and answers 2025
Calcitriol .- .ANS✓✓-active .form .of .vitamin .D .which .is .converted .in .the .kidneys .
-helps .with .the .absorption .of .calcium
-decreases .renal .calcium .excretion
podocytes .- .ANS✓✓-epithelial .cells .in .the .bowman .capsule .which .wrap .around
.the .capillaries .of .the .glomeruli. .They .form .long .processes .(foot .projections)
.called .pedicels .which .wrap .around .the .glomerular .capillaries .and .leave .slits
.between .them. .Blood .is .filtered .through .these .slits
JGA .(juxtaglomerular .apparatus) .- .ANS✓✓-collection .of .cells .consisting .of .the
.juxtaglomerular .cells, .the .macula .densa, .and .the .mesangial .cells
mesangial .cells .- .ANS✓✓-function .as .macrophages
-cells .the .monitor .renal .pressure .and .help .maintain .normal .GFR .through .the
.release .of .renin
release .of .renin .- .ANS✓✓-helps .increase .GFR .by .releasing .angiotensin .II
.which .constricts .the .efferent .arteriole .thereby .increasing .pressure .to .the
.glomerulus
macula .densa .cells .- .ANS✓✓-group .of .epithelial .cells .located .in .the .distal
.convoluted .tubule .that .are .in .close .contact .with .afferent .and .efferent .arterioles.
.They .help .to .regulate .GFR
Renal .blood .flow .- .ANS✓✓--1000-1200mL/min .of .blood
-20% .is .filtered .out .and .of .the .capillaries .and .enters .the .Bowman's .capsule .
-filtrate .then .enters .proximal .tubule .at .125mL/min .= .GFR
-80% .flows .out .of .glomerular .space .and .into .efferent .arterioles .
-efferent .arterioles .divide .into .capillaries .that .surround .the .tubules .= .peritubular
.capillaries .
-network .of .capillaries .in .conjunction .with .epithelial .cells .of .the .tubules .is
.responsible .for .solute .exchange .and .water .regulation
ACE .inhibitors .- .ANS✓✓-blocks .the .action .of .angiotensin .II .on .the .efferent
.arterioles .and .therefore .have .a .renal .protective .quality .in .diabetics .because .it
, .decreases .the .pressure .within .the .glomeruli; .however, .this .mode .of .action .may
.also .result .in .an .acute .kidney .injury, .particularly .in .someone .with .renal .artery
.stenosis
Calcium .stones .- .ANS✓✓--most .common .stone .
-frequently .calcium .oxalate .or .calcium .phosphate .
-caused .by .hyperparathyroidism=increased .osteoclast .activity .which .break
.down .bone
renal .calculi .- .ANS✓✓--AKA .nephrolithiasis .
-AKA .kidney .stones
-made .up .of .calcium, .struvite, .uric .acid .or .cystine .(an .amino .acid .found .in .most
.proteins)
Struvite .stones .- .ANS✓✓--second .most .common
-most .troubling .ones .because .they .frequently .cause .complications .with
.intractable .urinary .tract .infections, .pain, .bleeding, .and .abscess
-made .of .magnesium, .ammonium, .and .phosphate .salts
-results .from .chronic .UTIs .with .urease .that .produce .bacteria .such .as .proteus
.and .pseudomonas
Uric .acid .stones .- .ANS✓✓--third .most .common .
-results .from .the .breakdown .of .purines .(DNA)
-form .in .a .persons .with .excess .purine .intake .or .persons .with .gout
Cystine .stones .- .ANS✓✓--least .common
-usually .occur .in .children
renal .calculi .risk .factors .- .ANS✓✓--Gout .which .results .in .an .accumulation .of
.uric .acid
-Dehydration .whose .link .to .the .pathophysiology .of .nephrolithiasis .is .unknown
-High .protein .diets .resulting .in .an .increase .in .purine .intake
-High .sodium .diet .predisposes .the .individual .to .increased .calcium .excretion
.and .therefore .to .calcium .stone .formation.
-Essential .HTN .has .a .role .in .the .formation .of .renal .calculi .but .the .association .is
.not .clear.
Pathophysiology .of .renal .calculi .- .ANS✓✓-begins .with .the .oversaturation .of
.the .urine .with .the .ions .(calcium, .magnesium, .ammonium, .etc.). .The .cations .and
.anions .bond .with .one .another .and .form .salts .which .precipitate .into .crystals.
.The .crystals .then .form .stones .which .pass .into .the .ureter .and .cause
.excruciating .flank .pain .(renal .colic) .and .obstruction. .The .obstruction .causes
.the .urine .to .back .up .into .the .kidney .resulting .in .Hydronephrosis .and .renal
.failure. .If .the .stone .is .small .enough .it .will .pass .through .the .ureter .without .any
.complications. .Stones .which .are .5mm .or .less .in .size .have .a .50% .chance .of
.spontaneously .passing. .Those .stones .which .are .one .cm .or .larger .will .not .likely
.pass .spontaneously
Exam Questions and answers 2025
Calcitriol .- .ANS✓✓-active .form .of .vitamin .D .which .is .converted .in .the .kidneys .
-helps .with .the .absorption .of .calcium
-decreases .renal .calcium .excretion
podocytes .- .ANS✓✓-epithelial .cells .in .the .bowman .capsule .which .wrap .around
.the .capillaries .of .the .glomeruli. .They .form .long .processes .(foot .projections)
.called .pedicels .which .wrap .around .the .glomerular .capillaries .and .leave .slits
.between .them. .Blood .is .filtered .through .these .slits
JGA .(juxtaglomerular .apparatus) .- .ANS✓✓-collection .of .cells .consisting .of .the
.juxtaglomerular .cells, .the .macula .densa, .and .the .mesangial .cells
mesangial .cells .- .ANS✓✓-function .as .macrophages
-cells .the .monitor .renal .pressure .and .help .maintain .normal .GFR .through .the
.release .of .renin
release .of .renin .- .ANS✓✓-helps .increase .GFR .by .releasing .angiotensin .II
.which .constricts .the .efferent .arteriole .thereby .increasing .pressure .to .the
.glomerulus
macula .densa .cells .- .ANS✓✓-group .of .epithelial .cells .located .in .the .distal
.convoluted .tubule .that .are .in .close .contact .with .afferent .and .efferent .arterioles.
.They .help .to .regulate .GFR
Renal .blood .flow .- .ANS✓✓--1000-1200mL/min .of .blood
-20% .is .filtered .out .and .of .the .capillaries .and .enters .the .Bowman's .capsule .
-filtrate .then .enters .proximal .tubule .at .125mL/min .= .GFR
-80% .flows .out .of .glomerular .space .and .into .efferent .arterioles .
-efferent .arterioles .divide .into .capillaries .that .surround .the .tubules .= .peritubular
.capillaries .
-network .of .capillaries .in .conjunction .with .epithelial .cells .of .the .tubules .is
.responsible .for .solute .exchange .and .water .regulation
ACE .inhibitors .- .ANS✓✓-blocks .the .action .of .angiotensin .II .on .the .efferent
.arterioles .and .therefore .have .a .renal .protective .quality .in .diabetics .because .it
, .decreases .the .pressure .within .the .glomeruli; .however, .this .mode .of .action .may
.also .result .in .an .acute .kidney .injury, .particularly .in .someone .with .renal .artery
.stenosis
Calcium .stones .- .ANS✓✓--most .common .stone .
-frequently .calcium .oxalate .or .calcium .phosphate .
-caused .by .hyperparathyroidism=increased .osteoclast .activity .which .break
.down .bone
renal .calculi .- .ANS✓✓--AKA .nephrolithiasis .
-AKA .kidney .stones
-made .up .of .calcium, .struvite, .uric .acid .or .cystine .(an .amino .acid .found .in .most
.proteins)
Struvite .stones .- .ANS✓✓--second .most .common
-most .troubling .ones .because .they .frequently .cause .complications .with
.intractable .urinary .tract .infections, .pain, .bleeding, .and .abscess
-made .of .magnesium, .ammonium, .and .phosphate .salts
-results .from .chronic .UTIs .with .urease .that .produce .bacteria .such .as .proteus
.and .pseudomonas
Uric .acid .stones .- .ANS✓✓--third .most .common .
-results .from .the .breakdown .of .purines .(DNA)
-form .in .a .persons .with .excess .purine .intake .or .persons .with .gout
Cystine .stones .- .ANS✓✓--least .common
-usually .occur .in .children
renal .calculi .risk .factors .- .ANS✓✓--Gout .which .results .in .an .accumulation .of
.uric .acid
-Dehydration .whose .link .to .the .pathophysiology .of .nephrolithiasis .is .unknown
-High .protein .diets .resulting .in .an .increase .in .purine .intake
-High .sodium .diet .predisposes .the .individual .to .increased .calcium .excretion
.and .therefore .to .calcium .stone .formation.
-Essential .HTN .has .a .role .in .the .formation .of .renal .calculi .but .the .association .is
.not .clear.
Pathophysiology .of .renal .calculi .- .ANS✓✓-begins .with .the .oversaturation .of
.the .urine .with .the .ions .(calcium, .magnesium, .ammonium, .etc.). .The .cations .and
.anions .bond .with .one .another .and .form .salts .which .precipitate .into .crystals.
.The .crystals .then .form .stones .which .pass .into .the .ureter .and .cause
.excruciating .flank .pain .(renal .colic) .and .obstruction. .The .obstruction .causes
.the .urine .to .back .up .into .the .kidney .resulting .in .Hydronephrosis .and .renal
.failure. .If .the .stone .is .small .enough .it .will .pass .through .the .ureter .without .any
.complications. .Stones .which .are .5mm .or .less .in .size .have .a .50% .chance .of
.spontaneously .passing. .Those .stones .which .are .one .cm .or .larger .will .not .likely
.pass .spontaneously
