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MODIFIED TRUE OR FALSE

1. Asymptomatic Bacteriuriaa. Diagnosis involves both microbiologic and clinical criteriab. Microbiologic criterion is usually >/= 10 x 5 bacterial cfu/ml in catheter associated

diseasec. Patient may have fever and chillsd. Patient has no signs or symptoms referable to UTIe. Patient has dysuria but with no fever

2. Uncomplicated cystitis in womena. Acute onset of dysuria, fever and urgencyb. Dysuria in an otherwise healthy pregnant patientc. Does not always warrant urinalysisd. There is no longer a single best agent for ite. First line agent involves TMP-SMX and nitrofurantoin

3. Complicated UTIa. Must be guided by urine culture resultb. Xanthogranulomatous pyelonephritis is treated with percutaneous drainagec. 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 quinolone4. Results in autoregulation of glomerular filtration

a. Autonomous vasoactive reflex in the efferent arterioleb. Tubuloglomerular feedbackc. Angiotensin II mediated vasoconstriction of the afferent arterioled. Myogenic reflex in the afferent arteriolee. Increase blood pressure

5. Renal Membrane Transporta. Active transport involving channels requires metabolic energy generated by the

hydrolysis of ATP

b. Pumps are often electrogenic meaning they can create symmetric distribution ofelectrostatic charges across the membrane and establish a voltage or membrane

potential

c. The movement of solutes through a membrane protein by simple diffusion is calledpassive transport

d. Facilitated diffusion is a specialized type of active transport mediated by simpletransporters called carriers or uniporters

e. Cell membranes are composed of hydrophobic lipids that repel water and aqueoussolutes

6. The proximal tubule of the kidney

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a. Is responsible for reabsorbing 60 % of filtered NaCl and water as well as 90 % of filteredbicarbonate,glucose and amino acids

b. Utilizes both the cellular and paracellular transport mechanismsc. 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 anhydrasese. Chloride is poorly reabsorbed throughout the 3rd segment of the proximal tubule

7. Sodium Balancea. 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 increasesNa reabsorption

c. Angiotensin II promotes sodium reabsorption along the collecting duct by stimulatingsecretion of aldosterone by the adrenal cortex

d. The balance between Na intake and excretion is under the influence of baroreceptors inregional blood vessels and vascular hormone sensors modulated by ANP.

e. Chronic exposure to aldosterone causes a decrease in urinary sodium excretion lastingonly a few days, after which Na excretion returns to previous levels.

8. Common mechanism of progressive renal diseasea. 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 totrauma or transplantation produces significant consequences

c. Persistent glomerular injury produces local hypertension in capillary tufts, dcreases theirsingle nephron filtration rate and engenders protein leak into the tubular fluid

d. There is a high correlation between worsening glomerular proteinuria with renalprogression 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 hyperfiltration9. The cause of intrinsic acute kidney injury

a. Sepsisb. AGNc. Vasculitisd. Cyclosporinee. Bladder outlet obstruction

10. In ischemic Acute renal failure, there is decreased vasodilation in the glomerular and medullaryvasculature in response to

a. Nitric oxideb. PGE2c. Acetylcholined. Bradikinine. Adenosine

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11.