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Total Categories: 4
The sole primary physiological function of healthy kidneys is to filter toxins from the blood.
Answer: False
Healthy kidneys perform a multitude of vital functions beyond merely filtering toxins, including maintaining fluid and acid-base balance, regulating electrolytes, controlling blood pressure, producing hormones, and activating vitamin D.
The tubular component of the nephron is primarily responsible for secreting water and small molecules back into the blood.
Answer: False
The primary functions of the nephron's tubular lining cells are the reabsorption of water and small molecules from the filtrate back into the blood, and the secretion of wastes from the blood into the urine, not secreting water and small molecules *back into the blood*.
Regulating blood pressure is one of the vital functions performed by healthy kidneys.
Answer: True
Healthy kidneys play a crucial role in regulating blood pressure, alongside other vital functions such as maintaining fluid and electrolyte balance.
Which of the following is NOT listed as a primary physiological function of healthy kidneys?
Answer: Producing digestive enzymes
Healthy kidneys are involved in fluid balance, blood pressure regulation, and vitamin D activation, but they do not produce digestive enzymes; this is a function of the digestive system.
What microscopic structures are essential for the kidney's proper function of filtering blood?
Answer: Renal corpuscles, consisting of a glomerulus and a Bowman's capsule
The renal corpuscles, composed of a glomerulus and Bowman's capsule, are the microscopic filtration units critical for the kidney's blood filtering function.
Which of the following is a vital function of healthy kidneys related to hormone production?
Answer: Producing erythropoietin
Healthy kidneys produce hormones such as erythropoietin, which is vital for red blood cell production, and also play a role in activating vitamin D.
What fundamental processes in urine formation are illustrated by the diagram of the nephron?
Answer: Filtration, secretion, reabsorption, and excretion
The diagram of the nephron illustrates the fundamental processes of filtration, secretion, reabsorption, and excretion, which are essential for urine formation and fluid-electrolyte balance.
The Glomerular Filtration Rate (GFR) is considered the most reliable overall measure of kidney function and is utilized to monitor the progression of renal disease.
Answer: True
The Glomerular Filtration Rate (GFR) is widely recognized as the best overall indicator of kidney function, crucial for assessing the degree of impairment and tracking the advancement of kidney disease.
Creatinine clearance (Ccr) typically underestimates GFR due to creatinine reabsorption by the kidneys.
Answer: False
Creatinine clearance (Ccr) typically *overestimates* GFR, not underestimates it, because of active creatinine secretion by the kidneys, rather than reabsorption.
The differential basal tone of the afferent and efferent arterioles is a critical mechanism for maintaining Glomerular Filtration Rate (GFR).
Answer: True
The differential basal tone of the afferent and efferent arterioles is central to the physiological maintenance of GFR, as it regulates the pressure difference essential for filtration.
GFR is equivalent to the renal clearance ratio when a solute is freely filtered and completely reabsorbed by the nephrons.
Answer: False
GFR is equal to the renal clearance ratio only when a solute is freely filtered and is *neither reabsorbed nor secreted* by the nephrons, not when it is completely reabsorbed.
The normal range of GFR for men is generally higher than for women younger than 40.
Answer: True
The normal GFR range for men (100–130 mL/min/1.73 m²) is indeed higher than for women younger than 40 (90–120 mL/min/1.73 m²).
After the age of 40, GFR progressively decreases with age, typically by 0.4–1.2 mL/min per year.
Answer: True
GFR progressively declines after the age of 40, with an average decrease of 0.4–1.2 mL/min annually.
Estimated GFR (eGFR) is recommended for routine evaluation, whereas measured GFR (mGFR) is reserved for confirmatory tests requiring higher accuracy.
Answer: True
Clinical guidelines recommend eGFR for routine assessment, while mGFR is utilized for confirmatory testing when a more precise evaluation of kidney function is necessary.
What is considered the most comprehensive overall measure of the kidney's capacity to perform its numerous functions?
Answer: Glomerular Filtration Rate (GFR)
The Glomerular Filtration Rate (GFR) is recognized as the best overall measure of the kidney's ability to perform its diverse functions.
What is the primary reason creatinine clearance (Ccr) typically exceeds GFR?
Answer: Creatinine secretion by the kidneys
Creatinine clearance (Ccr) typically exceeds GFR because creatinine is actively secreted by the renal tubules, in addition to being filtered.
What physiological mechanism is central to maintaining the Glomerular Filtration Rate (GFR)?
Answer: The differential basal tone of the afferent and efferent arterioles
The differential basal tone of the afferent and efferent arterioles is a key physiological mechanism that regulates intraglomerular pressure, thereby maintaining a stable GFR.
Under what specific condition is GFR equivalent to the renal clearance ratio?
Answer: When a solute is freely filtered and neither reabsorbed nor secreted by the nephrons
GFR equals the renal clearance ratio when a substance is freely filtered by the glomerulus and is neither reabsorbed back into the blood nor secreted into the urine by the renal tubules.
What is the normal range of GFR for women younger than 40, adjusted for body surface area?
Answer: 90–120 mL/min/1.73 m²
For women younger than 40, the normal GFR range, adjusted for body surface area, is 90–120 mL/min/1.73 m².
How does GFR typically change after the age of 40?
Answer: It progressively decreases by 0.4–1.2 mL/min per year.
After the age of 40, GFR typically undergoes a progressive decline, decreasing by approximately 0.4–1.2 mL/min annually.
Which type of GFR measurement is recommended by clinical practice guidelines for *routine evaluation*?
Answer: Estimated GFR (eGFR)
Clinical practice guidelines advocate for the use of estimated GFR (eGFR) for routine evaluation of kidney function.
What is the precise definition of Glomerular Filtration Rate (GFR)?
Answer: The volume of fluid filtered from the renal glomerular capillaries into the Bowman's capsule per unit of time.
The Glomerular Filtration Rate (GFR) is precisely defined as the volume of fluid filtered from the renal glomerular capillaries into Bowman's capsule per unit of time, indicating the efficiency of blood filtration.
To ascertain the specific etiology of kidney disease, GFR measurement alone is deemed sufficient.
Answer: False
While GFR indicates the degree of kidney impairment, it does not identify the underlying cause of the disease. Additional tests such as urinalysis, urine protein excretion, kidney imaging, and potentially a kidney biopsy are required to determine the etiology.
Oedema, hypertension, and anaemia are potential clinical manifestations of abnormally functioning kidneys.
Answer: True
Abnormally functioning kidneys can lead to oedema due to impaired water balance, high blood pressure, and anaemia, among other symptoms.
Urine tests are exclusively used to measure the volume of urine produced and are ineffective for assessing protein filtration.
Answer: False
Urine tests are crucial for assessing the kidney's ability to filter protein, frequently measuring urine albumin or total urine protein levels, in addition to evaluating urine volume.
Blood tests for renal function encompass direct measurements of GFR and evaluations of electrolyte levels, such as potassium and phosphate.
Answer: True
Blood tests for kidney function include direct measures of GFR and assessments of electrolyte levels such as potassium and phosphate, along with acid-base status and full blood count.
Medical imaging techniques, such as kidney ultrasound, can directly quantify the rate of filtration by the kidneys.
Answer: False
Medical imaging techniques like kidney ultrasound indirectly assess renal function by revealing morphological changes indicative of chronic disease, such as a small or shriveled kidney, but do not directly measure the filtration rate. Nuclear medicine scans, however, can directly evaluate perfusion and excretion.
A comprehensive medical history, physical examination, renal ultrasound, and urinalysis constitute the recommended initial assessments for evaluating decreased renal function.
Answer: True
Initial assessment for decreased renal function typically includes a thorough medical history, physical examination, renal ultrasound, and urinalysis to gather comprehensive diagnostic information.
The presence of gross hematuria and a family history of heart disease are the most pertinent historical items for evaluating decreased renal function.
Answer: False
While gross hematuria is a relevant historical item, a family history of *kidney disease* (not heart disease) is considered pertinent for evaluating decreased renal function, alongside other factors like current medications, oedema, nocturia, diabetes, and polyuria.
Renal enlargement observed in an ultrasound may indicate conditions such as diabetic nephropathy or myeloma.
Answer: True
Renal enlargement detected via ultrasound can be a diagnostic clue for conditions like diabetic nephropathy, focal segmental glomerular sclerosis, or myeloma.
Beyond GFR, what additional diagnostic test is typically performed to identify the *source* or etiology of kidney disease?
Answer: Kidney biopsy
To identify the specific cause of kidney disease, beyond GFR measurement, a kidney biopsy is often performed, along with urinalysis and imaging.
Which of the following symptoms is specifically mentioned as an indicator of abnormally functioning kidneys due to the inability to regulate water balance?
Answer: Oedema
Oedema is a specific symptom of abnormally functioning kidneys, often resulting from the kidneys' impaired ability to regulate the body's water balance.
Which of the following medical imaging techniques *indirectly* assesses kidney function by revealing signs of chronic disease, such as a small or shriveled kidney?
Answer: Kidney ultrasound
Kidney ultrasound indirectly assesses renal function by visualizing morphological changes like a small or shriveled kidney, which are indicative of chronic renal disease.
When a patient presents with decreased renal function, which of the following is NOT listed as an initial recommended assessment?
Answer: Kidney biopsy
A kidney biopsy is typically a more invasive procedure performed after initial assessments like medical history, physical examination, renal ultrasound, and urinalysis, especially when the cause of decreased renal function remains unclear.
Which of the following physical examination findings is important in assessing decreased renal function?
Answer: Signs of vasculitis
Signs of vasculitis are an important physical examination finding in the assessment of decreased renal function, alongside other conditions like lupus erythematosus, diabetes, endocarditis, and hypertension.
What does urinalysis revealing no pathology suggest regarding the etiology of decreased renal function?
Answer: Extrarenal cause
A urinalysis that shows no pathology suggests that the cause of decreased renal function is extrarenal, meaning it originates outside the kidneys.
Renal enlargement observed in a renal ultrasound may suggest which of the following conditions?
Answer: Diabetic nephropathy
Renal enlargement on ultrasound can be indicative of conditions such as diabetic nephropathy, focal segmental glomerular sclerosis, or myeloma.
Smoking is not considered a significant risk factor for kidney disease.
Answer: False
Smoking is indeed identified as a significant risk factor for kidney disease, alongside diabetes, high blood pressure, family history, older age, and ethnic group.
A GFR exceeding 60 mL/min/1.73 m² is generally considered adequate for the majority of patients.
Answer: True
For most patients, a Glomerular Filtration Rate (GFR) above 60 mL/min/1.73 m² is considered sufficient for adequate kidney function.
Early diagnosis and timely treatment of kidney dysfunction can help preserve residual nephrons and potentially prevent the need for dialysis.
Answer: True
Prompt identification and management of kidney dysfunction are crucial for preserving remaining nephron function and may avert the necessity for dialysis.
Stage 0 of chronic kidney disease is characterized by a GFR below 90 mL/min/1.73 m² with no proteinuria.
Answer: False
Stage 0 of chronic kidney disease is defined by normal kidney function, meaning a GFR *above* 90 mL/min/1.73 m² and no proteinuria, not below.
Kidney failure, designated as Stage 5 of chronic kidney disease (CKD5), is defined by a GFR less than 15 mL/min/1.73 m².
Answer: True
Stage 5 of chronic kidney disease (CKD5) represents kidney failure and is precisely defined by a GFR less than 15 mL/min/1.73 m².
The classification of chronic kidney disease stages is universally accepted by all clinicians without controversy.
Answer: False
The current classification of chronic kidney disease stages is not universally accepted, with some clinicians raising concerns, particularly regarding the labeling of elderly individuals with mildly reduced kidney function as diseased.
The MDRD-eGFR value exclusively defines the severity of all six stages of chronic kidney disease.
Answer: False
While the MDRD-eGFR value defines the severity of the three most severe stages of chronic kidney disease, the initial three stages also incorporate other evidence of kidney damage, such as proteinuria, for their definition.
Which of the following is NOT identified as a risk factor for kidney disease?
Answer: Regular exercise
Regular exercise is generally considered beneficial for health and is not identified as a risk factor for kidney disease, unlike diabetes, high blood pressure, and older age.
What GFR level is generally considered adequate for the majority of patients?
Answer: Over 60 mL/min/1.73 m²
A Glomerular Filtration Rate (GFR) exceeding 60 mL/min/1.73 m² is generally considered sufficient for adequate kidney function in most patients.
What defines Stage 1 of chronic kidney disease (CKD1)?
Answer: GFR above 90 mL/min/1.73 m² with evidence of kidney damage
Stage 1 of chronic kidney disease (CKD1) is characterized by a GFR above 90 mL/min/1.73 m², accompanied by objective evidence of kidney damage, such as proteinuria.
What GFR range defines Stage 3 of chronic kidney disease (CKD3), considered moderate?
Answer: 30 to 59 mL/min/1.73 m²
Stage 3 of chronic kidney disease (CKD3), classified as moderate, is defined by a GFR ranging from 30 to 59 mL/min/1.73 m².
What GFR range defines Stage 4 of chronic kidney disease (CKD4), considered severe?
Answer: 15 to 29 mL/min/1.73 m²
Stage 4 of chronic kidney disease (CKD4), categorized as severe, is defined by a GFR ranging from 15 to 29 mL/min/1.73 m².
What GFR level defines Stage 5 of chronic kidney disease (CKD5), representing kidney failure?
Answer: Less than 15 mL/min/1.73 m²
Stage 5 of chronic kidney disease (CKD5), indicative of kidney failure, is defined by a GFR less than 15 mL/min/1.73 m².