Nokea
Which of the following statements about part of a nephron? antidiuretic hormone (ADH) is incorrect?
- A. renal pelvis
- B. ADH regulates the amount of water
- C. distal tubule reabsorbed by the kidneys
- D. collecting duct
Correct Answer:
Rationale: The correct answer is A: renal pelvis. The renal pelvis is not directly related to the action of antidiuretic hormone (ADH) in the nephron. ADH regulates water reabsorption in the collecting duct of the nephron to maintain water balance in the body. Choices B, C, and D are incorrect because they are all associated with the function of ADH in the nephron. ADH regulates the amount of water reabsorbed in the distal tubule and collecting duct, not the renal pelvis.
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A patient with psychologic disorder is being treated with a drug. Few months he is worried that he is constantly thirsty and urinates copiously frequently throughout the day and night. Which of the following drugs most likely cause inappropriate secretion of ADH?
- A. Diazepam
- B. Lithium
- C. Haloperidol
- D. Phenytoin
Correct Answer: B
Rationale: The correct answer is B: Lithium. Lithium is known to cause nephrogenic diabetes insipidus, leading to inappropriate secretion of ADH. This results in excessive thirst and copious urination. Diazepam (A) does not affect ADH secretion. Haloperidol (C) and Phenytoin (D) are not associated with ADH dysregulation.
The Na+Cl- transporter in the distal convoluted tubule of the kidney is blocked by:
- A. Spironolactone
- B. Thiazides
- C. Furosemide
- D. Ethacrynic acid
Correct Answer: B
Rationale: The correct answer is B: Thiazides. Thiazides work by inhibiting the Na+/Cl- transporter in the distal convoluted tubule, leading to decreased sodium reabsorption and increased urine output. This results in decreased blood volume and lower blood pressure. Spironolactone (A) works by blocking aldosterone receptors, affecting potassium and sodium balance. Furosemide (C) and Ethacrynic acid (D) act on the loop of Henle, inhibiting the Na+/K+/2Cl- transporter. Therefore, the correct answer is B because thiazides specifically target the Na+/Cl- transporter in the distal convoluted tubule.
What piece of the patient's medical history supports the diagnosis of a urinary tract infection?
- A. The patient's wife had a urinary tract infection 1 month ago.
- B. The patient has been followed for prostate disease for 2 years.
- C. The patient had intermittent catheterization 6 months ago.
- D. The patient had a kidney stone removed 1 year ago.
Correct Answer: C
Rationale: The correct answer is C because a history of intermittent catheterization increases the risk of urinary tract infections due to potential introduction of bacteria into the urinary system. This directly supports the diagnosis of a urinary tract infection.
A: The wife's history is irrelevant unless the patient had direct contact or shared personal items with her.
B: Prostate disease does not directly correlate with a urinary tract infection.
D: Kidney stones are not directly related to urinary tract infections unless there was an associated infection during the stone removal.
Most physical problems that occur during peritoneal or hemodialysis are related to which phenomenon that may result from
- A. nausea and vomiting due to too rapid removal of fluid
- B. movement of red blood cells across the dialyzing membrane
- C. movement of glucose from the dialyzing solution into the blood
- D. water intoxication from excessive fluid removal
Correct Answer: A
Rationale: The correct answer is A: nausea and vomiting due to too rapid removal of fluid during peritoneal or hemodialysis. This is because rapid removal of fluid can lead to electrolyte imbalances and changes in blood pressure, causing nausea and vomiting.
Choice B is incorrect because movement of red blood cells across the dialyzing membrane is not a common physical problem during dialysis.
Choice C is incorrect because movement of glucose from the dialyzing solution into the blood is not typically associated with physical problems during dialysis.
Choice D is incorrect because water intoxication from excessive fluid removal can occur, but it is not the most common physical problem during dialysis.
A 70 year old man has severe urinary hesitancy associated with bPH. He has * tried alpha blockers with little effect. His physician recommends a drug that blocks 5α-reductase in the prostate which is:
- A. Leuprolide
- B. Finasteride
- C. Flutamide
- D. Ketoconazole
Correct Answer: B
Rationale: The correct answer is B: Finasteride. Finasteride inhibits 5-alpha reductase, reducing conversion of testosterone to dihydrotestosterone (DHT) in the prostate. This helps shrink the prostate gland, relieving urinary symptoms in BPH. Leuprolide (A) is a GnRH agonist used for prostate cancer. Flutamide (C) is an antiandrogen for prostate cancer. Ketoconazole (D) is an antifungal, not for BPH. Finasteride is the most appropriate choice for this patient based on mechanism of action and indication.