RENAL SYSTEM: QUESTIONS
1. RBF + Juxtaglomerular apparatus
1. Discuss the autoregulation of renal blood flow.
2. Explain with a flowchart the role of juxta-glomerular apparatus when the blood pressure
falls.
3. Describe briefly the structure and functioning of Juxtaglomerular apparatus.
4. Explain the role of renin-angiotensin mechanism in the regulation of secretion of
aldosterone. Add a note on aldosterone escape.
5. Explain the physiological actions of angiotensin-II. What is the role of angiotensin
converting enzyme (ACE) inhibitors in regulation of blood-pressure.
2. GFR
6. Define GFR. Give its normal value. List the factors affecting it.
7. Explain the role of Juxtaglomerular apparatus in maintaining GFR
8. Describe the process of glomerular filtration and factors affecting filtration with special
emphasis on the net filtration pressure. Explain how GFR can be measured.
9. Explain how GFR is kept constant despite changes in mean arterial pressure within a
certain range.
10. In a diabetic individual GFR was 125ml/min and the blood glucose level was100mg/dl.
How much will be the tubular load of glucose in this patient. How much is the normal
renal threshold for glucose and what is the significance of this value?
11. Explain the concept of Renal Threshold and Renal Transport Maximum.
12. Explain renal tubular handling of sodium
13. Describe briefly the mechanism of Na+ reabsorption in different segments of renal
tubules.
3. Counter-current Mechanism
14. Explain the mechanism that maintains the hyperosmolarity of renal medullary
interstitium.
15. Explain with the help of a diagram, how kidney helps to create medullary osmoticgradient?
16. Explain the physiological mechanism involved in the formation of small amount of
dark yellow urine
17. Explain how protein rich diet and raised urea synthesis helps in concentrating urine.
Explain with a suitable diagram.
18. Explain the role of loop of Henle and vasa recta in counter current mechanism in the
kidney
4. Micturition
19. Describe micturition reflex with the help of a diagram.
20. Define cystometry and discuss the normal cystometrogram.
21. Compare and contrast water and osmotic diuresis
22. Define micturition and explain the pressure and volume change in urinary bladder
23. Draw a well labelled diagram to show innervation of urinary bladder. Explain the neural
pathway for control of micturition
24. Explain the effect of denervation on micturition reflex
4. Applied Aspects
25. Define renal clearance. Explain how renal blood flow can be estimated using renal
clearance of specific substances.
26. Define renal clearance. Explain how glomerular filtration rate is measured
27. Define renal clearance. Mention any 2 criteria of a substance to be used for estimating
renal clearance. Using the formula calculate the renal clearance for substance ‘X’ if
concentration of substance ‘X’ in plasma is 13 mg/ml and in urine is 48 mg/ml and
volume of urine produced is 34 ml/min.
28. A patient dies of acute renal failure on twelfth day following a mismatched emergency
blood transfusion.
a. Discuss the reasons for renal failure in the above case.
29. Explain how this can be prevented by doing hematological tests.
30. Calculate the clearance of a substance when its concentration in the plasma is 1mg /dl.
Its concentration in the urine is 100mg/dl, and urine flow rate is 2ml/min. Why
creatinine is used clinically in measurement of GFR?
31. An elderly man with chronic diabetes mellitus with renal failure, having generalized
edema comes to nephrology department for dialysis.
32. Describe the basic principles of dialysis
33. Give the reason for dialysis in the above patient? I
34. What is artificial kidney?
35. Metabolic acidosis
36. Explain the physiological basis of using dialysis in the treatment of renal failure patient.
37. Describe the process of acidification of urine
38. Explain the renal compensatory mechanisms in acid-base derangements
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