Renal – 2020

The question bank may take some time to load… Just enough time to stretch, blink a few times, and question your life choices — but not too long, we promise!

We recommend going Full Screen for the best experience. Have Fun !

/137

Report a question

You cannot submit an empty report. Please add some details.

Renal

Renal – 2020

Questions from The 2020  Module + Annual Exam of Renal

“Please enter your name and email so that we maybe able to send you statistics, but more importantly, a nice certificate upon completion. Thank you for using MedifyHelp!”

Think of the elderly patient on long-term cimetidine showing other changes rather than physical sign.

1 / 137

Category: GIT – Pharmacology

What is the most reported adverse effect of long-term use of cimetidine?

Focus on how glucose is reabsorbed in the nephron. Which transporter couples glucose uptake with sodium, has a high capacity but low affinity, and operates in the early proximal tubule where the bulk of glucose reabsorption occurs?

2 / 137

Category: Renal – Physiology

Which glucose transporter is present on the luminal side in the early part of the proximal convoluted tubule?

Think about substances released by endothelial cells that generally relax blood vessels and enhance organ perfusion.

3 / 137

Category: Renal – Physiology

Which of the following hormones or autocoids can increase the glomerular filtration rate (GFR) by decreasing vascular resistance in the glomerular capillaries?

Think about what is immediately life-threatening in opioid overdose and which intervention directly counteracts the drug’s mechanism.

4 / 137

Category: Neurosciences – Pharmacology

A 20-year-old man is brought into the emergency as he has overdosed on morphine. On examination, he is unconscious, pupils are pinpoint and nonreactive. Several injection marks are also seen on his arms. What is the immediate treatment to be precise after seeing breathing, and circulation?

Think about the organ asymmetry in the abdominal cavity and which organs are predominantly on the left vs. right side.

5 / 137

Category: Renal – Anatomy

Which of the following is not found anterior to the left kidney?

Consider the proportion of plasma filtered at the glomerulus versus the total plasma delivered to the kidney—this ratio is what determines the filtration fraction.

6 / 137

Category: Renal – Physiology

Which of the following is the normal value of filtration fraction?

Think about which nephron segment has opposing permeability properties along its length that allow a small energy expenditure to create a large osmotic gradient.

7 / 137

Category: Renal – Physiology

Which of the following is involved in the counter-current multiplier mechanism of kidneys?

Consider which drugs alter sodium handling in the distal nephron to directly influence potassium retention, rather than just removing fluid.

8 / 137

Category: Renal – Pharmacology

Which of the following drugs is effective in decreasing K+ ion secretion in the distal convoluted tubule?

Think about the combination of lactose fermentation, Gram stain, and motility—how each characteristic helps narrow down urinary pathogens.

9 / 137

Category: Renal – Pathology

A patient came to the outpatient department with frequent urinary discharge. A complete urinalysis on agar medium was done and bacteria were found to be non-lactose fermenter, gram -ve, rod-shaped with no signs of swarming movement. Which of the following could be the cause?

Consider what outcome directly reflects the patient’s day-to-day well-being and freedom from dialysis, rather than just survival or eligibility criteria.

10 / 137

Category: Renal – Pathology

Which of the following is most true for transplantation?

Think about the type of care that reduces patient uncertainty and anxiety by giving a comprehensive understanding of what they face medically and in their treatment plan.

11 / 137

Category: Renal – ComMed/BehSci

Which of the following correctly describes ‘informational care’?

Consider which substances in arterial blood directly reflect respiratory function and acid-base balance, versus those reflecting metabolic or kidney function.

12 / 137

Category: Renal – Biochemistry

Which of the following is measured through the arterial blood gas (ABG) test?

Think about which substances in the blood are reabsorbed or secreted variably in the renal tubules, and how that affects their reliability for measuring filtration.

13 / 137

Category: Renal – Physiology

Which of the following can not be used as a marker to measure glomerular filtration rate (GFR)?

Focus on the embryologic origin of the bladder versus the kidney collecting system—which structure comes from the urogenital sinus rather than the mesonephric derivatives?

14 / 137

Category: Renal – Embryology

Which of the following is not derived from ureteric bud?

Consider what structural change in the urinary outflow tract could chronically increase bladder pressure and reverse the normal flow of urine.

15 / 137

Category: Renal – Pathology

Which of the following is an acquired cause of vesicoureteral reflux in adults leading to urinary tract infection?

Think of the kidney as an organ wrapped in layers: which layer is responsible for holding the kidney in place in the retroperitoneum?

16 / 137

Category: Renal – Anatomy

Which of the following forms the outermost layer of the kidney?

Imagine cutting the kidney in half: the central hollow space containing urine-collecting structures and fat is your key. Which structure naturally belongs there?

17 / 137

Category: Renal – Anatomy

Which of the following can be seen in the renal sinus?

Think about how lymphatic drainage usually follows the arterial supply, and trace the ureter from kidney to bladder. Which nodes are closest to its origin?

18 / 137

Category: Renal – Anatomy

The superior portion of the ureter drains into which of the following lymph nodes?

Consider which solute most strongly determines extracellular fluid volume. Then think about which hormone directly controls its reabsorption in the kidney.

19 / 137

Category: Renal – Physiology

What is the major hormone involved in regulation of sodium and water balance in the body?

Ask yourself why the kidney maintains a much higher capillary pressure than other tissues, and how the unique arrangement of two arterioles in series allows this regulation.

20 / 137

Category: Renal – Physiology

What is the renal capillary pressure across the glomerular capillaries?

This enzyme doesn’t just break down purines — it also generates something that contributes to oxidative stress and must later be neutralized by catalase or peroxidase.

21 / 137

Category: Renal – Biochemistry

Xanthine oxidase is catalytically important for the formation of uric acid along with which of these?

Think of a design that measures both the condition and its possible causes at the same instant. It doesn’t look back into the past or follow anyone into the future — it just freezes the moment.

22 / 137

Category: Renal – ComMed/BehSci

Which of the following study design is also called a snap shot study?

When thinking about the filtration barrier, consider what structural feature allows water and small solutes to pass but prevents blood cells from escaping. Would a continuous lining allow this, or would a specialized, perforated lining be necessary?

23 / 137

Category: Renal – Histology

Which of the following is not the part of renal filtration barrier?

Consider what would happen if urine production continued at a normal rate while the ureter was blocked. Which mechanism could help protect the kidney from damage by decreasing filtration when downstream pressure rises?

24 / 137

Category: Renal – Physiology

Which reflex is initiated when the ureter is blocked by the stone resulting in intense pain?

Think about what makes the kidney’s circulation different from most organs: instead of a single capillary bed between an arteriole and a venule, the kidney uses two capillary networks in series. Ask yourself: after blood passes through the first set of capillaries, which type of vessel could possibly carry it onward to another capillary network?

25 / 137

Category: Renal – Anatomy

What are the vessels that connect glomerular capillaries with peritubular capillaries called?

Think about where in the nephron the body would most effectively fine-tune calcium balance. Consider which tubular region allows hormone-regulated, selective reabsorption rather than bulk reabsorption.

26 / 137

Category: Renal – Physiology

Under the influence of parathyroid hormone, the renal reabsorption of calcium mainly occurs in which part of the kidney?

Think of a substance that is filtered and excreted exactly as filtered, without any tubular interference, used as a gold standard to measure kidney function.

27 / 137

Category: Renal – Physiology

This substance is freely filtered by the glomerular capillaries but is neither reabsorbed nor secreted. Therefore, its excretion rate is equal to the rate at which it was filtered. Which substance is this?

Think of a waste product of muscle metabolism that is mostly filtered and slightly secreted, used routinely to estimate kidney function.

28 / 137

Category: Renal – Physiology

This substance is freely filtered at the glomerular capillaries and is not reabsorbed, but additional quantities of this substance are secreted from the peritubular capillary blood into the renal tubules. Which substance is this?

Think of substances that are nutritionally valuable, completely reclaimed by the tubules, and normally absent from urine.

29 / 137

Category: Renal – Physiology

The substance is freely filtered at the glomerular capillaries but is not excreted into the urine because all the filtered substance is reabsorbed from the tubules back into the blood. This pattern occurs for which of the following?

Consider how severe slowing of blood through the glomerulus concentrates plasma proteins, and how that affects filtration.

30 / 137

Category: Renal – Physiology

The severe constriction of efferent arterioles affects glomerular filtration rate (GFR) by which one of the following changes?

Think about the first committed and regulated cytosolic step in mammalian pyrimidine nucleotide synthesis.

31 / 137

Category: Renal – Biochemistry

Which enzyme catalyzes the rate-limiting step of pyrimidine biosynthesis in mammalian cells?

Brush borders are densely packed microvilli that maximize absorptive surface in the nephron’s first tubular segment.

32 / 137

Category: Renal – Histology

Which part of the nephron exhibits brush border on microscopy?

Think about the water channel responsible for constitutive, non-ADH-dependent water reabsorption in the proximal tubule.

33 / 137

Category: Renal – Physiology

The osmolality of the proximal convoluted tubule is the same as that of plasma, due to the presence of water channels on the basolateral membrane that causes reabsorption of water. Which water channels are present in the basolateral membrane of proximal convoluted tubules?

Consider the normal oxygen tension in arterial blood of a healthy adult breathing room air at sea level.

34 / 137

Category: Renal – Physiology

What is the normal PO2 level in arterial blood?

Think about the opposing pressure created by plasma proteins in the glomerular capillaries that resists filtration.

35 / 137

Category: Renal – Physiology

What is the normal glomerular capillary colloid osmotic pressure?

Think about a substance produced steadily, freely filtered, and not reabsorbed, which directly reflects the kidney’s filtering ability.

36 / 137

Category: Renal – Physiology

What is the most sensitive indicator of glomerular function?

Focus on the nephron segment that dives deep into the inner kidney to help concentrate urine.

37 / 137

Category: Renal – Anatomy

Which of the following is the only part present in the medullary region?

Think about the nephron segment responsible for active salt reabsorption without water, creating a concentrated medullary interstitium.

38 / 137

Category: Renal – Physiology

In which of the following are Na-K-Cl cotransporters present in?

Focus on the mechanism by which the proximal tubule recovers most of the filtered bicarbonate and its connection to hydrogen ion secretion.

39 / 137

Category: Renal – Biochemistry

The greatest amount of hydrogen ion secreted by the proximal tubule is associated with which of the following?

Look for extensions of the outer kidney layer pushing inward between the pyramids rather than the inner medullary structures.

40 / 137

Category: Renal – Anatomy

The examination of a cross-section of kidneys shows the renal columns of Bertin. Which statement best defines the renal columns of Bertin?

Trace the pathway from purine bases to the molecule excreted in urine that humans cannot degrade further.

41 / 137

Category: Renal – Biochemistry

What is the end product of purine metabolism in humans?

Think about the smallest unit in the kidney that can independently filter blood and form urine.

42 / 137

Category: Renal – Anatomy

Which of the following can the nephron be best defined as?

Consider which germ layer lines the distal opening of the urethra, which is continuous with the skin.

43 / 137

Category: Renal – Embryology

The distal part of the male urethra in the glans of the penis is derived from which of the following?

Trace the pathway of blood from the renal artery to the glomerulus and identify the smallest cortical artery before entering the glomerulus.

44 / 137

Category: Renal – Anatomy

Which of the following do the afferent arterioles arise from?

Focus on how the kidneys adjust chemical buffers to neutralize excess H⁺ in response to elevated CO₂.

45 / 137

Category: Renal – Biochemistry

What is the compensatory mechanism in respiratory acidosis (increased PCO2)?

Think about the major pelvic artery that gives off branches to structures near the bladder and ureter.

46 / 137

Category: Renal – Anatomy

Which of the following provides arterial supply to the pelvic part of the ureter?

Think about which organ is strictly on the opposite side of the body relative to the right kidney.

47 / 137

Category: Renal – Anatomy

Which structure is not related to the anterior surface of the right kidney?

Focus on the transport mechanism that directly uses ATP to pump ions against their gradient across the basolateral membrane.

48 / 137

Category: Renal – Physiology

Which type of transport facilitates the sodium absorption in distal convoluted tubule by Na pump across the basolateral membrane?

Think about how the kidney preserves the medullary osmotic gradient that allows water to be pulled out of the collecting duct.

49 / 137

Category: Renal – Physiology

Which of the following will increase the ability of the kidney to excrete concentrated urine?

Consider the bladder region that serves as the main reservoir and detects fullness most effectively.

50 / 137

Category: Renal – Anatomy

Where do the stretch signals for bladder emptying mainly originate?

Focus on the cation that must be excreted to balance the positive charge when sodium is reabsorbed in the distal nephron.

51 / 137

Category: Renal – Physiology

Sodium retention through aldosterone-mediated renal regulation results in the elimination of which one of the following?

Think about how potassium levels affect hydrogen ion handling in the distal nephron and the resulting acid-base consequences.

52 / 137

Category: Renal – Biochemistry

What does renal correction of acute hyperkalemia result in?

Consider the anatomical position of the uterus relative to the bladder—is it in front, behind, or above?

53 / 137

Category: Renal – Anatomy

Which of the following is not present anterior to the urinary bladder?

Think about a drug that pulls water out of brain tissue into blood vessels, reducing swelling and pressure.

54 / 137

Category: Renal – Pharmacology

Which of the following drugs should be used to decrease intracranial pressure?

Think about the first, high-capacity transporter that handles most of the filtered glucose in the early proximal tubule.

55 / 137

Category: Renal – Physiology

Which of the following is responsible for glucose reabsorption in the S1 segment of the proximal convoluted tubule?

Think about the cortical extensions that “invade” the medulla between pyramids, providing structural and vascular continuity.

56 / 137

Category: Renal – Anatomy

What are the regions of cortical parenchyma located between medullary pyramids rather than adjacent to the surface of the kidney called?

Consider which drug blocks a hormone that is already deficient in this disease—using it would be counterproductive.

57 / 137

Category: Endo – Pharmacology

Which of the following drugs is ineffective in Addison’s disease?

Think about which cytokine mediates structural changes in the glomerulus during nephritis and drives progressive damage.

58 / 137

Category: Renal – Pathology

Regarding glomerular diseases, which of the following is most likely the pathogenesis of glomerulonephritis?

Consider the average adult kidney rather than extremes or ranges reported in textbooks.

59 / 137

Category: Renal – Anatomy

What is the approximate length of kidney?

Trace the arterial pathway from the renal artery to the glomerulus and note which vessels actually give rise to the afferent arterioles.

60 / 137

Category: Renal – Anatomy

Which of the following is not true regarding blood supply to the kidneys?

Consider which ion secreted into the tubular lumen drives sodium reabsorption while also regulating acid-base balance.

61 / 137

Category: Renal – Biochemistry

Reabsorption of sodium in renal tubules is associated with the exchange of which of these ions?

Consider what gaseous signal in the blood can diffuse into renal cells and drive bicarbonate formation.

62 / 137

Category: Renal – Biochemistry

What causes the reabsorption of bicarbonates from renal tubules?

Think about which toxic nitrogenous waste the body needs to eliminate and which molecule starts that cycle.

63 / 137

Category: Renal – Biochemistry

Which of the following is carbamoyl phosphate a precursor of?

Consider which connective tissue layer around the kidney extends downward to support and enclose the ureter.

64 / 137

Category: Renal – Anatomy

Periureteric fascia is an extension of which of these?

Think about which part of the nephron contacts the glomerular arterioles and monitors sodium to regulate filtration.

65 / 137

Category: Renal – Physiology

On discussing histological features of the kidney, the students were asked about the location of macula densa. What is its location?

Think about how a healthy mind explains failures: avoid self-blame, see it as temporary, and specific rather than all-encompassing.

66 / 137

Category: Renal – ComMed/BehSci

Mr. Mughees did not score well in the exam. He has pessimistic explanatory styles and attributed his failure to generalized bad luck i.e. ‘I always had bad luck in all life situations’ (stable and global attribution), which lead to him being depressed. Which one of the following could preferably explain the causes of negative events contrary to this pessimistic explanatory style?

Consider what would empower the patient with knowledge and reduce uncertainty, not just soothe emotions

67 / 137

Category: Renal – ComMed/BehSci

Mrs. X, a 30-year-old, recently married female, presented with a breast lump for the first time in the clinic. The doctor listened to her attentively but was insensitive towards her symptoms and complications. The doctor did not say or discuss anything but advised her to get the list of investigations done. She returned from the clinic more apprehensive and confused. What do you think, could most likely address her apprehensions?

Consider which anion is directly elevated in the plasma that drives the pH upward in metabolic disorders.

68 / 137

Category: Renal – Biochemistry

Increase in which of the following characterizes metabolic alkalosis?

💡 Hint:

Think about what purine base is formed after removing the amino group from guanine before it becomes uric acid.

69 / 137

Category: Renal – Biochemistry

In purine metabolism, what does the deamination of guanine yield?

Focus on what both conditions deposit in the glomerulus that triggers kidney injury rather than their age or clinical syndrome.

70 / 137

Category: Renal – Pathology

How are membranous glomerulopathy and post-streptococcal glomerulonephritis similar?

Every research study starts by identifying what problem you want to solve or investigate.

71 / 137

Category: Renal – ComMed/BehSci

Which one of the following is the first step of research?

After you have all your raw data, the next step is to make sense of it systematically.

72 / 137

Category: Renal – ComMed/BehSci

Which of the following steps comes after data collection?

Consider the urease-producing organism that predisposes to renal calculi and chronic destructive infection.

73 / 137

Category: Renal – Pathology

Which of the following organisms is responsible for xanthogranulomatous pyelonephritis?

Think about which nodes are located along the aorta and receive lymph from retroperitoneal organs.

74 / 137

Category: Renal – Anatomy

Lymphatics of kidneys drain into which nodes?

Consider which cells are part of the filtration barrier versus those that participate in blood pressure sensing and regulation.

75 / 137

Category: Renal – Histology

Juxtaglomerular apparatus is very important in blood pressure regulation. Which of the following structure is not its part?

Think about which cells in the JGA provide structural support and signal transmission rather than directly secreting renin or sensing solutes.

76 / 137

Category: Renal – Histology

Juxtaglomerular apparatus is a specialized structure located at the vascular pole of the glomerulus. Which of the following is true concerning the juxtaglomerular apparatus?

If two-thirds of all body water is inside cells, and total body water is about 60% of weight, what fraction of weight does that come out to?

77 / 137

Category: Renal – Physiology

What percentage of total body water is contained in the intracellular fluid?

Consider which extracellular ion is the main determinant of water distribution and blood volume.

78 / 137

Category: Renal – Physiology

Renal retention of which of these ions is directly linked to an increase in extracellular fluid volume?

Think about what chemical substances in urine can react with reagents on a strip rather than structures that require a microscope.

79 / 137

Category: Renal – Biochemistry

In a detailed urine report, dipstick mechanism checks for which of these?

Consider how the kidneys remove base instead of acid to normalize an elevated blood pH.

80 / 137

Category: Renal – Biochemistry

In response to alkalosis, the kidneys may enhance which of these?

Think about how the kidney removes excess acid from the body to normalize blood pH.

81 / 137

Category: Renal – Biochemistry

In response to acidosis, the kidneys may enhance which of these?

Think about the definitive test that directly visualizes the pathological substance causing the disease rather than just clinical signs or risk factors.

82 / 137

Category: Renal – Pathology

Which one of the following confirms the diagnosis of gout?

Consider the maximum hypertonicity in the kidney that allows urine to be concentrated several times above plasma osmolarity.

83 / 137

Category: Renal – Physiology

Which one of the following is the approximate value of the osmolarity of the interstitial fluid in renal medulla?

Think about what type of cast indicates that WBCs originated in the kidney tubules rather than the bladder or urethra

84 / 137

Category: Renal – Pathology

In pyelonephritis, what is the diagnostic urinary finding?

Think about how the body responds when there is too much water in the extracellular fluid—what hormone would it reduce to restore balance?

85 / 137

Category: Renal – Physiology

Which of the following is true for the overhydration state?

Think about what type of urinary cast reflects bleeding originating from the glomerulus itself rather than from lower urinary tract or tubular injury.

86 / 137

Category: Renal – Pathology

Which of these is present on urinalysis in a patient with glomerulonephritis?

Consider the composition of glomerular filtrate compared to plasma before the nephron has made any significant modifications.

87 / 137

Category: Renal – Physiology

Which one of the following correctly states the osmolarity of the fluid entering the proximal convoluted tubules?

Think about the hormone that directly controls water reabsorption in response to plasma concentration rather than volume.

88 / 137

Category: Renal – Physiology

In a patient with severe dehydration, the plasma osmolality increases. This is corrected by which of the following?

Look for long-standing damage markers: small kidneys, anemia, and mineral imbalance rather than acute changes.

89 / 137

Category: Renal – Pathology

In a 60-year-old diabetic patient, a routine lab investigation shows hemoglobin: 8.2 gm/dL, creatinine (Cr): 5.0 mg/dL, calcium (Ca): 6.7 mg/dL, phosphate(PO4): 5.2 mg/dL, with small kidneys on ultrasound. What is the most likely diagnosis?

Consider all forces acting on the glomerulus—hydrostatic and oncotic—and determine the net driving force for filtration.

90 / 137

Category: Renal – Physiology

If plasma colloidal osmotic pressure is 40 mmHg, renal capillary pressure is 60 mmHg, and Bowman’s capsule hydrostatic pressure is 18 mmHg, which of the following effect occurs in the kidney?

Think about the level of the first lumbar vertebra and the lateral distance from the midline when locating the kidney hilum on the anterior abdominal wall.

91 / 137

Category: Renal – Anatomy

Where does the hilum of the left kidney lie?

Focus on the sudden nature of the condition and how early intervention can restore kidney function, unlike chronic kidney disease.

92 / 137

Category: Renal – Pathology

Which of the following is true regarding acute kidney injury (AKI)?

Think about what the body would do to conserve water when there is less circulating blood or fluid volume.

93 / 137

Category: Renal – Physiology

Which of the following factor causes an increase in the secretion of antidiuretic hormone (ADH)?

Consider the distal urethra in the glans—it needs a protective, multilayered epithelium but remains moist for fluid passage.

94 / 137

Category: Renal – Histology

Which one of the following is true about the epithelium of navicular fossa of glans penis?

Think about a muscle metabolite that is freely filtered and also slightly added to urine by tubular cells, which is why its clearance slightly overestimates GFR.

95 / 137

Category: Renal – Physiology

Which is true about creatinine during glomerular filtration at normal levels?

Focus on which nephron segment is specialized for active transport versus bulk reabsorption—brush borders are only present where high surface area is required.

96 / 137

Category: Renal – Histology

During a tutorial class on the microscopic structure of the kidney, specific features of each part of the nephron were being discussed. Which of the following is mismatched?

Think about what happens to blood pH when the kidney fails to reclaim a major base from the filtrate.

97 / 137

Category: Renal – Physiology

Disturbance in the renal reabsorption of bicarbonates in the proximal tubules leads to which one of the following?

Consider how the kidney responds when it senses low sodium delivery in the distal tubule—think about afferent arteriolar tone and GFR regulation.

98 / 137

Category: Renal – Physiology

A decrease in sodium chloride levels causes the macula densa to do which of the following?

Think about urine as a diluted solution of metabolic wastes, where the majority component is water to allow solute excretion.

99 / 137

Category: Renal – Physiology

Considering the normal urine composition, what is the water content of it in percentage?

Consider which renal-produced hormone directly stimulates red blood cell formation, and how its deficiency would lead to anemia in kidney disease.

100 / 137

Category: Renal – Physiology

In chronic renal failure, anemia develops due to which of the following?

In acute blood loss, the first fluid should stay in the vascular compartment and rapidly restore perfusion, rather than just provide calories or water.

101 / 137

Category: Renal – Physiology

An adult male had a road traffic accident and went into a hypovolemic shock due to blood loss. Which intravenous fluid is preferable to start as initial available therapy in an emergency?

Think about a situation where the kidney continues to excrete acid despite the blood being alkalotic—why would this “paradox” occur?

102 / 137

Category: Renal – Biochemistry

What is the alkaline nature of the extracellular fluid and acidic urine termed as?

Think about the approach that values living in accordance with one’s virtues and purpose, rather than simply seeking pleasure or satisfaction.

103 / 137

Category: Renal – ComMed/BehSci

Amina has recently completed her FCPS and now she is pursuing her career as a specialist. She was passionate about this field and always wanted to serve society and live a meaningful life. Which of the following approach of happiness most likely focuses on meaning and self-realization?

Think about the nephron segment that actively reabsorbs sodium and chloride but is impermeable to water, contributing significantly to urine dilution and solute reabsorption.

104 / 137

Category: Renal – Physiology

About 35% of the filtered load of sodium chloride is reabsorbed from which part of the nephron?

For moderate dehydration with inability to take oral fluids, think of isotonic solutions that restore both volume and electrolytes safely.

105 / 137

Category: Renal – Biochemistry

A young male presented in a dehydrated state of moderate degree. His renal function is normal but he is unable to take fluid orally because of drowsiness and vomiting. Which of the following intravenous fluids is preferable to start first?

Think about a molecule with a positive end and a negative end due to unequal sharing of electrons in a bent structure.

106 / 137

Category: Renal – Biochemistry

What is a water molecule with an electrical charge distributed asymmetrically about its structure referred to as?

Focus on the design that starts with the disease and looks backward to identify what exposures may have contributed, rather than following people forward from exposure.

107 / 137

Category: Renal – ComMed/BehSci

What is the research study design in which diseased people are selected and then compared with the non-diseased people to find out the risk factors of the disease called?

Think about the combined osmotic load from dietary electrolytes and protein metabolism that the kidneys must handle each day to maintain normal fluid and solute balance.

108 / 137

Category: Renal – Physiology

A normal 70 kg human must excrete about how many milliosmoles of solute each day?

Think about small proteins that can pass through the glomerular filter but not as freely as tiny solutes or ions.

109 / 137

Category: Renal – Physiology

A filterability of 1.0 means that the substance is filtered as freely as water, whereas a filterability of 0.75 means that the substance is filtered only 75%. Which of the following substance has a filterability of only 75 percent as rapidly as water?

Think about a child with nephritic syndrome following a streptococcal throat infection—focus on both the immune complexes and their typical location in the glomerulus.

110 / 137

Category: Renal – Pathology

A child after a streptococcal infection presents 10 days later with hypertension, hematuria, edema, and sometimes oliguria. There appear to be elevated titers of anti-streptolysin O antibodies. What is the key morphological feature of his disease?

Think about which naturally occurring purine base is directly upstream of uric acid in the degradation pathway. Structural similarity is key to enzyme inhibition.

111 / 137

Category: Renal – Biochemistry

Synthetic compound allopurinol given to treat hyperuricemia is an analog of which of the following?

Focus on the age of the patient, the nephrotic pattern, and the absence of hematuria. Consider which kidney lesion alters filtration function without immune complex deposition.

112 / 137

Category: Renal – Pathology

A 6-year-old boy presents with generalized edema and periorbital edema. Further investigations show hypoalbuminemia, lipiduria, and 3.6 g proteinuria. Renal biopsy and electron microscopy are carried out. Which of the following electron microscopic features do you expect to find in this patient?

Think about which TCA intermediate can be directly formed by transamination of an amino acid, providing a way for nitrogen-containing compounds to feed into energy metabolism.

113 / 137

Category: Renal – Biochemistry

Aspartate enters the tricarboxylic acid cycle (TCA cycle) in the form of which of the following?

Think about which enzyme removes the phosphate group from nucleotides before they are further broken down into nucleosides.

114 / 137

Category: Renal – Biochemistry

During degradation of purine nucleotides to uric acid, inosine monophosphate and guanosine monophosphate are broken down by which of the following enzymes?

Consider a kidney lesion that alters filtration selectively for proteins without triggering inflammation or visible changes under routine microscopy, especially in young children with edema.

115 / 137

Category: Renal – Pathology

A 5-year-old boy has had swelling around his eyes for one week, and he has been lethargic. On examination, he has periorbital edema. His temperature is 37°C, pulse is 75 bpm, respiratory rate is 22/minute, and blood pressure is 140/90 mmHg. Urine examination shows a specific gravity of 1.010 and a pH of 6.5, with 4+ protein, no glucose, no blood, no casts, and no ketones. Microscopic urinalysis exhibits fat bodies, but no leukocytes or erythrocytes. He improves with corticosteroid therapy. Which of the following is the most likely lesion in the kidney?

Think about age, type of edema, and urinary findings—certain kidney diseases are far more common in early childhood and show dramatic protein loss without inflammatory cells.

116 / 137

Category: Renal – Pathology

A 5-year-old boy presents with generalized edema and periorbital edema. Further investigations show hypoalbuminemia, lipiduria, and 3.7 g proteinuria. Which of the following conditions is the most likely cause in this patient?

Focus on the combination of heavy protein loss, minimal urinary inflammation, and a chronic systemic condition. Consider which organ systems or infections can subtly influence the kidney without triggering an active immune attack.

117 / 137

Category: Renal – Pathology

A 43-year-old man complains of malaise for 3 weeks. On examination, his blood pressure is 150/95 mm Hg, and presents with pitting edema of the lower extremities. Urinalysis shows no glucose, blood, ketones, nitrite, or urobilinogen, and the microscopic urinalysis reveals no RBC/HPF and only 1 WBC/HPF, 24-hour urine protein is 4.1 gm, serum creatinine is 3.5 mg/dL with urea nitrogen of 38 mg/dL. His hepatitis B surface antigen is positive. Which of the following is the most likely diagnosis in this patient?

Focus on stomach and pylorus position relative to the kidneys—they’re mostly midline or left-sided, not directly over the right kidney.

118 / 137

Category: Renal – Anatomy

A 2nd-year student is studying kidney anatomy and finds out that there are some structures anterior to the right kidney. Which of the following is not found anterior to the right kidney?

Some imaging tests are better for soft tissues, while others are better for hard, dense structures. If your goal is to detect something made of calcium, which kind of imaging would you expect to work best?

119 / 137

Category: Renal – Radiology/Medicine

A 40-year-old businesswoman came to the outpatient department for the workup of her recurrent renal stone disease. She has already undergone multiple investigations and now she is insisting to go for magnetic resonance imaging (MRI). How will you counsel her that for her particular disease, MRI is not a suitable modality?

When you drink a large amount of water in one go, which organ system is primarily responsible for restoring balance, and how does it achieve this?

120 / 137

Category: Renal – Physiology

Which of the following is a method to excrete excess water?

If an infection spreads beyond the bladder and starts affecting deeper structures of the urinary tract, what new type of symptom would appear that signals the whole body is reacting, not just the bladder?

121 / 137

Category: Renal – Pathology

Which of the following clinical symptoms differentiates pyelonephritis from cystitis?

If one of the DNA bases loses its amino group and is transformed into a base that normally belongs in RNA, which new base would you expect to appear?

122 / 137

Category: Renal – Biochemistry

Which of the following is formed as a result of deamination of cytosine?

If a structure designed to carry urine accidentally connects below the point where voluntary control normally occurs, what would that mean for continence in a child?

123 / 137

Category: Renal – Embryology

A 4-year-old girl is brought to the hospital with complaints of continuous dribbling of urine. On examination, the urine was coming out of the vagina. The possible cause of this embryological anomaly may be due to which of these?

Focus on which component of the filtration barrier—endothelium, basement membrane, or podocyte—when altered, would most directly increase selective leak of albumin without producing an aggressive inflammatory (nephritic) picture.

124 / 137

Category: Renal – Pathology

A 4-year-old girl presents with severe pitting edema. Further investigations show hypoalbuminemia, lipiduria, and 3.8 g proteinuria. Biopsy confirms the renal disease. Which of the following best describes the pathophysiology of proteinuria in this patient?

“Visualize the journey of blood from the hilum of the kidney to the outer cortex. In which order would arteries logically need to branch to supply the pyramids and the cortex surrounding them? Think ‘big to small’ and ‘center to periphery’.”

125 / 137

Category: Renal – Anatomy

Which of the following is the correct sequence of branching pattern of renal arteries?

Ask yourself: Which part of the kidney is most vulnerable to ischemic injury during severe infection?

126 / 137

Category: Renal – Pathology

Which of the following is a complication of acute pyelonephritis?

Ask yourself: Which imaging study lets you see the urethra filling and emptying while the baby voids, directly showing the obstruction?

127 / 137

Category: Renal – Radiology/Medicine

A 32-year-old lady comes to the ultrasound department for an antenatal scan which shows bilateral hydronephrosis, hydro-ureters, and a distended urinary bladder with a keyhole sign in the fetus. The fetus is suspected with a case of posterior urethral valves. She is advised to have a post-natal checkup of the baby. What is the investigation of choice in this particular case?

Ask yourself: Which complication arises simply because the catheter bypasses natural defenses of the urethra and provides a route for bacteria to enter the bladder?

128 / 137

Category: Renal – Pathology

A 30-year-old pregnant lady is going for an emergency cesarean section. She is being catheterized before the procedure. Which one is the most recurrent complication of urinary catheterization?

Ask yourself: Which tubular structure carries urine from the kidney to the bladder, always lined by urothelium, and has three layers of smooth muscle for peristalsis?

129 / 137

Category: Renal – Histology

A second-year medical student is looking at the histology slide of tissue with small-caliber lined by transitional epithelium and also observes three layers of smooth muscles in its wall. He is looking at a slide of which of the following?

Ask yourself: What is the simplest way to know the catheter tip is safely in the bladder without measuring the urethra?

130 / 137

Category: Renal – Pathology

A 10-year-boy is admitted to the ward with the complaint of urinary retention. A Foley catheter is passed to relieve the retention. How much length of catheter should be inserted before inflating the balloon of catheter?

Ask yourself: Which urinary infection presents with sudden bladder symptoms and pyuria, but spares the kidney (no casts)?

131 / 137

Category: Renal – Pathology

A 38-year-old woman came with severe suprapubic pain. Urine analysis showed neutrophils without a cast, cloudy, and foul-smelling urine. What is the most likely diagnosis?

Ask yourself: Which antibody is typically elevated a few weeks after a throat infection and triggers immune complex deposition in the glomeruli?

132 / 137

Category: Renal – Pathology

A 10-year-old girl complained of increasing fatigue and passing dark-colored urine for one week. She had a sore throat two weeks ago. On physical examination, there is no fever, and blood pressure is 140/90 mmHg. Laboratory studies show her serum creatinine is 2.8 mg/dL and urea nitrogen 24 mg/dL. Urinalysis shows 2+ blood, 1+ protein, no glucose, and no ketones. Microscopic urinalysis shows dysmorphic RBCs. A renal biopsy on microscopic examination shows glomerular hypercellularity, with polymorphonuclear leukocytes (PMNs) present. Electron microscopy shows subepithelial electron-dense humps. Which of the following laboratory findings is most likely to be present in this girl?

Ask yourself: Which part of the nephron fine-tunes water reabsorption based on hormonal signals rather than passive solute movement?

133 / 137

Category: Renal – Physiology

Which of the following parts of the nephron is involved in the facultative reabsorption of water?

Ask yourself: Which diuretic works upstream in the proximal tubule by blocking bicarbonate reabsorption rather than targeting Na⁺ transporters?

134 / 137

Category: Renal – Pharmacology

Which of the following is a carbonic anhydrase inhibitor?

Ask yourself: At what filtration rate does the kidney lose almost all ability to excrete waste and maintain fluid/electrolyte balance?

135 / 137

Category: Renal – Pathology

What is the value of the glomerular filtration rate below which it is classified as an end-stage renal disease (ESRD)?

Ask yourself: Which part of the nephron actually performs the filtration of plasma, and which part modifies the filtrate into urine?

136 / 137

Category: Renal – Anatomy

The nephron is the functional unit of the kidney responsible for the filtration of plasma. It consists of which two major components?

Ask yourself: Which compound accumulates in gout due to defective breakdown of purine nucleotides?

137 / 137

Category: Renal – Biochemistry

Which of the following is the end-product of purine metabolism?

Your score is

The average score is 25%

Follow us on our Socials ! Thank you.

0%

Thank you for your feedback.