1.
Which drug is the most commonly used loop diuretic
Correct Answer
A. Furosemide
Explanation
Furosemide is the most commonly used loop diuretic. It is a medication that helps to increase urine production, which can be beneficial in treating conditions such as edema, congestive heart failure, and kidney disease. Furosemide works by inhibiting the reabsorption of sodium and chloride in the loop of Henle, a part of the kidney. This leads to increased urine output and helps to reduce fluid buildup in the body. Furosemide is widely prescribed due to its effectiveness and relatively low cost compared to other loop diuretics.
2.
Which rug is potentially utilized by athletes to eliminate steroids from their body due the fact it is largely metabolized and fast acting?
Correct Answer
C. Bumetadine
Explanation
Bumetadine is potentially utilized by athletes to eliminate steroids from their body because it is largely metabolized and fast acting.
3.
A 54 year old patient has a blood pressure of 185/110 and needs anti-hypertensive medication. The patient suffers from dermatitis and has a history of rashis following aminoglycoside treatment. Which of the following diuretics would be the best option for treating the high blood pressure?
Correct Answer
D. Ethracyric Acid
Explanation
Ethracyric Acid would be the best option for treating the high blood pressure in this patient. This is because the patient has a history of rash following aminoglycoside treatment, which suggests a possible allergic reaction. Ethracyric Acid is a loop diuretic that does not contain an aminoglycoside structure, making it a safer choice for this patient compared to other loop diuretics like Bumetadine, Furosemide, and Torsemide, which may cross-react and cause a similar allergic reaction.
4.
Which of the following would be most effective in preventing the hypokalemia caused by furosemide.
Correct Answer
A. A drug that blocks Na+ channels in the collecting ducts
Explanation
Blocking Na+ channels in the collecting ducts would be most effective in preventing hypokalemia caused by furosemide. Furosemide is a loop diuretic that works by inhibiting the reabsorption of sodium and chloride in the loop of Henle. This leads to increased excretion of potassium in the urine, which can result in hypokalemia. By blocking Na+ channels in the collecting ducts, less sodium would be reabsorbed, resulting in less potassium being excreted and therefore preventing hypokalemia.
5.
A 55 year old male with kidney stones has been placed on a diuretic. After af ew weeks he has a attack of gout. Which diuretic was he taking?
Correct Answer
B. Hydrocholorothiaizde
Explanation
The patient developed an attack of gout after being on a diuretic for a few weeks. Gout is a type of arthritis that occurs due to the buildup of uric acid crystals in the joints. Diuretics can increase the levels of uric acid in the body by reducing its excretion through the kidneys. Hydrochlorothiazide is a diuretic that has been associated with an increased risk of gout. Therefore, it is likely that the patient was taking hydrochlorothiazide, which led to the development of gout.
6.
Physiologically, which is the only area of the nephron where no salt reabsorption occurs
Correct Answer
B. Thin Ascending Limb
Explanation
The correct answer is the Thin Ascending Limb. This is the only area of the nephron where no salt reabsorption occurs. In the Thin Ascending Limb, water is reabsorbed, but sodium and chloride ions are not. This allows for the concentration of urine, as water is removed without the reabsorption of salt. The Thick Ascending Limb, on the other hand, actively reabsorbs sodium and chloride ions, while the PCT, DCT, and Collecting Duct also play roles in reabsorption and concentration of urine.
7.
Concerning renal physiology, which area is the Na / K / 2Cl transporter found
Correct Answer
C. Thick Ascending Limb
Explanation
The Na/K/2Cl transporter is found in the thick ascending limb of the renal tubule. This transporter plays a crucial role in the reabsorption of sodium, potassium, and chloride ions from the tubular fluid back into the bloodstream. It helps in establishing the concentration gradient that drives the reabsorption of water in the later parts of the nephron. The thick ascending limb is impermeable to water, so the reabsorption of ions without water helps in creating a dilute urine.
8.
Which drug would most likely to be used to treat a standard case of hypertension
Correct Answer
A. Hydrochlorothiazide
Explanation
Thiazides are the most commonly used in treatinghypertension
9.
A patient who has a poor kidney is also suffering from pulmonary edema. What drug do you give to treat them?
Correct Answer
B. Torsemide
Explanation
Torsemide is the correct drug to treat a patient with poor kidney function and pulmonary edema. Torsemide is a loop diuretic that helps to remove excess fluid from the body by increasing urine production. It is commonly used to treat conditions such as congestive heart failure and kidney disease, which can lead to fluid accumulation in the lungs. By promoting diuresis, Torsemide helps to relieve the symptoms of pulmonary edema, such as shortness of breath and swelling.
10.
Which of the thiazides has the lowest oral bioavailability?
Correct Answer
B. Chlorothiazide
Explanation
Chlorothiazide has the lowest oral bioavailability among the thiazides listed. Oral bioavailability refers to the fraction of a drug that reaches the systemic circulation after oral administration. Chlorothiazide has a relatively low oral bioavailability due to its poor absorption from the gastrointestinal tract. This means that a smaller amount of the drug is available for systemic effects when taken orally compared to the other thiazides listed.
11.
Why do thiazides have the strongest efect in releiving blood pressure?
Correct Answer
A. Because of their secondary effect at the arterioles
Explanation
Thiazides have the strongest effect in relieving blood pressure because of their secondary effect at the arterioles. This means that thiazides not only directly affect the kidneys to increase urine production and decrease fluid volume, but they also cause dilation of the arterioles, which helps to reduce peripheral resistance and lower blood pressure. This secondary effect on the arterioles is believed to be the main reason for the effectiveness of thiazides in treating hypertension.
12.
The pharmacological actions of what class of drugs are classified ONLY by a increase in sodium loss and a increase in water loss?
Correct Answer
A. Carbonic Anhydrase Inhibitors
Explanation
Carbonic Anhydrase Inhibitors are a class of drugs that work by inhibiting the enzyme carbonic anhydrase, which is responsible for the reabsorption of sodium and water in the kidneys. By inhibiting this enzyme, carbonic anhydrase inhibitors increase the loss of sodium and water in the urine, leading to diuresis. This is the only class of drugs in the given options that is classified solely by an increase in sodium loss and water loss.
13.
The parmacological actions of what class of drugs are classified ONLY by a decrease in sodium, decrease in cl, decrease in water, decrease in calcium, decrease in magnesium, and decrease in K reabsorption?
Correct Answer
B. Loop Diuretics
Explanation
Loop diuretics are a class of drugs that act on the loop of Henle in the kidneys to inhibit the reabsorption of sodium, chloride, water, calcium, magnesium, and potassium. By decreasing the reabsorption of these ions, loop diuretics increase the excretion of water and electrolytes, leading to diuresis. This class of drugs is commonly used to treat conditions such as edema and hypertension.
14.
For the best diuretic efficacy, you would utilize a drug which targets which area of the nephron?
Correct Answer
C. Thick Ascending Limb
Explanation
The correct answer is the Thick Ascending Limb. This segment of the nephron is responsible for reabsorbing sodium and chloride ions, while impermeable to water. By inhibiting the reabsorption of these ions, diuretic drugs can increase the excretion of water and electrolytes, resulting in increased urine production. Therefore, targeting the Thick Ascending Limb would provide the best diuretic efficacy.
15.
Aldosterone and ADH act at which area of the nephron?
Correct Answer
E. Collecting Ducts
Explanation
Aldosterone and ADH act at the collecting ducts of the nephron. The collecting ducts are responsible for reabsorbing water and concentrating the urine. Aldosterone increases sodium reabsorption and potassium secretion in the collecting ducts, while ADH increases water reabsorption. Together, these hormones help regulate the body's fluid balance and maintain blood pressure.
16.
Which of the following statements concering Na+ reabsorption is incorrect?
Correct Answer
B. Passive transport is mediated by the same transport mechanism body wide
Explanation
Passive transport is not mediated by the same transport mechanism body wide. Passive transport refers to the movement of particles across a cell membrane without the use of energy. In the case of Na+ reabsorption, passive transport occurs through ion channels or leak channels that allow Na+ ions to move down their concentration gradient. This process is not the same throughout the body, as different cells and tissues may have different types of ion channels or transport proteins involved in passive Na+ transport. Therefore, the statement that passive transport is mediated by the same transport mechanism body wide is incorrect.
17.
Which fo the following statements concerning diuretics is false?
Correct Answer
B. All diuretics work by either actively or passivly flowing from the tubular lumen to their respective site of action
Explanation
The given statement is false because not all diuretics work by actively or passively flowing from the tubular lumen to their respective site of action. Some diuretics, such as carbonic anhydrase inhibitors, work by inhibiting the reabsorption of sodium and water in the proximal tubule. Therefore, this statement is incorrect.
18.
A patient who is suffering from renal failure comes into your office complaining that he cannot pee. Which of the following drugs should you prescribe him for maximal immediate efficacy
Correct Answer
A. Furosemide
Explanation
Furosemide is a loop diuretic commonly used to treat conditions such as congestive heart failure, kidney disorders, and high blood pressure. It works by inhibiting sodium and chloride reabsorption in the loop of Henle in the kidneys, leading to increased urine output (diuresis). In patients with renal failure, loop diuretics like furosemide are often preferred because they act directly on the kidneys and are effective even when kidney function is impaired. Furosemide provides maximal immediate efficacy in promoting diuresis, making it a suitable choice in this scenario.
19.
Which of the following statements concering diuretics is TRUE?
Correct Answer
A. Thiazide diuretics are the most effective class in lowering blood pressure
20.
A patient comes into your office who has had chronic trouble urinating. He also suffers from mild hypertension. Which treatment would be the best long term solution for his problem?
Correct Answer
A. Indapamide
Explanation
Indapamide is a thiazide like diuretics. Thiazide / thiazide like diuretics are used to treat chronic problems because of their long duration of action and antihypertensive properties.
21.
A Na / Ca exchanger is located on in what segment of the nephron on the apical side of the cell?
Correct Answer
D. DCT
Explanation
The correct answer is DCT. The distal convoluted tubule (DCT) is the segment of the nephron where a Na / Ca exchanger is located on the apical side of the cell. This exchanger plays a crucial role in the reabsorption of sodium and calcium ions from the filtrate back into the bloodstream. The DCT is responsible for fine-tuning the concentration of these ions in the urine, helping to maintain electrolyte balance in the body.
22.
When administered, which drug would lead to a increase in plasma calcium levels?
Correct Answer
A. Metolazone
Explanation
Metolazone is a thiazide-like diuretic that works by inhibiting the reabsorption of sodium and chloride ions in the distal convoluted tubules of the kidneys. This leads to increased excretion of water and electrolytes, including calcium. As a result, there is a decrease in calcium reabsorption, leading to an increase in plasma calcium levels. Therefore, Metolazone would be the drug that leads to an increase in plasma calcium levels.
23.
A common side effect of loop diuretics is hyponatremia. Which of the following compound would be given to best treat this?
Correct Answer
C. Tolvapatan
Explanation
Vasopression Antagonists, inhibit aldosterone, decreases water reabsorption, and thus are used to treat hyponatremia
24.
Which of the following statements concerning diuretics is FALSE?
Correct Answer
B. Eplerenome has a strong anti-androgen effect
25.
A patient walks into your office with a case of moderate hypertension. in order to most effectively treat him, what do you start him out on?
Correct Answer
B. Hydrochlorothiazide + Eplerone
Explanation
Eplernone is preferred to spironolactone because it has no anti androgen effect due to its lower affinity for androgen receptors
26.
THe most common side effect of K spairing drugs are
Correct Answer
A. Hyperkalemia
Explanation
The most common side effect of K sparing drugs is hyperkalemia, which refers to high levels of potassium in the blood. K sparing drugs work by preventing the excretion of potassium in the kidneys, leading to an accumulation of potassium in the body. This can disrupt the normal balance of electrolytes and cause symptoms such as muscle weakness, irregular heartbeat, and numbness or tingling. It is important to monitor potassium levels regularly when taking K sparing drugs to prevent hyperkalemia and its associated complications.
27.
Which statment is true concerning Osmotic DIuretics
Correct Answer
A. Osmotic diuretics are filtered at the glomerulus however are not reabsorbed in the nepHron
Explanation
They act on the PCT + Thin descending limb.
28.
Which of the following drugs has action at the thin descending limb?
Correct Answer
A. Mannitol
Explanation
Mannitol is the correct answer because it is a diuretic that acts primarily at the thin descending limb of the loop of Henle. It inhibits water reabsorption in this segment of the nephron, leading to increased urine output. Acetazolamide, Tolvaptan, Spironolactone, and Eplereone do not specifically target the thin descending limb.
29.
Which drug has its major site of action at the PCT and a minor site of action at the Collecting duct?
Correct Answer
A. Acetazolamide
Explanation
Acetazolamide is a diuretic that acts primarily at the proximal convoluted tubule (PCT) and has a minor site of action at the collecting duct. It inhibits the enzyme carbonic anhydrase in the PCT, which leads to decreased reabsorption of bicarbonate and increased excretion of sodium, potassium, and water. This increases the urine volume and decreases the reabsorption of water in the collecting duct. Therefore, acetazolamide's major site of action is at the PCT and its minor site of action is at the collecting duct.