. The renal clearances and plasma protein binding of three drugs in a 70 kg adult are as follows: Drug Renal Clearance (ml/min) % bound to plasma proteins 50 Theophylline Phenytoin Cefonicid 10 0.15 90 20 98 If GFR is 120 ml/min and urine flow is 1.5 ml/min, what is the likely involvement of filtration, secretion and reabsorption in the renal excretion of each of these drugs?
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- Minimal change glomerulopathy results in proteinuria and is a major cause of nephrotic syndrome. Briefly explain (make sense of) this statement and outline the changes occurring in the filtration barrier which permit proteins to enter the renal tubules, and explain two consequences of losing plasma proteins from the body.Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus His cardiovascular risk was > 15% http://www.cvdcheck.org.au/ His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs. Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet…Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15% http://www.cvdcheck.org.au/ His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs. Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet…
- A woman found confused on the floor of her apartment is brought to the emergency room by her daughter. She complains of muscle weakness. Serum electrolytes were determined and shown below. Use this information to answer questions 13-16. Electrolyte Plasma Levels (Normal) ICF Conductance Na+ 138 mM (135-155 mM) 14 mM 1 K+ 2.9 mM (3.5-5.0 mM) 155 mM 7 Cl- 115 mM (110-120 mM) 20 mM 0 13. The equilibrium potential for Na+ in this patient will be at__________. A) 60 mV B) -60 mV C) 65 mV D) -70 mV 14. The equilibrium potential for K+ in this patient will be at__________. A) -70 mV B) -90 mV C) 104 mV D) -104 mV 15. The resting membrane potential in this patient will be at__________. A) 0 mV B) -70 mV C) -83 mV D) -104 mV112. A 70 year old male developed difficulty in ability to form urinary stream and urgency. On per-rectal examination, prostate was found to be enlarged. Serum prostate specific antigen was within normal limits. The person is also a known hypertensive for which he is not taking any drug. The surgeon prescribed him a drug A which can quickly relieve his urinary problems as well as control his blood pressure. Effect of this drug on blood pressure of a dog in experimental set up is shown below. Drug A is likely to be.. Calculate creatinine clearance (and hence an estimate of glomerular filtration rate, GFR) for a 40 year old man from the data below: Urine creatinine (U) = 90 mg/dL 24 hour urine volume = 1.44 L Serum creatinine (P) = 2.0 mg/dL Comment on the value of GFR.
- choice all that applies. Ideally, increased osmotic pressure in the plasma will result to:a. increased arterial hydrostatic pressure c. increased water reabsorption in the tubulesb. increased glomerular filtration rate d. increase in interstitial colloid osmotic pressure e. none of the aboveMehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15% http://www.cvdcheck.org.au/ His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs. Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet…Evaluate the vitamin B-6 status: Excretion of xanthurenic acid after a 2 g L-tryptophan load Vitamin B-6 status > 50 mg/24hr Marginal or inadequate vitamin B-6 < 25 mg/24hr Acceptable Xanthurenic acid Excretion (mg/24hr) 47 64 55 285
- Mehmet Yavuz is 62 yo. He presented to the clinic and after having an HbA1c test (result 9%) was diagnosed with type 2 Diabetes mellitus. His cardiovascular risk was > 15% http://www.cvdcheck.org.au/ His renal health screen showed an eGFR 90 mL/min/1.73m2 with microalbuminuria of 3.5 mg/mmol. http://www.kidney.org.au/HealthProfessionals/DetectingCKD/tabid/632/Default.aspx He attended a podiatry appointment which detected decreased dorsalis pedis and posterior tibialis pulses in both legs. Management of his condition now includes the following: Exercise: at least 150 minutes of aerobic and 60 minutes of resistance exercise each week Diet: a plan worked out with an accredited dietician based on the Australian Dietary Guidelines (2013). Drug use: smoking cessation plan to stop cigarette use; alcohol consumption reduction to 1 - 2 full strength beers every second day Weight loss: Mehmet aims to lose 5 kg over the first 6 - 8 weeks after diagnosis Medications: Jardiamet…Renal Calculations Urine Vol Excretion Clearance [Urine] (ml/min) mg/ml [Plasma] mg/ml GFR Filtered (L/day) Load Rate (ml/min) (mg/min) (mg/min) Na+ 1.5 125 1.65 3.08 K+ 1.5 125 1.95 0.195 CI- 1.5 125 2.65 3.5 Glu 1.5 125 0.9 w ww4, H+ secretion in the renal tubule happens by Multiple Choice It follows a negative ion like Cl- or PO43- H+/HCO3- exchanger in the basolateral membrane Na+/H+ exchanger in the apical membrane It first combines with HCO3- and is then regenerated in the tubular fluid