Nephrology MCQs-14


PTH enhances urinary phosphate excretion by downregulating


A. Upregulating K+Cl− Symporter

B. Upregulating NPT2a cotransporter

C. Downregulating NPT2a cotransporter

D. Downregulating K+Cl− Symporter



Fibroblast growth factor-23 (FGF23) is a bone-derived hormone


A. Decrease phosphate reabsorption and vitamin D hormone synthesis in the kidney

B. Increase phosphate reabsorption and vitamin D hormone synthesis in the kidney

C. Increase phosphate reabsorption and decrease vitamin D hormone synthesis in the kidney

D. Decrease phosphate reabsorption and Increase vitamin D hormone synthesis in the kidney



Fibroblast growth factor-23 is a


A. Lipoprotein

B. Glycoprotein

C. Carbohydrate

D. Phospholipid



FGF23 suppress which of the following enzyme reducing its ability to activate vitamin D?


A. Prolyl 3-Hydroxylase

B. Lysyl Hydroxylase

C. Prolyl 4-hydroxylase

D. 1-alpha-hydroxylase



At the very early stages of chronic kidney disease levels of FGF23


A. Increase significantly

B. Decrease significantly

C. Not affected

D. Mild variation seen


Which of the following activates FGF23?

A. α-klotho

B. Calciferol

C. Titin

D. alpha-hydroxylase



Principal action of FGF23


The principal action of FGF23 on mineral metabolism that led to its discovery as a hormone is the

Suppressive effect on phosphate reabsorption from the urine.

FGF23 suppresses the synthesis of the vitamin D hormone, 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3], in the kidney.

Diseases characterized by excessive blood concentrations of intact FGF23 lead to

  • Renal phosphate wasting
  • Inappropriately low-circulating 1,25(OH)2D3 levels in patients with a normal kidney function

FGF23 is associated with Non-nutritional diseases of hypophosphatemia


FGF23 is associated with Non-nutritional diseases of hypophosphatemia:

  1. Autosomal dominant hypophosphatemic rickets
  2. X-linked hypophosphatemia
  3. Autosomal recessive hypophosphatemic rickets type 1, 2, and 3,
  4. Tumor-induced osteomalacia
  5. Hypophosphatemic rickets with hypercalciuria

FGFR mediating the suppressive effects of FGF23 on renal tubular 1,25(OH)2D3 synthesis


FGFR1c is probably the predominant FGFR mediating the suppressive effects of FGF23 on renal tubular 1,25(OH)2D3 synthesis


Klotho


α-klotho is highly expressed in the brain, liver and kidney.

β-klotho is predominantly expressed in the liver.

γ-klotho is expressed in the skin.

klothoHighly expressed in
1α-klotho brain, liver and kidney.
2β-klotholiver
3γ-klothoskin
klotho

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