Renal System Answers

The answer is i. (Katzwng, p 984.) Bacille Calmette-Guerin vaccine is a nonspecific stimulant of the reticuloendothelial system. It is an attenuated strain of Mycobacterium fruvis that appears most effective in small, localized bladder tumors. This agent is approved for intravesicular use in bladder cancer. Adverse reactions are associated with the renal system, such as problems with urination, infection, and cystitis. 

The answer is a. (Hardman, pp 885-8870 Lovastatin should not be used in patients with severe liver disease. With routine use of lovastatin, serum transaminase values may rise, and in such patients the drug may be continued only with great caution. Lovastatin has also been associated with lenticular opacities, and slit-lamp studies should be done before and one year after the start of therapy There is no effect on the otic nerve. The drug is not toxic to the renal system, and reports of bone marrow depression are very rare There is a small incidence of myopathy, and levels of creatinine kinase should be measured when unexplained muscle pain occurs. Combination with cyclosporine or clofibrate has led to myopathy There is no danger in use with bile acid sequestrants. 

By its very nature, the renal system carries a high-risk profile for drug-induced toxicity. Mechanistic and pathophysiologic thinking remains critical for a better understanding of observed harm and prediction of possible future harm. This requires at least vahd data on signals, exposure, denominator and confounders. When ever possible, proactive and prospective design of the data collection is preferable, if not in many cases the only way to get reliable answers. Current... 

The answers are 370-c, 371-d, 372-c. (Hardman, pp 697, 701, 705.) The loop diuretic ethacrynic acid has its site of action in the ascending limb of the loop of Henle. This drug inhibits the reabsorption of Na and Cl" by interfering with the Na+, K+, 2CL co-transport system. In addition, loop diuretics block the reabsorption of Mg and Ca from the renal tubular fluid into the blood in this segment of the nephron unit. 

Isolated renal cell components (cytosol, organelles, membranes) are also commonly used in vitro systems. Renal microsomes and cytosol are useful in examining the renal biotransformation and bioactivation of nephrotoxicants. Since mitochondria are frequently targets for nephrotoxicants, isolated renal mitochondria are also an important model system for determining the toxic mechanism(s) of some compounds. Also, the direct effects of toxicants on renal cell membranes can be studied in vesicles prepared from either the luminal (brush border) or basolateral (antiluminal, peritubular) membrane of renal cortical cells. The use of isolated cell components is helpful in answering specific questions about... 

Resistance to methotrexate does not occur within a few days—a longer time period is required. Serum methotrexate levels are not predictive of mucositis but are related to potential myelo-suppressive toxicity of the drug. Renal toxicity is unlikely to occur in this patient with the proposed protocol. Intrathecal administration of methotrexate is required for central nervous system leukemia. The answer is (A). 

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