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Retired NBME 19 Answers

nbme19/Block 4/Question#46 (reveal difficulty score)
24 yo woman; renal oxygen consumption found ...
Tubular reabsorption ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—cassdawg(1781)
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I am assuming this is just something we are expected to know; tubular reabsorption requires the most oxygen because it would consume the most ATP out of the processes in the kidney?

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waitingonprometric  I believe this is correct--assuming that active transport of solutes at the thick ascending limb and active transport of solutes (secondary to Na/K pump) at the PCT consumes O2 at highest rate b/c of ATP use. Since tubular reabsorption always happening...very high use of O2 relative to the other answer choices that occur sporadically in response to body homeostatic changes? Note: glomerular filtration is always happening, but that's passive movement through fenestrated capillaries (i.e. no ATP used). +3
hiroshimi  Also, PCT and thick ascending tubule are the two areas that are most susceptible to hypoxic injury in the kidneys. +6
surgerydoctorca_sgu  I looked at this question from the perspective of the PCT. It always seems that is most questions like this the PCT is the most active, and most of these processes require a lot of energy. I do agree this question is somewhat random and vague though which leads us to having to make some assumptions. +



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