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Renal Physiology- Physiology PMU- 2nd Year, 2nd Semester

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Renal Physiology- Physiology PMU- 2nd Year, 2nd Semester
Med Student
Quiz by Med Student , updated more than 1 year ago
Med Student
Created by Med Student almost 7 years ago
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Resource summary

Question 1

Question
The nephron:
Answer
  • has endocrine functions
  • is lined by a single layer of epithelial cells
  • is under endocrine control
  • absorbs more ions and molecules than it secretes
  • all of the above

Question 2

Question
The control of water excretion in the kidney is controlled by:
Answer
  • the antidiuretic hormone (ADH)
  • the medulla oblongata
  • blood plasma
  • sodium amount in the blood
  • potassium amount in the blood

Question 3

Question
The kidneys have a direct effect on which of the following?
Answer
  • blood pressure
  • how much water a person excretes
  • total blood volume
  • pH
  • all of the above

Question 4

Question
Glucose reabsorption occurs in the:
Answer
  • proximal tubule
  • loop of Henle
  • distal tubule
  • cortical collecting duct
  • medullary collecting duct

Question 5

Question
Renin is secreted by:
Answer
  • cells in the macula densa
  • cells in the proximal tubule
  • cells in the distal tubule
  • juxtaglomerular cells
  • cells in the peritubular capillary bed

Question 6

Question
Renin release:
Answer
  • is promoted by reduced arteriolar stretch in. the glomeruli
  • increases when systemic arterial pressure rises
  • directly activates angiotensin converting enzyme
  • tends to expand the plasma volume
  • a and d

Question 7

Question
The glomerulus:
Answer
  • has both afferent and efferent arterioles
  • contains capillaries, which are at a higher hydrostatic pressure than the peritubular capillaries
  • filters 20% of the renal plasma flow
  • contains renin-secreting cells
  • all of the above

Question 8

Question
The acid-buffering power:
Answer
  • of HCO3- in blood is increased by respiratory control of pCO2
  • of haemoglobin exceeds that of HCO3- in blood
  • of HCO3- is increased by the action of carbonic anhydrase
  • of venous blood is normally greater than that of arterial blood
  • a, b, and d

Question 9

Question
Urinary volume is increased with:
Answer
  • consumption of alcohol
  • hyperglycemia
  • increased aldosterone secretion
  • damage to the posterior pituitary
  • a, b, and d

Question 10

Question
The following occurs in the proximal tubule of the nephron:
Answer
  • reabsorption of all glucose
  • reabsorption of most water
  • active reabsorption of sodium
  • secretion of bicarbonate
  • a, b, and c

Question 11

Question
The antidiuretic hormone (ADH):
Answer
  • decreases the osmolarity of urine
  • decreases the volume of urine
  • increases the reabsorption of water in the proximal tubules
  • is synthesised in the posterior posterior pituitary gland
  • increases the excretion of glucose

Question 12

Question
Regarding the kidneys:
Answer
  • there are 1.3 million nephrons in each kidney
  • they produce aldosterone
  • they receive 12% of the cardiac output at rest
  • more blood flows through the renal cortex than the renal medulla
  • a, and d

Question 13

Question
Which of the following causes hyperkalemia
Answer
  • exercise
  • alkalosis
  • insulin injection
  • decreased serum osmolality
  • increased serum osmolality

Question 14

Question
Glucose is reabsorbed:
Answer
  • by active transport
  • by passive transport
  • by Na+ co-transport
  • by H+ counter-transport
  • a, and c

Question 15

Question
Simulation of the sympathetic nerves cause the following effects;
Answer
  • low diuresis
  • decreased net filtration pressure
  • increased glucose urine level
  • decreased glucose urine level
  • a, and b

Question 16

Question
The glomerular capillaries have the following functions:
Answer
  • blood plasma filtration
  • hormone secretion
  • water secretion
  • formation of primary urine
  • a, and d

Question 17

Question
Obligatory water loss from the body is:
Answer
  • 400 ml in faeces
  • 300 ml from the lungs
  • loss from skin & lungs
  • insensible water loss
  • 500 ml in urine

Question 18

Question
Blood flow at rest is most for:
Answer
  • brain
  • liver
  • kidneys
  • heart
  • skin

Question 19

Question
Renal blood flow is dependent on:
Answer
  • juxtaglomerular apparatus
  • [Na+] at macula densa
  • afferent vasodilatation
  • arterial pressure
  • efferent vasoconstriction

Question 20

Question
Which of the following substances has the highest renal clearance?
Answer
  • PAH
  • Glucose
  • Urea
  • Water
  • Insulin

Question 21

Question
The ascending limb of the loop of Henle is:
Answer
  • impermeable to Na+
  • involved in active transport of K+ into the lumen
  • involved in active transport of Cl- out of lumen
  • involved in active transport of Na+ into lumen
  • hypotonic at the top

Question 22

Question
Which of the following ls involved in the regulation of glomerular filtration rate (GFR)?
Answer
  • juxtaglomerular apparatus
  • afferent arteriolar tone
  • efferent arteriolar tone
  • chloride transport at the macula densa
  • all of the above

Question 23

Question
Water excretion by the kidney is due to:
Answer
  • osmosis
  • active transport into the lumen
  • passive secretion in the collecting tubule
  • solvent drag
  • facilitated diffusion

Question 24

Question
Kidneys produce:
Answer
  • Erythropoietin
  • ADH
  • Angiotensin ll
  • ANP
  • Cholecalciferol

Question 25

Question
Increase in GFR occurs when there is:
Answer
  • increased sympathetic stimulation
  • decreased renal blood flow
  • hypoproteinaemia
  • ureteric obstruction
  • none of the above

Question 26

Question
The clearance (or ‘renal regulation') of which one of the following is not regulated by a hormone:
Answer
  • sodium
  • potassium
  • calcium
  • phosphate
  • sulphate

Question 27

Question
The kidneys filter from the blood every day about:
Answer
  • 1000 ml
  • 180 l
  • 18 l
  • 50 l
  • 8 l

Question 28

Question
Direct control of water excretion in the kidney is controlled by:
Answer
  • the antidiuretic hormone
  • the medulla oblongata
  • aldosterone
  • sodium amounts in the blood
  • adrenal cortex

Question 29

Question
Kidneys have a direct effect on which of the following:
Answer
  • blood pressure
  • how much water a person excretes
  • total blood volume
  • pH
  • all of the above

Question 30

Question
The countercurrent exchange system includes:
Answer
  • glomerulus and macula densa
  • proximal convoluted tubule and distal convoluted tubule
  • loop of Henle and collecting tubule
  • afferent arteriole and efferent arteriole
  • ureters and bladder

Question 31

Question
Tubular reabsorption of a filtered substance is likely to be active rather than passive if:
Answer
  • its concentration in the tubular fluid is lower than in peritubular capillary blood
  • is carried out by the mechanism of simple diffusion
  • renal clearance is lower than that of insulin
  • renal clearance rises at low plasma levels
  • osmolality there is higher than the plasma one

Question 32

Question
The renal clearance of a substance:
Answer
  • is inversely related to its urinary concentration, U
  • is directly related to the rate of urine formation, and is expressed in units of volume per unit time
  • is directly related to its plasma concentration, P
  • is expressed in mm Hg
  • must fall in the presence of metabolic poisons

Question 33

Question
In the fluid in the distal part of the proximal convoluted tubule:
Answer
  • urea concentration is higher than in Bowman’s capsule
  • pH is less than 6 when the kidneys are excreting an acid urine
  • glucose concentration is similar to that in plasma
  • osmolality is about 25 per cent that of glomerular filtrate
  • bicarbonate concentration is higher than in plasma

Question 34

Question
Renal tubules normally reabsorb:
Answer
  • fluids with osmolality lower than the plasma one
  • all filtered HCO3- in respiratory alcalosis
  • substances closely related to Cl-
  • all filtered plasma proteins
  • more K+ and Cl-

Question 35

Question
In the nephron, the osmolarity or the fluid in the:
Answer
  • Tip of the loop Of Henle is less than that of plasma
  • Bowman's capsules is less than that in the distal tubules
  • Collecting duct rises when vasopressin is being secreted
  • Proximal convoluted tubule rises along its length
  • Proximal tubule is with lower osmolality than plasma one

Question 36

Question
Transport maximum (Tm) - limited reabsorption of a substance implies that its:
Answer
  • reabsorption is active
  • reabsorption is critically related to tubular transit time
  • reabsorption is passive
  • renal clearance falls with its plasma concentration
  • reabsorbtion is carried out by the mechanism of faciliated diffusion

Question 37

Question
When a patient’s mean arterial blood pressure falls by 50%
Answer
  • renal blood flow increases
  • glomerular filtration increases
  • there is a decrease in the circulating aldosterone level
  • renal vasoconstriction occurs
  • urinary output is increased

Question 38

Question
The cells of the distal convoluted tubule:
Answer
  • reabsorb about 50 % of the water filtered by the glomeruli
  • reabsorb all filtered aminoacide
  • reabsorb all filtered proteins
  • reabsorb sodium in exchange for hydrogen or potassium ions
  • determine the final composition of urine

Question 39

Question
Renal blood flow falls:
Answer
  • about 10 % when arterial pressure increases 10% above normal
  • about 5% when metabolic activity in the kidney falls by 5%
  • during emotional stress
  • after small haemorrhage
  • gradually from the inner medulla to the outer cortex per unit weight of tissue

Question 40

Question
Urea:
Answer
  • and glucose have different molar concentrations in normal blood
  • clearance is higher, than creatinins one
  • is actively secreted by the renal tubular cells into the tubular fluid
  • concentration in blood may rise ten-fold after a high protein meal
  • causes diuresis when its blood concentration is increased

Question 41

Question
The renal clearance of:
Answer
  • Inulin provides an estimate of glomerular filtration rate
  • Chloride increases after an injection of aldosterone
  • PAH falls when the PAH load exceeds the Tm for PAH
  • Urea is higher than that of insulin
  • Inulin is dependent of its plasma concentration

Question 42

Question
Aldosterone:
Answer
  • is a steroid hormone, secreted by the adrenal medulla
  • production ceases following removal of the kidneys and their juxtaglomerular cells
  • production decreases in treatment with drugs which block angiotensin-converting enzyme
  • secretion results in increased potassium reabsorption by the nephron
  • secretion results in a fall in plasma volume

Question 43

Question
In healthy people, urinary:
Answer
  • clearance of glucose differs 0, if its plasma concentration is below 11,1mmol.1-1
  • osmolality ranges from 200-400 mosmol/litre
  • colour is due to small quantities of bile pigments
  • pH falls as dietary protein rises
  • calcium excretion is decreased by parathormone

Question 44

Question
The renal clearance
Answer
  • glucose is above 0, if the plasma concentration of a given substance is below 11, mmol.1-1
  • of urea is higher than creatinin‘s one
  • of glucose provides an estimate of renal plasma flow
  • of phosphate is decreased by parathormone
  • of protein is normally zero

Question 45

Question
Secretion of renin:
Answer
  • occurs in the stomach during infancy
  • is stimulated by the hormone angiotensin 1
  • is stimulated by a fall in extracellular fluid volume and leads to raised levels of angiotensin II in the blood
  • inhibits the secretion of aldosterone
  • inhibits ACTH secretion by the pituitary gland

Question 46

Question
Diabetes insipidus (deficiency of antldiuretic hormone) causes a fall in the:
Answer
  • osmolality of the urine
  • reabsorption of water from the proximal tubules
  • extracellular but not intracellular fluid volume
  • extracellular fluid osmolality
  • intracellular fluid osmolality

Question 47

Question
Dialysis fluid used in the treatment of renal failure should contain the normal plasma levels of:
Answer
  • urea
  • potassium
  • osmolarity
  • plasma proteins
  • hydrogen ions

Question 48

Question
Long-standing obstruction of the urethra may cause:
Answer
  • enlargement of the prostate gland
  • dystrophy of the bladder muscle
  • dilation of the ureters and reduction of the glomerular filtration rate
  • increase and reduction of the glomerular filtration rate
  • a decrease in residual volume in the bladder

Question 49

Question
Emptying of the bladder may be less effective if:
Answer
  • the sympathetic nerves carrying afferent information from bladder to the spinal cord are cut
  • the pelvic nerves are cut or anticholinergic drugs are administered
  • cholinergic agonists are administered
  • alpha-adrenergic receptor antagonists are administered
  • beta-adrenergic receptor blockers are administered

Question 50

Question
Drugs which interfere with active transport of sodium in the proximal tubule tend to increase:
Answer
  • urine production
  • plasma osmorality
  • chloride reabsorbtion
  • intestinal fluid volume
  • plasma volume

Question 51

Question
A drug which inhibits carbonic anhydrase:
Answer
  • decreases bicarbonate formation and reabsorption in the kidney
  • increases plasma bicarbonate levels
  • increases blood pH
  • increases urinary loss of potassium ions
  • increases urinary volume and pH

Question 52

Question
A patient with chronic renal failure usually has:
Answer
  • an increased blood urea and blood uric acid
  • a decreased blood uric acid
  • an increased creatinine clearance
  • an increased acid-base disturbance when he or she vomits
  • an increased acid-base problem on a low protein diet

Question 53

Question
Cutting the sympathetic nerves to the bladder may cause:
Answer
  • difficulty in emptying the bladder
  • loss of tone in the internal sphincter of the bladder and loss of pain sensation in the bladder
  • loss of tone in the external sphincter of the bladder
  • increased pain sensation in the bladder
  • infertility in the female

Question 54

Question
Sudden (acute) renal failure differs from gradual (chronic) renal failure in that:
Answer
  • potassium retention tends to be more severe
  • blood urea levels tend to be higher
  • depression of bone marrow activity is unlikely to occur
  • metabolic acidosis is usually not a problem
  • dietary protein restriction is unnecessary

Question 55

Question
A long-standing increase in arterial pCO2 (respiratory acidosis) leads to:
Answer
  • an increase in renal bicarbonate formation
  • a decrease in urinary ammonium salts
  • a decrease in plasma potassium concentration
  • an increase of the monohydrogen/dihydrogen phosphate ratio in urine
  • a decrease in urinary bicarbonate excretion

Question 56

Question
The inhibition of the antidiurctic hormone (ADH), say by alcohol, would have what affect?
Answer
  • constriction of the afferent arteriole
  • inhibition of diuresis
  • stimulation of water conservation
  • constriction of the efferent arteriole
  • reduction in water conservation by the kidneys

Question 57

Question
Reabsorption of amino acids from the filtrate requires many different protein carriers because:
Answer
  • denaturation may occur
  • this transport is not competitive
  • there are only 10 different amino acids
  • transport of amino acids is typically highly specific
  • glucose inhibits amino acid transport

Question 58

Question
Reabsorption (transport) of both N a‘“ and glucose together from the renal lumen is an example of:
Answer
  • facilitated diffusion
  • secondary passive transport
  • primary direct active transport
  • secondary indirect active antiport
  • secondary indirect active symport

Question 59

Question
Drinking a litre of water:
Answer
  • increases secretion of antidiuretic honnone
  • reduces the plasma sodium concentration
  • increases osmolarity of the urine
  • causes body cells to shrink
  • decreases the specific gravity of the body

Question 60

Question
An acid-base buffer system:
Answer
  • can be a mixture of a weak acid and its conjugate base
  • can be a solution of sodium and bicarbonate ions
  • prevents any change in pH when acid is added
  • works best when acid and base are equal in concentration
  • is hemoglobin as an example of intracellular buffer

Question 61

Question
Acidosis in a patient may lead to:
Answer
  • increased urinary excretion of potassium
  • hypoventilation
  • a blood pH of less than 5.5
  • an urinary pH of less than 5.5
  • tetany

Question 62

Question
A rise in the osmolality of extracellular fluid may lead to:
Answer
  • thirst and release of vasopressin
  • increased water reabsorption in the proximal convoluted tubules
  • a decrease of vasopressin secretion
  • an increase in intracellular fluid volume
  • suppression of sweat secretion

Question 63

Question
A raised blood pH and bicarbonate level is consistent with:
Answer
  • metabolic acidosis
  • partly compensated respiratory alkalosis
  • a reduced pCO2
  • chronic renal failure with a raised pCO2
  • a history of persistent vomiting of gastric contents

Question 64

Question
A patient with partly compensated respiratory acidosis:
Answer
  • must have a raised pCO2
  • must have a raised bicarbonate concentration [HCO3-]
  • may have evidence of renal compensation
  • may have respiratory failure due to hypoventilation
  • all of the above

Question 65

Question
Sodium retention:
Answer
  • occurs for several days after major surgery
  • expands the extracellular fluid volume
  • expands the blood volume
  • increases the severity of oedema
  • all of the above

Question 66

Question
Sodium depletion differs from water depletion in that:
Answer
  • cardiovascular changes are less pronounced
  • intracellular fluid volume is less affected
  • the haematocrit increases
  • thirst is more severe
  • antidiuretic hormone levels are higher

Question 67

Question
A high blood potassium level (hyperkalaemia):
Answer
  • occurs in acute renal failure
  • follows severe crush injuries to the limbs
  • may diminish cardiac performance and cause death
  • may be reduced by Intravenous infusion of insulin and glucose
  • all of the above

Question 68

Question
A raised level of calcium in the blood (hypercalcaemia):
Answer
  • may occur when parathyrord activity decreases
  • may occur when the plasma protein level falls
  • may occur in chronic renal failure
  • increases the risk of stone formation in the urinary tract
  • causes increased excitability of nerve and muscle

Question 69

Question
Thirst is stimulated by:
Answer
  • increase in plasma osmolality and volume
  • increase in plasma osmolality and decrease in volume
  • decrease in osmolality and increase in volume
  • decrease in plasma osmolality and volume
  • increase in intracelular volume
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