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Analysis on Urine and other Bodily Fluids > Book: Renal Physiology > Flashcards

Book: Renal Physiology Flashcards

1
Q

The type of nephron responsible for renal concentration is the:

A

Juxtaglomerular

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2
Q

The function of the peritubular capillaries is?

Reabsorption
Filtration
Secretion
Both A and C

A

Both A and C

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3
Q

Blood flows through the nephron in the following order:

A

Afferent arteriole
Peritubular capillaries
Vasa recta
Efferent arteriole

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4
Q

Filtration of protein is prevented in the glomerulus by?

A

The glomerular filtration barrier

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5
Q

The renin-angiotensin-aldosterone system is responsible for all of the following except:

Vasoconstriction of the afferent arteriole
Vasoconstriction of the efferent arteriole
Reabsorbing sodium
Releasing aldosterone

A

Vasoconstriction of the afferent arteriole

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6
Q

The primary chemical affected by the renin-angiotensin-aldosterone system is:

A

Sodium

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7
Q

Secretion of renin is stimulated by:

A

Macula densa cells

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8
Q

The hormone aldosterone is responsible for:

A

Sodium retention

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9
Q

The fluid leaving the glomerulus has a specific
gravity of:

A

1.010

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10
Q

For active transport to occur, a chemical:

A

Must combine with a carrier protein to create
electrochemical energy

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11
Q

Which of the tubules is impermeable to water?

Proximal convoluted tubule
Descending loop of Henle
Ascending loop of Henle
Distal convoluted tubule

A

Ascending loop of Henle

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12
Q

Glucose will appear in the urine when the:

Blood level of glucose is 200 mg/dL
Tm for glucose is reached
Renal threshold for glucose is exceeded
All of the above

A

All of the above

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13
Q

Concentration of the tubular filtrate by the countercurrent mechanism depends on all of the following except:

High salt concentration in the medulla
Water-impermeable walls of the ascending loop of
Henle
Reabsorption of sodium and chloride from the
ascending loop of Henle
Reabsorption of water in the descending loop of
Henle

A

Reabsorption of water in the descending loop of
Henle

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14
Q

ADH regulates the final urine concentration by controlling:

A

Tubular permeability

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15
Q

Decreased production of ADH

Produces a low urine volume
Produces a high urine volume
Increases ammonia excretion
Affects active transport of sodium

A

Produces a high urine volume

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16
Q

Bicarbonate ions filtered by the glomerulus are returned
to the blood:

In the proximal convoluted tubule
Combined with hydrogen ions
By tubular secretion
All of the above

A

All of the above

17
Q

If ammonia is not produced by the distal convoluted
tubule, the urine pH will be:

A

Basic

18
Q

The largest source of error in creatinine clearance tests is:

Secretion of creatinine
Improperly timed urine specimens
Refrigeration of the urine
Time of collecting blood sample

A

Improperly timed urine specimens

19
Q

Given the following information, calculate the creatinine clearance:

24-hour urine volume: 1000 mL;
serum creatinine: 2.0 mg/dL; urine creatinine: 200 mg/dL

A

69 mL/min

20
Q

Clearance tests used to determine the glomerular filtration rate must measure substances that are:

Not filtered by the glomerulus
Completely reabsorbed by the proximal convoluted
tubule
Secreted in the distal convoluted tubule
Neither reabsorbed or secreted by the tubules

A

Neither reabsorbed or secreted by the tubules

21
Q

Performing a clearance test using radionucleotides:

A. Eliminates the need to collect urine
B. Does not require an infusion
C. Provides visualization of the filtration
D. Both A and C

A

Both A and C

22
Q

Variables that are included in the MDRD-IDSM estimated
creatinine clearance calculations include all of the
following except:

A. Serum creatinine
B. Weight
C. Age
D. Gender

A

Weight

23
Q

An advantage to using cystatin C to monitor GFR is that:

A. It does not require urine collection
B. It is not secreted by the tubules
C. It can be measured by immunoassay
D. All of the above

A

All of the above

24
Q

Solute dissolved in solvent will:

A. Raise the vapor pressure
B. Lower the boiling point
C. Decrease the osmotic pressure
D. Lower the freezing point

A

Lower the freezing point

25
Q

Substances that may interfere with freezing point measurement of urine and serum osmolarity include all of the following except:

A. Ethanol
B. Lactic acid
C. Sodium
D. Lipids

A

Sodium

26
Q

Clinical osmometers use NaCl as a reference solution
because:

A. 1 g molecular weight of NaCl will lower the freezing
point 1.86oC
B. NaCl is readily frozen
C. NaCl is partially ionized similar to the composition
of urine
D. 1 g equivalent weight of NaCl will raise the freezing
point 1.86oC

A

NaCl is partially ionized similar to the composition
of urine

27
Q

The normal serum osmolarity is:

A. 50 to 100 mOsm
B. 275 to 300 mOsm
C. 400 to 500 mOsm
D. 3 times the urine osmolarity

A

275 to 300 mOsm

28
Q

After controlled fluid intake, the urine-to-serum osmolarity ratio should be at least:

A. 1:1
B. 2:1
C. 3:1
D. 4:1

A

1:1

29
Q

Calculate the free water clearance from the following
results:

urine volume in 6 hours: 720 mL;
urine osmolarity: 225mOsm;
plasma osmolarity: 300mOsm

A

+0.5

30
Q

To provide an accurate measure of renal blood flow, a test substance should be completely:

A. Filtered by the glomerulus
B. Reabsorbed by the tubules
C. Secreted when it reaches the distal convoluted
tubule
D. Cleared on each contact with functional renal
tissue

A

Cleared on each contact with functional renal
tissue

31
Q

Given the following data, calculate the effective renal
plasma flow:

urine volume in 2 hours: 240 mL;
urine PAH: 150 mg/dL;
plasma PAH: 0.5 mg/dL

A

600 mL/min

32
Q

Renal tubular acidosis can be caused by the:

A. Production of excessively acidic urine due to
increased filtration of hydrogen ions
B. Production of excessively acidic urine due to
increased secretion of hydrogen ions
C. Inability to produce an acidic urine due to impaired
production of ammonia
D. Inability to produce an acidic urine due to increased
production of ammonia

A

Inability to produce an acidic urine due to impaired
production of ammonia

33
Q

Tests performed to detect renal tubular acidosis after
administering an ammonium chloride load include all
of the following except:

A. Urine ammonia
B. Arterial pH
C. Urine pH
D. Titratable acidity

A

Arterial pH

34
Q

A 44-year-old man diagnosed with acute tubular necrosis
has a blood urea nitrogen of 60 mg/dL and a blood
glucose level of 100 mg/dL. A 2+ urine glucose is also
reported.

State the renal threshold for glucose

A

160-mg/dL to 180-mg/dL

35
Q

34 (a)

What is the significance of the positive urine
glucose and normal blood glucose?

A

Renal tubular reabsorption is impaired

36
Q

A patient develops a sudden drop in blood pressure.

Diagram the reactions that take place to ensure
adequate blood pressure within the nephrons.

A

Juxtaglomerular apparatus → Angiotensinogen → Renin → Angiotensin I → Angiotensin II

37
Q

36 (a)

When blood pressure returns to normal, how does the kidney respond?

A

Production of renin decreases and, therefore, the actions of the renin-angiotensin-aldosterone system

38
Q

A physician would like to prescribe a nephrotoxic antibiotic for a 60-year-old Caucasian man. The patient has a serum creatinine level of 1.5 mg/dL.

How can the physician determine whether it is safe to prescribe this medication before the patient leaves the
office?

A

The physician can calculate the approximate creatinine
clearance using the MDRD-IDMS-traceable formula

39
Q

38 (a)

State two additional blood tests that the physician
could use to continue monitoring this patient

A

The cystatin C test
beta2-microglobulin test
serum tests

Analysis on Urine and other Bodily Fluids (17 decks)

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