CHAPTER 4: Renal Function Flashcards

1
Q

The type of nephron responsible for renal concentration is the:
A. Cortical
B. Juxtaglomerular
C. Efferent
D. Afferent

A

B. Juxtaglomerular

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2
Q

The function of the peritubular capillaries is:
A. Reabsorption
B. Filtration
C. Secretion
D. Both A and C

A

D. Both A and C

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3
Q

Blood flows through the nephron in the following order:
A. Efferent arteriole, peritubular capillaries, vasa recta,
afferent arteriole
B. Peritubular capillaries, afferent arteriole, vasa recta, efferent arteriole
C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta
D. Efferent arteriole, vasa recta, peritubular capillaries, afferent arteriole

A

C. Afferent arteriole, efferent arteriole, peritubular capillaries, vasa recta

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4
Q

Filtration of protein is prevented in the glomerulus by:
A. Hydrostatic pressure
B. Oncotic pressure
C. Renin
D. The glomerular filtration barrier

A

D. The glomerular filtration barrier

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5
Q

The renin–angiotensin–aldosterone system is responsible for all of the following except:
A. Vasoconstriction of the afferent arteriole
B. Vasoconstriction of the efferent arteriole
C. Reabsorbing sodium
D. Releasing aldosterone

A

A. Vasoconstriction of the afferent arteriole

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6
Q

The primary chemical affected by the renin–angiotensin– aldosterone system is:
A. Chloride
B. Sodium
C. Potassium
D. Hydrogen

A

B. Sodium

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7
Q

Secretion of renin is stimulated by:
A. Juxtaglomerular cells
B. Angiotensin I and II
C. Macula densa cells
D. Circulating angiotensin-converting enzyme

A

C. Macula densa cells

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8
Q

The hormone aldosterone is responsible for:
A. Hydrogen ion secretion
B. Potassium secretion
C. Chloride retention
D. Sodium retention

A

D. Sodium retention

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9
Q

The fluid leaving the glomerulus has a specific gravity of:
A. 1.005
B. 1.010
C. 1.015
D. 1.020

A

B. 1.010

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10
Q

For active transport to occur, a chemical must:
A. Combine with a carrier protein to create
electrochemical energy
B. Be filtered through the proximal convoluted tubule
C. Be in higher concentration in the filtrate than in the blood
D. Be in higher concentration in the blood than in the filtrate

A

A. Combine with a carrier protein to create electrochemical energy

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11
Q

Which of the tubules is impermeable to water?
A. Proximal convoluted tubule
B. Descending loop of Henle
C. Ascending loop of Henle
D. Distal convoluted tubule

A

C. Ascending loop of Henle

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12
Q

Glucose will appear in the urine when the:
A. Blood level of glucose is 200 mg/dL
B. Tm for glucose is reached
C. Renal threshold for glucose is exceeded
D. All of the above

A

D. 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:

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

A

D. Reabsorption of water in the descending loop of Henle

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14
Q

ADH regulates the final urine concentration by
controlling:

A. Active reabsorption of sodium
B. Tubular permeability
C. Passive reabsorption of urea
D. Passive reabsorption of chloride

A

B. Tubular permeability

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15
Q

Decreased production of ADH:
A. Produces a low volume of urine
B. Produces a high volume of urine
C. Increases excretion of ammonia
D. Affects active transport of sodium

A

B. Produces a high volume of urine

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16
Q

Bicarbonate ions filtered by the glomerulus are returned to the blood:
A. In the proximal convoluted tubule
B. Combined with hydrogen ions
C. By tubular secretion
D. All of the above

A

D. All of the above

17
Q

If ammonia is not produced by the distal convoluted tubule, the urine pH will be:
A. Acidic
B. Basic
C. Hypothenuric
D. Hypersthenuric

A

B. Basic

18
Q

Place the appropriate letter in front of the following clearance substances:
A. Exogenous B. Endogenous

beta2-microglobulin -
creatinine -
cystatin C -
125I-iothalmate -

A

beta2-microglobulin - B. Endogenous
creatinine - B. Endogenous
cystatin C - B. Endogenous
125I-iothalmate - A. Exogenous

19
Q

The largest source of error in creatinine clearance tests is:
A. Secretion of creatinine
B. Improperly timed urine specimens
C. Refrigeration of the urine
D. Time of collecting blood specimen

A

B. Improperly timed urine specimens

20
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

formula

A

69 ml/min

U x V/ P

21
Q

Clearance tests used to determine the glomerular
filtration rate must measure substances that are:
A. Not filtered by the glomerulus
B. Completely reabsorbed by the proximal convoluted tubule
C. Secreted in the distal convoluted tubule
D. Neither reabsorbed nor secreted by the tubules

A

D. Neither reabsorbed nor secreted by the tubules

22
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

D. Both A and C

23
Q

Variables that are included in the MDRD-IDSM estimated calculations of creatinine clearance include all of the following except:
A. Serum creatinine
B. Weight
C. Age
D. Gender

A

B. Weight

24
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

D. All of the above

25
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

D. Lower the freezing point

26
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

C. Sodium

27
Q

Clinical osmometers use NaCl as a reference solution because:
A. 1 g molecular weight of NaCl will lower the freezing point 1.86°C
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 1.86°C

A

C. NaCl is partially ionized, similar to the composition of urine

28
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

B. 275 to 300 mOsm

29
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

A. 1:1

30
Q

Calculate the free water clearance from the following results:
urine volume in 6 hours: 720 mL; urine osmolarity: 225 mOsm; plasma osmolarity: 300 mOsm

A

+ 0.5

31
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

D. Cleared on each contact with functional renal tissue

32
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

33
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

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

34
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

B. Arterial pH