Exam 3: Renal/Digestive/Reproductive Flashcards
1
Q
which of the following is not a function of the kidney?
a. excretes metabolic wastes
b. regulates blood gas concentration
c. synthesizes some hormones
d. regulates acid base balance
e. regulates water balance
A
b. regulates blood gas concentration
2
Q
if a substance is reabsorbed from the renal tubule, where is it traveling?
A
into the blood
3
Q
which of the following does not get filtered across the glomerular capillaries?
a. vitamins
b. RBCs
c. electrolytes
d. water
e. more than one of the above
A
b. RBCs
4
Q
Of the 3 forces (pressures) involved in filtration, which pressure most strongly opposes filtration?
a. fluid pressure in Bowman’s space
b. glomerular capillary hydrostatic pressure
c. osmotic forces due to the protein in the plasma
A
c. osmotic forces due to the protein in the plasma
5
Q
the structure that connects the kidney to the bladder is the
a. urethra
b. renal corpuscle
c. nephron
d. ureter
A
d. ureter
6
Q
glomerular filtration is driven by
a. active transport
b. cotransport
c. diffusion
d. bulk flow due to capillary hydrostatic pressure
A
d. bulk flow due to capillary hydrostatic pressure
7
Q
What are the kidney’s 2 sets of arteries and 2 sets of capillaries?
A
Arteries: efferent arteriole and afferent arteriole
capillaries: glomerular capillaries and peritubular capillaries
8
Q
fluid in the proximal convoluted tubule is __ compared to interstitial fluid
a. hypo-osmotic
b. hyper-osmotic
c. iso-osmotic
A
a. hypo-osmotic
9
Q
without the action of ADH, what would happen?
a. increased amount of water in the urine
b. increased amount of glucose in the urine
c. increased amount of salt in the urine
d. all are correct
A
a. increased amount of water in the urine
10
Q
these aquaporins have consistent expression (unregulated by ADH) and are found on the basolateral membrane of the collecting duct epithelial cells
A
APQ3 and APQ4
11
Q
sodium excreted is equal to..
a. the sodium reabsorbed plus the sodium filtered
b. the sodium filtered plus the sodium secreted plus the sodium reabsorbed
c. the sodium reabsorbed minus the sodium filtered
d. the sodium filtered plus the sodium secreted minus the sodium reabsorbed
e. the sodium filtered minus the sodium reabsorbed
A
e. the sodium filtered minus the sodium reabsorbed
12
Q
T/F: water freely crosses cell membranes
A
false
13
Q
If you have a concentration of 500mOsm in tubular fluid and a concentration of 700mOsm in interstitial fluid which way will water flow?
a. from the interstitial fluid to the tubular fluid
b. from the tubular fluid to the interstitial fluid
c. not enough information
A
b. from the tubular fluid to the interstitial fluid
14
Q
Fluid in the distal convoluted tubule is ________ compared to interstitial fluid.
a. hyper-osmotic
b. hypo-osmotic
c. iso-osmotic
A
b. hypo-osmotic
15
Q
Most of the water that goes to the renal tubule…
a. continues through circulation to the efferent arteriole
b. ends up in our pee
c. gets reabsorbed back into our blood
A
c. gets reabsorbed back into our blood
16
Q
Which limb of the loop of Henle is impermeable to water?
A
ascending
17
Q
What ensures that sodium stays low inside cells, thereby helping to drive sodium into the tubular epithelial cells from the tubular lumen?
A
Na/K pump
18
Q
sodium is actively transported
a. across the apical membrane of the tubular epithelium into the epithelial cell
b. from the interstitial space into the peritubular capillaries
c. across the basolateral membrane of the tubular epithelium into the interstitial fluid
d. across the apical membrane of the tubular epithelium into the tubular lumen
e. across the basolateral membrane of the tubular epithelium into the epithelial cell
A
c. across the basolateral membrane of the tubular epithelium into the interstitial fluid
19
Q
the proximal tubule of the nephron
a. reabsorbs HCO3- but not Cl-
b. produces a filtrate with varying osmolarity depending on plasma aldosterone
c. reabsorbs about 2/3 of the filtered Na+ at high and normal GFR
d. is important in regulating urine volume (ml/min)
e. participates in the juxtaglomerular apparatus
A
c. reabsorbs about 2/3 of the filtered Na+ at high and normal GFR
20
Q
if a substance is freely filtered and 70% of it is reabsorbed, assuming no additional secretion, what percentage of the substance is excreted into urine?
A
30
21
Q
Because of the active transport of sodium and chloride out of the ascending limb of the loop of Henle and its impermeability to water…
a. fluid in the distal tubule is hypo-osmotic compared to plasma
b. fluid in the ascending limb in the loop of Henle is hpo-osmotic compared to the surrounding environment
c. water is able to passively reabsorbed in the medullary collecting duct
d. two of these are correct
e. all of these are correct
A
e. all of these are correct
22
Q
T/F: in a healthy individual, glucose can be observed in the descending loop of Henle
A
false
23
Q
glucose travels across the basolateral membrane
a. pasively down its gradient through a transporter via facilitated diffusion
b. actively through a transporter
c. contransported with sodium, up its (glucose) gradient
d. passively through a leak channel permeable to glucose
e. none of these
A
a. pasively down its gradient through a transporter via facilitated diffusion
24
Q
t/f: if alpha adrenergic receptors are present on the afferent arteriole, then they would also likely be present on the efferent arteriole
A
false
25
t/f: water is actively transported out of the nephron only in the medullary collecting duct
false
26
in the process of secretion of HCl, the primary active transporting pump is on the ___ membrane of the stomach epithelial cells, unlike the renal epithelial cells
apical
27
what percentage of the pancreatic cells are devoted to its exocrine digestive function?
99%
28
which macromolecule(s) do you begin to chemically break down in the mouth?
a. carbs only
b. fats only
c. carbs and fats
d. carbs and proteins
e. proteins only
c. carbs and fats
29
which cells in the epithelial lining of the stomach secrete pepsin?
chief cells
30
T/F: heartburn is associated with stomach acid reaching some myocardial cells and creating a burning sensation
false
31
which of the following is not a way that GI processes are regulated?
a. distention of the wall by the volume of contents
b. chyme concentrations of specific digestive products
c. the overall protein content in the body
d. chyme osmolarity
e. chyme acidity
c. the overall protein content in the body
32
the purpose of the convoluted surface area of the lumen wall of the digestive tract
a. is to aid optimal digestion
b. is to assure that things don't get stuck in the digestive tract
c. is so that things move really slowly in the digestive tract
d. is to provide a very high surface area for absorption
d. is to provide a very high surface area for absorption
33
parasympathetic control of digestion..
a. ensures that saliva is more sparse and produces a dry mouth
b. ensures that saliva is plentiful and rich in enzymes
c. dampens motility of smooth muscle cells in digestive tract
d. shuts down production of stomach acid
b. ensures that saliva is plentiful and rich in enzymes
34
In the digestive tract, endocrine secretions end up in the ___________ while exocrine secretions end up in the _____________.
blood, intestinal lumen
35
right after the stomach experiences an influx of food, which of the following would then occur?
a. increase in HCl production
b. closing of the cardiac sphincter
c. gastrin release
d. two are correct
e. all are correct
e. all are correct
36
in addition to sodium reabsorption, aldosterone promotes
a. hydrogen ion reabsorption
b. hydrogen ion secretion
c. potassium reabsorption
d. potassium secretion
d. potassium secretion
37
an aldosteron receptor blocker
a. would block the action of aldosterone on the distal tubule cells
b. would block the vasoconstriction effects of angiotensin II
c. works with an ACE inhibitor to raise blood pressure
d. would turn the entire RAAS system off
a. would block the action of aldosterone on the distal tubule cells
38
t/f: as blood pressure rises, baroreceptor firing rate rises too
true
39
furosemide, a loop diuretic, blocks what?
a. Na channels in the proximal tubule apical membrane
b. NKCC transporter on ascending limb of the loop of Henle
c. AQP2 channels
d. Na/K pump
b. NKCC transporter on ascending limb of the loop of Henle
40
t/f: promoting sodium retention or reabsorption would most likely increase blood pressure
true
41
which of the following would occur if a person lost the ability to synthesize vasopressin?
a. the ability to reabsorb water in the proximal tubule would be lost
b. the excretion of glucose in the urine would increase
c. the urine production would decrease dramatically and the urine osmolarity would be hypertonic compared to plasma
d. blood pressure would increase significantly
e. the urine would become hypo-osmotic
e. the urine would become hypo-osmotic
42
which of the following is true regarding ANP?
a. it is secreted by macula dense cells
b. it promotes Na+ reabsorption
c. it is secreted in response to increased plasma volume
d. it decreases GFR by vasoconstricting the afferent arteriole
c. it is secreted in response to increased plasma volume
43
You have a patient with extensive birth defects that affect the kidney anatomy. Nevertheless, she does have some kidney function. One thing you've noticed in her labs is extremely low renin secretion. Which of the following anatomical locations is likely to exhibit abnormal development?
the juxtaglomerular apparatus
44
what does the term alkalosis mean?
a. hydrogen ion content is higher than usual
b. hydrogen ion content is higher than usual and plasma pH is low
c. plasma pH is low
d. hydrogen ion content is lower than usual
e. hydrogen ion content is lower than usual and plasma pH is low
d. hydrogen ion content is lower than usual
45
Lactic acid was generated by the leg muscles after a bunch of hard squats and is now circulating in the blood. Which of the following is likely to occur as a compensation of this lactic acid buildup?
a. increased plasma PCO2
b. decreased renal secretion of hydrogen ion
c. decreased urinary pH
d. decreased renal absorption of bicarbonate ion
c. decreased urinary pH
46
the juxtaglomerular cells
a. will secrete renin in response to low blood volume in the afferent arteriole
b. receive input from the macula densa cells about the water content of the distal tubular fluid
c. act as intra-neural baroreceptors
d. two of these are correct
e. all of these are correct
d. two of these are correct
47
the hydrogen ions that participate in making stomach, or gastric, acid enter the stomach lumen...
a. through active transport on apical membrane of a parietal cell, on a transporter coupled with K+
b. through active transport across the basolateral membrane of a parietal cell, on a transporter coupled with K+
c. through secondary active transport on the basolateral membrane of a parietal cell, on a transporter coupled with K+
d. through a secondary active transporter on the apical membrane of a parietal cell, on a transporter coupled with Na+
e. through active transport on the apical membrane of a parietal cell, on a transporter coupled with Na+
a. through active transport on apical membrane of a parietal cell, on a transporter coupled with K+
48
why is an ACE inhibitor useful for treating high BP?
a. it promotes more water to be in the urine (more excretion)
b. it disrupts the gradient in the medullary interstitial fluid
c. it promotes aldosterone to reabsorb sodium
d. it prevents the vasoconstrictive effects of angiotensin II
e. it promotes a higher urine volume (more excretion)
d. it prevents the vasoconstrictive effects of angiotensin II
49
opening of this sphincter when it should not be open is responsible for acid reflux, or 'heartburn'
lower esophageal sphincter
50
bringing useful nutrients from the digestive tract to the blood is
a. absorption
b. physical digestion
c. chemical digestion
d. secretion
a. absorption
51
an increase in H+ secretion
a. will increase HCO3- secretion
b. will both increase HCO3- secretion and raise plasma pH
c. will lower plasma pH
d. will increase HCO3- reabsorption
e. will raise plasma pH
f. will both increase HCO3- reabsorption and raise plasma pH
f. will both increase HCO3- reabsorption and raise plasma pH
52
what primary active transporter drives the formation of HCl?
a. Na+/K+ transporter (Na+ goes into the parietal cell and K+ goes into the stomach lumen)
b. H+/K+ transporter (H+ goes into the parietal cell and K+ goes into the lumen of the stomach)
c. H+/K+ transporter (H+ goes into the lumen of the stomach and K+ goes into the parietal cell)
d. Na+/K+ transporter (Na+ goes into the lumen of the stomach and K+ does into the parietal cell)
c. H+/K+ transporter (H+ goes into the lumen of the stomach and K+ goes into the parietal cell)
53
Babies and little kids are at a higher risk of choking not only because they are little and put weird things in their mouth but also because this structure is not fully matured and can't do it's job as well as it does in the adult.
epiglottis
54
which of the following components of the renin-angiotensin-aldosterone system is incorrectly matched with its role/function?
a. liver - secretes angiotensin
b. capillary endothelial cells - secrete angiotensin converting enzyme
c. macula dense cells of kidney - secrete renin
d. angiotensin II - promotes systemic vasoconstriction
e. angiotensin I - a biologically inactive precursor to angiotensin II
c. macula dense cells of kidney - secrete renin
55
in this module, we discussed hyperkalemia and its effects on potassium secretion in the kidney tubules. hyperkalemia..
a. increases GFR
b. decreases the rate of potassium secretion
c. promotes increased synthesis of Na/K pumps in distal tubule/cortical collecting duct epithelial cells
d. stimulates ADH release from the posterior pituitary
e. none of the above
c. promotes increased synthesis of Na/K pumps in distal tubule/cortical collecting duct epithelial cells
56
drugs that may be able to treat ulcers include..
a. a drug that accelerates the activity of the H+/K+ pump
b. an antibiotic that kills helicobacter pylori
c. a drug that stimulates the release of histamine
d. all of the above
b. an antibiotic that kills helicobacter pylori
57
which of the following is not a function of the large intestine?
a. absorption of 25% of carbohydrates
b. some secretion of K+
c. synthesis of some Vitamin K
d. absorption of Na and water
e. houses the microbiome
a. absorption of 25% of carbohydrates
58
The pancreatic duct cells secrete ______________ while the pancreatic acinar cells secrete ______________.
bicarbonate, pancreatic enzymes
59
T/F: water is absorbed by both the small and large intestines
true
60
what is the primary issue in individuals who suffer from celiac's disease?
a. gluten irritates the stomach lining, resulting in ulcers
b. neural connections to the small intestine are destroyed by gluten
c. absorption of water is completely disrupted
d. gluten destroys the diversity of the gut microbiome
e. surface area in the intestinal lumen is drastically reduced from gluten
e. surface area in the intestinal lumen is drastically reduced from gluten
61
which of the biomolecules enter the small intestinal epithelial cells by secondary active transport?
a. proteins and lipids
b. carbs and lipids
c. carbs, proteins, and lipids
d. carbs only
e. carbs and proteins
e. carbs and proteins
62
some functions of the gut microbiome include
a. vitamin K synthesis
b. metabolism
c. education of the immune system
d. all of these options are correct
d. all of these options are correct
63
which of the following is true regarding zymogens?
a. they are precursors to active enzymes that digest proteins
b. they catalyze the breakdown of triglycerides into monoglycerides
c. they can do digestion inside a pancreatic acinar cell
a. they are precursors to active enzymes that digest proteins
64
enterokinase..
a. activates trypsin from trypsinogen
b. is present in the stomach lumen
c. comes from the pancreatic duct cells
d. aids in the digestion of carbohydrates
a. activates trypsin from trypsinogen
65
how do bile and pancreatic lipase differ in their roles in fat digestion/absorption?
a. bile promotes solubilization of the fats while lipase chemically digests them
b. bile promotes solubilization of the fats and pancreatic lipase transports the fatty acids across the intestinal epithelial cell apical membrane
c. bile helps in transporting fatty acids across the apical membrane of the intestinal epithelial cell while pancreatic lipase chemically digests the fats
d. bile chemically digests the fats while lipase promotes solubilization of them
a. bile promotes solubilization of the fats while lipase chemically digests them
66
what describes androgen insensitivity syndrome?
a. that person is non responsive to testosterone
b. the person is XX but appears male
c. the person has the internal anatomy of a female
d. all choices are correct
a. that person is non responsive to testosterone
67
t/f: estrogen does both negative and positive feedback
true
68
which gland in the male reproductive system makes up the bulk of what is found in semen?
seminal vesicles
69
the SRY gene
a. codes for a transcription factor that promotes formation of the testes
b. codes for the Mullerian ducts to degenerate
c. codes for the Wolffian ducts to develop
d. codes for the synthesis and secretion of testosterone
e. codes for a transcription factor that promotes descent of the testes
a. codes for a transcription factor that promotes formation of the testes
70
viagra works by
inhibiting cGMP phosphodiesterase
71
which of the following statements regarding male reproductive function is false?
a. sperm formed in the testes enter the epididymis before entering the vas deferens
b. the seminal fluid is rich in nutrients
c. sperm entering the epididymis are fully motile
d. the sertoli cells produce androgen binding protein
c. sperm entering the epididymis are fully motile
72
this structure in the male reproductive system provides the sperm with fructose to power their trip out and into the female reproductive system
seminal vesicle
73
the primary follicle is..
a. the oocyte, surrounding zona pellucida and the granulosa cells
b. the exact same things as the egg or oocyte
c. the exact same thing as the ovary
d. the zona pellucida
a. the oocyte, surrounding zona pellucida and the granulosa cells
74
egg and sperm are made via
meiosis
75
FSH and LH are hormones secreted by
the anterior pituitary
76
shedding of the endometrial lining occurs...
a. as a result of a fall in plasma levels of estrogen and progesterone
b. because ovulation disrupts the growing follicle
c. a day after the LH surge
d. because of an increase in the levels of FSH
e. because the nondominant follicles undergo atresia
a. as a result of a fall in plasma levels of estrogen and progesterone
77
what percentage of labors begin with the "water breaking" (rupture of the amniotic sac)?
a. 25
b. 90
c. 75
d. 50
e. 10
e. 10
78
implantation of a blastocyte...
a. normally occurs within the oviduct
b. normally begins around day 21 of the typical menstrual cycle
c. occurs within 24 hours of fertilization of the oocyte
d. requires the presence of high concentrations of follicle-stimulating hormone
b. normally begins around day 21 of the typical menstrual cycle
79
which day of the ovarian cycle is the oocyte released for fertilization?
a. day 28
b. day 25
c. day 1
d. day 14
e. day 7
d. day 14
80
the corpus luteum is present during...
a. day 1-7
b. days 20-28
c. days 7-14
d. days 15-28
d. days 15-28
81
the trophoblast becomes...
a. the embryo and eventual fetus
b. support structures like the placenta
b. support structures like the placenta
82
the hormone that a pregnancy test detects is
hCG
83
t/f: the placenta must be delivered before the baby
false
84
which days of the ovarian/menstrual cycles will look different if a female gets pregnant during that cycle?
a. days 8-14
b. days 1-8
c. days 21-28
d. days 15-21
c. days 21-28
85
in the ovarian cycle, the dominant follicle..
a. continues to grow beyond day 7 of the cycle, while the other developing follicles degenerate
b. undergoes atresia
c. ruptures during ovulation on day 21 of the cycle
d. is selected to continue growing at about the middle of the luteal phase
e. is selected on day 1 of the cycle, and no other follicles develop beyond that day
a. continues to grow beyond day 7 of the cycle, while the other developing follicles degenerate
86
As a reproductive endocrinologist, you are trying to help a couple pin-point some of their fertility issues. You obtain a sperm sample from the husband and immediately figure out what the issue is. Which of the following could be contributing to this couple's infertility?
a. sperm composes only 10% of the semen sample
b. a large amount of mitochondria are present in the sperm cell bodies
c. the semen fluid lacks bicarbonate
d. FSH levels in the semen sample are high
e. more than one of these choices are correct
c. the semen fluid lacks bicarbonate
87
in oogenesis, the second meiotic division
a. happens once each month as a female goes through the ovarian cycle
b. results in two polar bodies
c. yields one egg and one corpus luteum
d. yields two haploid gametes
e. only happens after fertilization
e. only happens after fertilization
88
Why does it make sense that estrogen carries out a negative feedback loop on the anterior pituitary hormones during the luteal phase?
a. bc the uterus is preparing for pregnancy and doing so requires high levels of FSH and LH
b. because the uterus is preparing for pregnancy and there is no need to promote the growth of a new follicle when one was just released
c. because the ovaries need to prepare another follicle to be released the following month
e. because the follicle is preparing for ovulation and the anterior pituitary
b. because the uterus is preparing for pregnancy and there is no need to promote the growth of a new follicle when one was just released
89
why would estrogen be a bad choice for an ovulation kit hormone?
a. it is high early in the follicular phase, and that is not when you are ovulating
b. it is low throughout the entire follicular phase, so it wouldn't be able to predict ovulation
c. it has a peak in both the follicular and luteal phases, so you wouldn't be able to distinguish which phase is prior to ovulation
d. estrogen is always around in high concentrations in the female
e. it spikes just after the LH does, so you would miss the window with a viable oocyte after taking the test
c. it has a peak in both the follicular and luteal phases, so you wouldn't be able to distinguish which phase is prior to ovulation
90
which of the following best describes a genetic male (XY) who lacks functional androgen receptors (AIS)?
a. he will have male external genitalia but will have female appearing internal structures derived from Mullerian ducts
b. he will have undescended testes but female external genitalia and secondary sex characteristics
c. he will have female appearing external genitalia and ovaries but internal structures derived from the Wolffian ducts
d. he will have normal male external genitalia
e. he will have ovaries and female appearing external genitalia but male secondary sex characteristics
b. he will have undescended testes but female external genitalia and secondary sex characteristics
91
theca cells..
a. do not play a role in the luteal phase
b. are responsible for the release of prolactin during lactation
c. are targeted by FSH
d. secrete estrogen
e. are not part of the primary follicle
e. are not part of the primary follicle
92
which of the following is not true regarding ovulation?
a. it involves the release of only the oocyte from the follicle
b. it is stimulated by a sharp rise in progesterone
c. is it inhibited when a female is on oral contraceptives
d. it happens toward the end of the follicular phase of the ovarian cycle
e. a surge of LH happens less than a day before the event
b. it is stimulated by a sharp rise in progesterone
93
digestion
breaking down food physically or chemically
94
alimentary canal
what food touches - esophagus, stomach, intestines
95
digestive: secretion
blood --> digestive tract
96
digestive: absorption
digestive tract --> blood
97
what does the convoluted surface area do?
increase area for absorption
98
endocrine secretions end up in ___
the blood
99
exocrine secretions end up in __
digestive tract/leave body
100
chyme
ingested foods and digestive secretion
101
GI processes are regulated by
distention of wall by volume of contents
osmolarity of chyme
chyme acidity
chyme concentration of specific digestive products
102
contents and role of saliva
contents: mucus, water, bicarbonate, enzymes
role: lubricate food, buffer acidity
103
lysozyme
antibacterial enzyme that protects us from bacteria
104
salivary analyse
chemically digests carbs in mouth
105
salivary lipase
chemically digests fats in mouht
106
symp/parasymp control of the production/secretion of saliva
parasymp: increase salivary gland activity due to increased blood blow to salivary glands "rest and digest"
symp: increased salivary gland activity
"dry mouth"
107
lower esophageal sphincter is also known as the
cardiac sphincter
108
perisalsis
wave of contraction in esophagus, pushes food downward
109
parietal cells
secrete HCl (gastic acid)
secrete intrinsic factor (protein that binds and allows for absoption of vit B12 in SI)
110
chief cells
secrete pepsinogen
111
G cells
secrete gastrin (enteroedocrine)
112
stimulating HCl production
increased peptides in stomach lumen --> stimulates gastrin --> increased expression of H+/K+ pumps --> more acidity in stomach lumen
113
pyloric sphincter
at junction of stomach and SI, only allows a small amount of chyme in SI at a time
114
pancreatic secretions into SI
- makes bicarbonate to buffer chyme (made by pancreatic duct cells)
- pancreatic enzymes ex. pancreatic lipase/amylase - some secreted as zymogens (made by pancreatic acinar cells)
115
bile salts
solubilize the dietary fats (mechanical digestion), synthesized from cholesterol, absorbed by transporters in ileum + recycled to liver
116
CCK
signals gall bladder to contract and release bile
117
small intestine absorption of carbs
polysaccharides - salivary + pancreatic amylase breaks down to
disaccharides - brush border enzymes break down to
monosaccharides
glucose/galactose - on apical:
contransported with Na+, from lumen to
intestinal epithelial
fructose - on apical: GLUT transporter
on basolateral: all 3 have GLUT
transporters
118
SI absorption of proteins
broken down by enzymes like trypsin, chymotrypsin, carboxypeptidases, aminopeptidases
Apical:
2-3 short chains of amino acids absorbed by secondary active, coupled to H+ gradient
single aa's absorbed by secondary active, coupled to Na+ gradient
Basolateral:
amino acids by facilitated diffusion
