Final Test Questions Flashcards
As filtrate moves through the ______in mammals, it generally undergoes a dramatic decrease in osmolarity.
A. Distal convoluted tubule
B. Bowman’s capsule
C. Descending segment of the loop of Henle
D. Proximal convoluted tubule
E. Ascending segment of the loop of Henle
E
If a person is taking a drug that completely inhibits angiotensin-converting enzyme (ACE), what will happen to aldosterone secretion when the person goes on a low sodium diet?
A. There would likely be no increase in aldosterone production
B. There would be an increase in production of angiotensinogen from the kidney
C. Aldosterone production would increase, resulting in high blood pressure
D. The adrenal medulla would decrease its production of aldosterone
E. There would be an increase in production of ADH from the anterior pituitary gland
A
Creatinine is a waste product from the normal breakdown of muscle tissue. As creatinine is produced, it is filtered through the kidneys and excreted in urine. Doctors measure the blood creatinine level as a test of kidney function. The kidneys filter creatinine from the blood into the urine, and reabsorb almost none of it. The amount of blood the kidneys can make creatinine-free, each minute, is called the creatinine clearance. Creatinine clearance in a healthy young person is about 125 milliliters per minute – meaning each minute, that person’s kidneys clear 125 mL of blood free of creatinine.
The creatinine clearance is a good estimation of the _____
A. counter-current multiplier system
B. RAAS system
C. kidney’s ability to regulate pH
D. kidney’s ability to adjust water loss
E. glomerular filtration rate
E
Juxtaglomerular cell tumor (JCT) is an extremely rare kidney tumor of the juxtaglomerular cells that typically secretes renin. A person with JCT is likely to develop__
A. severe hypotension
B. Grave’s Disease
C. severe hypertension
D. Type 1 diabetes
E. Cushing’s Disease
C
Furosemide (also called Lasix) is a loop diuretic that may be used to treat hypertension (high blood pressure) and edema (fluid accumulation/swelling). How might furosemide work in the body?
A. It could act on the Na+/K+/2Cl− symporter (NKCC2) in the thick ascending limb of the loop of Henle to inhibit sodium, chloride and potassium reabsorption.
B. It could act on the Na+/K+/2Cl− symporter (NKCC2) in the descending limb of the loop of Henle to inhibit sodium, chloride and potassium reabsorption.
C. It could act on the Na+/K+/2Cl− symporter (NKCC2) in the descending limb of the loop of Henle to increase sodium, chloride and potassium reabsorption.
D. It could act to decrease the glomerular filtration rate (GFR), which would increase the production of urine
E. It could inhibit ANP, which would lower one’s blood pressure
A
A human who has no access to fresh water and decides to drink seawater instead __
A. will thrive under such conditions, as long as he has lived at the ocean most of his life.
B. will excrete more water molecules than taken in, because of the high load of ion ingestion.
C. will develop structural changes in the kidneys to accommodate the salt overload.
D. will risk becoming overhydrated within 12 hours.
E. none of the above
B
Acetazolamide is a compound that blocks the activity of the enzyme carbonic anhydrase inside kidney tubular epithelial cells. Acetazolamide_____
A. prevents the formation of carbonic acid from carbon dioxide and water
B. must be an anti-diuretic
C. increases the amount of H+ and HCO3- in the kidney tubular epithelial cell
D. increases Na+ reabsorption
E. all of the above
A
Polycystic kidney disease (PKD) is a chronic, genetic disease causing uncontrolled growth of cysts in the kidney, often leading to kidney failure. Signs of PKD include hypertension (high blood pressure), hematuria (blood in the urine) or a feeling of heaviness or pain in the back or abdomen. In PKD, cysts can press on blood vessels in the kidney, resulting in decreased blood flow to some parts of the kidney. How might this result in hypertension?
A. Decreased blood flow to some parts of the kidney activates ANP, resulting in high blood pressure
B. Decreased blood flow to some parts of the kidney activate sensors in the nephron that react as though the blood pressure in the kidney was low, triggering RAAS
C. Low blood pressure is sensed in the macula densa cells of the kidney, which respond by stimulating sodium secretion, followed by sodium excretion.
D. Both A and B
E. A, B and C
B
Normally, you should be able to sleep six to eight hours during the night without having to get up to go to the bathroom. People who have nocturia wake up more than once a night to urinate. This can cause disruptions in a normal sleep cycle. A physician may prescribe desmopressin (DDAVP). Why? Which of the following are likely true statements? (Hint: which of the following will help to keep a person from having to go to the bathroom?)
A. Because desmopressin can increase the number of aquaporin (water) channels in the nephron resulting in an increase in water reabsorption
B. Because desmopressin is a synthetic form of vasopressin (which is also known as ADH)
C. Because desmopressin causes natriuresis, which is defined as the excretion of an unusually large quantity of urine
D. Both A and B
E. Both B and C
D
An increase in renin may be caused by ___ ; while an increase in ADH is caused by____
A. a decrease in sodium intake; an increase in solute concentration in the ECF
B. a decrease in renal sympathetic nerve activity; an increase in blood pressure
C. an increase in blood pressure in the renal artery; a decrease in solute concentration in the ECF
D. an aldosterone-secreting adrenal tumor; stimulation of the hippocampus
E. hypertension; hypertension
A
Hypernatremia is indicated by a high level of sodium in the blood. It can occur in people who don’t drink enough water. This may be due to impaired thirst or mental judgment. Examples include someone with dementia or an infant who has limited access to fluids. Treatment may include drinking more water or IV fluids. Which of the following is (are) principally involved in sodium regulation in the body?
A. ACTH
B. aldosterone
C. ANP
D. A and B
E. B and C
E
Atrial natriuretic factor ___
A. is released in response to elevated atrial pressure.
B. stimulates the release of ADH.
C. decreases urine production.
D. stimulates release of aldosterone.
E. increases blood volume.
A
If your blood is too acidic, then
A. less HCO3- will be reabsorbed into the blood
B. your kidneys may excrete excess H+ and put bicarbonate back into the blood
C. more HCO3- will be excreted in the urine
D. your kidneys will transport H+ from the proximal tubule cells into the blood using Na+/H+ pumps
E. none of the above
B
Angiotensin II (active angiotensin) is a contributing factor to all of the following except
A. arteriolar constriction
B. stimulating thirst
C. stimulating ADH production
D. promoting natriuresis
E. raising blood pressure
D
Triglycerides with unsaturated fatty acids
A. usually come from animals
B. tend to be liquid at room temperature
C. have all carbons of the fatty acid backbone bonded to the maximum number of hydrogens
D. comprise cellulose
E. are the primary type of fat that contributes to atherosclerosis
B
Fecal transplantation is the transfer of stool from a healthy donor into the gastrointestinal tract of a recipient. Fecal transplantation is usually performed by colonoscopy. During colonoscopy, the colonoscope is advanced through the entire colon. As the colonoscope is withdrawn, the donor stool is delivered through the colonoscopy into the colon. Patients will need to follow a liquid diet followed by an enema or laxative preparation the night before their scheduled procedure. Why on earth would someone agree to do this?
A. They hope it will effectively treat their recurrent C. difficile colitis.
B. It is a common and effective treatment for viral infections
C. Because- when antibiotics kill off too many “good” bacteria in the digestive tract, fecal transplants can help replenish bacterial balance.
D. A and B
E. A and C
E
- The absorption of fats differs from that of carbohydrates in that the __
A. processing of fats does not require any digestive enzymes, whereas the processing of carbohydrates does.
B. fat absorption occurs in the stomach, whereas carbohydrates are absorbed from the small intestine.
C. carbohydrates need to be emulsified before they can be digested, whereas fats do not.
D. most absorbed fat first enters the lymphatic system, whereas carbohydrates directly enter the blood.
E. fats, but not carbohydrates, are digested by symbiotic bacteria before absorption.
D. most absorbed fat first enters the lymphatic system, whereas carbohydrates directly enter the blood.
Dr. Kuemerle’s college friend, who double majored in Molecular Genetics and Business, became the president of a pharmaceutical marking company. He gave Dr. Kuemerle an awesome part time job marketing a drug called Infliximab (trade name: Remicade), which is used to treat Crohn’s Disease (as well as some other diseases). Symptoms of Crohn’s Disease often include abdominal pain, diarrhea (which may be bloody if inflammation is severe), fever, and weight loss. Crohn’s disease is a type of inflammatory bowel disease (IBD) that may affect any part of the gastrointestinal tract. Which layer of the gastrointestinal tract is comprised of elastic connective tissue, neuronal networks, blood and lymph vessels?
A. submucosa
B. enteric ependymal layer
C. mucosa
D. serosa
E. muscularis
A
Gastroesophageal reflux (commonly called heartburn) is the reflux of acidic chyme from the stomach into the esophagus. It is treated by drugs that inhibit gastric acid secretion, such as the proton pump inhibitors, Prilosec and Prevacid. On which type of cells would these drugs most likely inhibit the proton pumps?
A. papillar cells
B. chief cells
C. parietal cells
D. serosal cells
E. gastric cells
C
Peptic ulcers are open sores that develop on the inside lining of your stomach (gastric ulcers) and the upper portion of your small intestine (duodenal ulcers). Stress and spicy foods do not cause peptic ulcers (but can make symptoms worse). A common cause of peptic ulcers is an infection by the bacterium, Helicobacter pylori. Which layer of the digestive tract is affected by peptic ulcers?
A. submucosal
B. oblique
C. serosal
D. mucosal
E. muscularis
D
Autoimmune Metaplastic Atrophic Gastritis (AMAG) is an inherited form of atrophic gastritis characterized by an immune response directed toward parietal cells that leads to the destruction of parietal cells. What is a consequence of this form of gastritis?
A. decreased amylase production from the pancreatic beta cells
B. hypochlorhydria (absent or low production of HCl in gastric secretions of the stomach)
C. increase in glucagon production from the liver
D. decreased gastrin production from the adrenal gland
E. hyperchlorhydria (high gastric acid levels)
B
Celiac Disease is due to the effects of gluten, a protein found in certain grains (such as wheat). When people with celiac disease eat foods containing gluten, their immune system forms antibodies to gluten which then attack the intestinal lining. This damages the intestinal villi and causes them to become blunted, thereby decreasing the intestinal surface. What primary consequence would this have?
A. malabsorption, in which the intestine’s ability to absorb important nutrients is compromised.
B. cholera infection, which would cause severe diarrhea
C. lacteal enlargement, resulting in the increased absorption of nutrients
D. peptic ulcers which are resistant to antibiotics
E. All of the above
A
Digestive enzymes found at the brush border of epithelial cells of the small intestine include all of the following, except
A. disaccharidases
B. aminopeptidase
C. phosphatases
D. pancreatic amylase
E. nucleotidases
D
When the digestion and absorption of organic molecules results in more energy-rich molecules (such as glucose) than are immediately required by an animal, the excess is
A. eliminated in the feces.
B. stored as starch in the liver.
C. stored as glycogen in the liver
D. oxidized and converted to ATP.
E. stored as glucagon in the muscle cells
C
During the digestive process, pepsin
A. is released from parietal cells
B. digests carbohydrates into sugars
C. is released from cells located in the villi
D. stimulates the release of HCl from glandular cells
E. None of the above
E
Which of the following is a false statement?
A. During fat digestion, bile salts coat fatty acids to form chylomicrons prior to the diffusion of monoglycerides and free fatty acids into the mucosal cell.
B. Diets rich in saturated fats likely contribute to atherosclerosis
C. Rice, corn, lentils and soybeans are good sources of essential amino acids
D. Polysaccharides are broken down in the mouth by amylase
E. Adipose cells secrete leptin
A
Which of the following is not correctly paired?
A. PYY- suppresses appetite
B. GIP-triggers insulin release
C. Leptin- triggers hunger
D. Secretin- stimulates HCO3- secretion into the duodenum
E. Gastrin-stimulates the stomach to secrete HCl and pepsinogen
C
When chyme enters the duodenum, it stimulates release of which hormone?
A.
HSH: hypothalamic satiety hormone
B.
gastrin
C.
cholecystokinin
D.
glucagon
E.
ghrelin
C
Which of the following is a false statement with regard to steroids?
A. Steroids can act as hormones
B. Steroids are only found in mammals
C. Cholesterol is an example of a steroid
D. Steroids can be classified as hydrophobic hormones
E. Most medical “steroid” drugs are corticosteroids
B