Module 7 - Renal System and Body Fluids Flashcards

1
Q

In a normal adult, what would be the average effective renal plasma flow?

  1. 350mL/min
  2. 625 mL/min
  3. 500mL/min
  4. 750mL/min
  5. 200mL/min
A

625 mL/min

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2
Q

Stimulation of renal nerves increases renin secretion by direct action on which structure?

  1. Juxtaglomerular cells
  2. Efferent arteriole
  3. Vasa recta
  4. Loop of Henle
  5. Afferent arteriole
A

Juxtaglomerular cells

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3
Q

Rapid diffusion of water across cell membranes depends on the presence of water channels called aquaporins. In the nephron, where are Aquaporin 1 channels located?

  1. Distal convoluted tubule
  2. Collecting duct – medullary portion
  3. Thick ascending limb
  4. Thin descending limb
  5. Collecting duct – cortical portion
A

Thin descending limb

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4
Q

What changes in blood glucose and GFR (glomerular filtration rate) are most likely to cause glycosuria?

  1. An increase in GFR and a decrease in blood glucose concentration
  2. A decrease in GFR and an increase in blood glucose concentration
  3. A decrease in GFR and a decrease in blood glucose concentration
  4. An increase in GRF and an increase in blood glucose concentration
  5. The same GFR and an increase in blood glucose concentration
A

An increase in GRF and an increase in blood glucose concentration

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5
Q

Which of the following would decrease renin secretion?

  1. Angiotensin II
  2. Constriction of the renal artery
  3. Cirrhosis
  4. Hypotension
  5. Prostaglandins
A

Angiotensin II

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6
Q

Within the kidneys, which cells produce erythropoietin?

  1. Lacis cells
  2. Macula densa cells
  3. Cortical nephrons
  4. Interstitial cells
  5. Granular cells
A

Interstitial cells

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7
Q

Buffering is of key importance in maintaining H+ homeostasis. What is the principal buffer system in the interstitial fluid?

  1. H2CO3 <> H+ + HCO3-
  2. HProt <> H+ + Prot -
  3. H2PO4 <> H+ + HPO42-
  4. HHb <> H+ + Hb-
  5. NH4+ <> NH3 + H+
A

H2CO3 <> H+ + HCO3-

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8
Q

What is the driving mechanism for H+ excretion in the proximal tubule of the nephron?

  1. Cl-/HCO3- antiporter system on basolateral membranes of intercalated cells
  2. H+ transporting ATPase at the luminal membrane of intercalated cells
  3. The dissociation of carbonic acid into CO2 and H2O in the tubular cells
  4. Na+K+ATPase at the basolateral membrane of tubular cells
  5. Diffusion of ammonia across the luminal surface of tubular cells
A

Na+K+ATPase at the basolateral membrane of tubular cells

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9
Q

What is the direct action of 1,25 dihydroxyvitamin D?

  1. Increases further 1-hydroxylation of 25-hydroxyVit D
  2. Promotes paracellular calcium absorption in the intestines
  3. Promotes calcium reabsorption in the kidney synergistically with PTH
  4. Promotes phosphate excretion in the intestines
  5. Promotes the mineralization of bone
A

Promotes calcium reabsorption in the kidney synergistically with PTH

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10
Q

A PCO2 of 56mmHg in an arterial blood gas is consistent with which acid-base condition?

  1. Compensated metabolic alkalosis
  2. Metabolic alkalosis
  3. Compensated metabolic acidosis
  4. Metabolic acidosis
  5. Compensated respiratory alkalosis
A

Compensated metabolic alkalosis

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11
Q

Normally 180L of fluid is filtered through the glomeruli each day while the average daily urine volume is about 1L. At least 87% of filtered water is reabsorbed.

Match the anatomical location within the glomeruli to the approximate percentage of water reabsorbed at that location.

  1. <5%
  2. 2-10%
  3. 15%
  4. 60-70%
A
  1. <5% - Distal tubule
  2. 2-10% - Cortical collecting duct
  3. 15% - Loop of Henle
  4. 60-70% - Proximal tubule
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12
Q

What percentage of the cardiac output do the kidneys receive approximately?

  1. 5%
  2. 15%
  3. 25%
  4. 35%
  5. 50%
A

25%

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13
Q

What is the effect of Angiotensin II on the regulation of renal blood flow?

  1. Dilatation of all the renal vessels
  2. Dilatation of the efferent arterioles only
  3. Constriction of afferent and efferent arterioles
  4. Increase in blood flow in renal medulla
  5. Increased glomerular capillary pressure and increased renal blood flow
A

Constriction of afferent and efferent arterioles

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14
Q

Stimulation of renal nerves increases renin secretion by direct action via the release of which neurotransmitter?

  1. Adrenaline
  2. Noradrenaline
  3. Angiotensin II
  4. Dopamine
  5. Acetylcholine
A

Noradrenaline

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15
Q

Regarding normal sodium reabsorption by the kidneys, about 60% of sodium is reabsorbed in which location?

  1. Proximal tubule
  2. Thin descending limb
  3. Thick ascending limb
  4. Distal convoluted tubule
  5. Collecting tubule
A

Proximal tubule

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16
Q

Essentially all glucose is reabsorbed in the proximal tubule of the kidneys. Glucose is carried into the proximal tubular cell predominately via which transporter on the apical membrane?

  1. GLUT 1 (glucose transporter)
  2. GLUT 2 (glucose transporter)
  3. SGLT 1 (sodium dependant glucose transporter)
  4. SGLT 2 (sodium dependant glucose transporter)
  5. SGEx (sodium glucose exchanger)
A

SGLT 2 (sodium dependant glucose transporter)

17
Q

Where are the sensors located that are involved in tubuloglomerular feedback?

  1. Vasa recta
  2. Juxtamedullary nephrons
  3. Macula Densa
  4. Lacis cells
  5. Granular cells
A

Macula Densa

18
Q

In the nephron, what is the location of the sodium, potassium and chloride co-transporter?

  1. Proximal tubule
  2. Thin descending limb
  3. Thick ascending limb
  4. Distal convoluted tubule
  5. Collecting tubule
A

Thick ascending limb

19
Q

In the collecting ducts of the nephron, aquaporin-2 is stored in vesicles. These vesicles are rapidly inserted into the apical membrane in response to which hormone?

  1. Vasopressin
  2. Angiotensin II
  3. Renin
  4. Dopamine
  5. Prostaglandin E
A

Vasopressin

20
Q

On what does the countercurrent concentrating mechanism in the kidney depend?

  1. Depends on the diffusion of sodium and chloride out of the ascending limb of Henle
  2. Depends on osmolality of 1200 mosmol/kg in the distal tubules
  3. Depends predominantly on the action of cortical nephrons
  4. Depends on the free movement of water and electrolytes across the walls of the vasa recta
  5. Depends on a low concentration of urea in the medullary interstitium
A

Depends on the free movement of water and electrolytes across the walls of the vasa recta

21
Q

Which of the following stimuli would decrease vasopressin secretion?

  1. Decreased extracellular fluid volume
  2. Pain, emotion, stress
  3. Standing
  4. Alcohol
  5. Nausea and vomiting
A

Alcohol

22
Q

Within the glomerulus, where is active renin formed?

  1. In the granular cells
  2. In the lacis cells
  3. In the macula densa
  4. In the lateral intercellular spaces
  5. In the cortical nephrons
A

In the granular cells

23
Q

What transporter is responsible for most of the H+ secretion in the proximal tubule?

  1. ENaC
  2. ATP driven proton pump
  3. Na-H exchanger
  4. H-K+ ATPase
  5. ROMK
A

Na-H exchanger

24
Q

Which of the following arterial blood gas results are consistent with a compensated metabolic acidosis?

  1. pH, HCO3- and PCO2 are all high
  2. pH and HCO3- are low, and PCO2 is normal
  3. pH is low, HCO3- and PCO2 are high
  4. pH, HCO3- and PCO2 are all low
  5. pH and HCO3- are high, PCO2 is low
A

pH, HCO3- and PCO2 are all low

25
Q

Which enzyme catalyses the formation of H2CO3?

  1. Carbonic anhydrase
  2. Renin
  3. Urease
  4. ACE
  5. Glutaminase
A

Carbonic anhydrase

26
Q

What equation is used to calculate the net urinary acid excretion?

  1. HProt + NH4+ - HCO3-
  2. NH3 + titratable acid - HCO3
  3. NH4+ + titratable acid + HCO3-
  4. HProt + NH4+ + HCO3-
  5. NH4+ + titratable acid - HCO3-
A

NH4+ + titratable acid - HCO3-

27
Q

What effect does atrial natriuretic peptide (ANP) have on the nephron?

  1. An increase in glomerular filtration
  2. Contraction of mesangial cells
  3. Increases sodium reabsorption in ascending loop of Henle
  4. Increases secretion of renin
  5. No effect on sodium reabsorption in the proximal convoluted tubule
A

An increase in glomerular filtration

28
Q

What is the difference between the solutes of the interstitial space and plasma?

  1. There is no major difference
  2. More chloride in the interstitial space
  3. More glucose in plasma
  4. More ionised calcium in plasma
  5. More protein in plasma
A

More protein in plasma

29
Q

What are the actions of parathyroid hormone on the kidney?

  1. Decreases the renal synthesis of 1-25 dihydroxycalciferol
  2. Increases calcium reabsorption and decreases phosphate reabsorption
  3. Decreases both calcium and phosphate reabsorption
  4. Decreases calcium reabsorption and increases phosphate reabsorption
  5. Increases both phosphate and calcium reabsorption
A

Increases calcium reabsorption and decreases phosphate reabsorption

30
Q

Diuretics are substances that cause increased urine output.

Match the diuretic with its mechanism of action.

  1. Inhibit vasopressin secretion
  2. Decrease tubular reabsorption of sodium and increase GFR
  3. Produce osmotic diuresis
  4. Inhibit Na-K-2Cl co-transporter
A
  1. Inhibit vasopressin secretion - Ethanol
  2. Decrease tubular reabsorption of sodium and increase GFR - Caffeine
  3. Produce osmotic diuresis - Mannitol
  4. Inhibit Na-K-2Cl co-transporter - Loop diuretics
31
Q

What is the effect of aldosterone on nephrons?

  1. Decreased tubular reabsorption of Na+, increased secretion of K+ and H+
  2. Decreased tubular reabsorption of Na+, increased reabsorption of K+ and H+
  3. Decreased tubular reabsorption of Na+, decreased secretion of K+ and H+
  4. Increase tubular reabsorption of Na+, increased secretion of K+ and H+
  5. Increase tubular reabsorption of Na+, increased reabsorption of K+ and H+
A

Increase tubular reabsorption of Na+, increased secretion of K+ and H+