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[OS 206] 3rd Exam > OS 206 E3 Samplex 2009 > Flashcards

OS 206 E3 Samplex 2009 Flashcards

1
Q

The functional unit of the kidney is the:

a. uriniferous tubule
b. renal corpuscle
c. collecting tubule
d. glomerulus

A

A

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2
Q

The stellate epithelial cells which constitute the
visceral layer of the Bowman’s capsule are called:

a. lacis cells
b. podocytes
c. mesangial cells
d. pedicels

A

B

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3
Q

Which of the following cells of the renal
corpuscle possesses phagocytic properties and has the ability to contract and respond to angiotensin II?

a. parietal cell
b. visceral cell
c. mesangial cell
d. endothelial cell

A

C

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4
Q

The Glomerular filtrate as it enters the Bowman’s capsule (is):

a. a protein-free plasma
b. identical in composition to urine
c. contains only substances that are not needed by the body
d. formed because of active transport processes

A

A

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5
Q

The glomerular colloidal osmotic pressure which contributes to a net filtration pressure is determined by:

a. plasma proteins
b. glucose
c. sodium
d. urea

A

A

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6
Q

The following can affect the filtration coefficient EXCEPT:

a. surface area of glomerular membrane
b. permeability of the glomerular membrane
c. hydrostatic pressure of the Bowman’s capsule
d. contraction of the mesangial cells

A

C

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7
Q

The glomerular capillary hydrostatic pressure is
78 mmHg
The Bowman’s capillary hydrotatic pressure is 15
mmHg
The colloidal osmotic pressure is 35 mmHg
The net filtration pressure is ______mmHg

a. (-)15
b. 28
c. 38
d. 58

A

B

solution: 78 –(15=3) = 28

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8
Q

The most dominant force affecting glomerular
filtration under normal condition is the:

a. glomerular capillary hydrostatic pressure
b. plasma colloidal osmotic pressure
c. hydrostatic pressure of the Bowman’s capsule
d. oncotic pressure at the Bowman’s capsule

A

A

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9
Q

Which of the following process regarding glomerular filtration is correct?

a. Bowman’s capsule hydrostatic pressure opposes filtration
b. The glomerular filtration rate is limited by a Tm
c. All of the plasma that enters the glomerulus is filtered
d. It is greatly affected by small fluctuations in
blood pressure

A

A

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10
Q

Which of the following factors would decrease the GFR?

a. a fall in plasma protein concentration
b. an obstruction such as crystal deposits in the
tubules
c. vasodilation of the afferent arterioles
d. relaxation of the mesangial cells

A

B

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11
Q

Which of the following is involved in the autoregulation of the GFR?

a. automatic constriction of the afferent arteriole when it is stretched
b. increased delivery of the Na+ and Cl- in the macula densa causing vasodilation of the afferent arteriole
c. sympathetically induced vasoconstriction of the afferent arterioles
d. vasoactive chemicals released from the renal nerves bring about afferent arteriolar vasoconstriction

A

A

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12
Q

When arterial blood pressure is elevated above normal, which of the following compensatory changes occur as a result of the baroreceptor reflex?

a. efferent arteriolar vasoconstriction
b. afferent arteriolar vasodilation
c. efferent arteriolar vasodilation
d. afferent arteriolar vasoconstriction

A

D

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13
Q

The juxtaglomerular apparatus (is):

a. a region of specialized cells at a point where the distal tubule comes into intimate contact with the afferent and efferent arterioles of the same nephron:
b. secretes renin in response to plasma volume expansion
c. a site of Na+ reabsorption in kidneys
d. controlled by the renal nerves

A

A

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14
Q

The thin ascending limb of the Henle’s loop of a juxtaglomerular nephron

a. actively transports NaCl out of the lumen into
the interstitial fluid
b. is highly permeable to water
c. is always permeable to Na+
d. is permeable to urea
A

D

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15
Q

The plasma clearance of the following substances (Na+, Glucose, inulin, creatinine) in the order from lowest to the highest would be:

a. glucose, Na+, inulin, creatinine
b. Na+, glucose, creatinine, inulin
c. Inulin, Na+, glucose, creatinine
d. Na+, inulin, creatinine, glucose

A

A

glucose – complete reabsorption
Na+ - partially reabsorbed
Inulin – No reabsorption
Creatinine – 20% reabsorbed

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16
Q

Which is/are true regarding the renal
corpuscle?

a. The visceral and parietal layers of the Bowman’s capsule are lined by cuboidal epithelium
b. The efferent arteriole has a wider diameter than the afferent arteriole to allow a pressure gradient to be maintained across the glomerulus
c. At the vascular pole, the podocyte layer of the glomerular capillaries becomes continuous with the parietal layer of the Bowman’s capsule
d. AOTA

A

C

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17
Q

Which of the following substances cause/s vasodilation of the afferent arteriole

a. adenosine
b. angiotensin II
c. BOTA
d. NOTA

A

D

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18
Q

Which is true regarding the renal tubule?

a. It extends from the Bowman’s capsule to the papilla
b. It is lined by a single layer of epithelial cells
c. It is capable only of selective reabsorption of water and solutes
d. It has six distinct histophysiological zones, each one of which performs different functions

A

B

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19
Q

The most important hormone that shifts potassium into cells after ingestion of K+ in a meal is:

a. aldosterone
b. insulin
c. epinephrine
d. ADH

A

B

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20
Q

which of the following will increase extracellular fluid K+ concentration?

a. metabolic acidosis
b. increased ECF osmolality
c. exercise
d. AOTA

A

D

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21
Q

Which of the following segments of the nephron can either secrete or reabsorb K+?

a. proximal tubule and loop of Henle
b. proximal tubule and distal tubule
c. loop of Henle and distal tubule
d. distal tubule and collecting duct

A

D

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22
Q

In the distal tubule and collecting duct:

a. entry of K+ into the cell across the basolateral
membrane occurs via the Na+K+ATPase pump
b. secretion of K+ into the tubular lumen occurs in the intercalated cell
c. K+ movement across the apical membrane is via a Na+K+ antiport mechanism
d. Secretion of k+ occurs against an electrochemical gradient

A

A

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23
Q

Barner’s syndrome is a set of autosomal recessive genetic disorders characterized by hypokalemia, metabolic alkalosis, and hyperaldosteronism. Which of the following transport mechanisms may be affected in this disorder?

a. Na+K+2Cl- contransporter
b. Apical K+ channel in the thick ascending limb
of the Henle’s loop
c. Basolateral Cl- channel in the thick ascending
limb of the Henle’s loop
d. Any of the above

A

D

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24
Q

The major physiological regulators of K+ in the kidney are:

a. plasma K+ and aldosterone
b. ADH
c. Acid base status
d. Tubular fluid flow rate

A

A

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25
Q

Calcium ions play a major role in all of the following processes EXCEPT in:

a. bone formation
b. neurotransmitter release
c. muscle contraction
d. none of the above is an exception

A

D

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26
Q

Parathyroid hormone increases plasma calcium concentration by:

a. stimulating bone resorption
b. increasing renal tubular reabsorption of calcium
c. stimulating the production of 1,25 (OH)2 vitamin D3
d. AOTA

A

D

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27
Q

Calcium reabsorption in the nephron is:

a. by both paracellular and transcellular routes in the proximal tubule
b. exclusively transcellular in the distal tubule
c. BOTA
d. Neither of the above

A

C

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28
Q

Which of the following statements is correct?

a. The proximal tubule is the main site of phosphate reabsoption
b. Magnesium reabsorption in the proximal tubule is exclusively transcellular
c. The distal tubule is the main site of calcium reabsorption
d. Only (a) and (b)

A

A

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29
Q

Juliana is a 23-year old ramp model of a well known couturier. She weighs about 55 kgs. How much total body water would Juliana have?

a. 33L
b. 27.5L
c. 38.5L
d. 49.5L
e. NOTA

A

B

solution: 50% x 55 = 27.5 L

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30
Q

Juliana is a 23-year old ramp model of a well known couturier. She weighs about 55 kgs. How much would be Juliana’s extracellular water?

a. 10L
b. 11L
c. 33L
d. 27.5L
e. NOTA

A

E

16.6% x 55 = 9.13 L

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31
Q

Juliana is a 23-year old ramp model of a well known couturier. She weighs about 55 kgs. Every month Juliana goes to her favorite gym for a two-hour workout. After 30 minutes in the treadmill, which of the following would you expect to be happening to Juliana?

a. There will be an increase in Juliana’s insensible water loss
b. There will be an increase in Juliana’s urine output
c. Her thirst response will be stimulated
d. Only a and c are correct

A

D

32
Q

Juliana is a 23-year old ramp model of a well known couturier. She weighs about 55 kgs. If Juliana’s plasma osmolality is measured and reads 300 milliosmoles/kg water on the freezing point osmometer , her E CF total body solute would be:

a. 3300 mosmoles
b. 3000 mosmoles
c. 9900 mosmoles
d. 8250 mosmoles
e. NOTA

A

E

solution: 9.13 x 300 mosom/kg = 2739 mosomoles per kg

33
Q

Regarding our body fluid compartments, which of the following is/are correct?

a. The body fluid compartments are in osmotic equilibrium
b. The number of anions and cations in each fluid compartment is equal
c. The main anions in plasma are chloride, bicarbonate and proteins
d. AOTA statements are correct

A

D

34
Q

In the normal setting, which of the following is the most effective osmole in the ECF?

a. urea
b. sodium
c. glucose
d. lipids

A

B

35
Q

Antidiuretic hormone (ADH):

a. is secreted by the supraoptic and paraventricular nuclei of the hypothalamus
b. is stored in the anterior pituitary and released in response to proper stimuli
c. secretion is stimulated by a decrease in plasma osmolality
d. stimulation is stimulated by an increase in effective circulating volume

A

A

36
Q

Secretion pf ADH is also stimulated by:

a. angiotensin II
b. atrial natriuretic peptide
c. renin
d. urodilatin

A

A

37
Q

Addition of 1.5 L of isotonic saline to ECF via an intravenous line will cause

a. an increase in plasma osmolality
b. expansion of ECF volume by 1.5 L
c. water movement from the cell to the ECF
d. ADH secretion

A

B

38
Q

Which of the following statements regarding role of ADH is correct?

a. ADH attaches to a receptor on the apical membrane of the collecting tubule
b. Adenylyl cyclase is the second messenger which mediates the increase in the collecting duct water permeability
c. Fusion of water channels with the apical membrane forming aquaporin2 enables the collecting tubule to reabsorb water
d. Only b and c are correct

A

C

Notes: ADH attaches to a receptor on the basolateral membrane of the collecting tubule; cAMP is the second messenger which mediates the increase in the collecting duct water permeability

39
Q

Localized edema may be caused by all of the following except:

a. a reduction in plasma albumin concentration
b. increased capillary permeability
c. venous obstruction
d. lymphatic obstruction

A

A

40
Q

The major determinant of extracellular volume is:

a. sodium
b. bicarbonate
c. chloride
d. potassium

A

A

41
Q

Anion which accompanies sodium reabsorption in the first half of the proximal tubule

a. chloride
b. bicarbonate
c. phosphate
d. lactate

A

B

42
Q

The main driving force for water reabsorption in
the proximal tubule is the:

a. reabsorption of glucose and amino acids
b. reabsorption of Na+
c. high colloid oncotic pressure in the peritubular capillaries
d. NOTA

A

B

43
Q

Which of the following will cause an increase in the renal threshold for glucose?

a. a decrease in the number of proximal tubule glucose carriers
b. a decrease in glomerular filtration rate
c. BOTA
d. Neither of the above

A

B

44
Q

Salicylic acid is a lipid soluble, weak acid that undergoes nonionic diffusion in the kidneys. Which of the ff. interventions would enhance urinary excretion of the substance in cases of overdose?

a. acidifying urine by asking patient to ingest NH4Cl
b. alkalinizing urine by ingesting NaHCO3
c. giving a drug which inhibits organic anion
secretion in the tubule
d. NOTA

A

B

45
Q

The ff are substances which are cotransported with sodium in the proximal tubule EXCEPT:

a. glucose
b. amino acids
c. phosphate
d. hydrogen

A

D

46
Q

End products of metabolism that circulate in plasma are usually in the form of organic anions and cations. They are eliminated from the body through organic ion secretory pathways located in the:

a. proximal tubule
b. thick ascending limb of loop of henle
c. distal tubule
d. collecting tubule

A

A

47
Q

Which specialized cells of the juxtaglomerular apparatus produce rennin?

a. macula densa in the PCT
b. lacis cells in the junction between the DCT and efferent arteriole
c. juxtaglomerular arteriole
d. AOTA

A

C

48
Q

Renin secretion is stimulated by:

a. decreased sympathetic activity
b. decreased NaCl passing through the macula densa
c. increased renal perfusion pressure
d. AOTA

A

B

49
Q

Angiotensin II stimulates all of the following
physiologic functions EXCEPT:

a. aldosterone secretion by adrenal cortex
b. thirst
c. ADH secretion
d. Atrial natriuretic peptide secretion

A

D

50
Q

Atrial natriuretic peptide acts to:

a. increase GFR
b. increase NaCl and water excretion
c. decrease rennin secretion
d. AOTA

A

D

51
Q

Which of the following statements is incorrect?

a. The thick ascending limb of henle’s loop is impermeable to water but permeable to NaCl
b. The osmolarity of medullary interstitium progressively increases from the corticomedullary junction to the papilla
c. NaCl reabsoprtion in the thick ascending limb of Henle’s loop dilutes the tubular fluid but increases medullary osmolarity
d. The vasa recta functions to decrease the hyperosmolaroty of the medullary interstitium

A

D

52
Q

In order to excrete concentrated urine:

a. maximal levels of ADH must be present
b. a hyperosmolar medullary intersitium must be
present
c. BOTA
d. Neither of the above

A

C

53
Q

A patient was diagnosed to have kidney failure from diabetic nephropathy. He was also hypertensive. Any of the ff medicines can be given to control his hypertension.

i. An angiotensin receptor blocker which primarily dilates the efferent arteriole
ii. A calcium antagonist which primarily dilates the afferent arteriole.

Discuss the effects of these drugs on the RBF (Renal blood flow) and GFR (glomerular filtration rate) and the FF (filtration fraction):

A. for INCREASE
B. for DECREASE
C. for NO CHANGE

Angiotensin receptor blocker
1.RBF \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
2.GFR \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
3. FF \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Calcium Antagonist
4.RBF \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
5.GFR \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
6. FF \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
A
  1. A
  2. B
  3. B
  4. A
  5. A
  6. C
54
Q

If HCO3- is distributed only in the ECF, what is
the total amount of bicarbonate in a 50 kg male who has a HCO3-level of 24 mmol/L?

a. 180 mmol/L
b. 210 mmol/L
c. 240 mmol/L
d. 300 mmol/L

A

C

solution ; (50 kg) (0.20) (24) = 240

55
Q

Which of the ff acid/base ratio will most likely give the correct estimate of plasma pH?

a. Ka [CO2]/[HCO3-]
b. Ka [H2PO4-]/[HPO42-]
c. Ka [HA]/[A-]
d. AOTA

A

D

56
Q

How does the concentration of HCO3- in the venous blood compare with arterial blood?

a. It is higher
b. It is lower
c. It is the same
d. No constant relationship can be found

A

A

It is higher because of the chloride shift

57
Q

How much is the filtered bicarbonate per day in
a patient with chronic kidney disease with a GFR of
30ml/min and plasma bicarbonate concentration of 15 mmol/L?

a. 450 mmol
b. 500 mmol
c. 610 mmol
d. 648 mmol

A

D

filtered bicarbonate = GFR x plasma conc
30 ml/min x 1400 min/24 x 15 mmol/L
= 648 mmol

58
Q

The plasma bicarbonate concentration of a patient is 30 mmol/L. What conclusion can you make?

a. There is metabolic alkalosis
b. There is metabolic acidosis
c. There is respiratory alkalosis
d. No definite conclusion can be made from the
above data

A

D

59
Q

In response to metabolic acidosis, the kidneys respond by increasing

a. the reabsorption of filtered bicarbonate
b. filtration of phosphate ions
c. the generation of ammonia
d. glomerular filtration

A

C

60
Q

NH3 is prevented from diffusing back to the cell by:

a. increasing production of NH3 in the cell
b. combining with H+ to produce an impermeable
ion
c. increasing luminal fluid flow rate to dissipate
concentration gradient
d. AOTA can occur

A

B

61
Q

High levels of plasma rennin causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

C

62
Q

Low plasma aldosterone levels causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

B

63
Q

Use of a carbonic anhydrase inhibitor in a
patient with glaucoma causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

C

64
Q

Accidental administration of a NA+K+ATPase
pump inhibitor causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

C

65
Q

Inhibition of H+ATPase pump causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

B

66
Q

Increased activity of luminal of Cl-HCO3-
transporter causing urinary acidification. Where is the affected mechanism located?

a. proximal tubule
b. distal tubule
c. both
d. neither

A

B

67
Q

What is the creatinine clearance of a 20 year old male weighing 70 kg who is diagnosed to have chronic kidney disease secondary to chronic glomerulonephritis.

He has the ff laboratory values:
Urine creatinine = 150 mg/dl
Urine volume = 1000 ml/24 hours
Serum creatinine = 5 mg/dl

a. 10 ml/min
b. 20 ml/min
c. 36 ml/ min
d. creatinine clearance cannot be computed
because of inadequate data collection

A

B

68
Q

A patient with chronic renal disease has metabolic acidosis. The ff hydrogen ion and bicarbonate ion levels were obtained:

[H+] = ? mmol/L
[HCO3-] = 15 mmol/L
What should be the value of the pCO2 to show compensation?

a. 40.0 mmHg
b. 37.5 mmHg
c. 32.0 mmHg
d. 38.0 mmHg

A

B

69
Q

A 3 year old boy is brought in the emergency room for diarrhea of 3 days duration. He is hypotensive. His urine is concentrated and blood also shows metabolic acidosis. The following is an appropriate description of the kidney:

a. efferent arteriole will dilate to conserve GFR
b. intercalated cells will increase in number
c. afferent arteriole will constrict and cause a
drop in GFR
d. the distal convoluted tubule through its macula
densa will cause a hypoosmolar urine

A

C

70
Q

If you produce 2 ml of urine per minute, how long will it take you to reach your normal bladder capacity?

a. 2 hours
b. 3 hours 20 minutes
c. 4 hours
d. 4 hours 30 minutes

A

B

71
Q

When your bladder is full and you are still 20 meters from the next toilet, the following occurs which prevents you from leaking urine:

a. pelvic nerve inhibition
b. cortisol stimulation
c. activation of pontine center
d. pudendal nerve inhibition

A

A

72
Q

During rectal surgery, the pelvic plexus of nerves are sometimes damaged. When this occurs, the patient cannot void adequately because:

a. his bladder neck is tightly closed
b. his detrusor cannot contract
c. his pelvis floor muscles are rendered hyperactive
d. his external urethral sphincter constantly tightens

A

B

73
Q

Detrusor contraction during normal voiding is mediated by the:

a. somatic nervous system
b. parasympathetic nervous system
c. sympathetic nervous system
d. autonomic nervous system

A

B

74
Q

The ff factor contributes to the urethral seal effect:

a. contraction of the outer circular layer of urethral smooth muscle layer
b. presence of an intact pubourethralis muscle
c. spongy tissue within the urethral submucosa
d. interdigitation of collagen fibers in the paraurethral tissue

A

C

75
Q

If you are watching a video of the lower urinary tract during voiding, the first event that you would see is:

a. external urethral sphincter relaxes
b. bladder neck opens
c. detrusor contracts
d. pelvic muscle relaxes

A

B

76
Q

Matching type

Column A
\_\_\_1. facilitated diffusion of glucose
\_\_\_2. active Na+ transport
\_\_\_3. acid base balance
\_\_\_4. ADH dependent water reabsorption
\_\_\_5. energy for active transport
Column B
A. extensive basolateral interdigitations
B. plentiful mitochondria
C. intercalated cells
D. brush border
E. principal cells
A
  1. D
  2. A
  3. C
  4. E
  5. B

[OS 206] 3rd Exam (6 decks)

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