Physio Module 7 Flashcards
(114 cards)
0
Q
Unfiltered substances will go to
A. Glomerular capillaries
B. Peri tubular capillaries
A
B
1
Q
Pores of the capillary membranes are permeable to the ff except A. Water B. Sodium C. Potassium D. Bicarbonate E. Proteins
A
E
2
Q
Substances like amino acids will have A. Clearance more than filtration rate B. Clearance less than filtration rate C. Clearance equal to filtration rate D. Zero clearance
A
D
3
Q
Distribution of fluid between ICF and ECF is determined by A. Osmotic effect B. Donnan's effect C. Starling's forces D. Countercurrent mechanism
A
A. Because the cell membrane is permeable to water BUT not to solutes
4
Q
Capillary filtration rate can be increased by the ff except
A. Increase capillary filtration coefficient
B. Increase capillary hydrostatic pressure
C. Increase capillary oncotic pressure
D. NOTA
A
C. Decrease
5
Q
Blood movement from the glomerular capillaries to bowman space A. Filtration B. Secretion C. Reabsorption D. Excretion
A
A
6
Q
Primary measurement of a patients fluid status A. Serum sodium B. Serum potassium C. Arterial blood gas D. Heart rate
A
A
7
Q
ABG pH: 7.25 pCO2: 30 HCO3: 21 A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
A
A. With respi compen
8
Q
Plasma has the same ionic composition as A. Water B. Interstitial fluid C. Intracellular fluid D. Blood
A
B
9
Q
Interstitial fluid and plasma is separated by a membrane that allows the exchange of ions passively
ICF and ECF is separated by a membrane that allows exchange of ions passively.
A. Both statements are true
B. Both statements are false
C. Only First statement is true
D. Only second statement is true
A
C. ICF and ECF- only water is allowed to pass through
10
Q
Which of the ff statement is FALSE
A. There is more cortical nephron than juxtamedullary
B. Cotical nephrons are efficient in concentrating urine
C. Longer loops are found in juxtamedullary nephrons
D. Kidney is an organ
A
B
11
Q
Protein concentration is highest in A. Plasma B. Interstitium C. ICF D. Transcellular
A
C
12
Q
Substances like PAH will have A. Clearance more than filtration rate B. Clearance less than filtration rate C. Clearance equal to filtration rate D. Zero clearance
A
A
13
Q
In administration of hypotonic solution the ff occurs except A. Increase in ECF osmolarity B. Decrease in ICF osmolarity C. Increase in ECF volume D. Increase in ICF volume
A
A
14
Q
Most important means of water output of the body A. Insensible loss B. Thru sweat C. Thru feces D, thru urine
A
D
15
Q
The ff is found in the renal cortex except A. PCT B. Glomerulus C. Loop of henle D. Macula densa
A
C
16
Q
Main function of peri tubular capillaries
A
Exchange of nutrients and oxygen
17
Q
Substances like creatinine will have A. Clearance more than filtration rate B. Clearance less than filtration rate C. Clearance equal to filtration rate D. Zero clearance
A
C
18
Q
Common side effect of acetozolamide A. Metabolic acidosis B. Respiratory acidosis C. Hypocalcemia D. Hyperkalemia
A
A
19
Q
The ff can increase GFR except A. Histamine B. Bradykinin C. Glucocorticoid D. Nitric oxide
A
A.
20
Q
Patients with Addison's disease will have the ff except A. Hyponatremia B. Hyperkalemia C. Metabolic acidosis D. Hypernatremia
A
D
23
Q
Workhorse of the nephrons A. PCT B. LOH C. DCT D. CT
A
A
25
Q
This is a sodium sensitive cell that is found on the DCT.
A
Macula densa
26
Q
ABG pH: 7.55 pCO2: 50 HCO3: 29 A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis
A
B. With respiratory compensation
28
```
The ff can increase ADH except
A. Dec blood pressure
B. Inc plasma osmolarity
C. Alcohol
D. Nausea
```
C
29
```
Blood movement from the interstitium to peri tubular capillaries
A. Filtration
B. Secretion
C. Reabsorption
D. Excretion
```
C
31
In administration of hypertonic solution the ff occurs
A. There is movement of water from ECF to ICF
B. There is movement of water from ICF to ECF
C. There is movement of solute from ICF to ECF
D. There is movement of solute from ECF to ICF
E, there is no movement
B. W
32
```
A patient has a serum potassium of 3 mEq/L ( NV 3.5-4.5). She is also Edematous. What diuretic would you most likely give
A. Furosemide
B. HCTZ
C. Spironolactone
D. Acetozolamide
```
C. Potassium sparring
34
Secretes rennin
JG cells
36
```
During states of reduced renal blood flow, renin is released from granular cells
A. Myogenic
B. Tubuloglomerular
C. RAAS
D. Glomerulotubular
```
C
37
Increasing the GFR can be attained by the ff except
A. Increasing glomerular capillary hydrostatic pressure
B. Decreasing glomerular capillary oncotic pressure
C. Decreasing bowman space hydrostatic pressure
D. Constriction of afferent arterioles
D
40
```
Good indicator of renal plasma flow
A. Glucose
B. Sodium
C. Insulin
D. PAH
```
D
41
```
Which of the ff secretes endothelin1
A. Glomerular capillaries
B. Capillary endothelium
C, basement membrane
D, podocytes
```
B
42
```
A patient is diagnosed with renal tubular acidosis. He has normal anion gap, normal potassium, no renal stones and has urine pH of 5. He has ________ RTA
A. Type 1
B. Type 2
C. Type 3
D. Type 4
```
B
43
```
To estimate GFR the ff substance can be used except
A. Creatinine
B. Iothalamate
C. Inulin
D. Amino acid
```
D
44
Severe constriction of the efferent arterioles would result to
A. Increase GFR
B. Decrease GFR
C. No change in GFR
B
45
```
Dialysate fluid will have the ff except
A. Higher bicarbonate concentration than plasma
B. Lower potassium conc than plasma
C. High level of phosphate
D. No urea
```
C
46
Auto regulation is primarily achieved by
A. Tubuloglomerular feedback
B. Myogenic autoregulation
C. Renin- angiotensin- aldosterone system
D. Monroe kellie
B
47
Where is aldosterone made
Zonal glomerulosa
48
Feature of nephrotic syndrome
Proteinuria
49
```
Primary mode of transport of substances from the interstitium to the peri tubular capillaries
A. Simple diffusion
B. Osmosis
C. Primary transport
D. Bulk flow
E. Secondary transport
```
D
50
A tachycardic patient was given Symphatolytic agent. What will happen to his potassium level
A. Increase
B. Decrease
A
51
```
ABG
pH: 7.3
pCO2: 45
HCO3: 33
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
```
C. With renal comp
52
```
Possible effect of ACE inhibitor in a patient with hypertension secondary to renal artery stenosis
A. Acute renal failure
B. Pulmonary embolism
C. Myocardial infarction
D. Hemorrhagic stroke
```
A
53
```
Basis for renal threshold and renal maximin
A. Energy
B. Saturation
C. Concentration gradient
D. Surface area
```
B
54
```
Proteins are transported via
A. Simple diffusion
B. Facilitated diffusion
C. Primary active
D. Secondary active
E. Pinocytosis
```
E
55
Chronic renal failure has
A. Less than 100% of nephrons functioning
B. Less than 50% of nephrons functioning
C. Less than 75% of nephrons functioning
D. Less than 25% of nephrons funcitoning
D
56
```
What diuretic would be the first line of drug in an hypertensive patient
A. Furosemide
B. HCTZ
C. Mannitol
D. Paracetamol
E. Spironolactone
```
B
57
```
Substances like sodium ions will have
A. Clearance more than filtration rate
B. Clearance less than filtration rate
C. Clearance equal to filtration rate
D. Zero clearance
```
B
58
```
Major form of excretion of calcium
A. Urine
B. Sweat
C. Feces
D. Insensible loss
```
C
59
```
The ff are characteristics of an uncharged substance except
A. Hydrophobic
B. Lipophilic
C. Absorb
D. Polar
```
D
60
```
To estimate GFR the ff substance can be used
A. Creatinine
B. PAH
C. Insulin
D. Bicarbonate
```
A
64
```
The ff can be stimulated by inc in serum potassium except
A. Inc aldosterone
B. Inc hydrogen ion
C. Inc tubular flow rate
D. Addison's disease
```
D
67
In administration of isotonic solution the ff occurs
A. There is movement of water from ECF to ICF
B. There is movement of water from ICF to ECF
C. There is movement of solute from ICF to ECF
D. There is movement of solute from ECF to ICF
E, there is no movement
E
72
Main function of glomerular capillary
GFR---- filtration
76
Glomerular cells of the afferent arterioles
JG cells
83
```
What secretes aldosterone
A. Adrenal medulla
B. Adrenal cortex
C. Liver
D. Hypothalamus
```
B. Zona glomerulosa
86
```
Resembles chronic use of Loop diuretics
A. Nephrotic syndrome
B. Nephritic syndrome
C. Bartter syndrome
D. Gitelman syndrome
```
C
92
Important in maintaining the osmolarity of urine by virtue of countercurrent exchange system
Vasa recta
93
```
The ff can cause Hyperkalemia
A. Insulin
B. Beta antagonist
C. Aldosterone
D. Alkalosis
```
B
94
```
Autoregulation wherein acute changes in renal perfusion evoke reflex constriction or dilation in the afferent arteriole
A. Myogenic
B. Tubuloglomerular
C. RAAS
D. Glomerulotubular
```
A
95
```
The ff can increase water permeability except
A. Vasopressin
B. Norepinephrine
C. Angiotensin
D. Aldosterone
E. ANP
```
E
96
```
Decreasing the sodium reabsorption is achieved by except
A. Urodilatin
B. Dopamine
C. BNP
D. Vasopressin
```
D
97
```
Distribution of fluids in the ECF between the plasma and interstitial fluid is determined by
A. Osmotic effect
B. Donnan's effect
C. Starling's forces
D. Countercurrent mechanism
```
C
98
```
Primary site of absorption of magnesium
A. PCT
B. LOH
C. DCT
d. CT
```
B
99
```
Stimuli for PTH
A. Inc phosphate
B. Dec phosphate
C. Inc calcium
D. Dec calcium
```
D
100
```
For a substance to be excreted, it must be
A. Water soluble
B. Uncharged
C. Lipophilic
D. Non polar
```
A
101
```
Maintains osmotic gradient in urine formation
A. LOH
B. DT
C. Vasa recta
D. AOTA
```
C
102
```
First line of defense when there is change in hydrogen content
A. Body buffer
B. Lungs
C. Kidney
D. NOTA
```
A
103
```
How many layers does the capillary endothelium have
A. 0
B. 1
C. 2
D. 3
```
3
104
```
A person with Conn's disease will have the ff serum electrolytes
A. Potassium of less than 3.5 mEq/L
B. Sodium of more than 159 mEq/L
C. Both
D. NOTA
```
C
105
```
A patient having panic attacks is more likely susceptible to
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
```
C
106
```
This changes the rate of filtration by reflex vasoconstriction and vasodilation of the afferent arteriole
A. Myogenic
B. Tubuloglomerular
C. RAAS
D. Glomerulotubular
```
B
107
Your friend ask you for advise. He was coerced to take methamphetamine (basic drug) by his friends. He ask you what he should do to excrete the said drug immediately.
A. Tell him to drink plenty of water
B. Tell him to take sodium bicarbonate
C. Tell him to increase his respiratory rate
D. Tell him to take ammonium chloride
D.
108
Concerning the measurement of renal plasma flow (RPF) and glomerular filtration rate(GFR):
A. inulin is a good GFR marker because it is freely filtered in the glomeruli and it is not reabsorbed, or secreted, by the renal tubules
B. inulin concentration in the proximal tubule's lumen increases progressively as water is reabsorbed in the segment of the nephron
C. PAH (para-amino-hippuric acid)is a good marker of renal plasma flow because it is freely filtered and is rapidly secreted by the proximal tubule; as a result very little PAH reaches the renal vein
D. A and C are correct
E. all are correct
E
109
```
Aquaporins is least seen in
A. PCT
B. ascending LOH
C. Descending LOH
D. DT
```
B. Impermeable to water so useless xa
110
```
Site of action of sodium channel blocker
A. PCT
B. DCT
C. LOH
D. CT
```
D
111
```
Principal cell for potassium absorption
A. Principal cell
B. Intercalated cell
C. Both
D. NOTA
```
B
112
```
Second line of defense to buffer effects of drastic GFR changes on urine output
A. Tubuloglomerular feedback
B. Glomerulotubular feedback
C. Starling forces
D. Hormonal control
```
B
113
```
CHF can cause
A. Pre renal ARF
B. Intra renal ARF
C. Post renal ARF
D. CRF
```
A
114
```
This diuretic inhibits Na- Cl transporter
A. Thiazides
B. Loop
C. Osmotic
D. Sodium channel blocker
E, aldosterone inhibitor
```
A
115
```
The juxtaglomerular apparatus is formed where the __________ projects between the afferent arteriole and efferent arteriole next to Bowman's capsule.
A) glomerulus
B) arcuate arteries
C) proximal tubule
D) distal tubule
E) collecting duct
```
D
116
Concerning the function of the proximal tubule:
A. most of the glomerular ultrafiltrate is reabsorbed in the proximal tubule in an
iso-osmotic fashion.
B. the concentration of PAH doesn't change much along the length of the proximal tubule
C. under normal conditions, most of the filtered glucose and bicarbonate are reabsorbed in the proximal tubule
D. A and C are correct
E. all are correct
D
117
```
The part of a nephron between Bowman's capsule and the loop of Henle is the
A) collecting duct.
B) distal tubule.
C) juxtaglomerular apparatus.
D) macula densa.
E) proximal tubule
```
E
118
An asthmatic patient comes to you. He said that he is feeling weak after nebulizing with salbutamol (beta agonist). What advise do you give him
A. Admit him in the hospital
B. Tell him to take banana because the drug can cause hypo kalmia
C. Tell him to refrain from taking banana because the drug can cause Hyperkalemia
D. Tell him to drink plenty of water
B
119
```
Mutations in Na- Cl co transporter in the DCT
A. Nephrotic syndrome
B. Nephritic syndrome
C. Bartter syndrome
D. Gitelman syndrome
```
D
120
```
Given these vessels:
1. arcuate vein
2. afferent arteriole
3. efferent arteriole
4. interlobular vein
5. peritubular capillaries
Arrange the vessels in the order in which a drop of blood from the interlobular artery passes through them.
A) 1,2,4,5,3
B) 2,3,5,4,1
C) 3,5,4,2,1
D) 4,2,5,3,1
E) 5,2,4,1,3
```
B
121
Active transport of substances from the blood into the nephron is called
A) filtration.
B) tubular reabsorption.
C) tubular secretion.
C
122
```
The part of the total cardiac output that passes through the kidneys is called the
A) filtration fraction.
B) plasma clearance.
C) renal blood flow rate.
D) renal fraction.
E) tubular maximum.
```
D
123
```
Which of these substances normally cannot pass through the filtration membrane?
A) hemoglobin
B) water
C) sodium ions
D) bicarbonate ions
E) glucose
```
A
124
```
As filtrate moves through the thin segment of the descending limb of the loop of Henle, water moves __________ the nephron, and solutes move __________ the nephron.
A) into, into
B) into, out of
C) out of, into
D) out of, out of
```
C
125
During tubular reabsorption in the proximal tubule of the nephron, most solutes are moved across the apical membrane by __________ , and across the basal membrane by __________ .
A) cotransport, cotransport
B) cotransport, facilitated diffusion
C) counter transport, cotransport
D) facilitated diffusion, cotransport
E) primary active transport, cotransport
B
126
```
All of these compounds are reabsorbed from the filtrate back into the blood EXCEPT
A) amino acids.
B) fructose
C) Na+ ions.
D) penicillin.
E) Ca2+ ions.
```
D
127
```
At which of these locations is the osmolality of the filtrate the highest?
A) Bowman's capsule
B) proximal tubule
C) bottom of the loop of Henle
D) distal tubule
E) top of the collecting duc
```
C
128
```
Juxtaglomerular cells secrete
A) ADH.
B) oxytocin.
C) renin.
D) aldosterone.
E) angiotensin
```
C
129
Constriction of the afferent arteriole only:
a. decreases hydrostatic pressure in the glomerular capillaries
b. decreases GFR
c. decreases RPF
d. a and b only are correct
e. a b and c are all correct
E
130
When the tubular load of a substance exceeds the tubular maximum, that substance will
A) be actively transported into the blood.
B) diffuse into the blood.
C) appear in the urine.
D) cause a backflow of filtrate from Bowman's capsule into the glomerulus.
E) be broken down by carbonic anhydrase.
C
131
```
permeability of the distal tubule and the collecting duct is controlled by
A) ADH.
B) aldosterone.
C) atrial natriuretic factor.
D) carrier molecules.
E) sodium ions.
```
A
132
If a single nephron was blocked, how would this affect overall kidney function?
A. It would cause a blockage cascade to the other nephrons.
B. It would cause a noticeable difference in kidney function.
C. It would not be noticeably affected.
D. It would signal the shut down of surrounding nephrons.
C
133
If the glomerular filtration was zero, how would the kidneys be affected?
A. Kidney function would be unaffected.
B. The kidneys would redirect filtrate flow through the vasa recta.
C. The afferent arteriole would flow blood directly into the proximal convoluted tubule.
D. The kidneys would not function.
D
134
What factor limits the maximum possible concentration?
A. The osmolarity of the interstitial gradient.
B. The blood volume.
C. The osmolarity of the GFR.
D. The blood pressure.
A
135
What would happen if there was more glucose than could be transported by the available number of glucose carrier molecules?
A. Glucose would be reabsorbed by the distal convoluted tubule.
B. Glucose would be present in the urine.
C. Glucose would leak out of the collecting tubules back into the interstitial fluid.
D. The body would recruit more glucose transport proteins to that site.
B
136
Consider this situation: We want to reabsorb sodium ions, but do not want to increase the volume of the blood by reabsorbing water from the filtrate. Assuming that aldosterone and ADH are both present, how would you adjust the hormones to accomplish the task?
A. Increase aldosterone / decrease ADH
B. Increase aldosterone / increase ADH
C. Decrease aldosterone / increase ADH
D. Decrease aldosterone / increase ADH
A
137
The main barrier precluding the free passage of albumin across the glomerular capillary walls is formed by:
A.the fenestrated glomerular endothelium
B.anionic proteoglycan clusters within the glomerular basement membrane
C. the filtration slits in between visceral epithelial cells (podocytes)
D.none are correct
E. all are correct
B
138
true or false. A substance that is filtered only at the glomerulus (i.e., neither reabsorbed or secreted in the nephrons) will be more concentrated in the urine than in the plasma
true
139
true or false. Parasympathetic output to the bladder causes relaxation of the external sphincter.
false
140
Which of the following is correct:
a. Excretion = Filtration + Reabsorption + Secretion
b. Excretion = Filtration + Reabsorption – Secretion
c. Excretion = Filtration – Reabsorption + Secretion
d. Excretion = Filtration – Reabsorption – Secretion
e. Filtration = Reabsorption – Secretion – Excretion
c
141
Which of the following is normally more concentrated in urine that in plasma:
a. Creatinine
b. Glucose
c. Plasma proteins
d. Bicarbonate
e. None of the above
A
142
Which of the following is/are involved in autoregulation of GFR and RPF (renal plasma flow) to increased MAP:
a. a myogenic response of glomerular capillaries
b. release of a vasoconstrictor substance from granular cells of the juxtaglomerular apparatus
c. increased sympathetic nervous system output to the kidneys
d. a and b only are correct
e. a, b and c are al correct
D
143
```
A person with a creatinine clearance of 5ml/min is categorized as ______ CKD.
A. Stage 0
B. Stage 1
C. Stage 2
D. Stage 3
E. Stage 4
F. Stage 5
```
F
144
The internal sphincter of the bladder is:
a. composed of skeletal muscle
b. composed of detrusor muscle fibers
c. innervated by fibers in the pudendal nerves
d. under voluntary control
e. both a and d are correct
B
145
The following factor(s) tend(s) to INCREASE the rate of glomerular filtration (GFR):
A.decreased albumin concentration in plasma
B. vasodilation of the afferent arteriole
C. vasoconstriction of the efferent arteriole
D. A and C are correct
E. all are correct
E
146
```
What diuretic can block tubuloglomerular feedback
A. Thiazides
B. Loop diuretics
C. Osmotic diuretic
D, aldosterone antagonist
```
B. By interfering with the NaCl reabsorption by macula densa
147
Kidney stones will
A. Decrease GFR
B. Increase GFR
C. Not change GFR
A. Inc un bowman's hydrostatic pressure
