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Animal Phys > Renal > Flashcards

Renal Flashcards

1
Q

What signs and symptoms lead the doctor to directly assume that Michael has gout?

blood work that showed an increased concentration of uric acid in Michael’s blood
hot and red joints accompanied by pain
a distinctive coloration in Michael’s urine
pain in the joints

A

hot and red joints accompanied by pain

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2
Q

Which of the following statements best describes the pathophysiology of gout?

crystallization of uric acid leading to activation of the inflammatory response within the joints
high levels of uric acid in the urine leading to crystallization and kidney stone formation
excessive filtration of uric acid at the glomerulus leading to a significant drop of plasma uric acid levels
None of the listed options explains the pathophysiology of gout.

A

crystallization of uric acid leading to activation of the inflammatory response within the joints

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3
Q

How is urate (the anionic form of uric acid) handled by the kidney under normal conditions?

net secretion
neither secreted nor reabsorbed
net reabsorption

A

net secretion

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4
Q

If administering a uricosuric agent enhances urate excretion, what might be the mechanism of action of this drug?

To competitively inhibit the transporter for uric acid.
To compete for the same transporter as uric acid.
To destroy the channels that transport urate.
To stimulate the cells of the proximal convoluted tubule that secrete urate to work faster.

A

To compete for the same transporter as uric acid.

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5
Q

The kidneys function to produce hormones, excrete wastes, regulate blood pressure, and maintain ion balance. Which of the following is another function of the kidneys?

Regulate osmolarity
Maintain blood glucose
Produce red blood cells
Generate body heat

A

Regulate osmolarity

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6
Q

The functional unit of the kidney is the __________.

juxtaglomerular apparatus
renal corpuscle
loop of Henle
nephron

A

nephron

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7
Q

A runner drank a lot of water during a race. What is the expected path of the extra filtered water molecules?

Afferent arteriole, glomerulus, nephron tubule, collecting duct
Efferent arteriole, glomerulus, afferent arteriole, peritubular capillaries
Afferent arteriole, glomerulus, nephron tubule, peritubular capillaries
Afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries

A

Afferent arteriole, glomerulus, nephron tubule, collecting duct

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8
Q

Put the following in order from where urine is produced to where it exits the body:
Urethra
Urinary bladder
Nephron
Ureter

4, 2, 1, 3
1, 2, 3, 4
2, 3, 4, 1
3, 4, 2, 1

A

3, 4, 2, 1

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9
Q

Blood leaves the glomerulus through which vessel?

Afferent arteriole
Efferent arteriole
Peritubular capillaries
Vasa recta

A

Efferent arteriole

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10
Q

A patient has a problem in her vasa recta. Where do you predict there could be problems with transport between the blood and the nephron tubule?

Loop of Henle
Distal tubule
Bowman’s capsule
Proximal tubule

A

Loop of Henle

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11
Q

Approximately how much liquid moves through the kidneys of an adult during a 24-hour period?

1.5 liters
18 liters
54 liters
180 liters

A

180 liters

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12
Q

Where does all filtration take place in the kidneys?

Collecting duct
Loop of Henle
Proximal convoluted tubule
Glomerulus

A

Glomerulus

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13
Q

Approximately what percent of the total filtered volume is excreted as urine each day?

Less than 1%
10%
30%
100%

A

Less than 1%

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14
Q

Which part of the nephron is responsible for the greatest possible increase in urine concentration?

Collecting duct
Proximal convoluted tubule
Loop of Henle
Bowman’s capsule

A

Collecting duct

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15
Q

Which of the following substances is not normally found in filtrate?

ions, such as sodium and potassium
water and small solutes
nitrogenous waste particles, such as urea
blood cells and large particles

A

blood cells and large particles

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16
Q

What is the primary driving force (pressure) that produces glomerular filtration?

colloid osmotic pressure of blood
gravity
hydrostatic pressure of blood (blood pressure)

A

hydrostatic pressure of blood (blood pressure)

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17
Q

Which substance would be found in higher concentration if the membrane were damaged?

glucose
protein
creatinine
chloride

A

protein

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18
Q

If the osmotic pressure in the glomerular capillaries increased from 28 mm Hg to 35 mm Hg, would net filtration increase or decrease?

net filtration would decrease
net filtration would increase
net filtration would not be altered

A

net filtration would decrease

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19
Q

Calculate the net filtration pressure if capillary hydrostatic pressure is 60 mm Hg, capillary osmotic pressure is 25 mm Hg, and capsular hydrostatic pressure is 10 mm Hg.

35 mm Hg
50 mm Hg
60 mm Hg
25 mm Hg

A

25 mm Hg

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20
Q

Which of the following correctly indicates the direction of the different forces causing filtration in the renal corpuscle (of fluid flow into or out of the Lumen of Bowman’s capsule from the glomerular capillaries)?

     Blood hydrostatic pressure-out; blood colloid osmotic pressure-in; hydrostatic fluid pressure of the Lumen of Bowman's capsule-in        
     Blood hydrostatic pressure-in; blood colloid osmotic pressure-out; hydrostatic fluid pressure of the Lumen of Bowman's capsule-out        
     Blood hydrostatic pressure-out; blood colloid osmotic pressure-out; hydrostatic fluid pressure of the Lumen of Bowman's capsule-in        
     Blood hydrostatic pressure-in; blood colloid osmotic pressure-in; hydrostatic fluid pressure of the Lumen of Bowman's capsule-in
A

Blood hydrostatic pressure-out; blood colloid osmotic pressure-in; hydrostatic fluid pressure of the Lumen of Bowman’s capsule-in

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21
Q

Which combination of changes would increase the glomerular filtration rate (GFR) the most?

Vasodilation of the afferent arteriole and vasoconstriction of the efferent arteriole
Vasoconstriction of both afferent and efferent arterioles
Vasodilation of both the afferent and efferent arterioles
Vasoconstriction of the afferent arteriole and vasodilation of the efferent arteriole

A

Vasodilation of the afferent arteriole and vasoconstriction of the efferent arteriole

22
Q

The three filtration barriers that substances must pass through when leaving the blood and entering the tubule lumen are the glomerular capillary endothelium, the epithelium of Bowman’s capsule, and which other structure?

Efferent arteriole
Basement membrane
Macula densa
Granular cells

A

Basement membrane

23
Q

What is the main factor in the net driving force for filtration in the glomerulus?

Capsular hydrostatic pressure
Glomerular filtration rate
Colloid osmotic pressure
Capillary hydrostatic pressure

A

Capillary hydrostatic pressure

24
Q

Glomerular filtration rate is determined by the net filtration pressure and the filtration coefficient. Which two factors determine the filtration coefficient?

Nephron number and colloid osmotic pressure
Nephron number and the plasma volume
Glomerular surface area and the permeability of the filtration slits
Permeability of filtration slits and fluid pressure in Bowman’s capsule

A

Glomerular surface area and the permeability of the filtration slits

25
Q

Which of these would cause the greatest increase in glomerular filtration rate?

Decreased diameter in the efferent arteriole
Decreased diameter in the afferent arteriole
Increased resistance in the afferent arteriole
Increased diameter in the efferent arteriole

A

Decreased diameter in the efferent arteriole

26
Q

Which change would cause an increase in afferent arteriolar resistance due to paracrine signaling from the macula densa?

Less blood volume in the afferent arteriole
Lower filtrate volume in the distal tubule
More blood volume in the efferent arteriole
Greater sodium concentration in the distal tubule

A

Greater sodium concentration in the distal tubule

27
Q

Most reabsorption of fluid from the filtrate back into the blood occurs from the __________.

proximal tubule
descending limb of the loop of Henle
ascending limb of the loop of Henle
distal tubule

A

proximal tubule

28
Q

In which process can glucose transport reach saturation?

Excretion
Filtration
Reabsorption
Excretion and reabsorption

A

Reabsorption

29
Q

What is the primary driving force for glucose transport into proximal tubule cells?

ATP hydrolysis allows active transport of glucose.
Glucose moves down its concentration gradient into tubular cells.
Sodium concentration gradient allows secondary active transport of glucose.

The apical Na+/K+-ATPase creates a gradient for K+, which can then flow down its concentration gradient to allow co-transport of glucose.

A

The apical Na+/K+-ATPase creates a gradient for K+, which can then flow down its concentration gradient to allow co-transport of glucose.

30
Q

f all glucose is normally reabsorbed in the proximal tubule of the nephron, why do people with diabetes have glucose in their urine?

The plasma concentration is greater than the renal threshold.
The excreted glucose is a product of chemical pathways that occur in the urine of diabetic patients.
Some glucose is secreted at the distal tubule when serum glucose concentrations are high.
The glucose concentration is below its saturation point.

A

The plasma concentration is greater than the renal threshold.

31
Q

A patient has a genetic defect that decreases the number of GLUT transporters in the nephron tubule. Which would you expect?

Decreased transport maximum and decreased glucose in urine
Decreased transport maximum and increased glucose in urine
Increased transport maximum and increased glucose in urine
Increased transport maximum and decreased glucose in urine

A

Decreased transport maximum and increased glucose in urine

32
Q

Secretion into the nephron is __________ because the direction is __________ the concentration gradient.

active; against
passive; against
active; with
passive; with

A

active; against

33
Q

Which transporter moves molecules with tertiary active transport?

Sodium-glucose cotransporters
Basolateral GLUT proteins
Organic anion transporters
Na+/K+-ATPase

A

Organic anion transporters

34
Q

Secretion is similar to ____.

Filtration, because in both, substances cross endothelial cells lining the glomerulus and epithelial cells of Bowman’s capsule

Reabsorption, because in both, substances cross endothelial cells lining the peritubular capillaries and epithelial cells lining the nephron tubule

Reabsoprtion, because in both, substances cross endothelial cells lining the glomerulus and epithelial cells of Bowman’s capsule

Filtration, because in both, substances cross endothelial cells lining the peritubular capillaries and epithelial cells lining the nephron tubule

A

Reabsorption, because in both, substances cross endothelial cells lining the peritubular capillaries and epithelial cells lining the nephron tubule

35
Q

What happens if reabsorption of a substance increases (and filtration and secretion stay the same)?

     Increased excretion of the substance and an increased amount of the substance in blood        
     Decreased excretion of the substance and an increased amount of the substance in blood        
     Increased excretion of the substance and a decreased amount of the substance in blood        
     Decreased excretion of the substance and a decreased amount of the substance in blood
A

Decreased excretion of the substance and an increased amount of the substance in blood

36
Q

Why is inulin administration an effective way of measuring renal clearance rates?

It is not filtered by the glomerulus.
Inulin is filtered and completely reabsorbed in the distal tubule.
Inulin is neither secreted nor reabsorbed.
Inulin is freely filtered and secreted.

A

Inulin is neither secreted nor reabsorbed.

37
Q

In a diabetic patient with high blood sugar above transport maximum, which would you expect?

There will be no reabsorption of glucose because of increased clearance.
There will be increased glucose in urine and increased glucose clearance.
Glucose clearance is equal to GFR.
All of the glucose that filters is reabsorbed, and glucose clearance is zero.

A

There will be increased glucose in urine and increased glucose clearance.

38
Q

Which of the following would best help a clinician understand how well the kidney was able to remove a substance from the body?

the concentration of the substance in the plasma
clearance of the substance
filtration of the substance
secretion of the substance
reabsorption of the substance

A

clearance of the substance

39
Q

Which of the following statements best describes clearance?

the rate at which a solute disappears from the plasma by either excretion or metabolism
the rate at which plasma is filtered at the glomerulus
the amount of urine produced by the body in an hour
the rate at which a solute is delivered back into the blood

A

the rate at which a solute disappears from the plasma by either excretion or metabolism

40
Q

Which of the following variables must be known in order to calculate the clearance of a substance?

Select all that apply.

the excretion rate of the substance
the amount of substance ingested by the body
the concentration of solute in the plasma
glomerular filtration rate

A

the concentration of solute in the plasma
the excretion rate of the substance

41
Q

Maintaining osmolarity is important to the body because the membranes of most cell types are freely permeable to ____.

water
cations
anions
proteins

A

water

42
Q

Most cell types are permeable to water. An exception is cells of the __________, which can be either impermeable or permeable, depending upon the location of __________.

loop of Henle; aquaporins
distal nephron; aquaporins
loop of Henle; ion channels
distal nephron; ion channels

A

distal nephron; aquaporins

43
Q

The __________ limb of the loop of Henle is permeable only to __________, which are reabsorbed all along the length because the fluid outside is __________ concentrated deeper in the medulla.

ascending; water molecules; more
descending; water molecules; more
ascending; water molecules; less
descending; ions; less

A

descending; water molecules; more

44
Q

Why is a high medullary interstitial osmolarity important to renal function?

It allows reabsorption of water.
It allows solutes to leave the filtrate.
It allows retention of water in the urine.
It allows for fine-tuning of hormonal release from granular cells.

A

It allows reabsorption of water.

45
Q

What is the mechanism of action of vasopressin?

Insertion of AQP2 into the apical membrane of collecting duct cells
Opening of AQP2 channels in the basolateral surface of proximal tubule cells
Closure of V2 receptor channels, preventing sodium movement and osmosis of water from the tubule to the interstitial pace
Decreasing the resistance in the afferent arteriole

A

Insertion of AQP2 into the apical membrane of collecting duct cells

46
Q

At a campus event, you ate a lot of salty treats. Which would you expect?

Vasopressin secretion and urination
Vasopressin secretion and thirst
Aldosterone secretion and thirst
Aldosterone secretion and vasopressin secretion

A

Vasopressin secretion and thirst

47
Q

What is the site and mechanism of the early response phase of aldosterone action?

Opening of aquaporins in the cortical collecting duct
Increased glucose secretion from the vasa recta
Increased number of Na+ and K+ channels in on the basolateral membrane of collecting duct epithelium
Increased Na+/K+-ATPase activity in P cells of the distal nephron epithelium

A

Increased Na+/K+-ATPase activity in P cells of the distal nephron epithelium

48
Q

Aldosterone secretion increases in response to __________ and causes __________.

increased angiotensin II; sodium secretion
renin; sodium reabsorption
increased angiotensin II; sodium reabsorption
decreased angiotensin II; sodium secretion

A

increased angiotensin II; sodium reabsorption

49
Q

At a holiday celebration, you ate foods high in salt. Which would you predict?

Decreased urine volume and decreased blood volume
Decreased urine volume and increased blood volume
Increased urine volume and decreased blood volume
Increased urine volume and increased blood volume

A

Decreased urine volume and increased blood volume

50
Q

Which hormone increases sodium excretion?

Renin
Aldosterone
Atrial natriuretic peptide
Angiotensin II

A

Atrial natriuretic peptide

51
Q

During a workout, a student drinks too much water. Which would you expect to be stimulated?

The renin-angiotensin-aldosterone system
Salt appetite
Oropharynx receptors
Angiotensin II

A

Salt appetite

52
Q

Dehydration leads to __________ blood volume, __________ blood pressure, and __________ osmolarity.

decreased; increased; decreased
decreased; decreased; increased
increased; decreased; increased
decreased; increased; increased

A

decreased; decreased; increased

Animal Phys (6 decks)

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