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PHYSIOLOGY > Renal - Batch 2019 > Flashcards

Renal - Batch 2019 Flashcards

1
Q
  1. In the collecting tubule
    a. Na+ reabsorption is stimulated by aldosterone
    b. A Na+-Cl-mechanism is responsible for Na+ reabsorption
    c. A Na+-H+ exchange mechanism is responsible for most of the Na+ reabsorption
    d. All of the above are correct
A

A

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2
Q
  1. Which of the following features of nephrotic syndrome is the main reason why these patients acquire edema?
    a. Proteinuria c. Anemia
    b. Hypertension d. High cholesterol levels
A

A

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3
Q
  1. The thick ascending limb of the loop of Henle is where:
    a. Aldosterone stimulates Na+ secretion
    b. NaCl is actively transported into the interstitial fluid leaving water behind because
    the tubular cells are not permeable to water
    c. NaCl passively leaves the tubular fluid down its concentration gradient d. K+ is secreted
A

B

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4
Q
  1. The development of the medullary gradient is initiated by the countercurrent multiplier mechanism, which has 2 main requirements namely:
    a. A descending arm that is significantly permeable to water and an ascending arm that significantly/actively reabsorbs Na+
    b. A descending arm tghat is significantgly permeable to waer and an ascending arm that is impermeable to Na+
    c. A descending arm that is impermeable to water and an asceding arm that is impermeable to Na+
    d. A descending arm thaqt is impermeable to water and an asceding arm thaqt significantly/actively reabsorbs Na+
A

A

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5
Q
  1. A moderate increase in efferent arteriolar resistance without any changes in the afferent arteriolar resistance is expected to:
    a. Decrease both RPF and GFR
    b. Increase both renal plasma flow (RPF) and glomerular filtration rate (GFR)
    c. Decrease RPF but increase GFR
    d. Increase RPF but decrease GFR
A

C

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6
Q
  1. Which of the following statements is NOT correct?
    a. There is net movement of water out of the descending limb of the loop of Henle
    b. Countercurrent flow in the vasa recti minimizes solute loss from the medulla of the kidney
    c. The thick ascending limb of the loop of Henle is highly permeable to water
    d. Blood flow through the vasa recti is very slow, compared to blood flow thorugh the peritubular capillaries of the cortical nephrons
A

C

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7
Q
  1. In the proximal tubule, the mechanism by which HCO3- is reabsorbed is through:
    a. Diffusion of carbonic acid out of the tubular cell into the peritubular fluid where it breaks down into H+ and HCO3- catalyzed by carbonic anhydrase
    b. Diffusion of the HCO3- formed from the breakdown of carbonic acid within the
    tubular cell
    c. Direct diffusion of filtered HCO3- via the paracellular route
    d. Direct diffusion of the filtered HCO3- via the transcellular route
A

B

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8
Q
  1. Infusing sterile water in the blood stream instantaneously causes the intracellular fluid to become:
    a. Hypoosmotic c. Hyperosmotic e. No change
    b. Hypotonic d. Hypertonic
A

E

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9
Q
  1. The plasma clearance of a substance can be used to calculate the glomerular filtration rate if that substance is freely filtered at the glomerulus and is:
    a. Neither reabsorbed nor secreted by the tubules
    b. Reabsorbed by the tubules
    c. Secreted by thge tubules
    d. Reabsorbed and secreted by the tubules
A

a

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10
Q
  1. During autoregulation, the site of major control in so far as GFR and RBF are concerned is the:
    a. Glomerulus c. Afferent Arteriole
    b. Efferent arteriole d. Vasa recti
A

C

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11
Q
  1. With regards glomerular filtration:
    a. 50% of blood that flows through the glomeruli is filtered
    b. 80% of blood that flows through the glomeruli is filtered
    c. 100% of blood that flows through the glomruli is filtered
    d. 20% of blood that flows through the glomeruli is filtered
A

D

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12
Q
  1. The ADH exerts its action in the kidneys by increasing:
    a. Water reabsorption in the collecting duct/tubule
    b. Na+ reabsorption in the collecing duct
    c. Water reabsortion in the ascending loop and early distal tubule
    d. Bicarbonate reabsorption in the loop of Henle
A

A

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13
Q
  1. Allergies cause edema by affecting which aspect of capillary filtration?
    A. Capillary filtration coefficient
    B. Capillary hydrostatic pressure
    C. Interstitial fluid hydrostatic pressure
    D. Capillary plasma colloid osmotic pressure
    E. Interstitial fluid colloid osmotic pressure
A

A

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14
Q
  1. In the proximal tubule, Na+ reabsorption is normally accompanied by: a. Secretion of two-thirds of the filtered water
    b. Secretion of K+
    c. Reabsorption of two-thirds of the filtered water
    d. An equal amount of H+ secretion
A

C

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15
Q
  1. A reduction in afferent arteriolar resistance without any change in efferent arteriolar resistance will cause:
    a. A reduction in both RPF and GFR
    b. An increase in RPF but a reduction in GFR
    c. A reduction in RPF but an increase in GFR
    d. An increase in both RPF and GFR
A

D

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16
Q
  1. Which part of the juxtamedullary nephron is responsible for establishing the vertical gradient in the medulla of the kidney?
    a. Distal tubule c. Afferent Arteriole
    b. Collecting duct d. Loop of Henle
A

D

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17
Q
  1. What is the most prominent molecule that balances out the positive charge of potassium ions in the cell?
    a. Chloride ions c. Phosphate ions
    b. Intracellular proteins d. Bicarbonate ions
A

C

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18
Q
  1. Which part of the juxtamedullary nephron is responsible for establishing the vertical gradient in the medulla of the kidneys?
    a. Distal tubule c. Collecting duct
    b. Loop of Henle d. Afferent arteriole
A

B

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19
Q
  1. Tm is the maximum rate:
    a. A substance can be reabsorbed because of saturation of the carrier molecule
    b. Of glomerular filtration
    c. A substance can be cleared from blood
    d. Of urine excretion
A

A

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20
Q
  1. The driving force for the reabsorption of Na+ in the proximal tubule is the activity of the:
    a. Starling’s forces c. Na+-K+ ATPase pump
    b. Sympathetic nervous system d. Renin-angiotensin-aldosterone system
A

C

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21
Q
  1. Which of the following statements is NOT correct?
    a. Countercurrent flow in the vasa recti minimizes solute loss from the medulla of
    the kidneys
    b. There is net movement of water out of the descending limb of the loop of Henle
    c. Blood flow through the vasa recti is very slow, compared to blood flow thorugh
    the peritubular capiollaries of cortical nephrons
    d. The thick ascending limb of the Loop of Henle is highly permeable to water
A

D

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22
Q
  1. Regarding fluid/electrolyte balance, burn patients are prone to which of the following conditions?
    a. Polyuria c. Hypertension
    b. Edema d. Hypernatremia
A

B & D

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23
Q
  1. A patient with a serum sodium of 110 mmol/L was rushed to the emergency room with a blood pressure of 60/40 (hypotensive). Considering his sodium level, which of the following precautions must be taken regarding his fluid resuscitation?
    a. Watch out for new neurologic signs and symptoms.
    b. Hypotonic fluids are preferred.
    c. 5% Dextrose in Water is an acceptable intravenous fluid for use in this case
    d. It is too dangerous to infuse saline solutions in his blood stream
A

A

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24
Q
  1. The major force that promotes fioltration within the glomerulus is the:
    a. Glomerular capillary hydrostatic pressure
    b. Bowman’s capsule oncotic pressure
    c. Bowman’s capsule hydrostatic pressure
    d. Glomerular capillary oncotic pressure
A

a

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25
Q
  1. In a 90-kg adult man, the intracellular compartment contains around how much liter of fluid?
    a. 18L b.54L c.45L d.36L
A

d

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26
Q
  1. Drinking salt water to quench your thirst will cause your anti-diuretic hormone blood level to:
    a. Increase B. Decrease c. No change
A

A

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27
Q
  1. At plasma concentrations of glucose higher than its transport maximum (Tm), the:
    a. Excretion rate of glucose increases with increasing plasma glucose
    b. Excretion rate of glucose equals its filtration rate
    c. Clearance of glucose is zero (0)
    d. Reabsorption rate of glucose equals its filtration rate
A

A

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28
Q
  1. What is the target sodium of a patient with a serum sodium of 109 mmol/L after 2 days of correction?
    a. 139 mmol/L b. 119 mmol/L c. 129 mmol/L d. 149 mmol/L
A

c

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29
Q
  1. An elderly female came in the emergency room for decrease in sensorium. She has been chronically taking hydrochlorothiazide but twice the recommended dose. Which of the following could be expected from her?
    a. Her condition can mimic the physiologic effects of excessive sweating
    b. Her condition can mimic the physiologic effects of Cushing’s syndrome
    c. Her condition can mimic the physiologic effects of adrenal insufficiency
    d. Her condition can mimic the physiologic effects of excess antidiuretic hormone
    e. Her condition can mimic the physiologic effects of Cushing’s disease
A

C

30
Q
  1. Magnesium ions are found more predominantly in which compartment?
    a. Not found in both the intracellular and extracellular compartment
    b. Intracellular compartment
    c. Extracellular compartment
    d. Present in equal amounts in both the intracellular and extracellular compartment
A

b

31
Q
  1. With regards renal blood flow, which of the following statements is/are TRUE?
    a. Increased activity in the renal sympathetic nerves results in increased blood flow
    to the kidneys
    b. The kidneys receive about a third of the resting cardiac output
    c. As cardiac output increases during exercise, renal blood flow increases
    d. Renal blood flow is maintained within narrow limits by autoregulation
A

D

32
Q
  1. Which of the following mechanism is responsible for causing bipedal edema in patients with heart failure?
    a. Decreased lymphatic drainage
    b. Increased capillary colloid osmotic pressure
    c. Decreased interstitial fluid hydrostatic pressure
    d. Increased capillary hydrostatic pressure
A

D

33
Q
  1. Which of the following prevents fluid accumulation in the potential spaces inside our body?
    a. No active mechanisms are present to prevent this
    b. Negative hydrostatic pressure
    c. Efficient blood flow towards these regions
    d. Efficient lymphatic drainiage towards these regions
A

B

34
Q
  1. The hydrostatic pressure within the glomerular capillaries:
    A. Is the sole determinant of the glomerular filtration rate
    B. Is greater than the pressure within the afferent arterioles
    C. Increases when the afferent arteriole constricts
    D. Increases when the efferent arteriole constricts
A

D

35
Q
  1. IN THE thin ascending limb of the loop of Henle:
    A. Na+ is being actively reabsorbed
    B. Water is reabsorbed
    C. Na+ passively diffuses out from the tubular lumen into the peritubular fluid
    D. Water is moving from the peritubular space into the tubular lumen
A

C

36
Q
  1. In a 90-kg adult man, the plasma contains around how much liter of fluid?
    a. 9L b.5L c.4L d.6L
A

C

37
Q
  1. The glomerular filtrate as it enters the Bowman’s capsule is:
    a. Essentially a protein-free plasma
    b. Formed at a constant rate under all circumstances
    c. Identical in composition to urine
    d. Formed as a result of active forces
A

A

38
Q
  1. If the filtration fraction is increased to >0.20, the GFR will eventually:
    a. Decrease c. Fluctuate wildly
    b. Not change d. Increase
A

A

39
Q
  1. Fluid entering the loop of Henle from the proximal tubule:
    a. Has a higher Na+ concentration than plasma
    b. Has a higher osmolality than plasma
    c. Has a higher glucose concentration than plasma
    d. Has a higher urea concentration than plasma
A

D

40
Q
  1. Excretion:
    a. Occurs by active transport of substances into the urinary bladder
    b. Conserves substances that are important to the body
    c. Is the process by which a substance moves from the peritubular capillary blood to
    the tubular fluid
    d. Is the removal from the body via the urine of substances that were filtered at the
    
A

D

41
Q
  1. Majority of the filtered HCO3- is reabsorbed in the:
    a. Proximal tubule
    b. Thin descending limb of the loop of Henle
    c. Formed at a constant rate under all circumstances
    d. Thick ascending limb of the loop of Henle
A

A

42
Q
  1. The segment of the nephron that is NOT permeable to water even in the presence of antidiuretic hormone is the:
    a. P roximal tubule
    b. Ascending limb of the loop of Henle
    c. Descending limb of the loop of Henle
    d. Distal tubule
A

B

43
Q
  1. FThe body fluid volume regulation abnormaility found in patients with primary aldosteronism can also be seen in patients with:
    a. Adrenal insufficiency c. Cushing’s disease
    b. Diabetes insipidus d. Excess ADH
A

C

44
Q
  1. Which of the following makes the activation of the Renin-Angiotensin-Aldosterone axis potentially life-saving in patients with very significant blood loss?
    a. Anuria
    b. Increased cortisol levels in the serum
    c. Increased blood flow in the vascular compartment
    d. Sodium retention
A

D

45
Q
  1. Which of the following alterations in the defense mechanism of the body to edema will cause greater susceptibility to develop edema?
    a. Lymphatic flow modified to be able to address an increase in interstitial free fluid pressure of 4 mm Hg
    b. More viscous interstitial gel
    c. More negative interstitial free fluid pressure
    d. Decreased protein wash-out by the lymphatics
A

D

46
Q
  1. With regards renal blood flow distribution:
    a. Half of the renal blood flow goes to the cortex and the other half to the medulla
    b. 80% are delivered to the medulla whereas only 20% goes to the cortex
    c. Variation occurs with 80% sometimes going to the cortex and sometimes to the
    medulla
    d. 80% are delivered to the cortex whereas only 20% goes to the medulla
A

D

47
Q
  1. The reaction of H2CO3- derived H+ with HCO3- in the proximal tubule is accompanied by movement of HCO3- into the peritubular fluid from the tubular cell. This represents:
    a. Generation of new HCO3- to replace plasma losses due to neutralization of fixed acids produced during metabolism
    b. Reabsorption/recovery of HCO3- filtered into the Bowman’s capsule.
    c. Actual secretion of acids into the urine
    d. Secretion of bases into the tubular lumen
A

B

48
Q
  1. The permeability of the loop of Henle to different substances differs such that the:
    a. Thick ascending limb is freely permeable to Na+ and Cl-
    b. Thin and thick ascending limbs are freely permeable to water
    c. Thin ascending limb is impermeable to Na+ and Cl-
    d. Thin descending limb is feely permeable to water
A

D

49
Q
  1. The tubular fluid that enters the descending limb of the loop of Henle has a Cl- concentration that is:
    a. Higher than that in plasma
    b. Equal to that in plasma
    c. Equal to that of the fluid found in the Bowman’s capsule
    d. Lower than that in plasma
A

A

50
Q
  1. The main driving force for water reabsorption in the proximal tubule epithelium is:
    a. Active reabsorption of amino acids and glucose
    b. Active reabsorption of Na+
    c. The high colloid osmotic pressure in the peritubular capillaries
    d. Active reabsorption of water Incorrect
A

B

51
Q
  1. Given a normal glomerular filtration rate of 125 ml/min and given the clearance rates of the following freely filtered substances, which substance is being reabsorbed?
    a. Substance D with a clearance rate of 75 ml/min
    b. Subsance C with a clearance rate of 125 ml/min
    c. Substance B with a clearance rate of 250 ml/min
    d. Substance A with clearance rate of 500 ml/min
A

A

52
Q
  1. With autoregulation, fluctuations in systemic arterial pressure within the range of 80 to 180 mm Hg will result in:
    a. An increase in RPF and GFR
    b. An increase in RPF but a decrease in GFR
    c. A decrease in RPF and GFR
    d. No significant change in RPF and GFR
A

D

53
Q
  1. The primary means for physiological regulation of the GFR is through changes in:
    a. Glomerular capillary oncotic pressure c. Bowman’s capsule oncotic pressure
    b. Glomerular capillary hydrostatic pressure d. Bowman’s capsule hydrostatic pressure
A

B

54
Q
  1. As the tubular fluid leaves tghe distal convoluted tubule and enters the connecting tubule, it is observed to have an osmolality that is:
    a. Similar to the fluid in the Bowman’s space
    b. Higher than that of plasma
    c. Similar to that of plasma
    d. Lower than that of plasma
A

D

55
Q
  1. Severe (more than threefold increase) efferent arteriolar constriction is expected to:
    a. Decrease both RBF and GFR c. Increase both RBF and GFR
    b. Decrease RBF butr increase GFR d. Increase RBF but decrease GFR
A

A

56
Q
  1. No change in tubular fluid volume occurs as it passes through which segment of the nephron?
    a. Descending limb of the loop of Henle c. Proximal convoluted tubule
    b. Ascending limb of the loop of Henle d. All of the above
A

B

57
Q
  1. Alteration or changes in the following can stimulate ADH secretion, EXCEPT
    a. Blood temperature
    b. Blood volume
    C. BLOOD PRESSURE
    D. PLASMA OSMOLALITY
A

A

58
Q
  1. Normally, approximately 67% of the filtered Na+ is absorbed in the:
    a. Loop of Henle
    b. Distal convoluted tubule
    c. proximal tubule
    d. collecting tubule
A

C

59
Q
  1. Which of the following is an example of a hypoosmotic, isotonic solution?
    a. 0.9% Sodium Chloride Solution (pNSS)
    b. 5% Dextrose in Normal Saline Solution (D5NSS) c. c. 0.45% Sodium Chloride Solution (0.45 NSS)
    d. 5% Dextrose in Water
A

D

60
Q
  1. in the tubuloglomerular feedback hypothesis explaining the autoregulation of the GFR: a. The mesangial cells in the distal tubule are the sensors
    b. The efferent arterioles are the effectors
    c. The concentraion of renin is the signal
    d. The tubular fluid volume is the signal
A

B

61
Q
  1. Which of the following is true of chronic hyponatremia and its effects in the brain?
    a. Decrease in water molecules intracellularly
    b. Decrease in potassium intracellularly
    c. Decrease in overall cell volume of the brain
    d. Decrease in organic solutes extracellularly
A

b

62
Q
  1. At plasma para-aminohippuric acid (PAH) concentrations below its transport maximum (Tm), PAH:
    a. Concentration in the renal vein is close to zero (0)
    b. Clearance equals inulin clearance
    c. Reabsorption is not saturated
    d. Secretion rate equals PAH excretion rate
A

c

63
Q
  1. The greatest reduction in tubular fluid volume occurs in which segment of the nephron?
    a. Thin ascending limb of the loop of Henle
    b. Proximal tubule
    c. Distal convoluted tubule
    d. Thin descending limb of the loop of Henle
A

b

64
Q
  1. Common property of the sements reperesenting the distal nephron:
    a. Active secretion of Na+ c. Active reabsorption of Na+
    b. Increased permeablity to urea d. Increased permeability to water
A

c

65
Q
  1. If a substance is freely filtered, niether reabsorbed nor secreted by the renal tubules nor metabolized by the kidneys, then the clearance of that substance:
    a. Is equal to the GFR
    b. Has no significant relationship with the GFR
    c. Is less than the GFR
    d. Is greater than the GFR
A

a

66
Q
  1. In contrast to extrarenal capillaries, in the glomerular capillaries:
    a. Majority of blood that passes through the kidneys are subjected to filtration
    b. Protein molecules are filtered together with other small molecular weight substances
    c. No reabsorption occurs even at the end of the glomerular capillaries
    d. No filtration occurs from the beginning to the end of the glomerular capillaries
A

C

67
Q
  1. In the kidneys, the effect/s of ADH is/are as follows:
    a. It inceases the secretion of sodium in the thick ascending limb of the loop of Henle
    b. It inhibitgs the reabsorption of water in the thin descending limb of the loop of Henle
    c. It increases the rate of solute reabsorption in the proximal tubule
    d. It increases the reabsorption of water in the distal and collecting tubules
A

D

68
Q
  1. Decreasing the tonicity of the intracellular fluid can be achieved by doing which of the following?
    a. Infusing 5% Dextrose in Normal Saline Solution (D5NSS) in the blood
    b. Infusing 3% Sodium Chloride Solution in the blood
    c. Infusing 0.9% Sodium Chloride Solution (Normal Saline Solution) in the blood
    d. Drinking distilled drinking water
    e. Infusing 0.45% Sodium Chloride Solution in the blood
A

E

69
Q
  1. Antidiuretic hormone (ADH):
    a. Is secreted from the adrenal cortex
    b. Is released via the posterior pituitary when plasma osmolality rises
    c. Decreases urinary osmolality through the osmotically driven absorption of water
    d. Does all of the above
A

b

70
Q
  1. The fluid that flows through the tubule is:
    a. Hypertonic as it moves through the hairpin bend of the loop of Henle
    b. Hypotonic as it leaves the thick ascending limb of the loop of Henle
    c. Has the same osmolality as plasma as it leaves the proximal tubule
    d. Described by all the other choices
A

d

PHYSIOLOGY (21 decks)

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