Renal Practice Quiz Flashcards
1
Q
The nephron consists of a glomerulus and a renal tubule. True or false?
A
t
2
Q
The glomerular capillary network emerges from an ______________ arteriole.
a. Afferent
b. Efferent
A
A
3
Q
A brush border exists on the cells lining the luminal side of the:
a. Loop of Henle
b. Distal convoluted tubule
c. Proximal convoluted tuble
d. Collecting ducts
A
C
4
Q
Nephrons with their glomeruli in the outer cortex and short loops of Henle are called:
a. Superficial cortical nephrons
b. Juxtamedullary nephrons
A
A
5
Q
Superficial cortical nephrons have higher filtration rates and thus, are essential for the
concentration of urine. True or false?
A
6
Q
Peritubular capillaries surround the nephron and receive their blood from the:
a. Afferent arterioles
b. Efferent afterioles
A
B
7
Q
What percentage of body weight comprises intracellular fluid?
a. 60%
b. 40%
c. 20%
A
B
8
Q
Of the extracellular fluid compartment, ¾ (16%) is found in the plasma. True or false?
A
9
Q
What is a MAJOR cation found in intracellular fluid?
a. K+
b. Na+
c. Cl-
d. ATP
A
A
10
Q
What is a MAJOR anion found in extracellular fluid?
a. Proteins
b. ATP
c. Mg2+
d. HCO3
-
A
D
11
Q
Interstitial fluid is an ultrafiltrate of plasma, and has nearly the same composition as
plasma (minus proteins and blood cells). True or false?
A
t
12
Q
The volume of a fluid compartment depends on the amount of solute in that
compartment; i.e., water will move into a compartment if needed so that osmolarity is
equal in both compartments. True or false?
A
t
13
Q
A decrease in ECF volume is referred to as:
a. Volume contraction
b. Volume expansion
A
A
14
Q
A decrease in ECF osmolarity would be referred to as:
a. Isosmotic
b. Hyperosmotic
c. Hyposmotic
A
C
15
Q
There is no water movement from the ICF compartment in diarrhea because the fluid
lost from the ECF compartment is isosmotic. True or false?
A
t
16
Q
In hyperosmotic volume contraction such as extreme sweating, ECF volume will be lost
and osmolarity in this compartment will increase. What will happen to ICF volume?
a. Increase
b. Decrease
c. No change
A
DECREASE
17
Q
What equation is this?
C = [U]x x V
________
[P]x
A
RENAL CLEARANCE
18
Q
As urinary excretion of a substance increases, renal clearance of that substance decreases. True or false?
A
FLASE
19
Q
Albumin and glucose both have a renal clearance of zero, but this clearance is zero for
different reasons. What are those reasons?
A
ZERO FOR ALBUMIN IN THE HEALTHY ANIMALS BECAUSE THIS PROTEIN IS TOO LARGE TO CROSS OUT OF THE GLOMERULAR CAPILLARY
ZERO FOR GLUCOSE BECAUSE ALTHOUGH IT IS FREELY FILTERED IT IS COMPLETLY REABSORBED BACK IN THE BLOOD IN HEALTHY ANIMALS
20
Q
The substances inulin and PAH are both freely filtered across the glomerulus; however,
PAH has a higher renal clearance than inulin? Why is this the case?
A
ANY PAH NOT FILTERED BY THE GLOMERULUS IS SECRETED FROM THE BLOOD INTO THE RENAL TUBULES, THEREFORE INCREASING RENAL CLEARENCE
21
Q
Which substance is most perfect for measuring GFR because it is freely filtered across
the glomerulus, but not reabsorbed by blood or secreted into the renal tubules?
a. PAH
b. Inulin
c. Creatinine
d. BUN
A
B
22
Q
Both afferent and efferent arterioles are innervated by the sympathetic nervous system.
Which arteriole has more α-1 receptors?
A
AFFERENT
23
Q
If sympathetic activity is increased, the afferent arterioles constrict. What happens to
RBF and GFR?
a. Increase in RBF and GFR
b. Increase in RBF, decrease GFR
c. Decrease in RBF, increase GFR
d. Decrease in RBF and GFR
A
D
24
Q
While angiotensin II constricts both afferent and efferent arterioles, efferent arterioles
are more sensitive. Therefore, low vs. high levels of angiotensin II have differing effects
on GFR. What effect do high levels of angiotensin II have on GFR and why?
A
HIGH LEVELS OF ANGIOTENSIN II DECREASE GFR BY CONSTRICTING AFFERENT AND EFFERENT ARTERIOLES
25
Renal autoregulation involves the regulation of renal blood flow. Renal blood flow can
be kept constant within what range of renal arterial pressure?
a. 80 to 150 mm Hg
b. 60 to 200 mm Hg
c. 80 to 200 mm Hg
d. 60 to 120 mm Hg
C
26
Renal blood flow (RBF) can be measured using clearance of PAH only. True or false?
27
Ultrafiltrate that enters Bowman’s space contains water and MOST solutes from the
blood. True or false?
28
There are 3 layers of the glomerular capillary wall that provide a barrier to filtration into
Bowman’s space. Which layer does not allow filtration of plasma proteins and therefore
provides the most significant barrier to filtration?
a. Endothelium (facing capillary lumen)
b. Basement membrane (3 layers)
c. Epithelium (facing Bowman’s space)
B
29
Which layer of the glomerular capillary wall has very small filtration slits?
a. Endothelium
b. Basement membrane
c. Epithelium
C
30
Negatively-charged glycoproteins located throughout the layers of the glomerular
capillary wall will REPEL what?
a. Positively-charged solutes
b. Negatively-charged SMALL solutes
c. Plasma proteins
C
31
What type of pressure increases along the length of the glomerular capillary and by the
end of the capillary, increases to the point that glomerular filtration stops?
a. Oncotic pressure in glomerular capillaries
b. Hydrostatic pressure in Bowman’s space
c. Hydrostatic pressure in glomerular capillaries
A
32
You want to measure your dog’s GFR. Your dog weighs 30 kg. You have the following
information to assess:
V = 6 mL/min urine formation
Pinulin = 9 mg/mL Uinulin = 95 mg/mL
PPAH = 13 mg/mL UPAH = 390 mg/mL
Hematocrit = 43%
GFR = (Uinulin x V) / Pinulin GFR = (95 mg/mL x 6 mL/min) / 9 mg/mL GFR = 570/9
GFR for this dog = 63.3 mL/min / 30 kg = 2.1 mL/min/kg
33
Which substance is similar to inulin in that it can be used as a marker for GFR?
However, this substance is secreted to a small extent and can slightly overestimate GFR.
a. PAH
b. Blood urea nitrogen
c. Creatinine
CREATININE
34
What percentage of RPF is typically filtered across the glomerular capillaries, i.e., what is
the typical or average filtration fraction?
a. 80%
b. 60%
c. 40%
d. 20%
D
35
What is the name of the process for fluid leaving the glomerular capillary and entering
Bowman’s space?
a. Filtration
b. Reabsorption
c. Secretion
d. Excretion
A
36
What is the name of the process for water and many solutes that are transported or
diffuse from the tubular fluid into the peritubular capillary?
a. Filtration
b. Reabsorption
c. Secretion
d. Excretion
B
37
What is the name of the process for substances that are transported from peritubular
capillaries into the tubular fluid?
a. Filtration
b. Reabsorption
c. Secretion
d. Excretion
C
38
Excretion is the sum of the processes of filtration, reabsorption, and secretion. True or
false?
t
39
What is the filtration fraction if GFR = 80 mL/min and RPF = 320 mL/min?
FF = GFR/RPF = 80 mL/min / 320 mL/min = 0.25 or 25%
40
In a healthy person/animal, all of the filtered glucose is reabsorbed in what portion of
the nephron?
a. Proximal convoluted tubule
b. Thin descending limb
c. Thin ascending limb
d. Distal convoluted tubule
A
41
There are a limited number of glucose transporters for the reabsorption of glucose.
True or false?
t
42
In what membrane is the Na/glucose co-transporter located for the process of glucose
reabsorption?
a. Peritubular membrane
b. Luminal membrane
B
43
What is the threshold plasma glucose concentration below which all filtered glucose can
be reabsorbed?
a. 100 mg/dL
b. 200 mg/dL
c. 300 mg/dL
d. 400 mg/dL
B
44
In diabetes mellitus, the filtered load of glucose is high (above reabsorptive capacity)
and glucose will be excreted in the urine. True or false?
t
45
When there is a large concentration difference for urea between tubular fluid and blood
and permeability is high, urea reabsorption will:
a. Not change
b. Decrease
c. Increase
C
46
Urea reabsorption does not generally follow the same pattern as water reabsorption.
True or false?
47
How much urea has been reabsorbed by the end of the proximal tubule?
a. 25%
b. 40%
c. 50%
d. 75%
C
48
Where is urea first secreted into tubular fluid?
a. Collecting ducts
b. Distal tubule
c. Thick ascending limb
d. Thin descending limb
D
49
Where are urea transporters located to move urea from the tubular fluid to the
interstitial fluid of the inner medulla?
a. Collecting ducts
b. Distal tubule
c. Thick ascending limb
d. Thin descending limb
A
50
More than 99% of the filtered load of Na will be reabsorbed in a normal, healthy
individual. True or false?
t
51
Where does most Na reabsorption occur?
a. Proximal convoluted tubule
b. Thick ascending limb
c. Thin descending limb
d. Early distal convoluted tubule
A
52
Water is reabsorbed along with Na in the thick ascending limb. True or false?
53
What areas are responsible for the fine tuning of Na reabsorption?
a. Early distal convoluted tubule and collecting ducts
b. Late distal convoluted tubule and collecting ducts
c. Thick ascending limb and early convoluted tubule
d. Thick ascending limb and late distal convoluted tubule
B
54
In which part of the proximal convoluted tubule is Na primarily reabsorbed with Cl?
LATE PROXIMAL TUBULE
55
Because Na and water are tightly coupled in reabsorption in the proximal tubule, what is
the osmolarity of the fluid towards the end of the tubule?
a. Hyposmotic
b. Hyperosmotic
c. Isosmotic
C
56
Where are most filtered glucose and amino acids absorbed?
a. Loop of Henle
b. Early proximal convoluted tubule
c. Late proximal convoluted tubule
B
57
Because most of the filtered HCO3
- has been absorbed in the early proximal tubule,
which anion has a high concentration in the late proximal tubule and will be
reabsorbed?
a. Cl-
b. PO4-
c. K+
A
58
Glomerulotubular balance ensures that a constant fraction of the filtered load is
reabsorbed by the proximal tubule, even if filtered load increases or decreases. True or
false?
t
59
Glomerulotubular balance cannot be altered by changes in ECF volume. True or false?
60
ECF volume expansion produces ________________ in fractional reabsorption in the
proximal tubule.
a. No change
b. An increase
c. A decrease
C
61
Which process occurs in the loop of Henle?
a. Countercurrent exchange
b. Countercurrent multiplication
B
62
Which area of the loop of Henle is impermeable to water?
a. Thin descending limb
b. Thick ascending limb
B
63
What moves into the thin descending limb during countercurrent multiplication?
a. Solutes
b. Water
A
64
The reabsorption mechanism for Na in the thick ascending limb is load-dependent,
which means that the more Na is delivered, the more it will reabsorb. True or false?
t
65
A large amount of energy is consumed in reabsorbing Na in the thick ascending limb.
How is the Na gradient maintained?
a. Na/K/2 Cl co-transporter
b. Na/H transporter
c. Na/glucose transporter
d. Na/K ATPase
D
66
Besides dehydration, what problem occurs when furosemide is administered?
a. Hyperkalemia
b. Hypokalemia
c. Increased reabsorption of Na
d. Increased reabsorption of Cl
B
67
What inhibits the Na/Cl co-transporter in the early distal tubule?
a. Thiazide diuretics
b. Loop diuretics
c. Spironolactone
A
68
Like the thin and thick ascending limbs, the early distal tubule is also impermeable to
water. True or false?
t
69
Principal cells and intercalated cells are present in the late distal tubule and collecting
ducts. Which cell type is involved in K secretion?
PRINCIPLE CELLS
70
Fine adjustments of Na reabsorption are made in the late distal tubule and collecting
ducts. True or false?
t
71
What hormone influences final Na reabsorption in the late distal tubule and collecting
ducts?
ALDESTERONE
72
What drug inhibits K secretion in the late distal tubule?
a. Thiazide diuretics
b. Loop diuretics
c. Spironolactone
C
73
When ADH levels are high in the late distal tubule and collecting ducts, aquaporin 2
channels are inserted into the intercalated cells for water reabsorption. True or false?
74
What is the result of K moving outside of cells and into the blood?
a. Hyperkalemia
b. Hypokalemia
A
75
Hyperosmolarity causing K to move out of cells is an example of external K balance.
True or false?
76
Adjustments in K excretion occur where?
a. Proximal convoluted tubule
b. Thick ascending limb
c. Distal tubule and collecting ducts
C
77
An H+/K+ ATPase will pump K+ from the lumen of the tubule into the intercalated cell if
K+ needs to be reabsorbed. True or false?
t
78
While aldosterone increases Na reabsorption in principal cells, what effect does it have
on K?
a. No effect
b. Secretion
c. Reabsorption
B
79
Unbound phosphate is freely filtered across glomerular capillaries and most is
reabsorbed by a Na/phosphate co-transporter in the proximal tubule. True or false?
t
80
Both PTH and FGF-23 can inhibit Na/phosphate co-transport, thus increasing
phosphaturia. True or false?
t
81
What percentage of Ca is in the free, ionized form?
a. 70%
b. 50%
c. 40%
d. 10%
B
82
Loop diuretics do not inhibit Ca reabsorption in the same way as Na reabsorption in the
thick ascending limb. True or false?
83
In which nephron segment is Ca reabsorption not coupled with Na reabsorption and is
independently regulated?
a. Thin descending limb
b. Thin ascending limb
c. Distal tubule
d. Collecting duct
C
84
Where is the major site of Mg reabsorption?
a. Thin ascending limb
b. Thick ascending limb
c. Distal tubule
d. Proximal tubule
B
85
Which process occurs in the loop of Henle?
c. Countercurrent exchange
d. Countercurrent multiplication
B
86
Which area of the loop of Henle is impermeable to water?
c. Thin descending limb
d. Thick ascending limb
B
87
What moves into the thin descending limb during countercurrent multiplication?
c. Solutes
d. Water
A
88
Like the thin and thick ascending limbs, the early distal tubule is also impermeable to
water. True or false?
t
89
When ADH levels are high in the late distal tubule and collecting ducts, aquaporin 2
channels are inserted into the intercalated cells for water reabsorption. True or false?
FALSE - THIS WOULD BE PRINCIPLE CELLS
90
If a person or animal is deprived of water, what will ultimately happen to urine
osmolarity?
a. Increases
b. Decreases
c. No change
A
91
How does the corticopapillary osmotic gradient change from the cortex to the papilla
within the kidney?
a. No change
b. Decreases
c. Increases
C
92
What process occurs in the loop of Henle and helps to create the corticopapillary
osmotic gradient that exists in the interstitial fluid around the nephron?
a. Countercurrent multiplication
b. Countercurrent exchange
c. Urea recycling
A
93
In what area is the osmolarity of both the tubular fluid and interstitial fluid highest?
a. Proximal tubule
b. Thin descending limb
c. Hairpin turn
d. Thick ascending limb
C
94
ADH increases both water and urea permeability in the cortical, outer medullary and
inner medullary collecting ducts. True or false?
False – ADH increases water AND urea permeability in the inner medullary
collecting ducts only
95
What process helps to maintain the corticopapillary osmotic gradient and involves the
vasa recta?
a. Countercurrent multiplication
b. Countercurrent exchange
c. Urea recycling
B
96
Where is tubular fluid most dilute (lowest osmolarity)?
a. Thick ascending limb
b. Early distal tubule
c. Collecting ducts
B
97
In nephrogenic diabetes insipidus, ADH secretion is normal, but the kidney has a defect
and cannot respond to the ADH. True or false?
t
98
Where is most filtered HCO3 reabsorbed in the nephron?
a. Thin descending loop of Henle
b. Distal tubule
c. Proximal tubule
d. Thin ascending loop of Henle
C
99
In the tubule lumen, H2CO3 decomposes into CO2 and H2O by the action of
carbonic anhydrase. True or false?
t
100
The process of filtered HCO3 reabsorption begins with which transporter reabsorbing
Na on the luminal membrane?
a. Na/K ATPase
b. Na/HCO3 symporter
c. Na/2Cl/K transporter
d. Na/H exchanger
D
101
Once CO2 and H2O enter the tubule cell and recombine, they are converted to H
and HCO3. HCO3 can now be reabsorbed via Na/HCO3 symport or Cl/HCO3 exchange.
True or false?
t
102
The reabsorption of HCO3 becomes saturated and some HCO3 will begin to be
excreted above what plasma HCO3 concentration?
a. 20 mEq/L
b. 30 mEq/L
c. 40 mEq/L
d. 10 mEq/L
C
103
What effect will ECF volume expansion have on reabsorption of HCO3 in the
proximal tubule?
a. Inhibits absorption
b. Promotes absorption
c. No effect on absorption
A
104
ECF volume contraction will stimulate HCO3 reabsorption, which results in
contraction alkalosis. When can contraction alkalosis occur?
a. Vomiting
b. Treatment with exogenous glucose
c. Treatment with isotonic NaCl
A
105
When PCO2 increases in respiratory acidosis, what will happen to reabsorption
of HCO3?
a. Increases
b. Decreases
c. No change
A
106
Where does most excretion of titratable acid (H + inorganic phosphate) occur?
a. β-intercalated cells of late distal tubule and collecting duct
b. Principal cells of collecting duct
c. α-intercalated cells of late distal tubule and collecting duct
d. Principal cells of late distal tubule
C
107
In the excretion of a titratable acid, carbonic acid inside the cell dissociates into
bicarbonate and H. H can be transported to the tubule lumen via H-ATPase or H/K
exchanger. True or false?
t
108
What hormone can influence the H-ATPase to stimulate H secretion in the α-
intercalated cells?
a. ADH
b. Aldosterone
c. PTH
d. FGF23
B
109
The H secreted into the lumen combines with H2PO4 to form a titratable acid
for excretion. True or false?
FALSE - H COMBINES WITH HPO4 TO FORM H2PO4 FOR EXCRETION
110
For each H excreted as a titratable acid, one new HCO3 is synthesized and
reabsorbed. True or false?
t
111
Three segments of the nephron participate in excretion of H as NH4, including
the α-intercalated cells of the collecting ducts, proximal tubule, and?
a. Thin descending limb of loop of Henle
b. Thin ascending limb of loop of Henle
c. Thick ascending limb of loop of Henle
d. Distal tubule
C
112
NH4 is first generated in the proximal tubule cells by metabolizing which amino
acid to glutamate + NH4 via glutaminase?
a. Asparagine
b. Glutamine
c. Glycine
d. Threonine
B
113
NH4 generated in the proximal tubule cell dissociates into NH3 + H. How is H
transported into the tubular fluid?
a. H/Na exchanger
b. H/K ATPase
c. H-ATPase
d. Diffuses across
A
114
In the α-intercalated cell of the collecting duct, both H-ATPase and H/K exchanger
will transport H into the tubular fluid to combine with NH3 for excreting H. This NH3
diffuses from the osmotic gradient in the interstitial fluid. True or false?
t
115
In the proximal tubule cells where glutamine breakdown is generating a
hydrogen ion for excretion, no new HCO3 is generated in this process. True or
false?
FALSE - NEW BICARB IS GENERATED IN THE PROCESS FROM GLUTAMATE AND WILL BE REABSORBED TO REPLINISH HCO3 STORES IN THE ECF
