Review Q's Flashcards by Landon Younger

Renal autoregulation refers to the relative constancy of GFR and renal blood flow. A decrease in arterial pressure and glomerular filtration rate ultimately leads to a reduction in the concentration of sodium ions at the macula densa. This results in which of the following responses that ultimately restores GFR?

A. Release of renin by the juxtaglomerular apparatus
B. Release of endothelin by the glomerular capillaries
C. Release of nitric oxide by the vasa recta endothelium
D. Release of angiotensin II by the juxtaglomerular apparatus

A. Release of renin by the juxtaglomerular apparatus

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GFR is determined by the net filtration pressure and the glomerular capillary filtration coefficient. Which of the following factors has the greatest effect on increasing GFR?

A. Glomerular capillary colloid osmotic pressure
B. Bowman’s capsule hydrostatic pressure
C. Bowman’s capsule colloid osmotic pressure
D. Glomerular hydrostatic pressure

D. Glomerular hydrostatic pressure

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Minimum change disease occurs when the negative charges on the filtration membrane of the glomerulus are not present. What abnormality in the urine would be expected under these conditions?

A. Urine would contain numerous red blood cells
B. Urine would contain excess albumin
C. Urine would contain excess sodium and chloride
D. Urine would be less concentrated

B. Urine would contain excess albumin

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A number of hormones are involved in the control of glomerular filtration rate. Which of the following preferentially constricts the efferent arterioles but has little to no effect on the afferent arterioles?

A. Bradykinin
B. Angiotensin II
C. Endothelial-derived nitric oxide
D. Endothelin

B. Angiotensin II

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Which of the following, in liters/day, represents the GFR in the average adult human?

A. 3
B. 125
C. 180
D. 360

C. 180

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An increase in which of the following factors will result in a decrease in glomerular hydrostatic pressure?

A. Arterial pressure
B. Afferent arteriolar resistance
C. Efferent arteriolar resistance
D. Both B and C 
E. All of the above

B. Afferent arteriolar resistance

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Approximately how much of the total cardiac output is received by the kidneys?

A. 25%
B. 50%
C. 75%
D. 100%

A. 25%

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The macula densa is found in which of the following parts of the renal tubule?

A. Proximal convoluted tubule
B. Thin descending limb of Henle
C. Thick ascending limb of Henle
D. Distal convoluted tubule

D. Distal convoluted tubule

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The thin descending loop of Henle is highly permeable to which of the following?

A. Sodium
B. Water
C. Urea
D. Amino acids

B. Water

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Aldosterone is an important regulator of sodium reabsorption and potassium secretion; one of its main targets is…?

A. Podocytes
B. Principal cells
C. Intercalated cells
D. Cells of macula densa

B. Principal cells

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Which of the following cells play a major role in the secretion of potassium?

A. Intercalated cells
B. Principal cells
C. Chief cells
D. Podocytes

B. Principal Cells

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Most potassium reabsorption occurs at which of the following sites?

A. Ascending loop of Henle
B. Distal convoluted tubule
C. Proximal convoluted tubule
D. Collecting duct

C. Proximal convoluted tubule

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Primary active hydrogen secretion involves a hydrogen-transporting ATPase. It occurs in which of the following parts of the renal tubules?

A. Descending limb of Henle
B. Ascending limb of henle
C. Late distal tubules in intercalated cells.
D. Early collecting tubules in principal cells

C. Late distal tubules in intercalated cells

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ADH (anti-diuretic hormone) is formed in the supraoptic and paraventricular nuclei. It is secreted by specialized neurons from which of the following areas?

A. Adrenal cortex
B. Adrenal medulla
C. Anterior pituitary
D. Posterior pituitary

D. Posterior Pituitary

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A normal 70 kg human must excrete about 600 mOsm of solute each day in order to get rid of waste products of metabolism and ions that are ingested. The maximal urine concentrating ability is 1200 mOsm/L. Which of the following represents the obligatory urine volume that must be excreted each day to get rid of metabolic waste products?
A. 1.0 L/day
B. 0.5 L/day
C. 0.3 L/day
D. 0.0 L/day

B. 05. L/Day

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ADH acts on which of the following regions of the nephron?
A. Proximal convoluted tubule
B. Descending loop of Henle
C. Ascending loop of Henle
D. Distal convoluted tubule

D. Distal convoluted tubule

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Which of the following reflects the amount of urine that the kidneys can excrete per day when there is a large excess of water?
A. 180 liters
B. 75 liters
C. 20 Liters
D. 4 liters

C. 20 Liters

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Which of the following reflects the maximum urine concentration that can be produced by the kidneys? 
A. 6000-7000 mOsml/L 
B. 5500-6000 mOsml/L 
C. 1200 - 1400 mOsml/L
D. 2000-2400 mOsml/L

C. 1200-1400 mOsml/L

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Osmoreceptor cells are located in which of the following regions?

A. Adjacent to carotid bodies
B. In the macula densa
C. In the anterior part of the third ventricle
D. In the distal collecting ducts

C. In the anterior part of the third ventricle

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Which of the following segments of the nephron is NOT permeable to water?

A. Proximal convoluted tubule in the presence of ADH
B. Descending loop of Henle in the presence of ADH
C. Ascending loop of Henle in the presence of ADH
D. Distal convoluted tubule in the presence of ADH

C. Ascending loop of Henle in the presence of ADH

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Which of the following plays a major role in stimulating potassium excretion by the kidney tubules?

A. Aldosterone
B. Angiotensin II
C. Sodium ion
D. PTH

A. Aldosterone

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Approximately how much of the body’s supply of calcium is stored in bone?

A. 1%
B. 47 %
C. 78%
D. 99%

D. 99%

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How much of filtered calcium is excreted by the kidneys?

A. 1%
B. 47%
C. 78 %
D. 99%

A. 1%

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Which of the following cells reabsorb potassium during potassium depletion?

A. Intercalated cells
B. Principal cells
C. Chief cells
D. Podocytes

A. Intercalated cells

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A high potassium intake would have which of the following effects on potassium excretion associated with increased renal tubular flow rate? A. Potassium excretion would increase with increased tubular flow rate. B. Potassium excretion would decrease with increased tubular flow rate. C. There would be little effect. D. Tubular flow rate would be decreased.

A. Potassium excretion would increase with increased tubular flow rate.

Which of the following describes a valid change in potassium distribution due to an acid-base abnormality? A. Metabolic acidosis decreased extracellular K+ concentration B. Metabolic alkalosis increases extracellular K+ concentration C. Metabolic acidosis increases extracellular K+ concentration D. Both A and B are valid.

C. Metabolic acidosis increases extracellular K+ concentration

Which of the following buffer systems is most important in buffering renal tubular fluid? A. Phosphate buffer system B. Carbonate buffer system C. Bicarbonate buffer system D. Hemoglobin buffer system

A. Phosphate buffer system

Compounds that dissociate incompletely into hydrogen ions and a conjugate base are members of which of the following compounds? A. Strong acids B. Weak acids C. Strong bases D. Weak bases

B. Weak acids

The bicarbonate buffer system consists of a bicarbonate salt and which of the following? A. Weak acid B. Strong acid C. Weak base D. Strong base

A. Weak acid

Which of the following buffer systems is the most important extracellular buffer systems? A. Phosphate buffer system B. Carbonate buffer system C. Bicarbonate buffer system D. Hemoglobin buffer system

C. Bicarbonate buffer system

Most bicarbonate reabsorption occurs in which of the following parts of the renal tubule? A. Proximal tubule B. Descending limb of Henle C. Ascending limb of Henle D. Distal tubule

A. Proximal tubule

Which of the following occurs when a decrease in bicarbonate ion results in a decrease in the ratio of bicarbonate ion to carbon dioxide in the extracellular fluid? A. Respiratory acidosis B. Respiratory alkalosis C. Metabolic acidosis D. Metabolic alkalosis

C. Metabolic acidosis

Respiratory alkalosis due to a decrease in carbon dioxide concentration caused by hyperventilation is compensated for by which of the following mechanisms? A. Increased ventilation rate B. Decreased ventilation rate C. Renal excretion of bicarbonate ion D. Renal addition of new bicarbonate ion to extracellular fluid

C. Renal excretion of bicarbonate ion

Which of the following would be a result of increased levels of angiotensin II? A. Decreased blood pressure B. Increased vasoconstriction C. Increased natriuresis D. Decreased aldosterone levels

B. Increased vasoconstriction

A 1-sodium, 2-chloride, 1-potassium co-transporter is found in the luminal membrane of which part of the renal tubule? A. Proximal convoluted tubule B. Thin descending limb of Henle C. Thick ascending limb of Henle D. Distal convoluted tubule

C. Thick ascending limb of Henle

If tidal volume is 0.5 liters, dead space is 0.15 liters, and breathing rate is 12 times per minute; calculate the minute ventilation A. 1.8 liters B. 4.0 liters C. 6.0 liters D. 7.8 liters

C. 6.0 liters??

The solubility of oxygen = 0.024; the solubility of carbon dioxide = 0.057. Because carbon dioxide is more soluble in water than oxygen, it will exert a partial pressure ( for a given concentration) that is less than 1/20th that of oxygen. This relationship between partial pressures and solubility illustrates which of the following gas laws? A. Henry's B. Boyle's C. Dalton's D. Euclid's

A. Henry's

``` If tidal volume is 0.5 liters, dead space is 0.15 liters, and breathing rate is 12 times per minute; calculate the minute alveolar ventilation A. 1.8 liters B. 3.5 liters C. 4.2 liters D. 6.0 liters ```

C. 4.2 liters

Humidification of air in the alveoli has which of the following effects on the partial pressures of nitrogen and oxygen in the alveoli? A. It increases the partial pressure of each of the other gases. B. It decreases the parital pressures of each of the other gases. C. It has no effect on the partial pressures of each of ther other gases. D. It increases the partial pressure of oxygen but decreases the partial pressure of nitrogen in alveolar air.

B. It decreases the partial pressures of each of the other gases.

The range in the pressure change (in cm of water) in alveolar pressure during inspiration is expressed by which of the following? A. 0 to -1 B. -5 to -7.5 C. -7.5 to -5. D. -1 to 0

A. 0 to -1

What would be the Va/Q ratio for alveolar air with a P02 of 104 and a PCO2 of 40? A. 2.5 B. 0.8 C. 0 D. infinity

B. 0.8

Which of the following would be characteristic of alveoli lacking perfusion as in the case of pulmonary embolism? A. Va/Q ratio = infinity B. Va/Q = 0 C. Blood gas composition remains unchanged D. Both A and C are characteristic

A. Va/Q ratio = infinity

Under normal conditions at rest, which of the following patterns regarding pulmonary blood flow would be most likely? A. Apices: zone 1; middle part of lungs: zone 1; Lower part of lungs: Zone 3 B. Apices: zone 2; middle part of lungs: zone 2; lower part of lungs: zone 3 C. Apices: zone 2; middle part of the lungs: zone 3; Lower part of the lungs: zone 3 D. Apices: zone 3; Middle part of the lungs: zone 2; lower part of the lungs: zone1

C.Apices: zone 2; middle part of the lungs: zone 3; Lower part of the lungs: zone 3

The pulmonary circulation can be divided into two systems. Which of the following describes the system supplying the trachea, bronchial tree and rest of the interstitium? A. High pressure - Low flow B. High pressure - High flow C. Low pressure - low flow D. Low pressure - high flow

A. High pressure - Low flow

Which of the following represents the mean pulmonary arterial pressure in mmHG? A. 7 B. 15 C. 25 D. 125

B. 15

The most common cause of pulmonary edema is left sided heart failure or mitral valve disease. Pulmonary edema occurs when pulmonary capillary pressure exceeds which of the following levels? A. 07 mmHg B. 15 mmHg C. 20 mmHg D. 25 mmHg

D. 25 mmHg

High potassium intake greatly increases the potassium secretion rate even at low tubular flow rates. Which of the following best describes the effect of high sodium intake on potassium secretion rate by the kidneys? A. High sodium intake greatly increases potassium secretion B. high sodium intake greatly decreases potassium secretion C. Rate of potassium secretion depends directly on ADH and indirectly on sodium intake D. High sodium intake has little effect on potassium secretion

D. High sodium intake has little effect on potassium secretion

``` About 80 mEq of nonvolatile acid is formed by metabolism per day. The minimal urie hyddrogen ion concentration is about 0.03 mEq/L. What would be the approximate volume of urine required to be excreted if all the excess hydrogen ion remained free in solution? A. 1.5 L/day B. 180 L/day C. 2700 L/day D. 4500 L/day ```

C. 2700 L/day

Which of the following are sensory endings (C fibers) in the alveolar wall next to pulmonary capillaries that are sensitive to pulmonary edema? A. Slow-adapting pulmonary stretch receptors B. Rapidly -adapting pulmonary stretch receptors C. J receptors D. Hering Breuer receptors

C. J receptors

``` Which of the following represents the oxygen utilization coefficient at rest? A. 15% B. 25% C. 50% D. 75% ```

B. 25%

``` What is the lowest limit of pH that can be achieved in the normal kidney? A. 6.5 B. 5.0 C. 4.5 D. 2.5 ```

C. 4.5

``` Which of the following factors decreases potassium uptake by cells? A. Aldosterone B. Metabolic acidosis C. Insulin D. Catecholamines ```

B. Metabolic acidosis

``` A hydrogen-transporting ATPase is first encountered in which of the following parts of the renal tubule? A. Proximal convoluted tubule B. Descending limb of Henle C. Ascending limb of Henle D. Distal convoluted tubule ```

D. Distal convoluted tubule

Normally, how much hydrogen ion must be secreted each day in order to reabsorb 4320 mEq of filtered bicarbonate? A. 2160 mEq B. 4320 mEq C. 8640 mEq D. The two processes of independent of one another

B. 4320 mEq

Decreased concentrations of calcium ion in the plasma would have a direct effect on which of the following? A. Activation of vitamin D3 B. Increase in interstinal calcium ion reabsorption C. Increase in release of parathyroid hormone D. Release of calcium ion from bones

C. Increase in release of parathyroid hormone

``` In a normal individual, which of the following represents the transport maximum for glucose? A. 125 mg/min B. 250 mg/min C. 375 mg/min D. 500 mg/min ```

C. 375 mg/min

``` Which of the following represents a substance that is actively secreted into the renal tubules? A. Urea B. Angiotensin II C. Creatinine D. ADP ```

C. Creatinine

Which of the following best describes the capillary filtration coefficient? A. Average diameters of the glomerular capillaries B. Mean of the capillary pressure within the glomerulus C. Product of the permeability and filtering surface area of the glomerular capillaries D. Mean of the hydrostatic pressure within the glomerular capillaries

C. Product of the permeability and filtering surface area of the glomerular capillaries

``` Which of the following is a vasodilator that may help to offset the effects of vasoconstrictors, especially on afferent arterioles? A. Bradykinin B. Endothelin C. Angiotensin II D. Norepinephrine ```

A. Bradykinin

Much of the oxygen consumed by the kidneys is related to which of the following factors? A. High rate of glucose reabsorption B. High rate of active sodium reabsorption C. High rate of active potassium reabsorption D. High rate of active amino acid reabsorption

B. High rate of active sodium reabsorption

``` Which of the following is responsible for partially inhibiting micturition except when micturition is desired? A. Parasympathetic system B. Sympathetic system C. Pudenal nerves D. Pelvic splanchnic nerves ```

C. Pudenal nerves

``` Without autoregulation, a slight increase in blood pressure could increase GFR up to 225 L/day. How much would this increase urine flow (excretion)? A. 20.0 L/day B. 32.7 L/day C. 46.5 L/day D. 180.0 L/day ```

C. 46.5 L/day

``` What is the partial pressure of oxygen in mmHg at the alveolar membrane if the percentage of oxygen in the alveoli is 20 percent? A. 75 B. 122 C. 152 D. 266 ```

C. 152

Using the FLick principle for calculating the cardiac output, the patient's resting oxygen consumption volume should be divided by which of the following? A. The difference between the oxygen concentration in the systemic arterial blood and the systemic mixed venous blood. B. The difference between the oxygen concentration in the systemic arterial blood and the pulmonary vein. C. The difference between the oxygen concentration in the systemic mixed venous blood and the pulmonary vein. D. The difference between the oxygen concentration in the systemic mixed venous blood and the pulmonary artery.

A. The difference between the oxygen concentration in the systemic arterial blood and the systemic mixed venous blood.

``` What is the glomerular filtration rate if the urine concentration rate of a substance is 125 mg/ml; the flow rate is 2 ml/min; and the plasma concentration of the substance is 1 mg/ml A. 10 B. 25 C. 125 D. 250 ```

D. 250

Almost 90 percent of glucose reabsorption occurs in the early proximal tubule. WHich of the following mechanisms is responsible for moving glucose from the tubular lumen into the cytoplasmic compartment? A. Primary active transport via a glucose ATPase pump. B. Secondary active transport via a sodium/glucose cotransporter. C. Secondary active transport via a sodium/glucose antiporter. D. Diffusion due to concentration differences between tubular fluid and cytoplasm.

B. Secondary active transport via a sodium/glucose cotransporter

``` A 24-year old woman presents to the emergency department with severe diarrhea. When she is supine,, her blood pressure is 90/60 mm Hg (decreased) and her heart rate is 100 bpm (increased). When she is moved to a standing position, her heart rate increases to 120 bpm. Which of the following accounts for the further increase in heart rate upon standing? A. Decreased total peripheral resistance B. Increased vasoconstriction C. Increased afterload D. Decreased venous return ```

D. Decreased venous return

Which of the following results in hypokalemia? A. Cell lysis B. Excess secretion of aldosterone C. Strenuous exercise D. Increased extracellular fluid osmolarity

B. Excess secretion of aldosterone

``` An increase in which of the following factors will result in a decrease in glomerular hydrostatic pressure? A. Arterial pressure B. Afferent arteriolar resistance C. Efferent arteriolar resistance D. Both B and C E. All of the Above ```

B. Afferent arteriolar resistance

``` Which of the following centers acts to control the "switch-off" point of the inspiratory ramp signal? A. Dorsal respiratory group B. Pneumotaxic center C. Ventral respiratory group D. Aortic body ```

B. Pneumotaxic center

``` ADH is formed in the supraoptic and paraventricular nuclei. It is secreted by specialized neurons from which of the following areas? A. Adrenal cortex B. Adrenal medulla C. Anterior pituitary D. Posterior pituitary ```

D. Posterior pituitary

``` A normal 70 kg human must excrete about 600 mOsm of solute each day in order to get rid of waste products of etabolism and ions that are ingested. The maximal urine concentrating ability is 1200 mOsm/L. Which of the following represents the obligatory urine volume that must be exreted each day to get rid of metabolic waste products? A. 1.0 L/day B. 0.5 L/day C. 0.3 L/day D. 0.0 L/day ```

B. 0.5 L/day

``` ADH acts on which of the following regions of the nephron? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Distal convoluted tubule ```

D. Distal convoluted tubule

``` Which of the following reflects the amount of urine that the kidneys can excrete per day when there is a large excess of water? A. 180 liters B. 75 liters C. 20 liters D. 4 liters ```

C. 20 liters

``` Which of the following reflects the maximum urine concentration that can be produced by the kidneys? A. 6000-7000 mOsm/L B. 5500-6000 mOsm/L C. 1200-1400 mOsm/L D. 2000-2400 mOsm/L ```

C. 1200-1400 mOsm/L

``` Because of paracellular diffusion of ions back into the tubule, what is the upper limit of the concentration gradient created by the countercurrent multiplier mechanism? A. 1200 mOsm/L B. 600 mOsm/L C. 400 mOsm/L D. 200 mOsm/L ```

D. 200 mOsm/L

Osmoreceptor cells are located in which of the following regions? A. Adjacent to carotid bodies B. In the macula densa C. In the anterior part of the third ventricle D. In the distal collecting ducts

C. In the anterior part of the third ventricle

Which of the following would NOT shift the oxygen-hemoglobin curve to the right and downward? A. A decrease in pH B. An increase in carbon dioxide C. An increase in temperature D. A decrease is BPG (bi-phosphoglycerate)

D. A decrease in BPG (bi-phosphoglycerate)

``` What percentage of carbon dioxide is carried in the blood as bicarbonate? A. 5% B. 25% C. 30% D. 70% ```

D. 70%

``` Which respiratory control center is primarily responsible for establishing the ramp signal during normal breathing? A. Dorsal respiratory group B. Pneumotaxic center C. Ventral respiratory center D. Carotid body ```

A. Dorsal respiratory group

``` What is the source of the hormone aldosterone? A. Juxtaglomerular cells B. Principal cells C. Adrenal cortex D. Liver ```

C. Adrenal cortex

Magnesium and calcium are reabsorbed from the tubular lumen through which of the following mechanisms? A. Antiport with sodium ions B. Active transport via transporters in basal membrane C. Paracellular transport due to negative charge in tubular lumen D. Paracellular transport due to negative charge in interstitium

C. Paracellular transport due to negative charge in tubular lumen

``` Shrinkage of osmoreceptor cells in the anterior hypothalamus in response to an increase in extracellular fluid osmolarity leads to the release of which of the following? A. ALdosterone B. Angiotensin I C. Angiotensin II D. ADH ```

D. ADH

Chemoreceptors associated with respiratory functions increase their rate of activity when hypoxia or hypercapnia occur. A. TRUE B. FALSE

A. TRUE

``` Most of the filtered electrolytes are reabsorbed in which of the following regions of the kidney tubule? A. Proximal convoluted tubule B. Descending loop of Henle C. Ascending loop of Henle D. Early collecting duct ```

A. Proximal convoluted tubule

``` The lower pH of the tubular fluid brings the operating range of the buffer closer to the pK of which of the following systems? A. Bicarbonate B. Phospahte C. Carbonic acid D. Proteins ```

B. Phosphate

Which of the following would NOT be true regarding the Haldane effect? A. Binding of oxygen with hemoglobin displaces carbon dioxide from blood. B. Binding of oxygen causes hemoglobin to become a stronger acid. C. Increased acidity of hemoglobin causes it to release hydrogen ions. D. Oxygen-hemoglobin dissociation curve shifts to the right.

D. Oxygen-hemoglobin dissociation curve shifts to the right.

Which of the following must happen before filtered bicarbonate can be reabsorbed? A. Kidneys must secrete new bicarbonate ion. B. Kidneys must reabsorb hydrogen ions. C. Kidneys must secrete carbonic anhydrase. D. Filtered bicarbonate must react with secreted hydrogen ion to form carbonic acid.

D. Filtered bicarbonate must react with secreted hydrogen ion to form carbonic acid.

Which of the following segments of the nephron is NOT permeable to water? A. Proximal convoluted tubule in the presence of ADH B. Descending loop of Henle in the presence ofADH C. Ascending loop of Henle in the presence of ADH D. Distal convoluted tubule in the presence of ADH

C. Ascending loop of Henle in the presence of ADH