TERM EXAM - MIDTERM Flashcards
How do kidneys make use
of the secreted H+?
a. used to reclaim most of filtered HCO3 b. Titrate renal buffers c. generate new HCO3 d. all of the choices e. except C
c. generate new HCO3
H+ fates: 1) Titrate with filtered HCO3- 2) Titrate with filtered phosphate (or other filtered buffers in 9tratable acid) 3) Titrate with NH3 (both secreted and filtered)
- In a patient with 11B-HSD2 deficiency, they are expected to have the following findings
hypokalemia, hypertension
and abnormal Na retention
11B-HSD2 Deficiency = Apparent Mineralocorticoid Excess (AME) = Abnormal Na+ retention, Hypokalemia, Hypertension
The following is/are true
about a cystometrogram,
except:
a. it is a test used to record the relationship between bladder volume and intravesical pressure b. once the bladder is empty, pressure is recorded while filling it with ~50mL increments of water c. Procedure starts by inserting a catheter through the urethra and emptying the bladder d. No exception
b. once the bladder is empty,
pressure is recorded while
filling it with ~50mL
increments of water
Ratio: A. Bladder tone is defined by the relationship between bladder volume and internal (intravesical) pressure. The record of the relationship between volume and pressure is a cystometrogram B. FALSE. [One first senses the urge for voluntary bladder emptying at a volume of ~150 mL] C. One can measure the volume-pressure relationship by first inserting a catheter through the urethra and emptying the bladder, and then recording the pressure while filling the bladder with 50-mL increments of water.
- long-term lack of potassium
can lead to several metabolic
disturbances such as the
following, except:
a. enhance secretion of ammonium in the kidneys b. high tendency to develop metabolic alkalosis c. inability to balance potassium homeostasis between the external and internal environment d. kidneys not being able to form a concentrated urine e. NOTA
c. inability to balance
potassium homeostasis
between the external and
internal environment
Ratio:
Chronic K+ depletion leads to several metabolic disturbances.
These include the following: (1) inability of the kidney to form a concentrated urine; (2) a tendency to develop metabolic alkalosis; and, closely related to this acid-base disturbance, (3) a striking enhancement of renal ammonium excretion (p792)
A. TRUE
B. TRUE
C. wala siya’y apil
D. TRUE
which of the following clinical examples in which reduced ECV can lead to inappropriate increase in AVP levels? a. severe hemorrhagic shock b. hypovolemic shock a. congestive heart failure b. all of the choices c. NOTA
a. congestive heart failure
- entry of sodium in the first
half proximal tubule is thru:
a. apical membrane via NA2+ coupled electrogenic cotransporter
b. basolateral membrane via
Na-K exchanger 3 (NHE3)
c. basolateral membrane via
electrogenic Na/HCO3
cotransporter 1 (NBCe1)
a. all of the choice
a. all of the choice
medullary trapping of K is
the result of steps happening in the nephron, such as the following,except:
a. passive secretion of K into tDLH by juxtamedullary nephrons a. K reabsorption by tALH TAL depositing k in medulla b. reabsorption of K by MCD c. K secretion in tDLH also known as medullary K recycling d. NOTA
a. passive secretion of K into
tDLH by juxtamedullary
nephrons
Ratio Medullary K+ Trapping is the result of 3 steps: 1) secrete K+ passively into tDLH — “MEDULLARY K+ RECYCLING” 2) K+ reabsorp9on by tALH and TAL — deposited in medullary interstitium 3) Reabsorption of K+ by MCD
two separate but closely
interrelated control systems
regulate the volume and
osmolality of ECF. how will the body regulate extracellular osmolality:
a. monitoring and adjusting the total body content of NaCl a. monitoring and adjus5ng the total body water content
a. monitoring and adjusting
the total body water
content
Ratio: The body regulates extracellular osmolality by adjusting total body water content chapter 40 page836
these are the site of reabsorption of calcium, except a. proximal tubule a. collecting duct b. TAL c. DCT
a. collecting duct
Ratio: Kidney REABSORBS ~99% of the filtered load of CALCIUM principally at PROXIMAL TUBULE (2/3 of calcium) and the remainder at TAL and DCT chapter 36 page 787
- a 6 year old female had
acute gastroenteritis with
severe dehydration and serum BUN was done. what is the expected result of serum BUN and physiologic mechanism?
a. increase urine flow — increase water reabsorp9on — increase urea reabsorp9on — increase serum UREA
b. decrease urine flow —
decrease water secre9on —
decrease urea reabsorp9on
— increase serum urea
c. decrease urine flow —
increase water reabsorp9on
— decrease urea secre9on
— increase serum urea
d. increase urine flow —
increase water reabsorp9on
— increase urea
reabsorp9on
c. decrease urine flow —
increase water reabsorption
— decrease urea secretion
— increase serum urea
large organic molecules such as proteins are not usually found in a. interstitial fluid b. intracellular fluid c. plasma
b. intracellular fluid
Ratio:
ECF are constantly mixing, so that the plasma and interstitial
fluids have about the same
composition except for proteins, which have a higher concentration in the plasma.
(ppt, 2020)
- which of the following is
correct:
a. MCD — countercurrent multiplier, Loop of henle — countercurrent exchanger, loop-shaped vasa recta — straight tube exchanger
B. loop of henle — countercurrent multiplier; loop-shaped vasa recta — countercurrent exchanger, MCD — straight tube exchanger
B. loop of henle — countercurrent multiplier; loop-shaped vasa recta — countercurrent exchanger, MCD — straight tube exchanger
Ratio:
Loop of henle acts as
COUNTERCURRENT
MULTIPLIER, loop-shaped vasa recta acts as COUNTERCURRENT EXCHANGER, the MCD acts as an unlooped or STRAIGHT-TUBE EXCHANGER.
The following are TRUE of
the role of nephrons in acidbase
transport, except:
a. most nephron segments secrete H+ to a varying degree b. nephron reclaims virtually all the filtered bicarbonate a. nephron generates new HCO3 mostly in the proximal tubule b. nephrons 9trate secreted NH3 which is responsible to less than half of net acid excre9on of new HCO3 in healthy people
a. nephron generates new
HCO3 mostly in the
proximal tubule
Ratio:
NEPHRON RECLAIMS virtually all the FILTERED HCO3 in the PROXIMAL TUBULE (~80%), TAL (~10%), DISTAL NEPHRON
(~10%) NEPHRON REGENERATES NEW HCO3, mostly in the PROXIMAL TUBULE
chapter 39
page 825
TRUE of sodium transport:
a. in transcellular pathway,
passive entry of Na in the
basolateral area thru
electrochemical gradient
a. in the trancellular pathway,
active extrusion of sodium
out of the cell across the
basolateral membrane
b. in paracellular pathway, the net driving force is NEGATIVE—favoring passive Na reabsorp9on—only in the S2 and S3 segment of PT and in TAL
a. in the trancellular pathway,
active extrusion of sodium
out of the cell across the
basolateral membrane
what is the most important
transporter of H+ from tubule cell to lumen (secretion)
a. ENaC
a. Na-H exchanger
b. H-K exchange pump
c. electrogenic H+ pump
a. Na-H exchanger
Renal kallikrein is produced in which epithelial element of the nephron:
a. Connecting tubule CNT
a. initial collecting tubule ICT
b. cortical collecting tubule
CCT
c. proximal convoluted tubule PCT
a. Connecting tubule CNT
