Charlotte Jakes
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Principles of Physiology and Pharmacology Quiz on Kidney Function: Producing Dilute Urine, created by Charlotte Jakes on 24/12/2019.

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Charlotte Jakes
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Kidney Function: Producing Dilute Urine

Question 1 of 42

1

How much waste are we obliged to eliminate in urine per day?

Select one of the following:

  • 600mosmol

  • 600osmol

  • 800mosmol

  • 1osmol

Explanation

Question 2 of 42

1

What is the maximum urinary osmolarity possible?

Select one of the following:

  • 1400mosm/l

  • 140mosm/l

  • 14osm/l

  • 1.4mosm/l

Explanation

Question 3 of 42

1

How much urine are we obliged to produce per day if we need to eliminate 600mosmol but can only produce urine concentrated up to 1400mosm/l?

Select one of the following:

  • 600/1400 = 0.428l

  • 600/1400 = 0.428ml

  • 600 x 1400 = 840,000ml

  • 1400/600 = 2.3l

Explanation

Question 4 of 42

1

What is oliguria?

Select one of the following:

  • Daily urine output of less than 0.428l

  • Daily urine output of more than 0.428l

  • Hourly urine output of less than 0.428l

  • The presence of starch in the urine

Explanation

Question 5 of 42

1

What is polyuria?

Select one of the following:

  • Urinary output above 3l per day

  • Urinary output below 3l per day

  • Urinary concentration of over 300mosmol/litre

  • Urinary concentration of less than 300/mosmol/litre

Explanation

Question 6 of 42

1

Why do we consider urine dilute when it has a concentration of less than 300mosmol/litre?

Select one of the following:

  • The osmolality of plasma is 300mosmol/l

  • The osmolality of the filtrate is 300mosmol/l

  • The osmolality of interstitial fluid is 300mosmol/l

  • The osmolality of intracellular fluid is 300mosmol/l

Explanation

Question 7 of 42

1

What is the name given to the volume of plasma cleared of osmotically active particles per unit time?

Select one of the following:

  • Osmolar clearance

  • Free water clearance

  • Renal clearance

  • Reabsorption

Explanation

Question 8 of 42

1

What is the correct equation for osmolar clearance if...
V = urine flow rate
Uosm = urine osmolarity
Posm = plasma osmolarity

Select one of the following:

  • (Uosm x V) / Posm

  • (Uosm x Posm) / V

  • (Uosm + Posm) / V

  • Uosm x Posm x V

Explanation

Question 9 of 42

1

What is the correct equation for free water clerance if...
V = urine flow rate
Uosm = urine osmolarity
Posm = plasma osmolarity

Select one of the following:

  • V - (Uosm x V)/Posm

  • V + (Uosm x V)/Posm

  • V + (Uosm x Posm)/V

  • V - V/(Uosm x Posm)

Explanation

Question 10 of 42

1

Fill the blank spaces to complete the text.

If free water clearance is greater than 0, the urine will be hypo-osmotic or .
If free water clearance is 0, the urine will be -osmotic with respect to .
If free water clearance is less than 0, the urine will be -osmotic or concentrated.

Explanation

Question 11 of 42

1

Where are the osmoreceptors found in the brain?

Select one or more of the following:

  • Organum vasculosum lamina terminalus

  • Median preoptic nucleus

  • Subfomical organ

  • Posterior pituitary

  • Paraventricular nuclei

  • Supraoptic nuclei

Explanation

Question 12 of 42

1

Fill the blank spaces to complete the text.

Fill in the blanks below to describe the release of ADH.
1. When plasma osmolality is , receptors in the o, m and s signal to neurosecretory cells in the and nuclei in the .
2. The nuclei synthesise a of ADH
3. The is passed into axons of neurons where it is cleaved into a amino acid ADH molecule in the
4. ADH is released into the blood of the artery to be targeted to the

Explanation

Question 13 of 42

1

ADH has a long half life in the blood.

Select one of the following:

  • True
  • False

Explanation

Question 14 of 42

1

Alcohol inhibits ADH secretion.

Select one of the following:

  • True
  • False

Explanation

Question 15 of 42

1

Nicotine, nausea, pain and stress stimulate ADH secretion.

Select one of the following:

  • True
  • False

Explanation

Question 16 of 42

1

Which factor is ADH secretion most sensitive to?

Select one of the following:

  • Plasma osmolality

  • Blood pressure

  • Blood volume

  • Blood temperature

Explanation

Question 17 of 42

1

What symptoms characterise diabetes insipidus?

Select one of the following:

  • Polyuria, polydipsia and nocturia

  • Oliguria, hematuria

  • Polydipsia, oliguria, dehydration

  • Jaundice, hematuria

Explanation

Question 18 of 42

1

What is neurogenic diabetes insipidus?

Select one of the following:

  • Lack of ADH secretion due to a congenital brain defect or head injury

  • Mutated V2 receptors or aquaporins

  • Caused by side effect of drugs or infection

  • Increased urination due to small molecules in renal tubule lumen causing excess water reabsorption

Explanation

Question 19 of 42

1

What name is given to diabetes insipidus caused by mutated V2 receptors or aquaporin channels OR acquired by infection or drug use?

Select one of the following:

  • Nephrogenic diabetes insipidus

  • Inflammatory diabetes insipidus

  • Neurogenic diabetes insipidus

  • Mutagenic diabetes insipidus

Explanation

Question 20 of 42

1

What condition is typical of diabetes mellitus whereby the presence of small molecules in the renal tubule prevents water reabsorption causing production of large quantities of dilute urine?

Select one of the following:

  • Osmotic diuresis

  • Neurogenic diabetes insipidus

  • Oliguria

  • Hematuria

Explanation

Question 21 of 42

1

Fill the blank spaces to complete the text.

Potassium has a concentration of mM in the extracellular fluid and mM in the intracellular fluid.

Explanation

Question 22 of 42

1

Fill the blank spaces to complete the text.

In the proximal tubule, the Na+/K+ moves potassium ions the epithelial cell. This concentration gradient draws potassium into the epithelial cell from the and out into the fluid via proteins. Potassium can also diffuse between cells via .

Explanation

Question 23 of 42

1

How does potassium enter the epithelial cells of the thick ascending limb of the loop of Henle?

Select one of the following:

  • Na+/K+/2Cl- transporter

  • Na+/K+ ATPase

  • Renal outer medullar K+ channel (ROMK)

  • K+/H+ ATPase

Explanation

Question 24 of 42

1

How does potassium enter the epithelial cells of the distal tubule?

Select one of the following:

  • K+/H+ exchanger

  • Na+/K+ ATPase

  • Na+/K+/2Cl ATPase

  • Renal outer medullar K+ channel (ROMK)

Explanation

Question 25 of 42

1

Fill the blank spaces to complete the text.

In the collecting duct, potassium is reabsorbed by intercalated cells in exchange for ions. This is outweighed by by the cells. In the principal cells, potassium moves out of the epithelium via (ROMKs). It also moves out through -activated big- K+ channels when tubular flow rates are . The K+/ transporter also removes potassium from the cell.

Explanation

Question 26 of 42

1

If more sodium enters the principal cells in the collecting duct epithelium, what happens to the secretion of potassium?

Select one of the following:

  • Increases because the filtrate becomes less positively charged

  • Increases because the filtrate becomes more positively charged

  • Decreases because the filtrate becomes more positively charged

  • Decreases because the filtrate becomes less positively charged

Explanation

Question 27 of 42

1

What hormone stimulations the K+ channels, Na+ channels and Na+/K+ ATPases of the collecting duct to increase secretion?

Select one of the following:

  • Aldosterone

  • ADH

  • Adrenaline

  • Testosterone

Explanation

Question 28 of 42

1

Which favours secretion more?

Select one of the following:

  • High tubular flow rates

  • Low tubular flow rates

Explanation

Question 29 of 42

1

What is hypokalaemia?

Select one of the following:

  • Plasma potassium concentration of less than 3.5mM

  • Plasma potassium concentration of more than 3.5mM

  • Intracellular potassium concentration of more than 3.5mM

  • Urinary potassium concentration of less than 3.5mM

Explanation

Question 30 of 42

1

Fill the blank spaces to complete the text.

Hypokalaemia can occur due to increased internal losses.
For example, in the kidney, tubular flow rates favour rates of potassium . Hyperaldosteronism the activity of the potassium channels, favouring potassium . Alkalosis is also associated with hypokalaemia because potassium is secreted due to changed in .
In the GI tract, vomiting and can cause excess potassium loss.
Potassium can be lost from the skin due to burns or intense .

Explanation

Question 31 of 42

1

How does insulin affect potassium uptake in cells?

Select one of the following:

  • Activates Na+/K+ ATPase

  • Deactivates Na+/K+ ATPase

  • Activates K+ channels

  • Activates Na+/H+ channels

Explanation

Question 32 of 42

1

Why does potassium intake into cells increase due to metabolic alkalosis?

Select one of the following:

  • H+ ions bound to buffers leave cells, K+ enter to maintain charge

  • H+ ions bound to buffers enter cells, K+ leave to maintain charge

  • K+ ions act as buffers to reduce plasma pH

  • K+ ions are exchanged for H+ on the K+/H+ exchanger

Explanation

Question 33 of 42

1

What is severe hypokalaemia?

Select one of the following:

  • < 2.5mM

  • > 2.5mM

  • < 3.5 mM

  • < 5 mM

Explanation

Question 34 of 42

1

Fill the blank spaces to complete the text.

In hypokalaemia, membrane potentials become more . Therefore, a larger intake of is required to exceed the and fire an . Therefore, action potentials are less likely to fire and the period is so muscles become weak and paralysed.

Explanation

Question 35 of 42

1

What is hyperkalaemia?

Select one of the following:

  • > 5.5mM

  • < 5.5mM

  • < 3.5 mM

  • > 3.5 mM

Explanation

Question 36 of 42

1

Reduced release of what hormone can cause hyperkalaemia?

Select one of the following:

  • Aldosterone

  • Adrenaline

  • ADH

  • Oestrogen

Explanation

Question 37 of 42

1

Hyperkalaemia can be caused by redistribution of potassium out of cells. Check the two specific examples of this.

Select one or more of the following:

  • Renal failure

  • Hypoaldosteronism

  • Action of drugs

  • Acidosis

  • Tissue destruction/cell lysis

Explanation

Question 38 of 42

1

Fill the blank spaces to complete the text.

In hyperkalaemia, the resting membrane potential becomes more . This means less is required to exceed the and fire an . Action potentials are likely to fire, causing hyperreflexia and of the muscles.

Explanation

Question 39 of 42

1

What can we administer intravenously to treat hyperkalaemia to decrease the action potential threshold in the heart?

Select one of the following:

  • Na+

  • K+

  • Ca2+

  • Acetylcholine

Explanation

Question 40 of 42

1

Which drug could we administer during hyperkalaemia to shift K+ into cells?

Select one of the following:

  • Insulin

  • Glucagon

  • Adrenaline

  • Diuretics

Explanation

Question 41 of 42

1

Of the treatments listed below, which are appropriate for treating hypokalaemia?

Select one or more of the following:

  • Eating potassium-rich foods

  • Oral or IV administration of KCl

  • Correction of alkalosis

  • Use of K+-sparing diuretics

  • Administration of insulin

  • IV Ca2+

  • IV Na+

Explanation

Question 42 of 42

1

What is severe hyperkalaemia?

Select one of the following:

  • > 7.5mM

  • < 7.5mM

  • > 5.5mM

  • < 5.5mM

Explanation

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