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Renal Physiology- Physiology PMU- 2nd Year, 2nd Semester

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Renal Physiology- Physiology PMU- 2nd Year, 2nd Semester

Renal Physiology- Physiology PMU- 2nd Year, 2nd Semester

Question 1 of 69

1

The nephron:

Select one of the following:

  • has endocrine functions

  • is lined by a single layer of epithelial cells

  • is under endocrine control

  • absorbs more ions and molecules than it secretes

  • all of the above

Explanation

Question 2 of 69

1

The control of water excretion in the kidney is controlled by:

Select one of the following:

  • the antidiuretic hormone (ADH)

  • the medulla oblongata

  • blood plasma

  • sodium amount in the blood

  • potassium amount in the blood

Explanation

Question 3 of 69

1

The kidneys have a direct effect on which of the following?

Select one of the following:

  • blood pressure

  • how much water a person excretes

  • total blood volume

  • pH

  • all of the above

Explanation

Question 4 of 69

1

Glucose reabsorption occurs in the:

Select one of the following:

  • proximal tubule

  • loop of Henle

  • distal tubule

  • cortical collecting duct

  • medullary collecting duct

Explanation

Question 5 of 69

1

Renin is secreted by:

Select one of the following:

  • cells in the macula densa

  • cells in the proximal tubule

  • cells in the distal tubule

  • juxtaglomerular cells

  • cells in the peritubular capillary bed

Explanation

Question 6 of 69

1

Renin release:

Select one of the following:

  • is promoted by reduced arteriolar stretch in. the glomeruli

  • increases when systemic arterial pressure rises

  • directly activates angiotensin converting enzyme

  • tends to expand the plasma volume

  • a and d

Explanation

Question 7 of 69

1

The glomerulus:

Select one of the following:

  • has both afferent and efferent arterioles

  • contains capillaries, which are at a higher hydrostatic pressure than the peritubular capillaries

  • filters 20% of the renal plasma flow

  • contains renin-secreting cells

  • all of the above

Explanation

Question 8 of 69

1

The acid-buffering power:

Select one of the following:

  • of HCO3- in blood is increased by respiratory control of pCO2

  • of haemoglobin exceeds that of HCO3- in blood

  • of HCO3- is increased by the action of carbonic anhydrase

  • of venous blood is normally greater than that of arterial blood

  • a, b, and d

Explanation

Question 9 of 69

1

Urinary volume is increased with:

Select one of the following:

  • consumption of alcohol

  • hyperglycemia

  • increased aldosterone secretion

  • damage to the posterior pituitary

  • a, b, and d

Explanation

Question 10 of 69

1

The following occurs in the proximal tubule of the nephron:

Select one of the following:

  • reabsorption of all glucose

  • reabsorption of most water

  • active reabsorption of sodium

  • secretion of bicarbonate

  • a, b, and c

Explanation

Question 11 of 69

1

The antidiuretic hormone (ADH):

Select one of the following:

  • decreases the osmolarity of urine

  • decreases the volume of urine

  • increases the reabsorption of water in the proximal tubules

  • is synthesised in the posterior posterior pituitary gland

  • increases the excretion of glucose

Explanation

Question 12 of 69

1

Regarding the kidneys:

Select one of the following:

  • there are 1.3 million nephrons in each kidney

  • they produce aldosterone

  • they receive 12% of the cardiac output at rest

  • more blood flows through the renal cortex than the renal medulla

  • a, and d

Explanation

Question 13 of 69

1

Which of the following causes hyperkalemia

Select one of the following:

  • exercise

  • alkalosis

  • insulin injection

  • decreased serum osmolality

  • increased serum osmolality

Explanation

Question 14 of 69

1

Glucose is reabsorbed:

Select one of the following:

  • by active transport

  • by passive transport

  • by Na+ co-transport

  • by H+ counter-transport

  • a, and c

Explanation

Question 15 of 69

1

Simulation of the sympathetic nerves cause the following effects;

Select one of the following:

  • low diuresis

  • decreased net filtration pressure

  • increased glucose urine level

  • decreased glucose urine level

  • a, and b

Explanation

Question 16 of 69

1

The glomerular capillaries have the following functions:

Select one of the following:

  • blood plasma filtration

  • hormone secretion

  • water secretion

  • formation of primary urine

  • a, and d

Explanation

Question 17 of 69

1

Obligatory water loss from the body is:

Select one of the following:

  • 400 ml in faeces

  • 300 ml from the lungs

  • loss from skin & lungs

  • insensible water loss

  • 500 ml in urine

Explanation

Question 18 of 69

1

Blood flow at rest is most for:

Select one of the following:

  • brain

  • liver

  • kidneys

  • heart

  • skin

Explanation

Question 19 of 69

1

Renal blood flow is dependent on:

Select one of the following:

  • juxtaglomerular apparatus

  • [Na+] at macula densa

  • afferent vasodilatation

  • arterial pressure

  • efferent vasoconstriction

Explanation

Question 20 of 69

1

Which of the following substances has the highest renal clearance?

Select one of the following:

  • PAH

  • Glucose

  • Urea

  • Water

  • Insulin

Explanation

Question 21 of 69

1

The ascending limb of the loop of Henle is:

Select one of the following:

  • impermeable to Na+

  • involved in active transport of K+ into the lumen

  • involved in active transport of Cl- out of lumen

  • involved in active transport of Na+ into lumen

  • hypotonic at the top

Explanation

Question 22 of 69

1

Which of the following ls involved in the regulation of glomerular filtration rate (GFR)?

Select one of the following:

  • juxtaglomerular apparatus

  • afferent arteriolar tone

  • efferent arteriolar tone

  • chloride transport at the macula densa

  • all of the above

Explanation

Question 23 of 69

1

Water excretion by the kidney is due to:

Select one of the following:

  • osmosis

  • active transport into the lumen

  • passive secretion in the collecting tubule

  • solvent drag

  • facilitated diffusion

Explanation

Question 24 of 69

1

Kidneys produce:

Select one of the following:

  • Erythropoietin

  • ADH

  • Angiotensin ll

  • ANP

  • Cholecalciferol

Explanation

Question 25 of 69

1

Increase in GFR occurs when there is:

Select one of the following:

  • increased sympathetic stimulation

  • decreased renal blood flow

  • hypoproteinaemia

  • ureteric obstruction

  • none of the above

Explanation

Question 26 of 69

1

The clearance (or ‘renal regulation') of which one of the following is not regulated by a hormone:

Select one of the following:

  • sodium

  • potassium

  • calcium

  • phosphate

  • sulphate

Explanation

Question 27 of 69

1

The kidneys filter from the blood every day about:

Select one of the following:

  • 1000 ml

  • 180 l

  • 18 l

  • 50 l

  • 8 l

Explanation

Question 28 of 69

1

Direct control of water excretion in the kidney is controlled by:

Select one of the following:

  • the antidiuretic hormone

  • the medulla oblongata

  • aldosterone

  • sodium amounts in the blood

  • adrenal cortex

Explanation

Question 29 of 69

1

Kidneys have a direct effect on which of the following:

Select one of the following:

  • blood pressure

  • how much water a person excretes

  • total blood volume

  • pH

  • all of the above

Explanation

Question 30 of 69

1

The countercurrent exchange system includes:

Select one of the following:

  • glomerulus and macula densa

  • proximal convoluted tubule and distal convoluted tubule

  • loop of Henle and collecting tubule

  • afferent arteriole and efferent arteriole

  • ureters and bladder

Explanation

Question 31 of 69

1

Tubular reabsorption of a filtered substance is likely to be active rather than passive if:

Select one of the following:

  • its concentration in the tubular fluid is lower than in peritubular capillary blood

  • is carried out by the mechanism of simple diffusion

  • renal clearance is lower than that of insulin

  • renal clearance rises at low plasma levels

  • osmolality there is higher than the plasma one

Explanation

Question 32 of 69

1

The renal clearance of a substance:

Select one of the following:

  • is inversely related to its urinary concentration, U

  • is directly related to the rate of urine formation, and is expressed in units of volume per unit time

  • is directly related to its plasma concentration, P

  • is expressed in mm Hg

  • must fall in the presence of metabolic poisons

Explanation

Question 33 of 69

1

In the fluid in the distal part of the proximal convoluted tubule:

Select one of the following:

  • urea concentration is higher than in Bowman’s capsule

  • pH is less than 6 when the kidneys are excreting an acid urine

  • glucose concentration is similar to that in plasma

  • osmolality is about 25 per cent that of glomerular filtrate

  • bicarbonate concentration is higher than in plasma

Explanation

Question 34 of 69

1

Renal tubules normally reabsorb:

Select one of the following:

  • fluids with osmolality lower than the plasma one

  • all filtered HCO3- in respiratory alcalosis

  • substances closely related to Cl-

  • all filtered plasma proteins

  • more K+ and Cl-

Explanation

Question 35 of 69

1

In the nephron, the osmolarity or the fluid in the:

Select one of the following:

  • Tip of the loop Of Henle is less than that of plasma

  • Bowman's capsules is less than that in the distal tubules

  • Collecting duct rises when vasopressin is being secreted

  • Proximal convoluted tubule rises along its length

  • Proximal tubule is with lower osmolality than plasma one

Explanation

Question 36 of 69

1

Transport maximum (Tm) - limited reabsorption of a substance implies that its:

Select one of the following:

  • reabsorption is active

  • reabsorption is critically related to tubular transit time

  • reabsorption is passive

  • renal clearance falls with its plasma concentration

  • reabsorbtion is carried out by the mechanism of faciliated diffusion

Explanation

Question 37 of 69

1

When a patient’s mean arterial blood pressure falls by 50%

Select one of the following:

  • renal blood flow increases

  • glomerular filtration increases

  • there is a decrease in the circulating aldosterone level

  • renal vasoconstriction occurs

  • urinary output is increased

Explanation

Question 38 of 69

1

The cells of the distal convoluted tubule:

Select one of the following:

  • reabsorb about 50 % of the water filtered by the glomeruli

  • reabsorb all filtered aminoacide

  • reabsorb all filtered proteins

  • reabsorb sodium in exchange for hydrogen or potassium ions

  • determine the final composition of urine

Explanation

Question 39 of 69

1

Renal blood flow falls:

Select one of the following:

  • about 10 % when arterial pressure increases 10% above normal

  • about 5% when metabolic activity in the kidney falls by 5%

  • during emotional stress

  • after small haemorrhage

  • gradually from the inner medulla to the outer cortex per unit weight of tissue

Explanation

Question 40 of 69

1

Urea:

Select one of the following:

  • and glucose have different molar concentrations in normal blood

  • clearance is higher, than creatinins one

  • is actively secreted by the renal tubular cells into the tubular fluid

  • concentration in blood may rise ten-fold after a high protein meal

  • causes diuresis when its blood concentration is increased

Explanation

Question 41 of 69

1

The renal clearance of:

Select one of the following:

  • Inulin provides an estimate of glomerular filtration rate

  • Chloride increases after an injection of aldosterone

  • PAH falls when the PAH load exceeds the Tm for PAH

  • Urea is higher than that of insulin

  • Inulin is dependent of its plasma concentration

Explanation

Question 42 of 69

1

Aldosterone:

Select one of the following:

  • is a steroid hormone, secreted by the adrenal medulla

  • production ceases following removal of the kidneys and their juxtaglomerular cells

  • production decreases in treatment with drugs which block angiotensin-converting enzyme

  • secretion results in increased potassium reabsorption by the nephron

  • secretion results in a fall in plasma volume

Explanation

Question 43 of 69

1

In healthy people, urinary:

Select one of the following:

  • clearance of glucose differs 0, if its plasma concentration is below 11,1mmol.1-1

  • osmolality ranges from 200-400 mosmol/litre

  • colour is due to small quantities of bile pigments

  • pH falls as dietary protein rises

  • calcium excretion is decreased by parathormone

Explanation

Question 44 of 69

1

The renal clearance

Select one of the following:

  • glucose is above 0, if the plasma concentration of a given substance is below 11, mmol.1-1

  • of urea is higher than creatinin‘s one

  • of glucose provides an estimate of renal plasma flow

  • of phosphate is decreased by parathormone

  • of protein is normally zero

Explanation

Question 45 of 69

1

Secretion of renin:

Select one of the following:

  • occurs in the stomach during infancy

  • is stimulated by the hormone angiotensin 1

  • is stimulated by a fall in extracellular fluid volume and leads to raised levels of angiotensin II in the blood

  • inhibits the secretion of aldosterone

  • inhibits ACTH secretion by the pituitary gland

Explanation

Question 46 of 69

1

Diabetes insipidus (deficiency of antldiuretic hormone) causes a fall in the:

Select one of the following:

  • osmolality of the urine

  • reabsorption of water from the proximal tubules

  • extracellular but not intracellular fluid volume

  • extracellular fluid osmolality

  • intracellular fluid osmolality

Explanation

Question 47 of 69

1

Dialysis fluid used in the treatment of renal failure should contain the normal plasma levels of:

Select one of the following:

  • urea

  • potassium

  • osmolarity

  • plasma proteins

  • hydrogen ions

Explanation

Question 48 of 69

1

Long-standing obstruction of the urethra may cause:

Select one of the following:

  • enlargement of the prostate gland

  • dystrophy of the bladder muscle

  • dilation of the ureters and reduction of the glomerular filtration rate

  • increase and reduction of the glomerular filtration rate

  • a decrease in residual volume in the bladder

Explanation

Question 49 of 69

1

Emptying of the bladder may be less effective if:

Select one of the following:

  • the sympathetic nerves carrying afferent information from bladder to the spinal cord are cut

  • the pelvic nerves are cut or anticholinergic drugs are administered

  • cholinergic agonists are administered

  • alpha-adrenergic receptor antagonists are administered

  • beta-adrenergic receptor blockers are administered

Explanation

Question 50 of 69

1

Drugs which interfere with active transport of sodium in the proximal tubule tend to increase:

Select one of the following:

  • urine production

  • plasma osmorality

  • chloride reabsorbtion

  • intestinal fluid volume

  • plasma volume

Explanation

Question 51 of 69

1

A drug which inhibits carbonic anhydrase:

Select one of the following:

  • decreases bicarbonate formation and reabsorption in the kidney

  • increases plasma bicarbonate levels

  • increases blood pH

  • increases urinary loss of potassium ions

  • increases urinary volume and pH

Explanation

Question 52 of 69

1

A patient with chronic renal failure usually has:

Select one of the following:

  • an increased blood urea and blood uric acid

  • a decreased blood uric acid

  • an increased creatinine clearance

  • an increased acid-base disturbance when he or she vomits

  • an increased acid-base problem on a low protein diet

Explanation

Question 53 of 69

1

Cutting the sympathetic nerves to the bladder may cause:

Select one of the following:

  • difficulty in emptying the bladder

  • loss of tone in the internal sphincter of the bladder and loss of pain sensation in the bladder

  • loss of tone in the external sphincter of the bladder

  • increased pain sensation in the bladder

  • infertility in the female

Explanation

Question 54 of 69

1

Sudden (acute) renal failure differs from gradual (chronic) renal failure in that:

Select one of the following:

  • potassium retention tends to be more severe

  • blood urea levels tend to be higher

  • depression of bone marrow activity is unlikely to occur

  • metabolic acidosis is usually not a problem

  • dietary protein restriction is unnecessary

Explanation

Question 55 of 69

1

A long-standing increase in arterial pCO2 (respiratory acidosis) leads to:

Select one of the following:

  • an increase in renal bicarbonate formation

  • a decrease in urinary ammonium salts

  • a decrease in plasma potassium concentration

  • an increase of the monohydrogen/dihydrogen phosphate ratio in urine

  • a decrease in urinary bicarbonate excretion

Explanation

Question 56 of 69

1

The inhibition of the antidiurctic hormone (ADH), say by alcohol, would have what affect?

Select one of the following:

  • constriction of the afferent arteriole

  • inhibition of diuresis

  • stimulation of water conservation

  • constriction of the efferent arteriole

  • reduction in water conservation by the kidneys

Explanation

Question 57 of 69

1

Reabsorption of amino acids from the filtrate requires many different protein carriers because:

Select one of the following:

  • denaturation may occur

  • this transport is not competitive

  • there are only 10 different amino acids

  • transport of amino acids is typically highly specific

  • glucose inhibits amino acid transport

Explanation

Question 58 of 69

1

Reabsorption (transport) of both N a‘“ and glucose together from the renal lumen is an example of:

Select one of the following:

  • facilitated diffusion

  • secondary passive transport

  • primary direct active transport

  • secondary indirect active antiport

  • secondary indirect active symport

Explanation

Question 59 of 69

1

Drinking a litre of water:

Select one of the following:

  • increases secretion of antidiuretic honnone

  • reduces the plasma sodium concentration

  • increases osmolarity of the urine

  • causes body cells to shrink

  • decreases the specific gravity of the body

Explanation

Question 60 of 69

1

An acid-base buffer system:

Select one of the following:

  • can be a mixture of a weak acid and its conjugate base

  • can be a solution of sodium and bicarbonate ions

  • prevents any change in pH when acid is added

  • works best when acid and base are equal in concentration

  • is hemoglobin as an example of intracellular buffer

Explanation

Question 61 of 69

1

Acidosis in a patient may lead to:

Select one of the following:

  • increased urinary excretion of potassium

  • hypoventilation

  • a blood pH of less than 5.5

  • an urinary pH of less than 5.5

  • tetany

Explanation

Question 62 of 69

1

A rise in the osmolality of extracellular fluid may lead to:

Select one of the following:

  • thirst and release of vasopressin

  • increased water reabsorption in the proximal convoluted tubules

  • a decrease of vasopressin secretion

  • an increase in intracellular fluid volume

  • suppression of sweat secretion

Explanation

Question 63 of 69

1

A raised blood pH and bicarbonate level is consistent with:

Select one of the following:

  • metabolic acidosis

  • partly compensated respiratory alkalosis

  • a reduced pCO2

  • chronic renal failure with a raised pCO2

  • a history of persistent vomiting of gastric contents

Explanation

Question 64 of 69

1

A patient with partly compensated respiratory acidosis:

Select one of the following:

  • must have a raised pCO2

  • must have a raised bicarbonate concentration [HCO3-]

  • may have evidence of renal compensation

  • may have respiratory failure due to hypoventilation

  • all of the above

Explanation

Question 65 of 69

1

Sodium retention:

Select one of the following:

  • occurs for several days after major surgery

  • expands the extracellular fluid volume

  • expands the blood volume

  • increases the severity of oedema

  • all of the above

Explanation

Question 66 of 69

1

Sodium depletion differs from water depletion in that:

Select one of the following:

  • cardiovascular changes are less pronounced

  • intracellular fluid volume is less affected

  • the haematocrit increases

  • thirst is more severe

  • antidiuretic hormone levels are higher

Explanation

Question 67 of 69

1

A high blood potassium level (hyperkalaemia):

Select one of the following:

  • occurs in acute renal failure

  • follows severe crush injuries to the limbs

  • may diminish cardiac performance and cause death

  • may be reduced by Intravenous infusion of insulin and glucose

  • all of the above

Explanation

Question 68 of 69

1

A raised level of calcium in the blood (hypercalcaemia):

Select one of the following:

  • may occur when parathyrord activity decreases

  • may occur when the plasma protein level falls

  • may occur in chronic renal failure

  • increases the risk of stone formation in the urinary tract

  • causes increased excitability of nerve and muscle

Explanation

Question 69 of 69

1

Thirst is stimulated by:

Select one of the following:

  • increase in plasma osmolality and volume

  • increase in plasma osmolality and decrease in volume

  • decrease in osmolality and increase in volume

  • decrease in plasma osmolality and volume

  • increase in intracelular volume

Explanation

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