a&p ii; ch 23, 26, 27

All of the following are wastes removed by the kidneys EXCEPT

A) urea

B) Bilirubin

C) creatine

D) drugs

E) water

E

A nephron includes a1. renal corpuscle. 2. renal tubule. 3. renal capsule.

A) 1 only

B) 2 only

C) 3 only

D) 1 and 2 are correct

E) 1,2, and 3 are correct

D

juxtamedullary nephrons

A) makes up about 80-85 % of the nephrons within the kidney

B) allows excretion of very dilute or concentrated urine

C) have renal corpuscles located in the outer portion of the renal cortex

D) have very short nephron loops

E) have very thick descending nephron loops

B

If the urinary excretion rate of a drug such as penicillin is greater than the rate at which it is filtered at the glomerulus, how else is it getting into the urine?

A) movement through intercellular clefts in the glomerular capillaries

B) active transport

C) blood colloid osmotic pressure

D) tubular reabsorption

E) tubular secretion

E

The glomerular filtrate contains a lower concentration of _____ than does blood plasma.

a) albumin

b) glucose

c) water

d) sodium

e) urea

A

Which of the following equations is CORRECT?

a) NFP= GBHP+ CHP - BCOP

b) NFP= GBHP- CHP + BCOP

c) NFP= GBHP + CHP + BCOP

d) NFP= GBHP - CHP - BCOP

e) NFP= GBHP - BCOP

D

Glomerular filtration rate is increased by all of the following EXCEPT

a) increased production of angiotensin II

b) increased secretion of atrial natriuretic peptide

c) increased stretching of smooth muscle fibers in afferent arterioles

d) increased activity of renal sympathetic nerves

B

Sodium ions may be reabsorbed through

a) sodium-glucose symporters in the proximal convoluted tubules.

b) sodium-hydrogen ion antiporters in the loop of henle

c) sodium-glucose symporters in the distal convoluted tubule

d) sodium-hydrogen ion antiporters in the late distal convoluted tubule

e) sodium-chloride symporters in the collecting duct

A

Which of the following hormones increases reabsorption of sodium in the kidney?1. angiotensin II 2. aldosterone 3.atrial natriuretic peptide

a) 1 only

b) 2 only

c) 3 only

d) 1 and 2 are correct

e) 1,2,3 are correct

D

Concentrated urine is formed in part because of the action of symporters which actively reabsorb ions from the fluid in the

a) glomerulus

b) proximal convoluted tubules

c) descending limb of the nephron loop

d) thick segment of the ascending nephron loop

e) collecting ducts

D

All of the following might be observed in a freshly voided normal urine sample EXCEPT

a) amber color

b) transparency

c) ammonia odor

d) ph 6.0

e) specific gravity 1.020

C

Which of the following might indicated abnormal kidney function?

a) creatinine clearance less than 120-140 mL/min

b) serum creatinine less than 1.5 mg/dL (135 mmol/liter)

c) glucose in the urine

d) A and B are both correct

e) A, B, and C are all correct

A

Urine moves from the renal pelvis to the urinary bladder due to1. peristalsis 2. gravity 3.hydrostatic pressure

a) 1 only

b) 2 only

c) 3 only

d) 1 and 2 are correct

e) 1,2,3 are all correct

E

Which of the following statements is NOT correct?

a) The female urethra extends from the internal to external urethral orifices.

b) The male urethra is about 20cm long.

c) Both the male and the female urethra contain transitional epithelium, stratified columnar epithelium, and stratified squamous epithelium.

d) All of the statements are correct.

e) none of the statements is correct

E

The _________ of the embryo develops into nephrons.

a) pronephros

b) mesonephros

c) metanephric mesoderm

d) metanephros

e) ureteric bud

C

The _________ of the embryo gives rise to collecting ducts, calyces, renal pelves, and ureters.

a) pronephros

b) mesonephros

c) metanephric mesoderm

d) metanephros

e) ureteric bud

E

Which of the following statements accurately reflect aging of the kidneys?1. The kidneys decrease in size. 2. Glomerular filtration rate decreases. 3. Renal blood flow decreases.

a) 1 only

b) 2 only

c) 3 only

d) 1 and 2 are correct

e)1,2,3 are correct

E

Which of the following correctly matches a body fluid compartment with its approximate volume?

a) intracellular fluid: 40% of total body fluids

b) extracellular fluid: 20% of total male body mass

c) interstitial fluid: 20% of extracellular fluid

d) plasma: 20% of interstitial fluid

e) solids: 55% of total female body mass

A

Thirst may be stimulated by

1. decreased flow of saliva

2. decreased blood pressure

3. decreased blood osmolarity

a) 1 only

b) 2 only

c) 3 only

d) 1 and 2 are correct

e) 1, 2, and 3 are correct

D

Atrial natriuretic peptide helps to regulate the volume and osmolarity of body fluids by

a) stimulating the desire to drink fluids to quench thirst.

b) stimulating the secretion of aldosterone.

c) increasing urinary excretion of sodium and chloride ions accompanied by water.

d) increasing the permeability of the collecting ducts to water.

e) increasing urinary reabsorption of sodium and chloride ions accompanied by water.

C

All of the following are functions of electrolytes in the body EXCEPT

a) they control osmosis of water between fluid compartments

b) they act as enzymes in some metabolic pathways

c) they serve as enzyme cofactors

d) they help maintain acid-base balance

e) they carry electrical current

B

Which of the following statements about phosphate is CORRECT?

a) Parathyroid hormone increases urinary excretion of phosphate ions

.b) Most phosphate ions are covalently bound to organic molecules.

c) About 15% of phosphate is found in ionized form in the body.

d) All of these choices are correct.

e) None of these choices is correct.

D

Respiratory acidosis

a) may be caused by inadequate inhalation of carbon dioxide.

b) may be corrected by hyperventilation.

c) is due to a decrease in blood bicarbonate levels.

d) is most commonly caused by excessive vomiting.

e) may be a side effect of diabetic ketosis

B

An infant with severe diarrhea and vomiting may experience greater problems with fluid, electrolyte, and acid-base balance than an adult with the same disorder because

a) more of an infant's body mass is water

b) infants have a slower metabolic rate

c) the less developed kidney function in infants causes increased excretion of acid

d) body surface area: body volume is less in infants than in adults

e) newborns have a tendency toward metabolic alkalosis to start with

A

This is the formation of a new glucose molecule.

a) glycolysis

b) gluconeogenesis

c) glucosamine

d) glucose

e) calcitriol

B

Which of the following is a waste product normally excreted by the kidneys?

a) urea

b) glucose

c) insulin

d) cholesterol

e) carbon dioxide

A

This is smooth dense irregular connective tissue that is continuous with the outer coat of the ureter.

a) adipose capsule

b) renal capsule

c) renal hilus

d) renal cortex

e) renal medulla

B

The portion of the kidney that extends between the renal pyramids is called the

a) renal columns

b) renal medulla

c) renal pelvis

d) calyces

e) renal papilla

A

Which is the correct order of blood flow through the kidneys?

a) renal artery > segmental artery > interlobular artery > peritubular capillaries > afferent arterioles

b) interlobar arteries > arcuate arteries > glomerular capillaries > arcuate veins

c) arcuate veins > arcuate arteries > glomerular capillaries > renal vein

d) renal vein > segmental arteries > interlobar arteries > efferent arterioles

e) interlobar veins > afferent arterioles > efferent arterioles > glomerular capillaries

B

Which is the correct order of filtrate flow?

a) glomerular capsule, proximal convoluted tubule (PCT), nephron loop, distal convoluted tubule (DCT), collecting duct

b) nephron loop, glomerular capsule, PCT, DCT, collecting duct

c) ascending limb of loop, PCT, DCT, collecting duct

d) collecting duct, DCT, PCT, collecting duct, glomerular capsule

e) PCT, glomerular capsule, DCT, collecting duct, nephron loop

A

This term means the return of substances into the blood stream from the filtrate.

a) reabsorption

b) filtration

c) secretion

d) excretion

e) none of these choices

A

This is a nephron process that results in a substance in blood entering the already formed filtrate.

a) reabsorption

b) filtration

c) secretion

d) excretion

e) none of these choices

C

Glomerular capillaries and podocytes together form the

a) glomerular endothelial cells

b) filtration membrane

c) pedicels

d) filtration slits

e) slit membrane

B

This occurs when stretching triggers contraction of smooth muscle walls in afferent arterioles.

a) glomerular filtration rate

b) tubulomerular feedback

c) myogenic mechanism

d) renal autoregulation

e) capsular hydrostatic pressure

C

This occurs when a substance passes from the fluid in the tubular lumen through the apical membrane, across the cytosol, and then into the interstitial fluid.

a) paracellular reabsorption

b) transcellular reabsorption

c) apical reabsorption

d) basolateral reabsorption

e) active transport

B

The proximal convoluted tubules reabsorb what percentage of filtered water?

a) 25%

b) 50%

c) 65%

d) 80%

e) 99%

C

Which of the following is NOT a way angiotensin II affects the kidneys?

a) It increases GFR

b) It can decrease GFR

c) It enhances reabsorption of certain ions

d) It stimulates the release of aldosterone

e) None of these choices

A

Urea recycling can cause a buildup of urea in the

a) renal capsule

b) nephron loop

c) ascending tubule

d) renal medulla

e) renal pelvis

D

Increased secretion of hydrogen ions would result in a(n) ______________ of blood ____________?

a) increase, pressure

b) decrease, volume

c) increase, sodium levels

d) decrease, pH

e) increase, urea

D

An analysis of the physical, chemical, and microscopic properties of urine is called

a) urinalysis

b) filtration study

c) concentration study

d) diuretic

e) osmolarity

A

Water accounts for what percentage of the total volume of urine?

a) 25%

b) 50%

c) 75%

d) 80%

e) 95%

E

This is a test to measure kidney function.

a) Plasma creatinine

b) Renal study

c) Kidney assay

d) Dialysis

e) Hilus study

A

This transports urine from the kidney to the bladder.

a) Urethra

b) Ureter

c) Descending nephron loop

d) Renal hilus

e) None of these choices

B

This layer of the ureter is composed of connective tissue, collagen and elastic fibers.

a) Mucosa

b) Transitional epithelium

c) Lamina propria

d) Adventitia

e) Lamina elastica

C

This lies in the anterior corner of the trigone of the bladder.

a) Urethral sphincter

b) Adventitia bundle

c) Ureter

d) Internal urethral orifice

e) Muscularis bundle

D

If an individual goes on a crash diet and loses weight very rapidly, he or she will risk the development of

a) kidney failure

b) kidney stones

c) nephroptosis

d) a urinary tract infection

e) bladder stones

C

Blood plasma and dissolved substances with molecules that are smaller than most proteins are filtered directly into the

a) renal tubule

b) collecting duct

c) proximal convoluted tubule

d) distal convoluted tubule

e) glomerular capsule

E

An increase in permeability of the filtration membrane due to disease, injury, or irritation of kidney cells by substances such as bacterial toxins, ether, or heavy metals manifests as which condition?

a) albuminuria

b) lucosuria

c) urobilinogenuria

d) ketonuria

e) bilirubinuria

A

Anorexia, starvation, or a diet too low in carbohydrates manifests as which condition?

a) albuminuria

b) glucosuria

c) urobilinogenuria

d) ketonuria

e) bilirubinuria

D

Stress, causing excessive amounts of epinephrine secretion which stimulates glycogen breakdown, manifests as which condition? This condition can also indicate diabetes mellitus.

a) albuminuria

b) glucosuria

c) urobilinogenuria

d) hematuria

e) bilirubinuria

B

Excessive urine concentration of a normal breakdown product of hemoglobin, caused by pernicious anemia, infectious hepatitis, jaundice or cirrhosis, manifests as which condition?

a) albuminuria

b) glucosuria

c) urobilinogenuria

d) hematuria

e) bilirubinuria

C

This substance gives bile its major pigmentation:

a) ketone bodies

b) erythrocytes

c) casts

d) bilirubin

e) glucose

D

These are tiny masses of material, hardened in the lumen of the urinary tubule and are flushed out when filtrate builds up behind them:

a) ketone bodies

b) erythrocytes

c) casts

d) microbes

e) urobilinogen

C

Candida albicans and E. coli are which type of abnormal constituent of urine:

a) ketone bodies

b) erythrocytes

c) casts

d) microbes

e) urobilinogen

D

What is the normal pH range of urine in humans?

a) 8.1 - 10.6

b) 4.6 - 8.0

c) 1.0 - 3.0

d) 3.1 - 4.0

e) 10.0 - 12.0

B

What is the normal volume of urine produced in humans?

a) 1-2 L / hr

b) 1-2 L / day

c) 2-3 L / hr

d) 3-4 L / week

e) 10 L / 24 hours

B

What is the normal specific gravity range of urine in humans?

a) 2.350 - 3.700

b) 0.002 - 1.000

c) 4.6 - 8.0

d) 1.001 - 1.035

e) 1.04 - 2.60

D

Consumption of salty food will cause an increase in this hormone.

a) Aldosterone

b) Renin

c) ANH

d) Angiotensin-II

e) ADH

E

In males, both the urinary system and the _________ use the urethra.

a) integument

b) reproductive system

c) respiratory system

d) digestive system

e) cardiovascular system

B

The kidneys release _________ to raise blood pressure.

a) renin

b) angiotensin II

c) ADH

d) ANP

e) epinephrine

A

The kidneys convert some of the bilirubin from hemoglobin breakdown to ________, a

yellow pigment.

a) urobilinogen

b) bile

c) stercobilin

d) urobilin

e) albumin

D

Shock wave lithotripsy is often used to treat which condition?

a) renal calculi

b) urinary tract infections

c) glomerulonephritis

d) polycystic kidney disease

e) urinary bladder cancer

A

Excessive calcium ingestion and low water intake can lead to which condition?

a) renal calculi

b) urinary tract infections

c) glomerulonephritis

d) polycystic kidney disease

e) urinary bladder cancer

A

Inflammation of the kidneys is called

a) cystitis

b) nephrotic syndrome

c) pyelonephritis

d) urethritis

e) glomerulitis

C

Some kidney diseases cause a change in the permeability of glomerular capillaries making

them more permeable to plasma proteins. This changes the colloid osmotic pressure, thus

drawing water out of the blood and into tissues. The result is

a) dehydration

b) edema

c) overhydration

d) high blood pressure

e) there is no actual change

B

Another name for the glomerular capsule is _____ capsule.

a) Cowper's

b) Skene's

c) Bartholin's

d) Bowman's

e) Brenner's

D

What type of cells are found in the proximal convoluted tubule?

a) simple squamous

b) simple columnar

c) simple cuboidal

d) stratified squamous

e) stratified cuboidal

C

The primary site for metabolic recycling is the

a) liver

b) kidney

c) heart

d) intestine

e) spleen

A

Embryologically, the kidneys differentiate starting which week of development?

a) first

b) second

c) third

d) fourth

e) fifth

C

How much of the total volume of body fluid is intracellular fluid?

a) 10%

b) 50%

c) 1/3

d) 2/3

e) 99%

D

80% of the extracellular fluid is

a) Plasma

b) Cytosol

c) Interstitial fluid

d) Lymph

e) Bile

C

Which of the following is produced when electrons are accepted by oxygen during cellular respiration?

a) Anions

b) Cations

c) Metabolic water

d) Lipids

e) Carbohydrates

C

The response of the body to decreasing blood pressure will NOT include which of the following?

a) Dehydration

b) Formation of angiotensin II

c) Stimulate the kidneys to secrete rennin

d) Formation of ADH

e) Increased vasoconstriction

A

Which of the following is the main factor that determines water loss?

a) Defecation

b) Sweating

c) Urination

d) Evaporation through the skin

e) Exhalation of water vapor

C

Which of the following is used to promote Na+ reabsorption by the kidneys?

a) Antidiuretic hormone

b) ANP

c) Aldosterone

d) Parathyroid hormone

e) All of these choices

C

Which of the following is used to promote water reabsorption by the kidneys?

a) Antidiuretic hormone

b) ANP

c) Aldosterone

d) Parathyroid hormone

e) All of these choices

A

Natriuresis

a) Is decreased Na+ levels in urine

b) Is decreased Cl- levels in urine

c) Is increased K+ levels in urine

d) Is increased PO- levels in urine

e) None of these choices

E

A decline in angiotensin II levels does NOT result in

a) Increased GFR

b) Reduced Na+ and Cl- reabsorption by the kidneys

c) Reduced water reabsorption by the kidneys

d) Increased Calcium reabsorption

e) Increased urine output

D

Which of the following is a function of an electrolyte in the body?

a) Controlling osmosis between compartments

b) Maintaining acid-base balance

c) Carry electrical currents

d) Serve as cofactors

e) All of these choices

E

In extracellular fluid the most abundant cation is

a) Na+

b) Cl-

c) K+

d) HPO42-

e) HCO3-

A

In extracellular fluid the most abundant anion is:

a) Na+

b) Cl-

c) K+

d) HPO42-

e) HCO3-

B

In intracellular fluid the most abundant anion is

a) Na+

b) Cl-

c) K+

d) HPO42-

e) HCO3-

D

The Na+ level in blood is controlled by

a) Aldosterone

b) Insulin

c) ATP production

d) Krebs cycle

e) Glucagon

A

Which of the following is the most abundant mineral in the body?

a) Na+

b) Calcium

c) Magnesium

d) Phosphate

e) Iron

B

PTH, calcitriol and calcitonin are

a) The main regulators of magnesium in the blood

b) The main regulators of phosphate in the blood

c) The main regulators of calcium in the blood

d) The main regulators of NaCl in the blood

e) None of these choices

C

Most of the phosphate in the body is present as

a) Lipids

b) Plasma membranes

c) DNA

d) Calcium phosphate salt

e) Carbohydrates

D

Buffer systems, exhaling carbon dioxide and excretion by the kidneys, are all

a) Ways to balance interstitial fluid

b) Means of balancing blood volume

c) Ways of controlling H+ levels in the body

d) Ways to make ions

e) Ways to increase blood volume

C

Metabolic reactions can produce

a) H+

b) HCO3-

c) Nonvolatile acids

d) Volatile bases

e) Ca+

C

In partial compensation

a) pH is brought into the normal range

b) systemic arterial blood is still lower than 7.35

c) systemic arterial blood is higher than 9.5

d) pH is greater than 5.5

e) pH is lower than 2.5

B

Inadequate exhalation of carbon dioxide can cause

a) Blood pH to drop

b) Alkalosis

c) Respiratory compensation

d) Unequal distribution of water

e) Metabolic alkalosis

A

Which imbalance results when systemic arterial blood HCO3- levels drop significantly (below 22 mEq/liter)?

a) Metabolic alkalosis

b) Metabolic acidosis

c) Respiratory acidosis

d) Respiratory alkalosis

e) None of these choices

B

Which imbalance results when systemic arterial blood CO2 levels raise to abnormal values?

a) Metabolic alkalosis

b) Metabolic acidosis

c) Respiratory acidosis

d) Respiratory alkalosis

e) None of these choices

C

Which of the following is the most common cause of metabolic alkalosis?

a) Hemorrhage

b) Vomiting

c) Pneumothorax

d) Diabetes

e) Cancer

B

The rate of fluid intake and outflow is how much higher in an infant than in an adult?

a) 2 times higher

b) 5 times higher

c) 7 times higher

d) 10 times higher

e) They are equal

C

The breathing rate of an infant

a) Is twice as fast as an adult

b) Causes greater water loss from the lungs

c) Removes less carbon dioxide than in an adult

d) Makes the infant blood more acidic

e) Is normal to an adult

B

What part of the brain contains the thirst center?

a) Thalamus

b) Hypothalamus

c) Midbrain

d) Brain stem

e) Cerebrum

B

Most buffer systems in the body consist of

a) A weak acid

b) A weak base

c) A weak acid and the salt of that acid

d) A weak base and the salt of that base

e) None of these are correct

C

Which of the following chemicals is considered to be a volatile acid?

a) CO2

b) O2

c) H2CO3

d) Hemoglobin

e) Calcitriol

C

Which cells of the kidney are the most important for regulation of pH of body fluids?

a) Glomerular podocytes

b) Principal cells

c) PCT cells

d) DCT cells

e) Intercalated cells

E

Which of the following is the most plentiful buffer in the tubular fluid of the kidney collecting duct?

a) Bicarbonate ion

b) Monohydrogen phosphate ion

c) Ammonium ion

d) Dihydrogen phosphate ion

e) None of these

B