Essay

1.    Podocytes are found in the
a.    walls of the peritubular capillaries.
b.    ascending limb of the loop of Henle.
c.    urinary bladder.
d.    visceral layer of the glomerular capsule.
e.    parietal layer of the glomerular capsule.

2.    A falling blood pH and a rising partial pressure of carbon dioxide due to pneumonia or emphysema indicates
a.    respiratory acidosis    c.    respiratory alkalosis    e.    None of the answers is correct.
b.    metabolic acidosis    d.    metabolic alkalosis

3.    The primary role of the carbonic acid-bicarbonate buffer system is
a.  to buffer stomach acids.
b.  to buffer carbonic acid formed by carbon dioxide.
c.  the prevention of pH changes in body fluids.
d.  to buffer urine.
e.  to increase the amount of carbonic acid during ventilation.

4.    The process of filtration occurs across the filtration membrane within
a.the collecting duct.            c.  the loop of Henle    e.    the proximal convoluted tubule.
b.     the renal corpuscle.            d. the distal convoluted tubule.

5.    As H+ ion are secreted in the distal convoluted tubules of the kidneys, they move from
a.    filtered fluid (filtrate) to epithelial tubule cells, to interstitial fluid to peritubular capillaries.
b.    peritubular capillaries to interstitial fluid, to epithelial tubule cells, to filtered fluid (filtrate).
c.    vasa recta to epithelial tubule cells, to interstitial fluid, to filtered fluid (filtrate).
d.    peritubular capillaries to epithelial tubule cells, to interstitial fluid, to filtered fluid (filtrate).
e.    interstitial fluid to the filtered fluid (filtrate), to peritubular capillaries, to epithelial tubule cells.

6.    Dan has been lost in the desert for 2 days with very little water.  As a result of his exposure, you would expect to observe
elevated ADH levels.    c.    normal urine production.    e.    All of the answers are correct.
increased blood volume.        d.    excess dilute urine.

7.    A glomerulus is
a.    the blood vessel that transports blood away from the renal corpuscle.
b.    a knot of capillaries that lies within the Bowman’s capsule.
c.    the portion of the nephrons closest to the renal corpuscle.
d.    the portion of the nephron that attaches to the collecting duct.
e.    the blood vessel that brings blood into the renal corpuscle.

8.    A person is in fluid balance when
a.the ECF and ICF are isotonic.
b.no fluid moves between intra- and extracellular compartments.
c.the amount of water gained each day is equal to the amount lost to the environment.
d.a and c only
e.a, b, and c

9.    An increase in blood carbon dioxide levels is followed by a (an) __________ in H+ and a (an) __________ in blood pH.
increase, increase    c.    decrease, increase    e.    The H+ concentration will not be affected and,
increase, decrease    d.    decrease, decrease        as a result, the pH will not be affect.

10.    The urinary system does all of the following, except
a.    secretes excess glucose molecules.
b.    regulates blood volume.
c.    contributes to stabilizing blood pH.
d.    eliminates organic waste products.
e.    regulates plasma concentrations of electrolytes.

11.    The glomerular filtration rate is regulated by all of the following, except
a.  renalautoregulation.    c.    electrolyte levels.    e.    intrinsic control         b. neural regulation                         d.     hormonal regulation.

12.    An important function of the juxtaglomerular apparatus is to
a.    secrete water and sodium into the tubular fluid.
b.    release renin in response to an increase in renal blood pressure or blood flow.
c.    make sure that the diameter of the efferent arteriole is kept larger than that of the afferent arteriole.
d.    produce ADH in response to increased glomerular filtration.
e.    activate the renin-angiotensin-aldosterone mechanism, which results in an increased blood pressure.

13.    Which of the following is greater?
the concentration of solute in the filtrate at the bottom of the descending loop of Henle
the concentration of solute in the filtrate at the beginning of the loop of Henle

14.    Annie has just eaten a large order of heavily salted French fries, some pickled eggs, and some cheese.  How will consuming this
much salt affect her physiology?
It will cause a prolonged increase in the osmolality of the blood.
There will be a temporary increase in blood volume.
She will experience hypotension.
There will be a shift in the pH of her body fluids to the higher side of the pH scale.
Both a and b are correct.

15.    Which of these conditions causes a decrease extracellular fluid volume?
a.    release of renin    c.increased water intake    e.    All of the answers are correct.
b. increased ADH secretiond.decreased aldosterone secretion

16.    Which of these ions is used to cotransport of glucose through the apical membrane of the nephron epithelial cells?
a.    calcium                c.    chloride    e.    magnesium
b.    sodium                d.    potassium

17.    Antidiuretic hormone (ADH)
is secreted by the kidney.
stimulates the kidneys to retain sodium ions.
stimulates water conservation at the kidneys.
causes the kidney to produce a large volume of urine.
all of the above

18.    The role of the countercurrent multiplier in the kidney is to
produce a urea gradient that will promote the diffusion of urea into the collecting duct.
maintain the concentration gradient which will allow the nephron to produce a hypotonic filtrate.
produce a salt gradient that will allow the kidney to concentrate urine.
produce a glucose gradient that will facilitate the secretion of glucose.
actively pump water from the nephron into the renal medulla.

19.    The process of urine formation involves all of the following, except
a.    filtration of plasma            c.    reabsorption of certain ions.    e.    secretion of glucose molecules.
b.    reabsorption of water        d.    secretion of wastes.

20.    Which of the following describes the distribution of sodium and potassium between cells and body fluids?
a.    K+ mainly in the cells, Na+ in the body fluids
b.    Na+ mainly in the cells, K+ in the body fluids
c.    equal amounts of each ion in the cells and body fluids
d.    little of either in the cells, but large amounts of each in the body fluids
e.    None of the answers is correct.

21.    Given the following regions:
collecting duct            3.    glomerular capsule    5.    proximal convoluted tubule
distal convoluted tubule        4.    loop of Henle

Choose the arrangement that lists the structures in the order of filtrate flow through a nephron.
3, 4, 5, 2, 1            c.    3, 4, 5, 2        e.    3, 5, 4
3, 5, 4, 2, 1            d.    3, 5, 4, 2

22.    Which of the choices below is not a method by which the cells of the renal tubules raise blood pH?
by secreting hydrogen ions into the filtrate
by reabsorbing filtered H+
by producing new bicarbonate ions
by secreting sodium ions
All of the above are correct.

23.    A kidney stone blocking a ureter would interfere with urine flow to
blood vessels.    c.    the ureters.        e.    All of the answers are correct.
urinary bladder.            d.    the urethra.

24.    Increased aldosterone causes
a.    decreased reabsorption of Na+.
b.    decreased blood volume.
c.    decreased reabsorption of water.
d.   decreased extracellular fluid volume.
e.    decreased urine volume.

25.    A patient is suffering from thirst, fever, and restlessness as a result of hypersecretion of aldosterone.  Which of the following
conditions is most closely associated with the above symptoms?
hypernatremia        c.    hypercalcemia    e.    hyperkalemia
hyponatremia            d.    hypocalcemia

26.
Which of the following is greater?
a.    The amount of ADH released when blood solute concentration is high.
b.    The amount of ADH released when blood soluteconcentration is low.

27.    The loop of Henle and vasa recta
a.    both play an important role in diluting the renal medulla.
b.    both release antidiuretic hormone  and aldosterone.
c.    both play a role in establishing and maintaining a high solute concentration in the medulla.
d.    secrete renin in the presence of low Na+.
e.    All of the answers are correct.

28.    Damage to the renal cortex would interfere first with the functioning of the
a.   renal corpuscle.        c.   collecting duct.    e.    renal pyramid.
b.  minor calyx.        d.   major calyx.

29.    When baroreceptors detect an increase in systemic blood pressure,
a.     afferent arterioles constrict.
b.     blood volume increases.
c.     sympathetic stimulation declines.
d.    afferent arterioles are not affected.
e.     extracellular fluid volume increases.

30.    Most reabsorption occurs at the
glomerulus.            c.    distal convoluted tubule.    e.    loop of Henle.
glomerular capsule.            d.    proximal convoluted tubule.

31.    Increased glomerular filtration rate leads to
a.             an increase in angiotension II, resulting in an decrease in extracellular fluid volume.
b.    a decrease in angiotension II, resulting in an increase in extracellular fluid volume.
c.    an increase in angiotension II, resulting in an increase in extracellular fluid volume.
d.    a decrease in angiotension II, resulting in an decrease in extracellular fluid volume.
e.    no changes in blood volume.

32.    The process of filtration is driven by
active transport.            c.    diffusion.    e.    osmosis.
facilitated diffusion.        d.    hydrostatic pressure.

33.    The sensation of thirst involves all of the following, except
a.    renin secretion.
b.    aldosterone secretion.
c.    ADH secretion.
d.    increase in the glomerular filtration rate (GFR).
e.    angiotensin-converting enzyme (ACE) activity.

34.    Which of the following statements is not correct?
a.    The urinary bladder is composed of transitional epithelium.
b.    ADH is an important regulator of electrolyte reabsorption.
c.    The renal corpuscle consists of a glomerulus and glomerular capsule.
d.    The stretching of the bladder wall acts as a trigger for micturition.
e.    Simple squamous epithelium forms the parietal layer of the glomerular capsule.

35.    When water is lost but electrolytes are retained
The osmolality of the extracellular fluid (ECF) falls.
There is an increase in the volume of the intracellular fluid (ICF).
Osmosis moves water from the ICF to the ECF.
Both the ECF and the ICF become more dilute.
Both a and b

36.    When blood pH increases, countertransport of H+ ions at the apical membrane of renal tubular cells
a.    increases.
b.    decreases.

37.    The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the
a.    nephron loop.            c.    vasa recta.        e.    glomerular filtration membrane.
b.    distal convoluted tubule.        d.    proximal convoluted tubule.

38.    Given these structures:
minor calyx    3.    renal papilla
major calyx    4.    renal pelvis

Choose the arrangement that lists the structures in order as urine leaves the collecting duct and travels to the ureter.
3, 2, 1, 4    c.    3, 2, 4, 1    e.    1, 3, 2, 4
3, 4, 2, 1    d.    3, 1, 2, 4

39.    The permeability of the collecting ducts to water is regulated by
a.    aldosterone.    c.    renin.    e.    angiotensinogen.
b.    antidiuretic hormone.    d.    angiotensin II.

40.    If, through injury, the blood flow to the kidneys decreases, which of the following will occur?
Sodium reabsorption will be inhibited.
There will be systemic vasodilation.
Water reabsorption will decrease.
Aldosterone secretion will increase.
The amount of ADH in the blood will decrease.

41.    All of the following are factors in the glomerular filter except
a.   slit membranes.        c.   endothelial cells.    e.    microvilli.
b.   basement membranes.    d.   fenestrations.

42.    Intrinsic control or autoregulation maintains the glomerular filtration rate (GFR) through all of the processes listed below, except
a.    the contraction or relaxation of the smooth muscle within the afferent arteriole walls.
b.    the constriction of afferent arterioles when GFR has increased.
c.    the constriction of afferent arterioles in the presence of angiotensin II.
d.    the dilation of afferent arterioles in the presence of aldosterone.
e.    the dilation of afferent arterioles when NaCl concentration has increased.

43.    Which of the following hormones is important in the regulation of sodium ion concentrations in the extracellular fluid?
a.   antidiuretic hormone        c.    erythropoietin        e.    angiotensin-converting enzyme (ACE)
b.    renin                            d.    aldosterone

44.    If there were an obstruction in the renal artery, one might expect to see a (an)
a.    decrease in GFR.
b.    increase in the renin secretion.
c.    increase in GFR.
d.    Both a and b are correct.
e.    Both b and c are correct.

45.    Dehydration would cause
fluid to shift from the ICF to the ECF.
increased secretion of ADH.
increased thirst.
increased levels of aldosterone.
all of the above

46.    Blood pH would decrease during
hyperventilation.
hypoventilation.

47.    Which of the following statements regarding the countercurrent multiplier and exchange mechanisms is not correct?
a.      Countercurrent multiplication creates a concentration gradient that encourages osmosis of water out of the descending limb of the nephron loop.
b.      During countercurrent exchange, the vasa recta carry sodium chloride away from the medulla.
c.      The countercurrent multiplier creates the osmotic gradient in the medulla.
d.      The vasa recta remove water, but not sodium chloride, from the medulla.
e.      The nephron loop and vasa recta are associated with establishing and maintaining the high solute concentration in the medulla.

48.    Factors that increase the secretion of ADH include all of the following, except
decreased renal blood flow.    c.    increased water volume in ECF.    e.    increased concentration of sodium ions in ECF.
water deprivation.    d.    increased osmolality in ECF.

MATCHING (            / 6) – Choose the item in COLUMN 2 that best matches each explanation in COLUMN 1.  Shade in your choice on the Scantron® sheet.

COLUMN 1    COLUMN 2

49.    Excess sodium in plasma    a.    hypocalcemia
50.    Depletion of potassium    b.    hyponatremia
51.    Depletion of sodium    c.    hyperkalemia
52.    Excess potassium    d.    hypernatremia
e.    none of the above

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53.    Reabsorbs approximately 65% of filtrate    a.    juxtaglomerular apparatus
54.    Releases renin    b.    loop of Henle
55.    Establishes osmotic gradient in renal medulla    c.    proximal convoluted tubule
56.    Receives filtrate from the loop of Henle    d.    d. distal convoluted tubule
e.    collecting duct

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57.    Caused by accumulation of ketone bodies    a.    metabolic acidosis
58.    Caused by hyperventilation due to severe anxiety    b.    respiratory acidosis
59.    Caused by excessive vomiting    c.    metabolic alkalosis
60.    Caused by hypoventilation due to emphysema    d.    respiratory alkalosis
e.    none of the above