PGY 300 Renal Practice Questions Spring 2021 PDF

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practice problems. repeated questions appear on the actual exam...

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PGY300 Renal Practice Questions

These are questions from previous exams. Some pertain to topics that were not covered this semester. Some of the question formats below do not work in the online setting but may be useful in studying for the class exam. 1)

Functions of the kidneys include all but one of the following. Identify the exception. a) regulation of extracellular fluid volume b) maintenance of ion balance in body fluids c) d) regulation of blood osmolarity e) homeostatic regulation of blood pH

2)

Substances directly regulated by the kidney include all EXCEPT which of the following? a) Na+ b) K+ c) Ca2+ d) HCO3e) e

3)

The characteristic yellow color of urine is attributed to the presence of which of the following? a) b) uric acid c) urea d) renin e) bile

4)

Urea is produced primarily by which of the following? a) proximal tubule b) collecting duct c) kidney d) adrenal gland e)

5)

Urine is carried to the urinary bladder by a) blood vessels. b) lymphatics. c) . d) the urethra. e) none of the above

6)

Technically, the kidneys are located a) in the thoracic cavity. b) in the abdominal cavity. c) behind the pleural membranes. d) . e) in the pelvic cavity. Page 1 of 16

PGY300 Renal Practice Questions

7)

Blood flow through the kidney includes a feature seen in only a few organs. What is it? a) b) arterial shunts c) vascular sinuses d) veins containing highly oxygenated blood e) anastomoses

8)

Which structure is NOT part of the blood circulation through the kidney? a) vasa recta b) c) glomerulus d) renal corpuscle

9)

Which statement is NOT true? a) The blood supply to the kidneys comes through the renal arteries. b) As much as one fourth of the cardiac output may flow to the kidneys at any given moment. c) . d) The urinary bladder is filled by two ducts, called ureters, and emptied by the single urethra. e) Women are more likely to develop urinary tract infections than men.

10)

The Bowman's capsule and glomerulus make up the a) renal pyramid. b) loop of Henle. c) d) renal papilla. e) collecting system.

11)

A glomerulus is a) the expanded end of a nephron. b) . c) the portion of the nephron closest to the renal corpuscle. d) the portion of the nephron that attaches to the collecting duct. e) the hairpin-shaped segment of the nephron.

12)

The portion of the nephron closest to the renal corpuscle is the ___________ a) b) . c) distal tubule. d) collecting duct. e) minor calyx.

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PGY300 Renal Practice Questions 13)

The portion of the nephron that precedes the collecting duct is the __________ . a) loop of Henle b) proximal tubule c) d) renal pelvis e) minor calyx

14)

The hairpin-shaped segment of the nephron is the ___________ a) b) proximal tubule. c) distal tubule. d) vasa recta. e) minor calyx.

15)

The process of filtration in the kidney is most accurately described as a) highly specific (selective). b) completely nonspecific (nonselective). c)

16)

The filtration fraction of a normal kidney is approximately __________ of the renal plasma flow. a) 4/5 (80%) b) c) 3/4 (75%) d) 1/2 (50%) e) 9/10 (90%)

17)

In normal kidneys, blood cells and plasma proteins are a) filtered then reabsorbed. b) secreted then reabsorbed. c) d) filtered and secreted.

18)

Which is NOT a kidney filtration barrier? a) glomerular capillary endothelium b) basal lamina c) podocyte foot process d)

19)

The major force for Net filtration pressure is the a) b) oncotic pressure in the glomerular capillaries. c) hydrostatic pressure of the filtrate. d) reabsorption in the nephron. e) none of the above

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PGY300 Renal Practice Questions 20)

Which of the following would be the most important function of the proximal tubule? a) filtration b) c) excretion of acids and ammonia d) secretion of drugs e) adjusting the urine volume

21)

Glucose and amino acids are reabsorbed by which of the following mechanisms? a) diffusion b) c) facilitated diffusion d) sodium coupled counter transport (antiporter) e) sodium channel (ENaC)

22)

Which of the following statements about autoregulation is NOT true? a) Myogenic response is the intrinsic ability of vascular smooth muscle to respond to pressure changes. b) c) In tubuloglomerular feedback, adenosine is released by the macula densa, resulting in depolarization of smooth muscle cells. d) In the myogenic response, the macula densa cells send a paracrine message to the neighboring afferent arteriole.

Match each step in the formation of urine to its description. (a) (b) (c) (d)

excretion filtration reabsorption secretion

23)

movement from the nephron lumen to the external environment

24)

movement from the nephron lumen to the blood

25)

movement from the glomerulus to the nephron lumen

26)

movement from the peritubular capillaries to the nephron lumen

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PGY300 Renal Practice Questions Match each substance with its primary mode of transport across the kidney epithelium. (a) (b) (c) (d)

transcytosis active transport symport with a cation passive reabsorption/diffusion

27)

sodium

28)

glucose

29)

urea

30)

small plasma proteins

Match the following terms to one of the next five questions. a) filtration fraction b) urethra c) GFR or glomerular filtration rate d) transport maximum e) urinary bladder 31)

After it is formed, urine is temporarily stored in the __ ______.

32)

Urine is carried to the external environment by the __________.

33)

The plasma concentration at which all of the renal carriers for a given substance are saturated is the __________.

34)

The amount of filtrate entering the proximal tubules of the kidneys each minute is the __________.

35)

The percentage of total plasma volume that is filtered is called the ___ _____.

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PGY300 Renal Practice Questions Match the following terms to one of the next five questions. a) renal arteries, abdominal aorta b) cortex, juxtamedullary, medulla c) tubuloglomerular feedback d) vasa recta e) renal veins, inferior vena cava 36)

When fluid flow through the distal tubule increases as a result of increased GFR, the macula densa cells send a chemical message to the neighboring afferent arteriole. The afferent arteriole constricts, increasing resistance and decreasing GFR. This type of autoregulation involving both the kidney tubule and the arteriole is known as __________.

37)

The __________ branch off the __________ and supply blood to the kidneys.

38)

The __________ carry blood from the kidneys back to the __________.

39)

Eighty percent of the nephrons in a kidney are contained within the ________, but the other 20%, called the __________ nephrons, dip down into the __________.

40)

The __ ______ are the long peritubular capillaries that dip into the medulla.

Match the following terms to one of the next five questions. a) sympathetic neurons, alpha, vasoconstriction b) glucosuria or glycosuria c) mesangial cells d) podocytes; foot processes e) Bowman's capsule

41)

The nephron begins with a hollow, ball-like structure called __________.

42)

The __ ______ lie between and around the glomerular capillaries.

43)

The specialized cells found in the capsule epithelium are called __ have long cytoplasmic extensions called __________.

44)

Neural control of GFR is mediated by ___ _____ that innervate __________ receptors on vascular smooth muscle causing __________.

45)

The excretion of glucose in the urine is called ___

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_____.

______. These cells

PGY300 Renal Practice Questions 46)

Place the following blood vessels that carry blood to and within the kidney in the order in which blood passes through them. 1. afferent arteriole 2. efferent arteriole 3. glomerulus 4. peritubular capillary a) 4, 2, 3, 1 b) c) 4, 3, 2, 1 d) 1, 2, 3, 4 e) 3, 4, 2, 1

47)

When the clearance of a substance exceeds inulin clearance, then ____________ must be greater than ______________. a) reabsorption, secretion b) secretion, excretion c) d) none of the above Damage to the renal medulla would interfere first with the functioning of the a) Bowman's capsule. b) distal tubule. c) d) proximal tubule. e) glomerulus.

49)

An obstruction in a glomerular capillary would first reduce the hydrostatic pressure in a) the renal artery. b) c) the afferent arteriole. d) the renal vein. e) vasa recta.

50)

If blood pressure in the afferent arterioles transiently increases, a) b) c) d)

51)

the smooth muscle in the vessel walls stretches to accommodate the increased flow. the stretch triggers further relaxation of the arteriolar wall, lessening blood pressure. B and C

Urea is a) actively secreted in the distal tubule. b) actively reabsorbed in the proximal tubule. c) d) completely eliminated in the urine. e) actively transported into the filtrate by the cells of the collecting duct.

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PGY300 Renal Practice Questions 52)

Proximal tubular fluid has a Na+ concentration __________ the Na+ concentration inside the cells of the tubule epithelium. a) b) is slightly higher than c) is about the same as d) is slightly lower than e) is much lower than

53)

The typical pattern for molecules absorbed by Na+-dependent transport involves this: an apical __________ and a basolateral __________. a) facilitated diffusion carrier, osmotic gradient c) d) e)

symport protein, osmotic gradient osmotic gradient, symport protein facilitated diffusion carrier, symport protein

54)

One substance has no membrane transporters to move it but can diffuse freely through open leak channels if there is a concentration gradient. Initially, this substance's concentrations in the filtrate and extracellular fluid are equal. Later, however, the active transport of Na+ and other solutes creates a gradient by removing water from the lumen of the tubule where it is located. What substance is this? a) glucose b) glycine c) d) A and B e) A, B, and C

55)

Measurements in a nephron reveal a glomerular hydraulic pressure of 69 mm Hg, and a fluid pressure in the Bowman's capsule of 15 mm Hg. Assuming that the plasma osmotic pressure is 30 mm Hg, and that essentially no plasma proteins are filtered by the glomerulus, what is the net glomerular filtration pressure in this case? a) -6 mm Hg b) c) 54 mm Hg d) 84 mm Hg e) 114 mm Hg

56)

In a normal kidney, which of the following conditions would cause an increase in the glomerular filtration rate (GFR)? a) constriction of the afferent arteriole b) a decrease in the hydraulic pressure of the glomerulus c) an increase in the capsular hydraulic pressure d) e) a decrease in the net glomerular filtration pressure

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PGY300 Renal Practice Questions 57)

A person with cirrhosis of the liver has lower than normal levels of plasma proteins and a higher than normal GFR. Which of the following statements are true? a) A decrease in plasma protein concentration would cause an increase in GFR. b) The primary driving force for GFR is blood pressure, opposed by fluid pressure in Bowman's capsule and the glomerular capillary oncotic pressure due to plasma proteins. c) If a person has fewer plasma proteins due to liver disease, the plasma will have a lower oncotic pressure. d) With less oncotic pressure opposing the GFR, GFR will increase. e)

58)

Patrick's urine sample reveals a high concentration of glucose. Which of the following statements are true? a) Glucose is normally present in the urine and is not a concern. b) Glucose transporters in the distal tubule may not be functional. c) Tubular fluid glucose concentration is below the transport maximum for glucose. d) e) Tubular glucose secretion has been stimulated.

59)

Trace a water molecule through the urinary system, beginning with the plasma in the renal artery. 1) urethra 2) glomeruli 3) urinary bladder 4) afferent arterioles 5) nephrons 6) renal calyces 7) ureter 8) renal pelvis 9) collecting ducts a) b) 2,4,5,9,8,6,3,7,1 c) 4,2,9,5,6,8,7,3,1 d) 2,4,9,5,6,8,3,7,1 e) 4,2,5,9,6,8,1,3,7

60)

Which of the following “real” volumes plays the most important role in determining an optimum effective circulating volume? a) intracellular volume b) interstitial volume c) cerebral spinal fluid volume d) transcellular volume e)

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PGY300 Renal Practice Questions Which of the following fluid compartments has the smallest volume? a) intracellular volume. b) extracellular volume. c) interstitial volume. d) blood volume. e) 62)

What percentage of the body weight of a normal adult human is composed of water? a) 30 % b) 40 % c) d) 75 % e) There is no predictable relationship between body weight and body water.

63)

Which of the following sensors will detect an increase in the vascular volume? a) Osmoreceptors b) c) ADH receptors d) Aldosterone receptors e) ANP receptors

64)

Which of the following actions will result from a sustained increase in the mean arterial pressure (MAP)? a) release of antidiuretic hormone (ADH) b) c) release of renin release d) release of aldosterone e) decrease in sodium excretion

65)

Which of the following occur immediately after severe hemorrhage? a) The arterial blood pressure will go up. b) The blood pressure proximal to the afferent arteriole will go up. c) d) The activity of angiotensin II will decrease.

66)

The antidiuretic hormone is released from which of the following locations? a) The carotid bodies. b) The right atrium of the heart. c) d) The cerebral cortex. e) The adrenal glands.

67. Which of the following is correct? a) Excretion = Filtration + Reabsorption + Secretion b) – c) Excretion = Filtration – Reabsorption – Secretion d) – e) Filtration = Reabsorption – Secretion – Excretion

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PGY300 Renal Practice Questions . Approximately _____ of total body water is contained in the extracellular fluid compartment. The remaining _____ of total body water is contained in the intracellular fluid compartment. The extracellular fluid compartment is subdivided into the plasma and interstitial compartments in a ______ to ______ratio. a) 2/3, 1/3, 1/4, 3/4 b) 1/3, 3/4, 1/4, 2/3 d) 3/4, 1/4, 1/3, 2/3 e) 1/4, 3/4, 2/3, 1/3 69. The effective circulating blood volume (ECBV) has its greatest effect on ____________. a) b) Total body water c) Total body weight d) Interstitial fluid volume e) Extracellular fluid volume . On average, the percentage of body weight contributed by body water is _______ in females as compared to males due to the larger amount of ________ tissue in females. a) Larger, adipose b) Larger, muscle c) d) Smaller, muscle e) None of the above are correct. 71. The assessment of ______by the kidney can be determined by measuring the clearance of ______? b) Renal blood flow, inulin c) Tubular metabolism, para-aminohippurate d) Glomerular filtration rate, para-aminohippurate 72. A decrease in the effective circulating blood volume is first detected by _________. a) Osmoreceptors b) c) Chemoreceptors d) Vasoreceptors e) Renal V-2 receptors . Liver failure will lead to the loss of production of plasma proteins, which will ________ net filtration pressure due to the ____________ in oncotic pressure. a) I b) Increase, increase c) Decrease, increase d) Decrease, decrease e) Not change, increase . Glucose is reabsorbed at the lumen-facing membrane of the __________ by _________ active transport. a) Proximal tubule, primary b) Distal tubule, primary c) Loop of Henle, secondary d) Distal tubule, secondary

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PGY300 Renal Practice Questions 75. As blood passes along the glomerular capillaries from the afferent arteriole to the efferent arteriole, the oncotic pressure of the plasma in the glomerular capillaries______________. a) Remains constant b) Decreases c) First decreases, reaches a minimum halfway along the glomerular capillary, then increases. d) First increase, reaches a maximum halfway along the glomerular capillary, then decreases The human body contains many salts, of which sodium and its anions is the major one, making up around 0.4 per cent of the body’s weight at a concentration around 140 millimoles/liter. Most of the sodium is found in the _______________. a) Plasma b) Intracellular fluid c) d) Blood e) Interstitial fluid The renal system is responsible for regulating the excretion of sodium from the body. The primary hormone responsible for this action is __________ and its primary nephron target is ____________. a) Vasopressin, Henle’s loop b) Vasopressin, proximal tubule c) Angiotensin converting enzyme, collecting duct d) e) Aldosterone, proximal tubule 78. The antidiuretic hormone is released from which of the following locations? a) Adrenal gland b) c) Pinal gland d) Afferent arteriole e) Efferent arteriole . Changing the relative resistances of the afferent and efferent arterioles is an important mechanism of controlling renal plasma flow (RPF) and glomerular filtration rate (GFR). If the resistance of the afferent arteriole is made to be ______ than that of the efferent arteriole, then the RPF will ________and GFR ______________. Assume the efferent arteriole resistance does not change. a) more, decrease, increase b) c) less, increase, decrease d) less, decrease, increase

.

Tubuloglomerular feedback (TGF) is an important renal mechanism that _____________. a) adjusts tubular filtration to match tubular secretion capacity b) c) Involves the hypothalamic-pituitary-renal-neuro-endocrine system d) e) adjust tubular secretion to match tubular reabsorption capacity The normal amount of glucose in urine should be between 0 - 0.8 millimoles / liter. A diabetic that is not under good control may have values much higher than the normal. Which of the following statements best explain the higher levels of glucose in the urine of these patients? a) It is a result of hypoglycemia. b) It occurs when there is too much sugar in the diet. c) Gluconeogenesis by the diabetic proximal tubule will increase glucose excretion. d) e) The diabetic proximal tubule is secreting too much glucose.

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PGY300 Renal Practice Questions 82. The reabsorption (conservation) of most of the filtered bicarbonate occurs in the __________ by ____________. b) c) d) e)

Proximal tubule, active transport of bicarbonate Proximal tubule, endocytosis Loop of Henle, diffusion through the paracellular pathway Collecting duct, diffusion through the paracellular pathway

The plasma osmolality of a person who does not have access to water (e.g., someone lost in the desert) would be expected to rise above the normal value. The first response to this change would be ________________. b) c) d) e)

Inhibition of osmoreceptors will increase ADH secretion. Stimulation of...