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Chapter 17

1. The main function of the kidneys is the regulation of the intracellular fluid.

False

2. The actions of the kidney include regulation of
A. blood plasma pH.
B. blood plasma volume.
C. blood plasma electrolyte concentration.
D. All of the choices are correct.

D. All of the choices are correct.

3. Urine collects in the urinary bladder prior to entry into the urethra.

True

4. Damage to the lumbar region of the spinal cord could impair micturition.

False

5. The renal pelvis receives urine from the
A. minor calyces.
B. ureters.
C. renal pyramids.
D. major calyces.

D. major calyces

6. Damage to __________ neurons would impair micturition.
A. parasympathetic
B. sympathetic
C. somatic motor
D. association

A. parasympathetic

7. ________ are composed of crystals and proteins that grow until they break loose and pass into the urine collection system.
A. Renal columns
B. Renal calculi
C. Renal calyces
D. Renal pyramids

B. renal calculi

8. Shock-wave lithotripsy is used to treat
A. polycystic kidney disease.
B. glomerulonephritis.
C. acute renal failure.
D. renal calculi.

D. renal calculi

9. Incontinence could develop as a result of
A. pressure on the detrusor muscle.
B. poor bladder compliance.
C. damage to the external urethral sphincter.
D. All of the choices are correct.

D. all of the choices are correct

10. The process of urination is called
A. deglutition.
B. micturition.
C. incontinence.
D. glomerular filtration.

B. micturition

11. The __________ is the functional unit of the kidney.
A. calyx
B. nephron
C. neuron
D. medulla

B. nephron

12. The __________ is a capillary network that produces a blood filtrate that enters the urinary tubules.
A. vasa recta
B. peritubular capillary
C. glomerulus
D. interlobar capillary

C. glomerulus

13. _______________ is an autosomal dominant inherited condition in which progressive renal failure develops due to expanded portions of the renal tubule.
A. Glomerulonephritis
B. Renal calculus
C. Polycystic kidney disease
D. Pyelonephritis

C. polycystic kidney disease

14. The _______________ nephrons play an important role in producing concentrated urine.
A. juxtamedullary
B. cortical
C. pelvic
D. calical

A. juxtamedullary

15. What structure is an arteriole capillary bed - drained by an arteriole instead of a venule?
A. peritubular capillaries
B. vasa recta
C. glomerulus
D. juxtaglomerular apparatus

C. glomerulus

16. The efferent arteriole delivers blood to the
A. peritubular capillaries
B. vasa recta
C. glomerulus
D. juxtaglomerular apparatus

A. peritubular capillaries

17. Which of the following is the correct order of the nephron tubule structures?
A. distal convoluted tubule, loop of Henle, proximal convoluted tubule, Bowman's capsule
B. proximal convoluted tubule, Bowman's capsule, distal convoluted tubule, loop of Henle
C. Bowman's capsule, proximal convoluted tubule, loop of Henle, distal convoluted tubule
D. loop of Henle, Bowman's capsule, proximal convoluted tubule, distal convoluted tubule

C. bowman's capsule, proximal convoluted tubule, loop of henle, distal convoluted tubule

18. Which of the following is NOT a potential filtration barrier in the glomerular capsule?
A. glomerular basement membrane
B. capillary fenestrae
C. parietal layer of the capsule
D. slit diaphragm

C. parietal layer of the capsule

19. The primary filter to exclude proteins from the filtrate is the
A. glomerular basement membrane
B. capillary fenestrae
C. parietal layer of the capsule
D. slit diaphragm

B. capillary fenestrae

20. Which of the following is a layer of the renal corpuscle?
A. glomerular visceral epithelium
B. glomerular parietal epithelium
C. glomerular endothelium
D. All of the choices are correct.

D. all of the choices are correct

21. The average glomerular filtration rate is equal to
A. 180 L/day.
B. 5.5 L/min.
C. 100 mmHg/hour.
D. 8 mg/hour.

A. 180 L/day

22. Dilation of the afferent arteriole would increase glomerular pressure.

True

23. Elevated blood pressure stimulates an increased glomerular filtration rate.

True

24. Macula densa cells of the juxtaglomerular apparatus secrete renin.

False

25. The ability of the kidneys to maintain a relatively constant GFR despite fluctuating blood pressures is called
A. renal plasma threshold.
B. renal transport maximum.
C. renal plasma clearance.
D. renal autoregulation.

D. renal autoregulation

26. Hypotension would induce __________ of afferent arterioles.
A. constriction
B. dilation
C. no change

B. dilation

27. The sensor in tubuloglomerular feedback is a group of cells called the
A. macula densa.
B. glomerulus.
C. vasa recta.
D. macula lutea.

A. macula densa

28. Glomerular filtration would be decreased by
A. increased plasma protein concentration.
B. increased glomerular filtrate protein concentration.
C. decreased glomerular hydrostatic pressure.
D. increased mean arterial pressure.

C. decreased glomerular hydrostatic pressure

29. Through renal autoregulation, an increase in blood pressure will cause the afferent arteriole to ____ and therefore the GFR will _____.
A. dilate, not change
B. dilate, decrease.
C. constrict, decrease.
D. constrict, not change.

D. constrict, not change

30. Under conditions of severe dehydration approximately 99.2% of the glomerular ultrafiltrate volume is reabsorbed.

False

31. The minimum urine volume needed to excrete metabolic wastes produced by the body is called the
A. renal plasma threshold.
B. renal autoregulation.
C. obligatory water loss.
D. renal transport minimum.

C. obligatory water loss

32. The return of molecules from the tubules to the blood is called
A. reabsorption.
B. secretion.
C. filtration.
D. autoregulation.

A. reabsorption

33. The majority of reabsorption occurs in the
A. collecting duct.
B. distal convoluted tubule.
C. loop of Henle.
D. proximal convoluted tubule.

D. proximal convoluted tubule

34. The obligatory water loss needed to excrete metabolic wastes is _____ per day.
A. 300 mL
B. 400 mL
C. 600 mL
D. 800 mL

B. 400 mL

35. The transport of water is always an active process.

False

36. The proximal convoluted tubule reabsorbs approximately 65% of water and ions salt entering it.

True

37. The __________ surface of the simple cuboidal epithelia in the proximal convoluted tubule contains microvilli.
A. lateral
B. basal
C. basolateral
D. apical

D. apical

38. Na+ reabsorption is a(n) __________ process, while Cl- reabsoprtion is a(n) __________ process.
A. active, active
B. active, passive
C. passive, passive
D. passive, active

B. active, passive

39. As the tubular filtrate moves through the descending limb of the loop of Henle, the osmolality of the filtrate increases.

True

40. Na+ is actively transported into the tubule cells of the ascending limb of the Loop of Henle from the tubular lumen.

False

41. The __________ limb of the loop of Henle is impermeable to water.
A. ascending
B. descending
C. both limbs
D. neither

A. ascending

42. The tubular filtrate osmolarity __________ as it flows through the ascending limb of the loop of Henle.
A. increases
B. decreases
C. remains unchanged

B. decreases

43. Inhibition of the functions of the descending limb of the loop of Henle would stimulate
A. decreased water reabsorption.
B. increased Na+ reasbsorption.
C. decreased Na+ reabsorption.
D. increased water reabsorption.

A. decreased water reabsorption

44. The vasa recta have the net effect of concentrating solutes in the interstitial fluid of the renal medulla.

True

45. The __________ acts as a countercurrent exchanger.
A. juxtaglomerular apparatus
B. peritubular capillaries
C. vasa recta
D. macula densa

C. vasa recta

46. The concentration of renal filtrate is highest in the
A. proximal convoluted tubule.
B. base of the Loop of Henle.
C. distal convoluted tubule.
D. cortical portion of the collecting duct.

B. base of the Loop of Henle

47. Countercurrent multiplication occurs by the actions of the
A. vasa recta.
B. peritubular capillaries.
C. loop of Henle.
D. Both vasa recta and loop of Henle are correct.

D. both vasa recta and loop of Henle

48. _________ is a nonsalt molecule that contributes to the hypertonicity of the interstitial fluid of the renal tubules.
A. Urea
B. Protein
C. Creatinine
D. Xenobiotic molecule

A. urea

49. Urea transport in the collecting duct is a(n) __________ process.
A. active
B. passive
C. exocytosis
D. endocytosis

B. passive

50. Urea is transported out of the descending loop of Henle to add to the high osmolarity of the medulla.

False

51. Diabetes mellitus is a disease associated with the inadequate secretion or action of ADH.

False

52. The maximal response to antidiuretic hormone occurs in the cortical nephrons.

False

53. Water permeability of the proximal convoluted tubule is regulated by antidiuretic hormone.

False

54. The presence of antidiuretic hormone causes aquaporins to be formed in the collecting duct cells.

True

55. Antidiuretic hormone exerts its effect via a cAMP second messenger system.

True

56. Neurohypophyseal secretion of __________ stimulates formation of concentrated urine.
A. aldosterone
B. renin
C. antidiuretic hormone
D. angiotensin I

C. ADH

57. Tubular ultrafiltrate enters the collecting duct from the
A. glomerulus.
B. loop of Henle.
C. distal convoluted tubule.
D. proximal convoluted tubule.

C. distal convoluted tubule

58. Antidiuretic hormone
A. stimulates water reabsorption by the kidney.
B. induces fusion of aquaporin containing vesicles with the plasma membrane.
C. is secreted in response to dehydration.
D. All of the choices are correct.

D. all of the choices are correct

59. Tubular secretion of drugs is often accomplished by polyspecific organic anion transporters.

True

60. The ability of the kidneys to remove molecules from the blood plasma by excreting them in the urine is known as
A. glomerular filtration.
B. renal clearance.
C. micturition.
D. reabsorption

B. renal clearance

61. Which transporters in the proximal tubule are polyspecific and transport drugs and toxins to the ultrafiltrate?
A. water transporters
B. renal aquaporins
C. organic anion transporters
D. toxiporins

C. organic anion transporters

62. The effectiveness of some antibiotics, such as penicillin, is enhanced by preventing their excretion by use of
A. toxiporins.
B. organic anion transporters.
C. probenecid.
D. xenobiotics.

C. probenecid

63. The movement of molecules and ions from the peritubular capillaries into interstitial fluid and then into the nephron tubule is called
A. secretion.
B. reabsorption.
C. excretion.
D. filtration.

A. secretion

64. Inulin clearance gives a measurement of the glomerular filtration rate.

True

66. Inulin is a good measure of GFR because it is filtered but neither reabsorbed nor secreted by the kidneys.

True

67. Plasma measurement of creatinine is a close estimate of GFR.

True

68. Decreased glomerular filtration rate would
A. increase plasma protein clearance rate.
B. increase plasma urea clearance rate.
C. decrease plasma creatinine clearance rate.
D. decrease plasma glucose clearance rate.

C. decrease plasma creatinine

69. The renal plasma clearance of a substance that is filtered and reabsorbed must be less than the GFR.

True

70. The renal plasma clearance of a substance that is filtered and secreted is ____ the GFR.
A. greater than
B. less than
C. equal to

A. greater than

71. The renal plasma clearance of a substance that is filtered but not reabsorbed or secreted is ___ the GFR.
A. greater than
B. less than
C. equal to

C. equal to

72. Renal clearance of PAH __________ glomerular filtration rate.
A. is equal to
B. exceeds
C. is less than

B. exceeds

73. The minimum plasma concentration of a substance that results in the excretion of that substance in the urine is the
A. transport maximum.
B. GFR.
C. renal plasma clearance.
D. renal plasma threshold.

D. renal plasma threshold

74. The concentration of glucose in the glomerular ultrafiltrate is less than that of plasma.

False

75. The _________________ is the saturation point of renal carrier molecules.
A. transport maximum
B. GFR
C. renal plasma clearance
D. renal plasma threshold

A. transport maximum

76. People with diabetes mellitus have glycosuria because
A. the total renal blood flow is low.
B. the plasma glucose concentration is greater than the renal plasma threshold.
C. they have inadequate amounts of ADH.
D. None of the choices are correct.

B. the plasma glucose concentration is greater than the renal plasma threshold

77. People with diabetes mellitus have polyuria because
A. they have inadequate amounts of ADH.
B. they have greater oncotic pressure in the kidney tubules.
C. they have inadequate amounts of aldosterone.
D. they drink a lot of water.

B. they have greater oncotic pressure in the kidney tubules

78. Increased aldosterone secretion stimulates renal potassium retention.

False

79. Inhibition of __________ secretion from the adrenal cortex stimulates hyperkalemia.
A. aldosterone
B. renin
C. angiotensin I
D. angiotensin II

A. aldosterone

80. Excessive aldosterone secretion would induce
A. decreased plasma potassium.
B. decreased plasma sodium.
C. decreased plasma chloride.
D. no change in plasma ion balance.

A. decreased plasma potassium

81. Diuretics
A. decrease urine production.
B. induce hypertension.
C. often act on the proximal convoluted tubule.
D. often act on the distal convoluted tubule.

D. often act on the distal convoluted tubule

82. The main region of aldosterone action is the
A. distal convoluted tubule.
B. proximal convoluted tubule.
C. medullary collecting duct.
D. cortical collecting duct.

D. cortical collecting duct

83. Granular cells of the juxtaglomerular apparatus respond to decreased blood volume and increased sympathetic nerve activity by secreting
A. renin.
B. inulin.
C. angiotensinogen.
D. natriuretic hormone.

A. renin

84. Angiotensin-converting enzyme is mostly present in the capillaries of the
A. liver.
B. kidneys.
C. lungs.
D. adrenal medulla.

C. lungs

85. The presence of renin secreting tumors may cause
A. hypertension.
B. increased aldosterone secretion.
C. increased renal sodium reabsorption.
D. All of the choices are correct.

D. All of the choices are correct

86. Hemorrhage would induce
A. increased renin secretion.
B. increased atrial natriuretic peptide secretion.
C. decreased ADH secretion.
D. All of the choices are correct.

A. increased renin secretion

87. An inadequate dietary intake of NaCl will cause
A. a rise in blood volume.
B. a rise in renal blood flow.
C. increased renin secretion.
D. decreased aldosterone secretion.

C. increased renin secretion

88. Aldosterone secretion from the adrenal cortex is stimulated by a(n) ____ in blood Na+ or a(n) ___ in blood K+.
A. increase, decrease
B. increase, increase
C. decrease, increase
D. decrease, decrease

C. decrease, increase

89. The conversion of angiotensin I into angiotensin II occurs primarily in the
A. liver.
B. adrenal cortex.
C. kidneys.
D. lungs.

D. lungs

90. Potassium secretion by the kidneys is only possible due to the action of aldosterone.

False

91. Diuresis is stimulated by atrial natriuretic peptide.

True

92. Changes in blood volume are detected by
A. osmoreceptors in hypothalamus.
B. stretch receptors in the atria.
C. cells in the proximal convoluted tubule.
D. osmoreceptors in the medulla.

B. stretch receptors in the atria

93. Conn's syndrome results in hypokalemia and
A. metabolic alkalosis.
B. metabolic acidosis.
C. loss of H+.
D. Both metabolic alkalosis and loss of H+ are correct.

D. both metabolic alkalosis and loss of H+

94. Depletion of extracellular K+ may induce
A. metabolic acidosis.
B. metabolic alkalosis.
C. hyperventilation.
D. None of the choices are correct.

B. metabolic alkalosis

95. An increase in extracellular H+ concentration may result in ______ extracellular K+.
A. increased
B. decreased
C. no change in

A. increased

96. The buffers of urinary pH are ammonia and monohydrogen phosphate.

True

97. Inhibiting the actions of __________ would impair the ability of the kidney to regulate pH of the blood.
A. aldosterone
B. ADH
C. carbonic anhydrase
D. inulin

C. carbonic anhydrase

98. In response to alkalosis
A. the kidney maximally reabsorbs bicarbonate.
B. the kidney excretes bicarbonate.
C. excess H+ enters the tubular filtrate.
D. tubular carbonic anhydrase is inhibited.

B. the kidney excretes bicarbonate

99. The apical membranes of the tubular cells are impermeable to bicarbonate.

True

100. Bicarbonate must be converted to ____ to move into tubule cells to reduce blood pH.
A. carbonic anhydrase
B. carbonic acid
C. carbon dioxide
D. None of the choices are correct.

C. carbon dioxide

101. The kidneys can directly reabsorb bicarbonate.

False

102. Since most filtered bicarbonate is reabsorbed, where does the bicarbonate come from that is used to compensate for acidosis?
A. carbonic acid
B. carbon dioxide
C. glutamine
D. glucose

C. glutamine

103. The osmotic diuretic mannitol inhibits salt and water absorption in the proximal convoluted tubule.

False

104. Hypertension and edema are often treated with diuretics.

True

105. Neuromuscular disorders and electrocardiographic abnormalities can result from
A. hypokalemia.
B. excessive use of loop diuretics.
C. excessive use of thiazide diuretics.
D. All of the choices are correct.

D. all of the choices are correct

106. Spironolactone
A. inhibits the actions of aldosterone.
B. blocks bicarbonate reabsorption.
C. stimulates hypertension.
D. activates Na+/K+ pumps.

A. inhibits the actions of aldosterone

107. Loop diuretics such as Lasix
A. inhibit the actions of ADH.
B. add extra solutes to the filtrate.
C. inhibit active transport of salt out of the ascending loop of Henle limb.
D. inhibit salt transport in the first section of the distal convoluted tubule.

C. inhibit active transport of salt out of the ascending loop of Henle limb

108. Thiazide diuretics
A. inhibit the actions of ADH.
B. add extra solutes to the filtrate.
C. inhibit active transport of salt out of the ascending loop of Henle limb.
D. inhibit salt transport in the first section of the distal convoluted tubule.

D. inhibit salt transport in the first section of the distal convoluted tubule

109. Renal damage often produces microalbuminuria.

True

110. Glomerulonephritis may result from destruction of the glomerular capillary basement membrane.

True

111. Renal insufficiency often results from dialysis.

False

112. __________ is believed to be an autoimmune disease affecting the kidney.
A. Pyelonephritis
B. Polycystic kidney
C. Glomerulonephritis
D. Cystitis

C. glomerulonephritis

113. Which test can be used to detect renal damage from diabetes or hypertension?
A. urea clearance
B. PAH clearance
C. inulin clearance
D. albumin excretion rate

D. albumin excretion rate

114. Renal insufficiency
A. stimulates metabolic alkalosis.
B. often results from dialysis.
C. may occur as a result of arteriosclerosis.
D. stimulates hypokalemia.

C. may occur as a result of arteriosclerosis

115. CAPD utilizes the _________ as a dialysis membrane.
A. artificial semipermeable membrane
B. urinary bladder
C. peritoneum
D. lungs

C. peritoneum

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