McqMate
Chapters
| 1. |
Which substance is 60 times more concentrated in urine than in plasma? |
| A. | glucose |
| B. | creatinine |
| C. | sodium |
| D. | urea |
| Answer» D. urea | |
| 2. |
Regarding the anatomy of the kidney: |
| A. | the afferent arteriole is smaller than the efferent |
| B. | the kidney contains 1.3 million nephrons |
| C. | there are three layers separating the blood in the arteriole from the glomerular filtrate |
| D. | podocytes are contractile and regulate GFR |
| Answer» B. the kidney contains 1.3 million nephrons | |
| 3. |
Regarding the glomerulus filtration fx: |
| A. | it allows passage of molecules up to 4nm diameter freely, and up to 8nm with some difficulty depending on charge |
| B. | positively charged molecules pass more easily than neutral |
| C. | endothelial pores have a greater diameter than podocyte filtration slits |
| D. | the basal lamina contains interruptions |
| Answer» A. it allows passage of molecules up to 4nm diameter freely, and up to 8nm with some difficulty depending on charge | |
| 4. |
The renal tubule: |
| A. | all sections are lined with cuboidal epithelial cells with luminal microvilli |
| B. | the thick loop of Henle rises to lie adjacent to its glomerulus |
| C. | there are a greater number of juxtamedullary nephrons than cortical |
| D. | the lacis cells of the juxtaglomerular apparatus secrete renin |
| Answer» B. the thick loop of Henle rises to lie adjacent to its glomerulus | |
| 5. |
Regarding glomerular blood supply: |
| A. | the efferent arterioles are branches of the interlobular arterioles |
| B. | the descending vasa recta vessels contain fenestrated endothelium to assist urea transport |
| C. | the efferent arterioles empties into the peritubular network |
| D. | the glomerular capillaries drain into the efferent vein |
| Answer» C. the efferent arterioles empties into the peritubular network | |
| 6. |
If [urine]PAH = 14mg/ml, urine flow = 0.9ml/min and [plasma]PAH = 0.02mg/ml
|
| A. | ClPAH = 630, renal blood flow = 1273ml/min |
| B. | ClPAH = 630, renal blood flow = 700mb/min |
| C. | ClPAH = 77, renal blood flow = 155mb/min |
| D. | ClPAH = 777mb/min, renal blood flow = 1569mb/min |
| Answer» A. ClPAH = 630, renal blood flow = 1273ml/min | |
| 7. |
Renal blood pressure: |
| A. | the pressure drop across the glomerulus is about 20mmHg |
| B. | pressure in the renal vein is about 15mmHg |
| C. | the glomerular capillary pressure is about 80% that of arterial |
| D. | the greatest drop in pressure (percentage wise) is from the efferent arteriole to the peritubular capillary |
| Answer» D. the greatest drop in pressure (percentage wise) is from the efferent arteriole to the peritubular capillary | |
| 8. |
Regarding renal innervation: |
| A. | transplanted kidneys initially have reduced concentrating ability because of lack of innervation of the juxtaglomerular cells and therefore decreased renin secretion |
| B. | norepinephrine acts directly on α receptors on the juxtaglomerular cells |
| C. | renal blood flow increases during exercise |
| D. | autoregulation of renal blood flow can be disrupted by angiotensin-II inhibitors when renal perfusion is low |
| Answer» D. autoregulation of renal blood flow can be disrupted by angiotensin-II inhibitors when renal perfusion is low | |
| 9. |
The glomerular filtration rate: |
| A. | is usually in the order of 125mL/min for an average healthy male |
| B. | is equal to the clearance of creatinine |
| C. | is indirectly related to filtration coefficient |
| D. | is determined by [urine]inulin |
| Answer» A. is usually in the order of 125mL/min for an average healthy male | |
| 10. |
Which of the following will cause an increase in GFR? |
| A. | dehydration |
| B. | ureteral obstruction |
| C. | afferent arteriole constriction |
| D. | hypoproteinaemia |
| Answer» D. hypoproteinaemia | |
| 11. |
Na+ resorption does not occur in which part of the nephron? |
| A. | proximal convoluted tubule |
| B. | thin descending loop of Henle |
| C. | thick ascending loop of Henle |
| D. | distal convoluted tubule |
| E. | collecting duct |
| Answer» B. thin descending loop of Henle | |
| 12. |
Which is NOT resorbed via cotransport with Na+ in the PCT? |
| A. | lactate |
| B. | phosphate |
| C. | hydrogen |
| D. | amino acids |
| E. | collecting duct |
| Answer» C. hydrogen | |
| 13. |
Fanconi’s syndrome of decreased levels of ATP in the tubular epithelium of the PCT: |
| A. | decreases Na+ extrusion from the cell into the interstitium |
| B. | causes increased phosphate absorption |
| C. | causes metabolic alkalosis |
| D. | results in decreased amino acid excretion |
| E. | collecting duct |
| Answer» A. decreases Na+ extrusion from the cell into the interstitium | |
| 14. |
Anti-diuretic hormone controls the concentration of urine, |
| A. | and can concentrate urine to up to 2500mosm/kg H??? H2O |
| B. | in its absence, the collecting duct is impermeable to water |
| C. | causing the ultimate resorption of up to 99.7% of the filtrate |
| D. | by causing upregulation of aquaporin-1 channels |
| E. | collecting duct |
| Answer» C. causing the ultimate resorption of up to 99.7% of the filtrate | |
| 15. |
Regarding H+ renal excretion: |
| A. | the distal convoluted tubule brush border contains carbonic anhydrase |
| B. | H+ secretion occurs in all segments of the nephrons |
| C. | H+ + NH3 →NH4+ is the most significant tubular buffering reaction |
| D. | CO2 is recycled / resorbed in the PCT to allow enhanced acid secretion |
| E. | collecting duct |
| Answer» D. CO2 is recycled / resorbed in the PCT to allow enhanced acid secretion | |
| 16. |
In the nervous control of the bladder which nerves do NOT play a role in micturition? |
| A. | sympathetic nerves from L2 in hypogastric nerve |
| B. | somatic motor neurons in pudendal nerve |
| C. | sensory neurons to S2/3 in pelvic nerves |
| D. | parasympathetic supply in pelvic nerves |
| E. | collecting duct |
| Answer» A. sympathetic nerves from L2 in hypogastric nerve | |
| 17. |
Which is the least significant buffering system in the blood? |
| A. | H+ + plasma protein HProt |
| B. | H+ +HPO4 2- H2PO4- |
| C. | H+ + HCO3 - H2CO3 |
| D. | H+ + Hb HHb |
| E. | collecting duct |
| Answer» B. H+ +HPO4 2- H2PO4- | |
| 18. |
In which body compartment is the bicarb buffering system least important? |
| A. | intracellular |
| B. | interstitial |
| C. | CSF |
| D. | blood |
| E. | collecting duct |
| Answer» A. intracellular | |
| 19. |
In which state is extracellular buffering more important than intracellular? |
| A. | respiratory acidosis |
| B. | respiratory alkalosis |
| C. | metabolic acidosis |
| D. | metabolic alkalosis |
| E. | collecting duct |
| Answer» D. metabolic alkalosis | |
| 20. |
Renal acid secretion is enhanced by: |
| A. | respiratory acidosis |
| B. | respiratory alkalosis |
| C. | hyperkalaemia |
| D. | carbonic anhydrase inhibition |
| E. | collecting duct |
| Answer» A. respiratory acidosis | |
| 21. |
Carbonic anhydrase is not inhibited by: |
| A. | cyanide |
| B. | zinc |
| C. | azide |
| D. | sulphide |
| E. | collecting duct |
| Answer» B. zinc | |
| 22. |
What increases GFR: |
| A. | moderate constriction of efferent arterioles |
| B. | moderate constriction of afferent arterioles |
| C. | increased Bowman’s capsule pressure |
| D. | increased glomerular capillary osmotic pressure |
| E. | collecting duct |
| Answer» A. moderate constriction of efferent arterioles | |
| 23. |
What increases the anion gap: |
| A. | increased concentration of Mg2+ |
| B. | decreased concentration of plasma proteins |
| C. | decreased concentration of lactate |
| D. | increased concentration of ketoacids |
| E. | collecting duct |
| Answer» D. increased concentration of ketoacids | |
| 24. |
Which is CORRECT? |
| A. | humans have approximately 1.3 million nephrons |
| B. | glomerular membrane excludes substances greater than 4nm in diameter |
| C. | total area of glomerular capillary endothelium is 8m2 |
| D. | nephrons length is 45-65mm |
| E. | collecting duct |
| Answer» D. nephrons length is 45-65mm | |
| 25. |
Which of the following is TRUE? |
| A. | U/P ratio for creatinine is 150mg/dl |
| B. | U/P ratio for glucose is 10 |
| C. | Na concentration in the urine usually exceeds over 150mg/dl |
| D. | the usual glucose excretion in the urine is 100mg/dl |
| E. | collecting duct |
| Answer» A. U/P ratio for creatinine is 150mg/dl | |
| 26. |
Which of the following is FALSE? |
| A. | proximal convoluted tubular cells have lateral intercellular spaces |
| B. | the cells in the descending loop of Henle have large numbers of mitochondria |
| C. | the ascending loop of Henle contributes to the formation of juxtaglomerular apparatus |
| D. | in humans only 15% of the nephrons have long loops |
| E. | collecting duct |
| Answer» B. the cells in the descending loop of Henle have large numbers of mitochondria | |
| 27. |
Regarding tubular function: |
| A. | 90% of the water is absorbed by the proximal convoluted tubule |
| B. | renal threshold for glucose is 300mg/dl |
| C. | the main mechanism of the Na reabsorption from the tubular fluid to proximal convoluted tubule is via Na/K/ATP a pump |
| D. | the main mechanism of Na absorption in the ascending loop of Henle is via cotransport of Na/K/2Cl: |
| E. | collecting duct |
| Answer» D. the main mechanism of Na absorption in the ascending loop of Henle is via cotransport of Na/K/2Cl: | |
| 28. |
The maximum effect of vasopressin occurs at: |
| A. | distal convoluted tubule |
| B. | proximal convoluted tubule |
| C. | cortical part of the collecting duct |
| D. | medullary part of collecting duct |
| E. | thick ascending limb of loop of Henle |
| Answer» C. cortical part of the collecting duct | |
| 29. |
Regarding the buffer system in the tubular fluid, which one is TRUE? |
| A. | the main buffer system is H2PO4 |
| B. | the main mechanism of H+ secretion in the proximal tubule is via proton pump |
| C. | dibasic phosphate buffer is most effective at proximal convoluted tubule |
| D. | the H+ secretion at proximal tubule is mediated Na/K/ATPase |
| E. | thick ascending limb of loop of Henle |
| Answer» D. the H+ secretion at proximal tubule is mediated Na/K/ATPase | |
| 30. |
Regarding the renin-angiotensin system, which is CORRECT? |
| A. | renin has many functions including the formation of angiotensin I from angiotensinogen |
| B. | after nephrectomy, circulating levels of prorenin fall |
| C. | renin is formed in the juxtaglomerular cells of the kidney |
| D. | active renin has a half-life in the circulation of 40 minutes or less |
| E. | prorenin is biologically active |
| Answer» C. renin is formed in the juxtaglomerular cells of the kidney | |
| 31. |
All of the following increase renin secretion EXCEPT: |
| A. | sodium depletion |
| B. | diuretics |
| C. | hypertension |
| D. | cardiac failure |
| E. | cirrhosis |
| Answer» C. hypertension | |
| 32. |
All of the following factors inhibit renin secretion EXCEPT: |
| A. | prostaglandins |
| B. | angiotensin II |
| C. | vasopressin |
| D. | increased afferent arteriolar pressure |
| E. | increased Na+ and Cl- reabsorption across the macular densa |
| Answer» A. prostaglandins | |
| 33. |
Which of the following blood gas results is consistent with a three-week residence at 4000m altitude, after previously living at sea-level? pH HCO3 - (meq/L) pCO2 |
| A. | 7.40 24.1 40 |
| B. | 7.50 30.1 40 |
| C. | 6.96 5.0 23 |
| D. | 7.34 33.5 64 |
| E. | 7.48 18.7 26 |
| Answer» E. 7.48 18.7 26 | |
| 34. |
In a resting adult, the kidneys receive how much of the cardiac output? |
| A. | 15% |
| B. | 20% |
| C. | 25% |
| D. | 30% |
| E. | 35% |
| Answer» C. 25% | |
| 35. |
Which of the following is INCORRECT regarding regulation of renal blood flow? |
| A. | noradrenaline constricts the renal vessels |
| B. | dopamine causes renal vasodilation and natriuresis |
| C. | angiotensin II exerts a constrictor effect on the efferent arterioles |
| D. | prostaglandins increase blood flow in the renal cortex and decrease blood flow in the renal medulla |
| E. | acetylcholine produces renal vasoconstriction |
| Answer» E. acetylcholine produces renal vasoconstriction | |
| 36. |
Erythropoietin: |
| A. | is produced in the juxtaglomerular cells of the kidney |
| B. | production is stimulated by theophylline |
| C. | secretion is facilitated by the acidosis that develops at high altitude |
| D. | has a half-life in the circulation of about 5 hours |
| E. | is produced predominantly in the spleen in neonates |
| Answer» D. has a half-life in the circulation of about 5 hours | |
| 37. |
Mesengial cell contraction is stimulated by: |
| A. | ANP |
| B. | dopamine |
| C. | PGE2 |
| D. | cAMP |
| E. | angiotensin II |
| Answer» E. angiotensin II | |
| 38. |
Ethanol’s action as a diuretic occurs by: |
| A. | inhibition of vasopressin secretion |
| B. | inhibition of the action of vasopressin on the collecting duct |
| C. | production of an osmotic diuresis |
| D. | decreasing tubular reabsorption of Na and increasing GFR |
| E. | inhibition of the Na+ -K+ -Cl- cotransporter in the medullary thick ascending limb of the loop of Henle |
| Answer» B. inhibition of the action of vasopressin on the collecting duct | |
| 39. |
With regard to diuretics: |
| A. | frusemide acts on the thick ascending limb of the loop of Henle |
| B. | antagonists to V2 vasopressin receptors act on the early portion of the distal convoluted tubule |
| C. | thiazides act primarily on the thick ascending limb of the loop of Henle |
| D. | loop diuretics act on the collecting ducts |
| E. | aldosterone antagonists act on the early portion of the distal convoluted tubule |
| Answer» A. frusemide acts on the thick ascending limb of the loop of Henle | |
| 40. |
In the presence of vasopressin, most filtered water is absorbed in the? |
| A. | proximal tubule |
| B. | loop of Henle |
| C. | distal tubule |
| D. | cortical collecting system |
| E. | medullary collecting system |
| Answer» A. proximal tubule | |
| 41. |
Which pattern of laboratory findings in the tale below is most consistent with a diagnosis of diabetes insipidis? 24 Hr Urine Vol Ketones Glucose Protein |
| A. | 4.0 + 0 0 |
| B. | 6.2 2+ 4+ 0 |
| C. | 1.6 0 0 4+ |
| D. | 6.4 0 0 0 |
| E. | 5.0 0 0 3+ |
| Answer» D. 6.4 0 0 0 | |
| 42. |
On which of the following does aldosterone exert its greatest effect? |
| A. | glomerulus |
| B. | proximal tubule |
| C. | thin portion of loop of Henle |
| D. | thick portion of look of Henle |
| E. | cortical collecting system |
| Answer» E. cortical collecting system | |
| 43. |
What is the clearance of a substance when its concentration in plasma is 1mg/ml, its concentration in urine is 10mg/ml and the urine flow is 2ml/min? |
| A. | 2ml/min |
| B. | 10ml/min |
| C. | 20ml/min |
| D. | 200ml/min |
| E. | clearance cannot be determined from the information given |
| Answer» C. 20ml/min | |
| 44. |
Glucose reabsorption occurs in the: |
| A. | proximal tubule |
| B. | loop of Henle |
| C. | distal tubule |
| D. | cortical collecting system |
| E. | medullary collecting system |
| Answer» A. proximal tubule | |
| 45. |
As urine flow increases during osmotic diuresis: |
| A. | the osmolality of urine falls |
| B. | the osmolality of urine increases |
| C. | the osmolality of urine approaches that of plasma |
| D. | the osmolality of urine is unchanged |
| E. | the osmolality of urine depends primarily on other factors |
| Answer» C. the osmolality of urine approaches that of plasma | |
| 46. |
Which of the following is NOT true regarding the voiding reflex? |
| A. | it involves parasympathetic fibres |
| B. | it remains intact in the period of spinal shock following transaction of the spinalcord |
| C. | it occurs when the bladder volume reaches 300-400mls |
| D. | it is integrated in the sacral segments of the spinal cord |
| E. | its threshold is altered by inhibitory fibres from the brainstem |
| Answer» B. it remains intact in the period of spinal shock following transaction of the spinalcord | |
| 47. |
Which of the following substances is NOT actively secreted in to the tubular lumen by the proximal renal tubule? |
| A. | urate |
| B. | para-amino hippuric acid |
| C. | catecholamines |
| D. | sodium |
| E. | creatinine |
| Answer» D. sodium | |
| 48. |
Angiotensin II causes: |
| A. | greater constriction of efferent than afferent arterioles |
| B. | greater construction of afferent than efferent arterioles |
| C. | constriction of afferent arterioles only |
| D. | constriction of efferent arterioles only |
| E. | has no effect on arteriolar constriction |
| Answer» A. greater constriction of efferent than afferent arterioles | |
| 49. |
With regard to the effect of hormones on renal tubules, which is CORRECT? |
| A. | aldosterone increases potassium reabsorption from the distal tubule |
| B. | angiotensin II increases hydrogen ion secretion from the proximal tubules |
| C. | ADH increases water reabsorption in the proximal tubule |
| D. | atrial naturetic peptide decreases sodium reabsorption from the proximal tubules |
| E. | parathyroid hormone increases phosphate reabsorption |
| Answer» B. angiotensin II increases hydrogen ion secretion from the proximal tubules | |
| 50. |
With regard to tuboglomerular feedback: |
| A. | the GFR increases when flow through the distal tubule increases |
| B. | the macula densa on the afferent arteriole is the sensor |
| C. | the afferent arteriole is constricted by thromboxane A2 |
| D. | it is designed to maintain sodium reabsorption |
| E. | it does not operate in individual nephrons |
| Answer» C. the afferent arteriole is constricted by thromboxane A2 | |
| 51. |
The primary reason for the decreased medullary hypertonicity associated with osmotic diuresis is: |
| A. | an associated increased urine volume |
| B. | the limiting concentration gradient for sodium reabsorption is reached |
| C. | tubular fluid has an increased sodium concentration |
| D. | the total amount of sodium reaching the loop of Henle is increased |
| E. | the associated maximal vasopressin secretion |
| Answer» B. the limiting concentration gradient for sodium reabsorption is reached | |
| 52. |
With respect to renal handling of glucose: |
| A. | glucose is reabsorbed from within the distal tubule by co-transport |
| B. | glucose is reabsorbed from within the proximal tubule by facilitated diffusion |
| C. | glucose is always completely reabsorbed |
| D. | movement of glucose from tubular epithelial cells is by passive diffusion |
| E. | none of the above |
| Answer» E. none of the above | |
| 53. |
Creatinine: |
| A. | is synthesised in the liver from methionine, glycine and anganine |
| B. | is converted directly to creatine |
| C. | has variable excretion from day to day |
| D. | creatinuria occurs normally in the elderly and in pregnant women |
| E. | all of the above |
| Answer» D. creatinuria occurs normally in the elderly and in pregnant women | |
| 54. |
The thin ascending loop of Henle is: |
| A. | relatively permeable to water |
| B. | relatively impermeable to sodium ion |
| C. | permeable to both water and sodium ion |
| D. | relatively impermeable to water |
| E. | relatively impermeable to both water and sodium ion |
| Answer» D. relatively impermeable to water | |
| 55. |
The primary effect of angiotensin II on renal vasculature is: |
| A. | constriction of efferent arterioles |
| B. | enhanced prostaglandin mediated increased blood flow to the renal cortex |
| C. | enhanced catecholamine mediated afferent arteriolar vasoconstriction |
| D. | enhanced catecholamine mediated afferent vasodilatation |
| E. | constriction of interlobular arteries |
| Answer» A. constriction of efferent arterioles | |
| 56. |
What percentage of filtered sodium is reabsorbed by the kidney? |
| A. | 1% |
| B. | 93% |
| C. | 99% |
| D. | 50% |
| E. | 100% |
| Answer» C. 99% | |
| 57. |
Tuboglomerular feedback refers to: |
| A. | the process of increased sodium reabsorption associated with an increased glomerular filtration |
| B. | changes in peri-tubular oncotic pressure associated with changes in glomerular filtration |
| C. | decreased glomerular filtration associated with increased flow through the loop of Henle |
| D. | increased glomerular filtration associated with decreased peri-tubular oncotic pressure |
| E. | thromboxane A2 mediated increased sodium reabsorption associated with increased renal blood flow |
| Answer» C. decreased glomerular filtration associated with increased flow through the loop of Henle | |
| 58. |
Frusemide acts mainly at: |
| A. | proximal tubule |
| B. | thin limb of loop of Henle |
| C. | thick limb of loop of Henle |
| D. | distal tubule |
| E. | collecting duct |
| Answer» C. thick limb of loop of Henle | |
| 59. |
At which site does tubular fluid osmolality exceed that of plasma by the greatest amount? |
| A. | proximal tubule |
| B. | thin limb of loop of Henle |
| C. | thick limb of loop of Henle |
| D. | distal tubule |
| E. | collecting duct |
| Answer» B. thin limb of loop of Henle | |
| 60. |
At which site is sodium ion NOT actively reabsorbed? |
| A. | proximal tubule |
| B. | thin limb of loop of Henle |
| C. | thick limb of loop of Henle |
| D. | distal tubule |
| E. | collecting duct |
| Answer» B. thin limb of loop of Henle | |
| 61. |
At which site(s) is potassium ion secreted? |
| A. | distal tubule and collecting duct |
| B. | proximal tubule and distal tubule |
| C. | think limb of loop of Henle only |
| D. | thin limb and thick limb of loop of Henle |
| E. | none of the above |
| Answer» A. distal tubule and collecting duct | |
| 62. |
At which site does chlorthiazide act? |
| A. | proximal tubule |
| B. | thin limb of loop of Henle |
| C. | thick limb of loop of Henle |
| D. | distal tubule |
| E. | collecting duct |
| Answer» D. distal tubule | |
| 63. |
The cortical portion of the collecting duct has the capacity to reabsorb approximately 10% of the filtered water. Which substance is most important in regulating this effect? |
| A. | angiotensin II |
| B. | histamine |
| C. | vasopressin |
| D. | sodium |
| E. | prostaglandins |
| Answer» C. vasopressin | |
| 64. |
With respect to GFR: |
| A. | clearance of p-amino hippuric acid is used to determine GFR |
| B. | inulin cannot be used to measure GFR |
| C. | GFR is usually reduced in ureteric obstruction |
| D. | filtration pressure changes with change in blood pressure |
| E. | contraction of mesangial cells increases GFR |
| Answer» C. GFR is usually reduced in ureteric obstruction | |
| 65. |
With respect to the loop of Henle: |
| A. | the ascending limb is highly permeable to water |
| B. | the descending limb is impermeable to water |
| C. | the thick ascending limb co-transports sodium, potassium and chloride out of the lumen |
| D. | tubular fluid becomes concentrated as it passes through the ascending limb |
| E. | the ascending limb removes approximately 15% of filtered water |
| Answer» C. the thick ascending limb co-transports sodium, potassium and chloride out of the lumen | |
| 66. |
Mesangial cells: |
| A. | are specialised cells that are characterised by numerous pseudopodia |
| B. | are made to contract by dopamine |
| C. | are made to contract by angiotensin II |
| D. | lie within the renal medulla |
| E. | decrease the area for filtration when they relax |
| Answer» C. are made to contract by angiotensin II | |
| 67. |
Regarding the proximal tubule, the following statements are true EXCEPT: |
| A. | sodium is co-transported out of the tubule with glucose |
| B. | sodium is actively transported into the intercellular spaces by Na-K-ATPase |
| C. | the cells are characterised by a brush border and tight junctions |
| D. | vasopressin increases the permeability to water by causing the rapid insertion of water channels into the luminal membrane |
| E. | water moves passively out of the tubule along osmotic gradients |
| Answer» D. vasopressin increases the permeability to water by causing the rapid insertion of water channels into the luminal membrane | |
| 68. |
Renal autoregulation of GFR helps prevent large fluctuations in GFR despite wide variations in arterial blood pressure. With regard to autoregulation, which is TRUE? |
| A. | the macula densa cells sense change in afferent arteriolar pressure |
| B. | falling GFR results in a feedback to decrease efferent arteriolar pressure |
| C. | falling GFR results in an increase in renin secretion from macula densa cells |
| D. | decreased macula densa concentration of NaCl results in dilatation of afferent arterioles |
| E. | decreased GFR decreases NaCl reabsorption in the ascending loop of Henle |
| Answer» D. decreased macula densa concentration of NaCl results in dilatation of afferent arterioles | |
| 69. |
Aldosterone has its principle effect in the: |
| A. | proximal convoluted tubule |
| B. | descending loop of Henle |
| C. | thick ascending loop of Henle |
| D. | distal convoluted tubule |
| E. | collecting ducts |
| Answer» E. collecting ducts | |
| 70. |
85% of NaHCO3 in the filtrate is reabsorbed in the: |
| A. | proximal convoluted tubule |
| B. | descending loop of Henle |
| C. | thick ascending loop of Henle |
| D. | distal convoluted tubule |
| E. | collecting ducts |
| Answer» A. proximal convoluted tubule | |
| 71. |
Thiazide diuretics exert their main effect in the: |
| A. | proximal convoluted tubule |
| B. | descending loop of Henle |
| C. | thick ascending loop of Henle |
| D. | distal convoluted tubule |
| E. | collecting ducts |
| Answer» D. distal convoluted tubule | |
| 72. |
Ethacrynic acid exerts its principle effect in the: |
| A. | proximal convoluted tubule |
| B. | descending loop of Henle |
| C. | thick ascending loop of Henle |
| D. | distal convoluted tubule |
| E. | collecting ducts |
| Answer» C. thick ascending loop of Henle | |
| 73. |
When considering fluid balance, which of the following is INCORRECT? |
| A. | the minimum daily fluid output may normally be estimated by measuring the urine output and adding 500ml |
| B. | urine output is always the single largest contributor to fluid output |
| C. | fluid intake and output may be altered in response to a change in extracellular osmolarity |
| D. | fluid intake and output may be altered in response to a change in extracellular volume |
| E. | the hypothalamus is an important regulator of fluid intake |
| Answer» B. urine output is always the single largest contributor to fluid output | |
| 74. |
Which of the following does NOT stimulate erythropoietin secretion? |
| A. | cobalt salts |
| B. | thromboxanes |
| C. | androgens |
| D. | adenosine |
| E. | prostaglandins |
| Answer» B. thromboxanes | |
| 75. |
Glomerular filtration rate is best measured using: |
| A. | inulin |
| B. | glucose |
| C. | PAH |
| D. | urea |
| E. | creatinine |
| Answer» A. inulin | |
| 76. |
“Renal dose” dopamine increases glomerular filtration rate by: |
| A. | dilating the renal arteries |
| B. | dilating the vasa recta |
| C. | constricting the efferent arteriole |
| D. | relaxing glomerular perivascular mesangial cells |
| E. | all of the above |
| Answer» D. relaxing glomerular perivascular mesangial cells | |
| 77. |
Regarding the kidney: |
| A. | the glomerular filtration rate is 125mls/hr |
| B. | the renal threshold for glucose 300mg/dL |
| C. | glucose transport is an example of secondary active transport |
| D. | the blood flow in the renal medulla is greater than in renal cortex |
| E. | a high protein diet decreases renal blood flow |
| Answer» C. glucose transport is an example of secondary active transport | |
| 78. |
Which of the following substances is not excreted by the kidney in a normal adult on an average diet? |
| A. | K+ |
| B. | uric acid |
| C. | creatinine |
| D. | glucose |
| E. | urea |
| Answer» D. glucose | |
| 79. |
Which of the following statements regarding erythropoietin is INCORRECT in an adult? |
| A. | half-life of about 5 hours |
| B. | hypoxia can increase secretion within minutes |
| C. | is secreted by spleen and salivary glands |
| D. | is secreted in adequate amounts by liver in absence of kidneys |
| E. | is a glycoprotein |
| Answer» D. is secreted in adequate amounts by liver in absence of kidneys | |
| 80. |
“Renal dose” dopamine is: |
| A. | 1-2 mcg/kg/min |
| B. | 1-5 mcg/kg/min |
| C. | 1-10 mcg/kg/min |
| D. | 1-20 mcg/kg/min |
| E. | greater than 20 mcg/kg/min |
| Answer» D. 1-20 mcg/kg/min | |
| 81. |
Frusemide acts as a diuretic primarily by: |
| A. | inhibiting Na+ /K+ /Cl- co-transport in loop of Henle |
| B. | inhibiting action of vasopressin on collecting duct |
| C. | decreasing H+ secretion with resultant increase in Na+/K+ excretion |
| D. | inhibiting vasopressin secretion |
| E. | inhibiting Na+/K+ exchange in collecting ducts by inhibiting the action of aldosterone |
| Answer» A. inhibiting Na+ /K+ /Cl- co-transport in loop of Henle | |
| 82. |
Regarding the osmolality of renal tubular fluid, is it? |
| A. | hypotonic in loop of Henle |
| B. | isotonic in proximal tubule |
| C. | hypertonic in distal tubule |
| D. | hypotonic in collecting duct |
| E. | hypotonic in proximal tubule |
| Answer» B. isotonic in proximal tubule | |
| 83. |
Which of the following statements regarding renal tubular glucose absorption is INCORRECT? |
| A. | binds to SGLT-2 in luminal membrane |
| B. | example of secondary active transport |
| C. | transported out of luminal cell by GLUT-2 |
| D. | about 100% reabsorption in proximal tubule if less than transport maximum |
| E. | linked to sodium reabsorption |
| Answer» A. binds to SGLT-2 in luminal membrane | |
| 84. |
Which of the following does NOT increase renal tubular sodium reabsorption? |
| A. | cortisol |
| B. | oestrogen |
| C. | growth hormone |
| D. | insulin |
| E. | glucagon |
| Answer» E. glucagon | |
| 85. |
Regarding renal handling of glucose, which is INCORRECT? |
| A. | transport maximum varies depending on sex |
| B. | proximal tubular absorption is an example of a symport mechanism |
| C. | not all nephrons handle glucose filtration and reabsorption equally |
| D. | phlorhizin inhibits distal tubular reabsorption |
| E. | GLUT-2 transports glucose into interstitial fluid |
| Answer» D. phlorhizin inhibits distal tubular reabsorption | |
| 86. |
Regarding renal handling of sodium, which is INCORRECT? |
| A. | more than 95% of filtered sodium is reabsorbed |
| B. | proximal tubular reabsorption is an example of secondary active transport |
| C. | aldosterone increases reabsorption despite increasing GFR |
| D. | glucocorticoids may increase or decrease urinary excretion |
| E. | renal oxygen consumption is directly proportional to sodium reabsorption |
| Answer» C. aldosterone increases reabsorption despite increasing GFR | |
| 87. |
Which of the following agents cause relaxation of mesangial cells of the glomerulus? |
| A. | angiotensin II |
| B. | dopamine |
| C. | endothelins |
| D. | vasopressin |
| E. | noradrenaline |
| Answer» B. dopamine | |
| 88. |
Regarding renal handling of bicarbonate ion, which is INCORRECT? |
| A. | small size of bicarbonate ion affects reabsorption |
| B. | reabsorption is reciprocally related to chloride ion reabsorption in proximal tubule |
| C. | most reabsorption occurs in proximal tubule |
| D. | reabsorption requires carbonic anhydrase |
| E. | reabsorption is decreased by ECF expansion |
| Answer» A. small size of bicarbonate ion affects reabsorption | |
| 89. |
Regarding renal handling of ammonia, which is INCORRECT? |
| A. | ammonia is not filtered at the glomerulus |
| B. | ammonia is synthesised in proximal and distal tubules |
| C. | glutaminase plays a role in ammonia excretion |
| D. | non-ionic diffusion of ammonia maintains a concentration gradient for further diffusion |
| E. | ammonia diffusion can increase up to 30 fold |
| Answer» E. ammonia diffusion can increase up to 30 fold | |
| 90. |
Regarding renal handling of calcium, which is INCORRECT? |
| A. | metabolic acidosis decreases reabsorption |
| B. | growth hormone increases reabsorption |
| C. | calcium is actively reabsorbed |
| D. | about 60% of filtered calcium load is reabsorbed in proximal tubules |
| E. | glucocorticoids increase calcium reabsorption |
| Answer» B. growth hormone increases reabsorption | |
| 91. |
Regarding renal handling of chloride, which is INCORRECT? |
| A. | about 25% of filtered load is actively reabsorbed in thick ascending limb |
| B. | proximal tubular reabsorption is reciprocally related to bicarbonate reabsorption |
| C. | it is actively secreted in distal tubule |
| D. | two chloride per sodium are reabsorbed in thick ascending limb |
| E. | chloride-hydroxide antiport are present in the kidney |
| Answer» C. it is actively secreted in distal tubule | |
| 92. |
Regarding glomerular filtration: |
| A. | the glomerular filtration rate varies les than the renal plasma flow |
| B. | inulin is stored in the kidney |
| C. | sialoproteins in the glomerular capillary wall are positively charged |
| D. | dopamine causes contraction of mesangial cells |
| E. | changes in renal blood flow do not affect glomerular filtration rate |
| Answer» A. the glomerular filtration rate varies les than the renal plasma flow | |
| 93. |
Regarding renal handling of phosphate, which is INCORRECT? |
| A. | no tubular secretion occurs |
| B. | most reabsorption occurs actively in proximal tubule |
| C. | parathyroid hormone inhibits tubular reabsorption |
| D. | less than 5% of filtered load is excreted |
| E. | phosphate is a much more powerful buffer in tubular fluid than in blood |
| Answer» D. less than 5% of filtered load is excreted | |
| 94. |
Regarding renal handling of hydrogen ion, which is INCORRECT? |
| A. | acetazolamide decreases tubular secretion |
| B. | aldosterone increases distal tubular secretion |
| C. | much more acid secretion occurs in proximal than distal tubule |
| D. | lowest tubular fluid pH achievable is 4.5 |
| E. | secondary active transport mechanism operates in distal tubule |
| Answer» E. secondary active transport mechanism operates in distal tubule | |
| 95. |
In diabetes insipidis: |
| A. | percentage of filtered water reabsorbed is increased compared to normal |
| B. | there is a net gain of water in excess of solute (L/day) |
| C. | urine volume (L/day) is decreased |
| D. | urine concentration (msom/L) is markedly reduced |
| E. | glomerular flow (ml/min) is increased |
| Answer» D. urine concentration (msom/L) is markedly reduced | |
| 96. |
Which site of diuretic action is INCORRECT? |
| A. | antidiuretic hormone antagonists act in collecting duct |
| B. | loop agents act in thin ascending limb |
| C. | carbonic anhydrase inhibitors act in proximal tubule |
| D. | thiazides act in early distal tubule |
| E. | aldosterone antagonists act in cortical collecting tubule |
| Answer» B. loop agents act in thin ascending limb | |
| 97. |
Which of the following statements regarding angiotensin is INCORRECT? |
| A. | angiotensin II has a half-life of about 1-2 minutes |
| B. | angiotensin I is physiologically inactive |
| C. | angiotensin III has equivalent pressor activity to angiotensin II |
| D. | angiotensinogen mainly comes from the liver |
| E. | angiotensin converting enzyme is a dipeptidyl carboxypeptidase angiotensin converting enzyme |
| Answer» C. angiotensin III has equivalent pressor activity to angiotensin II | |
| 98. |
Regarding renal tubular function: |
| A. | Na+ is actively transported out of the thin portions of the loop of Henle |
| B. | Na+ -K+ ATPase pumps Na+ out of the renal tubule |
| C. | Cl- is transported only by co-transport |
| D. | glucose is reabsorbed mainly in the distal tubule |
| E. | penicillin is not actively secreted into tubular fluid |
| Answer» B. Na+ -K+ ATPase pumps Na+ out of the renal tubule | |
| 99. |
Regarding the actions of angiotensin II, which is INCORRECT? |
| A. | selective renal efferent arteriolar constriction |
| B. | acts on CNS without crossing blood-brain barrier |
| C. | contract mesangial cells |
| D. | direct positive chronotropic action on heart |
| E. | increases conversion of cholesterol to pregnenelone |
| Answer» D. direct positive chronotropic action on heart | |
| 100. |
Normal values for renal function include all of the following EXCEPT: |
| A. | filtration fraction =0.2 |
| B. | 22% of cardiac output |
| C. | GFR = 180 litres/day |
| D. | RPF = 900 litres/day |
| E. | Tm glucose = 450 mg/minute |
| Answer» E. Tm glucose = 450 mg/minute | |
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