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Chapter:

140+ Renal Solved MCQs

in Physiology

These multiple-choice questions (MCQs) are designed to enhance your knowledge and understanding in the following areas: Biology .

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Chapter: Renal
1.

Which substance is 60 times more concentrated in urine than in plasma?

A. glucose
B. creatinine
C. sodium
D. urea
Answer» D. urea
discuss
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
discuss
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
discuss
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
discuss
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
discuss
6.

If [urine]PAH = 14mg/ml, urine flow = 0.9ml/min and [plasma]PAH = 0.02mg/ml
i) What is the clearance of PAH?
ii) If the extraction ratio of PAH is 0.9, what is the renal blood flow (Hct=45%)?

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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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-
discuss
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
discuss
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
discuss
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
discuss
21.

Carbonic anhydrase is not inhibited by:

A. cyanide
B. zinc
C. azide
D. sulphide
E. collecting duct
Answer» B. zinc
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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:
discuss
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
discuss
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
discuss (1)
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
discuss
31.

All of the following increase renin secretion EXCEPT:

A. sodium depletion
B. diuretics
C. hypertension
D. cardiac failure
E. cirrhosis
Answer» C. hypertension
discuss
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
discuss
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
discuss
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%
discuss
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
discuss
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
discuss
37.

Mesengial cell contraction is stimulated by:

A. ANP
B. dopamine
C. PGE2
D. cAMP
E. angiotensin II
Answer» E. angiotensin II
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss
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
discuss

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