Renal system

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If a urine specific gravity was measured to be 1.03, an interpretation would be that: A. the person was dehydrated B. the person was well hydrated C. the urine sample had a density less than water D. the urine was dilute

Answer is A: 1.03 is at the upper limit of urine SG, indicating that the kidney is conserving water so the person is dehydrated.

Complete the following sentence correctly. Angiotensin II A. stimulates the adrenal glands to release aldosterone B. causes the wall of the collecting duct of the nephron to increase in perme-ability to water C. increases sodium (Na + ) excretion at the kidneys. D. reduces our thirst

Answer is A: ADH increases the permeability of the collecting duct to water. ANP diminishes thirst and increases sodium secretion at the kidneys.

Which hormone causes an increase in permeability to water in the collecting ducts of the kidney? A. antidiuretic hormone B. aldosterone C. angiotensin II D. atrial natriuretic hormone

Answer is A: ADH. If the collecting ducts are permeable to water, more water will be reclaimed from the fi ltrate. This will decrease its volume and there will be less diuresis. Hence anti-diuretic hormone.

Which list has the blood vessels of the nephron in the correct order of blood fl ow? A. afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries, vasa recta B. efferent arteriole, glomerulus, afferent arteriole, peritubular capillaries, vasa recta C. afferent arteriole, vasa recta, efferent arteriole, peritubular capillaries, glomerulus D. afferent arteriole, peritubular capillaries, efferent arteriole, glomerulus, vasa recta

Answer is A: Afferent arteriole bring blood into the glomerulus, then glo-merular capillaries are next.

Complete the following sentence correctly. Angiotensin II A. stimulates the adrenal glands to release aldosterone B. increases potassium reabsorption from the fi ltrate C. increases sodium (Na + ) excretion at the kidneys. D. reduces our thirst

Answer is A: Aldosterone is produced by the adrenal cortex in response to angiotensin II. A II also stimulates thirst.

Which one of the following is NOT produced by the kidneys? A. Aldosterone B. Renin C. Erythropoietin D. Calcitriol

Answer is A: Aldosterone is produced in the adrenal cortex (not the kidneys). The kidneys, along with the skin and liver contribute to producing calcitriol.

If aldosterone is present in the blood, what happens in the distal convoluted tubule? A. sodium ions are reabsorbed from the fi ltrate. B. calcium ions are reabsorbed from the fi ltrate. C. sodium ions are secreted into the fi ltrate. D. bicarbonate ions are reabsorbed from the fi ltrate.

Answer is A: Aldosterone promotes the absorption of sodium from the fi ltrate.

What effect does aldosterone have? A. increases the absorption of Na + from the kidney tubules. B. makes the kidney tubules more permeable to water. C. catalyses the formation of angiotensin I. D. blocks the release of ADH

Answer is A: Aldosterone stimulates the active absorption of sodium from the fi ltrate (and the secretion of potassium).

Which material is actively reabsorbed from the filtrate in the kidney tubule? A. N a + B. HCO 3− C. Cl − D. H 2 O

Answer is A: All other substances are passively reabsorbed.

Which of the following are organic wastes produced by the body? A. Uric acid and ammonium ions B. Amino acids and potassium ions C. Albumin and globulin D. Urea and sodium ions

Answer is A: Ammonium ions are produced when amino acids are deami-nated. Sodium is not organic.

What is the function of angiotensin II? A. causes constriction of systemic arteries. B. causes the collecting ducts to become permeable to water. C. causes the formation of atrial natriuretic hormone. D. causes constriction of the efferent arterioles.

Answer is A: Angiotensin II promotes general vasoconstriction (which raises blood pressure), and stimulates the adrenal cortex to release aldosterone.

What is the effect on the kidney caused by increasing the release of ADH? A. the collecting duct becomes more permeable to water B. the ascending limb of the loop of Henle becomes impermeable to water C. the descending limb of the loop of Henle becomes permeable to water D. the collecting duct becomes impermeable to water.

Answer is A: Antidiuretic hormone prevents diuresis (decreases urine forma-tion) by causing more water to be reabsorbed from the fi ltrate as it passes through the collecting duct.

How are cortical nephrons different from juxtamedullary nephrons? A. cortical nephrons lie almost entirely outside the renal medulla. B. cortical nephrons have an associated vasa recta. C. cortical nephrons have a longer tubule. D. there are fewer cortical nephrons.

Answer is A: Cortical nephrons are situated almost entirely within the cortex, while the far less numerous juxtamedullary nephrons have their glomeruli adjacent to the medulla and extend their loop of Henle into the medulla.

One way to increase the glomerular fi ltration rate is to dilate: A. the afferent arteriole and to constrict the efferent arteriole. B. the efferent arteriole and to constrict the afferent arteriole. C. both the afferent arteriole and the efferent arteriole. D. the efferent arteriole and to increase the permeability of the capillary endothelium.

Answer is A: Dilating the afferent arteriole increases the volume of blood fl owing into the glomerulus, while constricting the efferent arteriole decreases the volume of blood leaving the glomerulus. This means water and solutes must leave the glomerulus and enter the Bowman's capsule, that is GFR increases.

What is the term applied to the fi rst process in urine formation, where some components of blood pass into the Bowman's capsule? A. filtration B. active transport C. dialysis D. osmosis

Answer is A: Filtration is the fi rst process driven by a fl uid pressure gradient.

The concentration of blood is 280 to 300 mosmol/L, but may rise to 1200 mosmol/L in which situation? A. In the vasa recta of the kidney B. In severe dehydration C. In the peritubular capillaries of the kidney D. In severe over-hydration

Answer is A: Juxtamedullary nephrons have a capillary bed known as the vasa recta which descends into the kidney medulla. As it does so the concentration of he contained blood increases to 1200 mosmol/L.

Glomerular fi ltration rate can be altered by all of the following EXCEPT one. Which one? A. constriction of renal tubule by macula densa B. vasoconstriction of afferent arteriole C. decrease in concentration of plasma proteins D. vasoconstriction of efferent arteriole

Answer is A: Macula densa does not constrict the tubule. A decrease in plasma protein would increase the osmotic pressure opposing glomerular fi ltration.

In what part of the kidney are the glomeruli located? A. In the cortex B. In the medulla C. In the hilus D. In the minor calyces

Answer is A: Only the cortex contains glomeruli.

Which statement about kidney anatomy is correct? Renal pyramids are in the: A. medulla and end in a papilla that empties into a minor calyx B. medulla and end in a column that empties into a major calyx C. cortex and end in a papilla that empties into a minor calyx D. cortex and end in a column that empties into a minor calyx

Answer is A: Pyramids for the medulla. They contain collecting ducts that deliver urine a minor calyx via a papilla.

The gradient in osmotic concentration of the interstitial fl uid in the medulla of the kidney is caused by: A. blood fl owing through the vasa recta. B. Na + and Cl − pumped out of the ascending limb of the loop of Henle and urea. C. Na + and Cl − pumped out of the descending limb of the loop of Henle and urea. D. water diffusing out of the descending limb of the loop of Henle and aldosterone.

Answer is B: Sodium and chloride leave from the ascending limb not the descending limb

What is the resulting effect of renin being released by the kidney? A. Angiotensin II is formed B. aldosterone is released C. macula densa sends paracrine message to afferent arterioles. D. efferent arterioles are constricted

Answer is A: Renin catalyses the formation of angiotensin I from angioten-sinogen. ACE then converts angiotensin I to angiotensin II. Aldosterone is released from the adrenal cortex due to angiotensin II. Angiotensin II also promotes systemic vasoconstriction (not just in efferent arteriole).

What is renin? A. an enzyme released by the juxtaglomerular cells of the kidney when arte-rial pressure falls. B. it catalyses the formation of angiotensin II in the lungs. C. it is a rapid acting, intense vasoconstrictor of arterioles. D. a protein that stimulates the adrenal glands to release aldosterone.

Answer is A: The JG cells produce renin which leads to angiotensin II being formed which will cause blood pressure to rise.

From which part of the nephron is the greatest proportion of Na + absorbed from the fi ltrate? A. the proximal convoluted tubule B. the ascending limb of the loop of Henle C. the distal convoluted tubule D. the collecting duct in the presence of aldosterone

Answer is A: The PCT absorbs the greatest proportion of all things that are reabsorbed from the fi ltrate. It is the fi rst part of the renal tube that fi ltrate passes through.

Which statement about the descending limb of the Loop of Henle is true? A. it is freely permeable to water B. it is impermeable to water C. it is impermeable to water when ANP is present D. it is permeable to water when ADH is present

Answer is A: The ascending limb is impermeable to water. ADH and ANP have no effect on the loop of Henle.

Which statement about kidney anatomy is correct? A. The cortex is superficial to the medulla and contains all of the glomeruli. B. The cortex is deep to the medulla and contains the collecting tubules. C. The pyramids are in the cortex and contain the collecting tubules. D. The pyramids are in the medulla and contain all of the glomeruli.

Answer is A: The cortex is superfi cial to the medulla. All glomeruli are in the cortex. The medulla has the collecting ducts.

Filtrate passes through each of the structures of the renal tubule listed below. Which list has the structures in the correct order? A. proximal convoluted tubule, descending limb, ascending limb, distal con-voluted tubule, collecting duct. B. Bowman's capsule, proximal convoluted tubule, ascending limb, distal convoluted tubule, descending limb. C. collecting duct, proximal convoluted tubule, descending limb, ascending limb, distal convoluted tubule. D. proximal convoluted tubule, distal convoluted tubule, descending limb, ascending limb, collecting duct.

Answer is A: The descending and ascending limbs should be between the PCT and DCT, while the collecting duct is last.

Which part of the renal tubule is impermeable to water? A. the ascending limb of the loop of Henle B. the collecting duct C. the proximal convoluted tubule D. the thin portion of the loop of Henle

Answer is A: Water does not pass through the ascending limb. However sol-utes (Na & Cl) do pass through

If a urine specifi c gravity was measured to be 1.003, an interpretation would be that: A. the person was dehydrated B. the person was well hydrated C. the urine sample had a density less than water D. the urine was concentrated

Answer is B: 1.003 is close to the lower limit of urine SG, indicating that the kidney is not conserving water so the person is well hydrated.

What could be concluded of a person who (during the previous three hours) has produced a total of 100 ml of urine that is bright yellow and has a strong (but not unpleasant) odour? A. They are well hydrated. B. Their urine will have a high specifi c gravity. C. They are an uncontrolled diabetic. D. They have more than the usual concentration of bilirubin in their urine.

Answer is B: 100 ml/3 h is a low rate of urine production, indicating dehydra-tion. Hence the urine will be concentrated as the body is conserving water and its SG will be high.

What is the term meaning the production of urine? A. oliguria B. diuresis C. hypouria D. anuria

Answer is B: A drug that promotes urine production is a diuretic, while one that does the reverse is an antidiuretic.

Which one of the statements about the collecting ducts is true? The collecting duct absorbs: A. calcium if parathyroid hormone is present. B. water if antidiuretic hormone is present. C. sodium if atrial natriuretic hormone is NOT present. D. urea.

Answer is B: ADH cause aquaporins (water channels) to be inserted into the collecting duct walls. The collecting duct is impermeable to the other substances.

Complete the following sentence correctly. Atrial natriuretic peptide A. causes the wall of the collecting duct of the nephron to increase in perme-ability to water B. increases sodium (Na + ) excretion at the kidneys. C. causes peripheral vasoconstriction D. stimulates the adrenal glands to release aldosterone

Answer is B: ADH increases the permeability of the collecting duct to water. Angiotensin II stimulates the adrenal glands to release aldosterone and pro-motes peripheral vasoconstriction.

What is the body's response to a rise in blood plasma osmotic pressure? A. The anterior pituitary releases ADH which makes the renal tubule perme-able to water. B. The posterior pituitary releases ADH which makes the renal tubule perme-able to water. C. The juxtaglomerular apparatus releases renin which promotes diuresis D. The glomerular fi ltration rate increases so more urine is produced.

Answer is B: ADH, from the posterior pituitary, would allow more water to be reclaimed from the fi ltrate so that plasma osmotic pressure does not increase further. Renin and its effects does not promote diuresis.

The kidney produces all but one of the following. Which one? A. calcitriol B. atrial natriuretic peptide C. renin D. bicarbonate ions

Answer is B: ANP is produced by the walls of the heart's atria. It inhibits the absorption of sodium from the fi ltrate.

The kidneys produce all of the following EXCEPT one. Which one? A. erythropoietin B. aldosterone C. renin D. active vitamin D

Answer is B: Aldosterone is produced in the adrenal cortex.

The kidneys produce all of the following EXCEPT one. Which one? A. erythropoietin B. angiotensinogen C. hydronium ions D. bicarbonate ions

Answer is B: Angiotensinogen is produced in the liver. Renin (produced in the kidneys) converts it to angiotensin I.

What effect is achieved by having an arteriole that supplies blood and another that drains blood from the glomerulus? A. oxygen rich blood can be supplied to the nephron after blood leaves the glomerulus B. the blood pressure within the glomerulus can be manipulated. C. reabsorption of water and nutrients from the fi ltrate is facilitated. D. the concentration gradient within the kidney's medulla can be maintained.

Answer is B: Arterioles have smooth muscle in their wall which allows them to constrict and dilate, hence adjusting the fl ow through them and conse-quently the blood pressure within them.

Which of the following mechanisms operates in the nephron to maintain pH balance in the body? A. Bicarbonate ions from the tubule cells are secreted into the fi ltrate, then H ++ HCO 3−→ H 2 CO 3→ CO 2 + H 2 O B. In tubule cells CO 2 + H 2 O → H 2 CO 3→ H + + HCO 3− then hydrogen ions are secreted into the fi ltrate C. In tubule cells CO 2 + H 2 O → H 2 CO 3→ H + + HCO 3− then hydrogen ions are transported into the peritubular capillaries D. In tubule cells CO 2 + H 2 O → H 2 CO 3→ H + + HCO 3− then bicarbonate ions are secreted into the fi ltrate

Answer is B: Carbon dioxide and water form hydronium and bicarbonate ions, the hydronium ions being secreted into the fi ltrate for excretion in urine.

Which of the following happens as we descend deeper into the kidney medulla? A. the concentration of the interstitial fluid doesn't change B. the concentration of the interstitial fluid increases C. the concentration of the fi ltrate within the tubule increases D. the concentration of the interstitial fl uid decreases

Answer is B: Concentration of the interstitial fl uid increases. Choice C is not correct as the nephron tubule does not necessarily descend into the medulla.

From which arteriole does blood enter the peritubular capillaries of the nephron? A. arcuate B. efferent C. afferent D. renal

Answer is B: Efferent arteriole leaves the glomerulus and enters the peritubu-lar capillaries.

The infl uence (or infl uences) that drives blood fi ltration in the kidney is A. difference in osmolarity between blood in the glomerulus and fi ltrate in the Bowman's capsule B . fl uid pressure difference between blood in the glomerulus and fi ltrate in the Bowman's capsule C. the osmotic pressure difference between blood in the glomerulus and fi l-trate in the Bowman's capsule D. diffusion along the concentration gradient between blood and fi ltrate, and active transport

Answer is B: Filtration occurs because of a pressure difference. Osmotic pres-sure does not drive the process.

The renal tubule of the nephron includes which of the following structures? A. Proximal convoluted tubule, vasa recta, Bowman's capsule, collecting duct. B. Distal convoluted tubule, ascending limb of Loop of Henle, Bowman's capsule, proximal convoluted tubule. C. Descending limb of Loop of Henle, collecting duct, distal convoluted tubule, ascending limb of Loop of Henle. D. Glomerulus, proximal convoluted tubule, distal convoluted tubule, Bowman's capsule.

Answer is B: Glomerulus, collecting duct and vasa recta are not part of the tubule. The loop of Henle has both and ascending arm and a descending arm.

What influences and structures facilitate blood filtration in the renal corpuscle? A. high osmotic pressure in the capillaries and sinusoidal capillaries B. high hydrostatic pressure in the capillaries and fenestrated capillaries C. high osmotic pressure in the capillaries and fenestrated capillaries D. high hydrostatic pressure in the capillaries and sinusoidal capillaries

Answer is B: High hydrostatic pressure facilitates filtration and pores in the capillary walls (fenestre) allow easy passage.

What is indicated if the specifi c gravity of a patient's urine is high? A. the patient has kidney disease B. the urine's concentration is high C. the patient is well hydrated D. the urine density is low

Answer is B: High urine concentration correspond to a high SG.

What is the name for the entry point to the kidney for nerves, blood vessels, ureters and lymphatics? A. calyx B. hilus C. pelvis D. pyramid

Answer is B: Hilum is the name of the point of attachment between an organ and its supply services.

What is the entry point to the kidney for the renal artery, renal vein, lymphat-ics and nerves called? A. renal pyramid B. renal hilus C. renal capsule D. renal column

Answer is B: Hilus is a general term referring to the entry point (e.g. hilus of the lung)

Complete the following sentence correctly. Antidiuretic hormone A. stimulates our thirst B. causes the wall of the collecting duct of the nephron to increase in perme-ability to water. C. increases sodium (Na + ) excretion at the kidneys. D. stimulates the adrenal glands to release aldosterone

Answer is B: Increased permeability of the collecting duct means that more water will be reclaimed from the fi ltrate. Angiotensin II stimulates thirst. ANP diminishes thirst and increases sodium secretion at the kidneys.

What is the name of the tube that connects the bladder to the kidney? A. renal tubule B. ureter C. urethra D. collecting duct

Answer is B: Not to be confused with the urethra through which urine exits the body.

What does the term "oliguria" refer to? A. a daily urine production of much more than 2 litres B. a daily urine production of less than 500 ml C. production of less than 50 ml of urine in a day D. the condition of excessive concentration of urea in the blood

Answer is B: Oliguria refers to a less than normal daily volume of urine being produced. Normal is about two litres per day.

Which one of the following is a function of the renal system? A. produce bile B. produce the enzyme renin C. produce the hormone aldosterone D. produce vitamin K

Answer is B: Renin is produced in the kidney.

The density of water is 1.00 g/ml and it has a specific gravity of 1.000. Which of the following is most likely to be the specific gravity of a urine sample? A. 1.000 B. 1.015 C. 0.980 D. 1.020 g/ml

Answer is B: SG has no unit so choice D is wrong. Choice C cannot be correct as the density is less than that of water.

Which ion does aldosterone stimulate the kidneys to reabsorb? A. calcium B. sodium C. potassium D. bicarbonate

Answer is B: Sodium absorption is what aldosterone promotes.

In which structure does blood fi ltration in the kidney occur? The: A. macula densa B. renal corpuscle C. major calyx D. vasa recta

Answer is B: Solutes are fi ltered out of the blood in the glomerular capillaries into the Bowman's capsule. Together the two structures form the renal corpuscle.

From which part of the nephron is the greatest proportion of Na + absorbed from the filtrate? A. the Bowman's capsule (i.e. renal capsule) B. the proximal convoluted tubule C. the ascending limb of the loop of Henle D. the distal convoluted tubule

Answer is B: The PCT absorbs about 65 % of the sodium from the fi ltrate.

Four sections of the vasculature of the kidney tubule are listed below. Which one lists them in correct order of blood fl ow from left to right? A. efferent arteriole, glomerulus, afferent arteriole, peritubular capillaries. B. afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries. C. peritubular capillaries, afferent arteriole, glomerulus, efferent arteriole. D. glomerulus, afferent arteriole, peritubular capillaries, efferent venule.

Answer is B: The afferent arteriole carries blood into the glomerulus so must be first.

How does the composition of the filtrate change as it travels through the loop of Henle? A. In the ascending limb, the volume decreases and in the descending limb, the concentration increases. B. In the descending limb, the volume decreases and in the ascending limb, the concentration decreases. C. In the descending limb, the volume decreases and in the ascending limb, the concentration increases. D. In the ascending limb, the volume decreases and in the descending limb, the concentration decreases.

Answer is B: The descending limb is permeable to water so water fl ows out of the tubule decreasing fi ltrate volume. The ascending limb is impermeable to water, so its volume does not change, however sodium, potassium and chlo-ride ions are reabsorbed which decreases the concentration of the fi ltrate.

What is the collective term applied to the proximal and distal convoluted tubules, the loop of Henle (i.e. the nephron loop) and the glomerular capsule? A. The renal corpuscle B. The renal tubule C. The nephron D. The renal capsule

Answer is B: The nephron includes the glomerulus whereas the tubule does not

The infl uence(s) that drives blood fi ltration in the kidney is A. dialysis through a semi-permeable membrane due to the different osmolar-ity of blood and fi ltrate B . fl uid pressure difference between blood and fi ltrate C. osmotic pressure difference between blood and fi ltrate D. diffusion along a concentration gradient between blood and fi ltrate, and active transport

Answer is B: The term "fi ltration" refers to a process that is driven by a pres-sure difference.

Which of the following statements about the structures in the loop of Henle is correct? A. its ascending limb is permeable to water B. its descending limb is impermeable to urea C. its descending limb is impermeable to water D. its ascending limb is impermeable to solutes

Answer is B: The thin descending limb is impermeable to urea.

Which material is secreted into the filtrate in the kidney tubule? A . H 2 O B. urea C. Na + D. albumin

Answer is B: Urea (a waste product) is lipid soluble so can passively move out of the filtrate into the tubule cells. It is secreted back into the filtrate to effect its excretion.

By what name is the condition where nitrogenous wastes accumulate in the blood known? A. anuria B. uremia C. polyuria D. oliguriacv

Answer is B: Uremia. The other terms describe the volume of urine produced. Anuria = no urine; polyuria = far more than normal; oliguria, less than normal.

Which of the following statements about urine specifi c gravity is WRONG A. if urine specifi c gravity is 1.003, the urine is dilute. B. a urine specifi c gravity value of 1.015 = 1015 mmol/L. C. if urine specifi c gravity is 1.030, the person is dehydrated. D. a specifi c gravity value of 1.010 is equal to a urine density of 1.010 g/ml.

Answer is B: Urine SG is the same value as urine density in g/ml, but without the units.

Which of the following chemicals is produced by the kidney? A. angiotensinogen B. bicarbonate ions C. sodium ions D. vitamin C

Answer is B: carbon dioxide and water react to form carbonic acid which dis-sociates into hydronium ions and bicarbonate ions. The bicarbonate ions are transported to the blood while the hydronium is excreted in acidic urine.

What is the kidney tubule's response to a rise in blood pH? A. Bicarbonate ions are created from carbonic acid and absorbed into the blood. B. Hydronium ions are secreted into the fi ltrate, where they are buffered by bicarbonate ions in the fi ltrate. C. Bicarbonate ions are secreted into the fi ltrate, while hydronium ions are absorbed from the fi ltrate into the blood. D. Hydronium ions are secreted into the fi ltrate, while bicarbonate ions are absorbed from the fi ltrate into the blood.

Answer is C: A rise in blood pH means it is getting more alkaline. That is there is too much bicarbonate in the blood. To counter this some bicarbonate ions are secreted into the fi ltrate, while some hydronium ions are absorbed from the fi ltrate into the tubule cells

The kidneys produce all of the following except one. Which one? A. the enzyme renin B. the hormone erythropoietin C. antidiuretic hormone D. the vitamin calcitriol

Answer is C: ADH is produced in the hypothalamus and released from the posterior pituitary.

What is the purpose of ANP in urine production? A. stimulate the reabsorption of Na + B. stimulate the reabsorption of Ca ++ C. inhibit the reabsorption of Na + D. stimulate the reabsorption of water

Answer is C: ANP triggers the dilation of the afferent arterioles and constric-tion of efferent arterioles which increases GFR. It also decreases sodium reab-sorption from the fi ltrate. Hence urine volume increases (and blood volume and pressure decreases).

What structure does the blood from the afferent arteriole enter? A. the peritubular capillaries B. the vasa recta C. the glomerulus D. Bowman's capsule

Answer is C: Afferent (incoming) arteriole enters the glomerulus, the efferent arteriole leaves the glomerulus.

Which list of structures is presented in the correct order in which urine passes through them on the way to the bladder? A. Ureter, minor calyx, major calyx, renal pelvis, papilla B. Renal pelvis, major calyx, minor calyx, papilla, ureter C. Papilla, minor calyx, major calyx, renal pelvis, ureter D. Minor calyx, major calyx, papilla, renal pelvis, ureter

Answer is C: Collecting ducts empty into the papilla, so the papilla must be first.

In which part of the nephron does most of the reabsorption of water and solutes occur? A. the collecting duct B. the nephron loop (loop of Henle) C. the vasa recta D. the proximal convoluted tubule

Answer is D: The PCT absorbs the bulk of the water and solutes.

How does the juxtaglomerular apparatus respond when systemic blood pressure is too high? A. the juxtaglomerular cells send a message to the afferent arteriole to dilate. B. The macula densa sends a message to the efferent arteriole to constrict. C. The macula densa sends a message to the afferent arteriole to constrict. D. The granular cells release renin which causes systemic arterioles to constrict.

Answer is C: Constricting the afferent arteriole will decrease the volume of blood entering the glomerulus and hence the blood pressure in it. All other choices will result in an increase in pressure within the glomerulus.

What name is given to the blood vessel that drains blood from the glomerulus after fi ltration? A. vasa recta B. afferent arteriole C. efferent arteriole D. efferent vein

Answer is C: Efferent means outgoing.

By what process(es) do water and solutes move from blood in the glomerulus into the Bowman's capsule? A. diffusion B. osmosis and diffusion C. fi ltration D. dialysis

Answer is C: Filtration which is driven by the hydrostatic pressure difference between blood (at high pressure) in the glomerular capillaries and the fi ltrate (at lower pressure) in the Bowman's capsule.

In the kidney, the fi ltrate passes through several structures on its way to becoming urine. Which of the following lists presents these structures in the correct order? A. collecting duct, glomerulus, proximal convoluted tubule, distal convoluted tubule, loop of Henle. B. proximal convoluted tubule, collecting duct, glomerulus, loop of Henle, distal convoluted tubule. C. glomerulus, proximal convoluted tubule, loop of Henle, distal convoluted tubule, collecting duct. D. glomerulus, collecting duct, proximal convoluted tubule, distal convoluted tubule, loop of Henle.

Answer is C: Glomerulus must precede the collecting duct. Collecting duct must be after the DCT

The filtrate that is formed in the kidney contains all of the following except one. Which one? A. metabolic wastes B. electrolytes C. plasma proteins D. nutrients

Answer is C: Plasma proteins are too large to pass through the fi ltration slits of the glomerular capillaries.

What is the role of aldosterone? A. to convert angiotensinogen into angiotensin I. B. to inhibit the absorption of Na + . C. to promote the absorption of Na + . D. to promote the absorption of Ca ++

Answer is C: Sodium ions are always reabsorbed from the fi ltrate, Aldosterone promotes greater reclamation of sodium from the DCT.

What part of the renal tubule is NOT able to reabsorb water? A. the descending limb of the loop of Henle B. the proximal convoluted tubule C. the ascending limb of the loop of Henle D. the distal convoluted tubule

Answer is C: The ascending limb is impermeable to water.

What part of the renal tubule does NOT reabsorb water? A. the juxtaglomerular apparatus B. the ureter C. the ascending limb of the loop of Henle D. the collecting duct

Answer is C: The ascending limb is the only listed structure that is part of the renal tubule.

Which part of the nephron is impermeable to water? A. Proximal convoluted tubule B. Distal convoluted tubule in the presence of ADH C. Ascending limb of the loop of Henle D. Descending limb of the loop of Henle

Answer is C: The ascending limb. Hence volume of filtrate does not change as it passes through the ascending limb.

How does the descending limb of the loop of Henle differ from the ascending limb? A. the descending limb is impermeable to water but permeable to sodium chloride. B. the ascending limb is permeable to water but impermeable to sodium chloride. C. the descending limb is permeable to water but impermeable to sodium chloride. D. the ascending limb is permeable to both water and to sodium chloride.

Answer is C: The descending limb is permeable to water (the ascending limb is not). The descending limb is impermeable to solutes except urea

What name is given to the blood vessel that connects the capillaries of the glomerulus to the vasa recta? A. macula densa B. afferent arteriole C. efferent arteriole D. afferent vein

Answer is C: The efferent arteriole transports blood from the glomerulus to the peritubular capillaries and vasa recta.

The nephron of the kidney consists of which of the following structures? A. glomerulus, renal tubule and collecting duct. B. bowman's capsule, proximal convoluted tubule, loop of Henle, and distal convoluted tubule. C. glomerulus and renal tubule D. renal tubule and collecting duct.

Answer is C: The glomerulus and renal tubule together constitute the nephron.

What method does the glomerulus of the kidney nephron use to remove the dissolved substances from the blood to the fi ltrate? A. active transport B. diffusion along the concentration gradient C. high hydrostatic pressure D. osmosis

Answer is C: The larger diameter of the afferent arteriole along with the smaller diameter of the efferent arteriole creates a high pressure in the glom-erulus which facilitates fi ltration of dissolved material into the Bowman's capsule.

What may correctly be said of the juxtaglomerular apparatus (or complex)? A. The juxtaglomerular cells are chemoreceptors B. The granular cells are chemoreceptors C. The macula densa cells are chemoreceptors D. The macula densa cells are mechanoreceptors

Answer is C: The macula densa cells are chemoreceptors that respond to changes in Na + & Cl − ions. The granular cells are mechanoreceptors

The majority of material reabsorbed from the fi ltrate is reabsorbed from the renal tubule: A. after the Loop of Henle B. in the descending limb of the Loop of Henle C. before the Loop of Henle D. in the ascending limb of the Loop of Henle

Answer is C: The majority of reabsorption occurs in the proximal convoluted tubule which is before the loop of Henle.

Through which structure must the fi ltrate move to enter the Bowman's capsule from the glomerulus? A. The capillary endothelial cell walls B. The capillary endothelial wall and basement membrane C. The capillary endothelial wall, basement membrane and podocytes D. The capillary endothelial wall, basement membrane, podocytes and the vasa recta

Answer is C: Together these three structures form the fi ltration membrane

Which type of anti-hypertensive drug aims to prevent vasoconstriction? A. beta blockers B. diuretics C. ACE inhibitors D. calcium channel blockers

Answer is D: The contraction of smooth muscle causes vasoconstriction. Calcium is necessary for muscle contraction. A Ca channel blocker prevents Ca entering the cytoplasm and so prevents vasoconstriction.

The descending limb of the Loop of Henle is permeable to water so water dif-fuses out of the descending limb into the interstitial fl uid. What happens to this water? A. it fl ows through the renal papillae into the minor calyces to become urine. B. it diffuses into the ascending limb of the Loop of Henle. C. it diffuses into the peritubular capillaries and ascending vasa recta for return to the blood. D. it diffuses into the fi ltrate for elimination from the body.

Answer is C: Water (and solutes) that are reabsorbed from the fi ltrate return to the blood stream via the peritubular capillaries and the vasa recta.

What is the effect of antidiuretic hormone on the kidney tubules? A. It causes Na + to be absorbed from the fi ltrate into the tubular cells. B. It causes the concentration of urine to decrease. C. It causes the fi ltrate volume to increase. D. It causes the walls of the collecting duct to become permeable to water.

Answer is D: ADH causes more water channels (aquaporins) to be inserted in the wall of the collecting duct. Hence the duct is more permeable to water.

In which section of the renal tubule is most water reabsorbed? A. descending limb of the loop of Henle. B. ascending limb of the loop of Henle. C. collecting duct. D. proximal convoluted tubule.

Answer is D: About 2/3 of water in the fi ltrate is absorbed from the PCT.

Under what conditions will the kidney produce concentrated urine? If: A. glomerular fi ltration rate is low. B. glomerular fi ltration rate is high. C. atrial natriuretic peptide and aldosterone are present in blood. D. antidiuretic hormone and aldosterone are present in the blood.

Answer is D: Aldosterone causes sodium to be absorbed from the fi ltrate at the DCT and collecting duct. This sets up an osmotic gradient. ADH makes the tubule more permeable to water. Hence water can move from the fi ltrate into the tubule cells along the osmotic gradient.

Which hormone causes increased sodium reabsorption in the kidney? A. angiotensin I B. antidiuretic hormone C. vasopressin D. aldosterone

Answer is D: Aldosterone stimulates the active absorption of sodium (and the secretion of potassium) from the filtrate.

The renal tubule reabsorbs all of the following ions except one. Which one? A . N a + B. HCO 3− C. Cl − D. NH 4+

Answer is D: Ammonium ions are a waste product so are not reabsorbed.

When systemic blood pressure increases, how does the kidney respond to maintain glomerular fi ltration rate? A. The afferent arteriole dilates B. The efferent arteriole constricts C. The efferent arteriole dilates D. The afferent arteriole constricts

Answer is D: An increase in BP stretches the walls of the efferent arteriole which respond by constricting. The resulting decrease in diameter decreases glomerular blood fl ow which keeps GFR within normal limits.

In what part (or parts) of the renal tubule reabsorb the least material from the fi ltrate? A. the distal convoluted tubule B. the loop of Henle C. the proximal convoluted tubule D. the distal convoluted tubule and the collecting duct together

Answer is D: By the time the fi ltrate has passed through the PCT, loop of Henle the majority of the reabsorption that is going to happen has happened. Nevertheless, the DCT & collecting duct do reabsorb some electrolytes and water.

Which of the statements about the capillaries of the glomerulus is NOT true? A. glomerular capillaries are fenestrated (i.e. porous). B. blood enters and leaves the glomerulus via arterioles. C. the blood pressure in glomerular capillaries is higher (55 mmHg) than in the capillaries in the rest of the body. D. glomerular capillaries have smooth muscle in their walls.

Answer is D: Capillary walls are made of endothelial cells, there is no smooth muscle.

What is the place where the arteries, veins, lymphatics and nerves enter or leave the kidney called? A. The carina B. The reno-atrio notch C. The renal pelvis D. The hilus

Answer is D: Carina is in the trachea; renal pelvis refers to the ureter; reno-atrio notch does not exist.

If the glomerular fi ltration rate is too high, the macula densa sends a message to the afferent arteriole. What is the effect of this message? A. granular cells of arteriole walls release renin B. afferent arteriole dilates C. it inhibits the action of ATP and adenosine on the afferent arteriole D. afferent arteriole constricts

Answer is D: Constricting the afferent arteriole will decrease the rate of fl ow of blood into the glomerulus. This will decrease the GFR.

In the glomerulus, what is the method by which solutes are transferred from the blood to the Bowman's capsule? A. diffusion B. active transport C. secretion D . filtration

Answer is D: Filtration due to the pressure difference between the capillary blood and fl uid in the Bowman's capsule.

What is the term used to describe the production of an insuffi cient volume of urine? A. polyuria B. uremia C. anuria D. oliguria

Answer is D: Oliguria is the production of about 50-500 ml urine per day. Anuria is producing less than 50 ml per day.

Which section of the renal tubule is permeable to urea? A. descending limb of the loop of Henle. B. ascending limb of the loop of Henle. C. collecting duct in the presence of aldosterone. D. proximal convoluted tubule.

Answer is D: PCT is permeable to urea, so as volume of fi ltrate in PCT decreases due to absorption of water, urea concentration in fi ltrate increases. This promotes passive reabsorption of urea along its concentration gradient.

What molecule catalyses the formation of angiotensin I? A. carbonic anhydrase B. calcitriol C. erythropoietin D. renin

Answer is D: Renin is an enzyme that catalyses the reaction that forms angio-tensin I from angiotensinogen.

Given that the specifi c gravity of a urine sample is 1.009, which of the follow-ing statements is correct? A. the patient is dehydrated B. the sample contains 1.009 mmol/L of dissolved particles C. the sample contains 1.009 millimole of dissolved solutes D. the urine has a density of 1.009 g/ml

Answer is D: SG is a measure of urine density (or concentration). It is the ratio of urine density to water density, so has no units.

What does the presence of aldosterone in the blood cause? A. calcium to be absorbed from the DCT B. the collecting duct to become permeable to water C. more bicarbonate to be formed in the tubule cells D. more sodium to be reabsorbed from the DCT

Answer is D: Sodium ions are reabsorbed from the fi ltrate, Aldosterone pro-motes greater reclamation of sodium from the DCT.

Solutes move from the blood in the glomerular capillaries into the Bowman's capsule due to which of the following influences? A. osmotic pressure difference B. diffusion down the concentration gradient C. by active transport D. hydrostatic pressure difference

Answer is D: The efferent (outgoing) arteriole has a smaller diameter than the afferent arteriole, hence the glomerulus is a high pressure area. This aids the movement of dissolved substances through the fi ltration membrane.

In the nephron, if the afferent arteriole dilates and the efferent arteriole con-stricts, which of the following would be true? A. The glomerular fi ltration rate would decrease. B. The pressure in the glomerulus will decrease. C. The absorption of sodium and chloride ions form the fi ltrate would increase. D. Before these events, the granular cells would have released renin.

Answer is D: The granular cells of the afferent arteriole respond to low blood pressure by releasing renin. As a result, angiotensin II would form which causes systemic vasoconstriction, which increases blood pressure, which dilates the afferent arteriole and increases glomerular fi ltration rate.

To what does the "juxtaglomerular apparatus" refer? A. to those nephrons whose loop of Henle penetrate deep into the medulla B. to the lamina densa and podocytes that form fi ltration slits around the cap-illaries of the glomerulus C. to the capillaries that surround the loop of Henle of juxtamedullary nephrons D. to certain cells of the distal convoluted tubule where it touches the afferent arteriole.

Answer is D: The juxtaglomerular = macula densa cells (of the DCT wall) and granular cells (of the afferent arteriole wall).

Which one of the following is part of the renal tubule? A. glomerulus B. vasa recta C. collecting duct D. macula densa

Answer is D: The macula densa consists of cells in the wall of the distal con-voluted tubule at the juxtaglomerular apparatus

Which of the following may be said of the renal medulla? A. it is the more superficial part of the kidney. B. it contains all of the glomeruli. C. it produces adrenaline and noradrenaline. D. it contains the pyramids and columns.

Answer is D: The medulla is deep to the cortex. In this region are many blood vessel (in the columns) and the collecting ducts (in the pyramids)

The nephrons of the kidney consist of A. Bowman's capsule, a loop of Henle, a collecting duct and a renal tubule B. a juxtaglomerular apparatus and collecting duct C. a glomerulus and a juxtaglomerular apparatus D. a glomerulus, a proximal convoluted tubule, loop of Henle, and a distal convoluted tubule

Answer is D: The nephron includes the glomerulus and renal tubule. The later includes the Bowman's capsule. Choice D is best even though Bowman's cap-sule is not listed.

What part of the nephron performs the majority of the reabsorption of materi-als from the fi ltrate? A. The Bowman's capsule and glomerulus B. The loop of Henle (the nephron loop) C. The distal convoluted tubule and collecting duct D. The proximal convoluted tubule

Answer is D: The proximal convoluted tubule (the fi rst part or the renal tubule) absorbs most of the required material.

Where are all of the glomeruli of the kidney located? A. in the medulla B. in the columns C. in the pyramids D. in the cortex

Answer is D: The tubules and collecting ducts extend into the medulla, but all glomeruli are in the cortex.

What does the renal system consists of? A. 2 kidneys, 2 urethra, bladder, 1 ureter. B. 2 adrenal glands, 2 kidneys, 1 ureter, 2 urethra, bladder. C. 2 adrenal glands, 2 kidneys, 2 ureters, 2 urethra, bladder. D. 2 kidneys, 1 urethra, bladder, 2 ureters.

Answer is D: There are 2 ureters (from kidney to bladder) and one urethra (from bladder to outside).

The functional unit of the kidney that fi lters blood and produces urine is called the: A. medulla B. glomerulus C. neurone D. nephron

Answer is D: the nephron performs all of the kidney functions.


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