Physio 3200 Renal

Consider a hypothetical drug with the following parameters: V = 4 ml/min, U = 10 mg/ml of drug, and P = 0.32 mg/ml of drug (where V= urine volume, U = urine concentration of drug, P = plasma concentration of drug). The renal clearance rate for this drug would be ml/min.

125 U*V/P

The daily volumes of water gain and loss listed below are for a normally-hydrated person who is maintaining water balance. What is the daily urine volume? Intake in liquids: 1500 mL; Insensible loss: 950 mL; Intake in foods: 1150 mL; Sweat: 100 mL; Metabolic production: 400 mL; Feces: 150 mL 1850 mL 1050 mL 2850 mL 1800 mL 4250 mL

1850 intake-loss= 1850

Which of these would occur following a loss of Na+ and water from the body due to diarrhea? Multiple select question. A compensatory constriction of afferent renal arterioles Renal excretion of Na+ and water would be increased A compensatory decrease in net glomerular filtration pressure Arterial blood pressure would decrease from normal A compensatory increase in glomerular filtration rate

A compensatory constriction of afferent renal arterioles A compensatory decrease in net glomerular filtration pressure Arterial blood pressure would decrease from normal

Which of these accurately describes part of the homeostatic response to a decrease in total body Na+? Multiple select question. An increase in the amount of Na+ reabsorbed A decrease in the amount of Na+ filtered An increase in the amount of Na+ excreted An increase in the amount of Na+ secreted A decrease in the amount of Na+ secreted

An increase in the amount of Na+ reabsorbed A decrease in the amount of Na+ filtered

The maximum concentration gradient of the renal medullary interstitium is determined by the capacity of the active transport pumps in the ________ limb of the loop of Henle.

Ascending

In which section of the nephron tubule is the osmolarity of the filtrate normally the highest? Where the proximal convoluted tubule meets the descending loop of Henle At the end of the distal convoluted tubule Where the ascending loop of Henle becomes the distal convoluted tubule In the cortical region of the collecting duct At the tip of the loop of Henle

At the tip of the loop of Henle

Which two of these provide the major inputs to neurons that secrete vasopressin? Multiple select question. Chemoreceptors Baroreceptors Macula densa Osmoreceptors Juxtaglomerular cells

Baroreceptors Osmoreceptors

Which nephron region is responsible for hormonally-controlled, fine-tuning of the final amounts of ions and water that are excreted in the urine?

Bowman's capsule Distal tubule and collecting duct Descending limb of loop of Henle Ascending limb of loop of Henle Proximal convoluted tubule

Which best describes the mechanism by which water is reabsorbed from the nephron tubule into the renal interstitial space? By transporters that move 3 water molecules in exchange for 2 Na+ ions By bulk flow down a hydrostatic pressure gradient By ATP-dependent water pumps By osmosis, following Na+, Cl- and other solutes

By osmosis, following Na+, Cl- and other solutes

Which of the following are proximal tubule mechanisms by which Na+ enters tubular epithelial cells from the nephron lumen? Multiple select question. Countertransport with H+ Facilitated diffusion through Na+ channels Cotransport with organic nutrients Countertransport with K+

Countertransport with H+

Which of the following are proximal tubule mechanisms by which Na+ enters tubular epithelial cells from the nephron lumen? Countertransport with H+ Countertransport with K+ Facilitated diffusion through Na+ channels Cotransport with organic nutrients

Countertransport with H+

Tubular reabsorption of Na+ from the proximal tubule involves which of the following mechanisms? Multiple select question. Countertransport with H+, with Na+ moving from the filtrate into epithelial cells Facilitated diffusion from epithelial cells into the interstitial fluid Countertransport with glucose and amino acids, with Na+ moving from epithelial cells into the interstitial fluid Primary active transport from epithelial cells into the interstitial fluid Cotransport with glucose and amino acids from the filtrate into epithelial cells Primary active transport from the cytosol of epithelial cells into the tubule lumen

Countertransport with H+, with Na+ moving from the filtrate into epithelial cells Primary active transport from epithelial cells into the interstitial fluid Cotransport with glucose and amino acids from the filtrate into epithelial cells

The filtrate entering the descending limb of the loop of Henle is more Blank______ than the filtrate at the start of the ascending limb.

Diluted

Which of these is a disease caused by a genetic mutation in a transport protein that reduces the reabsorption of glucose? Diabetes mellitus Hereditary galactosemia Diabetes insipidus Familial renal glucosuria

Familial renal glucosuria

Which of the following are normally excluded from the filtrate entering Bowman's space? Multiple select question. Fatty acids bound to plasma proteins Glucose Charged ions like Na+ and K+ Globulins Red blood cells Albumins

Fatty acids bound to plasma proteins Globulins Red blood cells Albumins

With regard to tubular reabsorption by the kidney, which of the following is generally incorrect?

Filtered loads of useful substances like organic nutrients and ions are so small that the reabsorption rates are quite small.

______ is the involuntary release of urine.

Incontinence

When action potential frequency from arterial baroreceptors decreases, vasopressin secretion Decreses Increases

Increases

Complete this equation: Na+ excreted = Blank______. Multiple choice question. Na+ filtered −- Na+ secreted Na+ secreted −- Na+ reabsorbed Na+ filtered −- Na+ reabsorbed Na+ secreted −- Na+ filtered Na+ reabsorbed −- Na+ filtered

Na+ filtered −- Na+ reabsorbed

Which generalizations about Na+ and water handling by the nephron are normally true? Regulation of the final amounts of Na+ and water that are excreted in the urine is determined by the amount secreted into nephron tubules. Na+ reabsorption is an active process occurring in all tubular segments except the descending loop of Henle. Water reabsorption is by osmosis (passive) and is dependent upon Na+ reabsorption. Most Na+ and water reabsorption occurs in the distal tubule and collecting duct, but hormonal control is primarily regulated in the proximal tubule.

Na+ reabsorption is an active process occurring in all tubular segments except the descending loop of Henle. Water reabsorption is by osmosis (passive) and is dependent upon Na+ reabsorption.

Which generalizations about Na+ and water handling by the nephron are normally true? Multiple select question. Na+ reabsorption is an active process occurring in all tubular segments except the descending loop of Henle. Water reabsorption is by osmosis (passive) and is dependent upon Na+ reabsorption. Most Na+ and water reabsorption occurs in the distal tubule and collecting duct, but hormonal control is primarily regulated in the proximal tubule. Regulation of the final amounts of Na+ and water that are excreted in the urine is determined by the amount secreted into nephron tubules.

Na+ reabsorption is an active process occurring in all tubular segments except the descending loop of Henle. Water reabsorption is by osmosis (passive) and is dependent upon Na+ reabsorption.

The ________ convoluted tubule is the primary site of solute and water reabsorption.

Proximal

What region of the nephron receives filtrate as it exits from Bowman's capsule?

Proximal convoluted tubule

A genetic mutation can lead to an abnormality in the Na+-glucose cotransporter that mediates reabsorption of glucose in the proximal tubule. This condition, which is called familial ______ ______ , can lead to the appearance of glucose in the urine.

Renal Glucosuria

Voluntary prevention of urine voiding during the micturition reflex is effected by strong input from Blank______ neurons. Multiple choice question. cerebellar parasympathetic somatic motor sympathetic

Somatic Motor

Stress incontinence Urge incontinence

Stress incontinence Due to sneezing, coughing, or exercise Urge incontinence Associated with the desire to urinate

What are routes by which body water is lost from the body? Metabolic condensation reactions Sweat and feces Insensible routes Urine Menstrual flow (potentially, in biological females) Liquids and moist foods

Sweat and feces Insensible routes Urine Menstrual flow (potentially, in biological females)

Half of the plasma calcium bound to plasma proteins and virtually all of the plasma fatty acids that are bound to plasma protein are not filtered. T F

T

The amount of water and ions reabsorbed by the nephron is typically more than 99% of the amount filtered. True false question. TrueFalse

T

Which is not one of the factors contributing to the countercurrent multiplier system that creates the concentrated renal medullary interstitium? Multiple choice question. The countercurrent anatomy of the loop of Henle of juxtamedullary nephrons Hairpin loops of vasa recta that minimizes solute washout from the medullary interstitium Reabsorption of NaCl in the ascending limbs of the loops of Henle of juxtamedullary nephrons Trapping of urea in the medulla The isosmotic reabsorption of Na+ and water from the proximal convoluted tubules of juxtamedullary nephrons Impermeability to water of the ascending limbs of the loops of Henle of juxtamedullary nephrons

The isosmotic reabsorption of Na+ and water from the proximal convoluted tubules of juxtamedullary nephrons

What is the definition of "renal clearance?" The rate at which fluid leaves the plasma to enter Bowman's capsule The volume of urine formed per unit time The volume of the filtrate it takes to remove a harmful substance from the body The volume of plasma from which a given substance is completely removed per unit time

The volume of plasma from which a given substance is completely removed per unit time

How can molecules that were not filtered at Bowman's capsule be cleared from the plasma before blood leaves the kidney? They are reabsorbed by the proximal convoluted tubule cells. Reason: Secreted, not reabsorbed. They can be filtered in the renal pelvis. They cannot be cleared from the plasma if they are not filtered. They can be secreted into the nephron tubules from the peritubular capillaries.

They can be secreted into the nephron tubules from the peritubular capillaries.

The secretion of renin increases in response to which of the following? Multiple select question. Decreased renal sympathetic nerve activation Increased blood volume and pressure Total-body Na+ depletion Decreased NaCl delivery to the macula densa

Total-body Na+ depletion Decreased NaCl delivery to the macula densa

Renal clearance is the net effect of which of the following? Tubular reabsorption Glomerular filtration Dietary intake Metabolic deactivation Tubular secretion

Tubular reabsorption Glomerular filtration Tubular secretion

Urine moves from the renal pelvis to the urinary bladder via long ducts called the?

Ureter

In the distal tubule and cortical collecting duct, the reabsorption of Na+ is physiologically regulated by Blank______. Multiple choice question. vasopressin aldosterone parathyroid hormone angiotensin II

aldosterone

__________ is a steroid hormone secreted by the adrenal cortex that regulates the reabsorption of Na+ by the distal convoluted tubule and cortical collecting ducts.

aldosterone

Under normal physiological conditions, the most important stimulator of brain thirst centers is Blank______. Multiple choice question. an increase in plasma osmolarity a decrease in angiotensin II an increase in plasma volume a decrease in plasma osmolarity

an increase in plasma osmolarity

When the atria walls are stretched due to increased blood volume, _______ ______ _____- is released and acts as an endogenous diuretic to lower blood volume.

atrial natriuretic peptide

Fill in the Blank Question Any substance that can reversibly bind H+ is called a(n) _________.

buffer

The sequence of structures through which urine passes from production through elimination from the body is collecting duct system --> ureter --> urinary bladder ---> renal pelvis --> urethra collecting duct system --> renal pelvis --> urethra --> urinary bladder --> ureter collecting duct system --> renal pelvis --> ureter --> urinary bladder --> urethra collecting duct system --> urethra --> urinary bladder ---> renal pelvis --> ureter

collecting duct system --> renal pelvis --> ureter --> urinary bladder --> urethra

The glomerular filtrate normally contains small solutes but no cells and few proteins is identical in composition to plasma is identical in composition to urine has a high concentration of large proteins

contains small solutes but no cells and few proteins

A decreased blood pressure Blank______ Na+ excretion by acting on the tubules to Blank______ Na+ reabsorption. Multiple choice question. increases; minimize decreases; enhance

decreases; enhance

Atrial natriuretic peptide (ANP) Blank______ blood volume by Blank______ the reabsorption of Blank______ from the tubular fluid. Multiple choice question. increases; inhibiting; potassium decreases; inhibiting; sodium decreases; stimulating; potassium increases; inhibiting; sodium increases; stimulating; sodium

decreases; inhibiting; sodium

The smooth muscle that makes up the wall of the urinary bladder is called the ______ muscle

detrusor

The hormone aldosterone stimulates Na+ reabsorption in the Blank tubule and BLANK, collecting ducts.

distal, cortical

The function of the urethra is to drain the renal pelvis drain the urinary bladder concentrate the urine produce and filter the urine

drain urinary bladder

Potassium ions are Blank______. Multiple select question. freely filtered by glomerular capillaries secreted into the cortical collecting ducts reabsorbed in the cortical collecting duct reabsorbed from the proximal tubule secreted into the loop of Henle

freely filtered by glomerular capillaries secreted into the cortical collecting ducts reabsorbed from the proximal tubule

Multiple Choice Question A common loop diuretic is Blank______. Multiple choice question. cycloheximide furosemide amiloride spironolactone

furosemide

Fill in the Blank Question The kidneys are ultimately responsible for balancing _______ ion gains and losses so as to maintain its plasma concentrations within a narrow range.

hydrogen

HCO3- reabsorption depends on the tubular secretion of _________, which combines in the lumen with filtered HCO3-.

hydrogen

Multiple Select Question Select all that apply A net gain of hydrogen ions results from Blank______. Multiple select question. hypoventilation vomiting hyperventilation loss of HCO3- in urine

hypoventilation loss of HCO3- in urine

Multiple Choice Question A net loss of hydrogen ions will Blank______ arterial plasma pH, a condition called Blank______. Multiple choice question. increase; alkalosis increase; acidosis decrease; acidosis decrease; alkalosis

increase; alkalosis

As the filtrate passes down the descending limb of the loop of Henle, the osmolarity of the filtrate Blank______. Multiple choice question. increases stays the same decreases

increases

When plasma volume is high, the transmission of impulses from cardiovascular baroreceptors to the hypothalamus Blank______, which Blank______ vasopressin secretion. Multiple choice question.

increases, decreases

Most diuretics act on the tubules to Blank______. Multiple choice question. inhibit the reabsorption of Na+ and associated anions, resulting in decreased excretion of water inhibit the reabsorption of Na+ and associated anions, resulting in increased excretion of water increase the reabsorption of Na+ and associated anions, resulting in increased excretion of water inhibit the secretion of Na+ and associated anionis, resulting in increased excretion of water

inhibit the reabsorption of Na+ and associated anions, resulting in increased excretion of water

During bladder filling, parasympathetic firing to the detrusor muscle is Blank______ and sympathetic firing to the internal sphincter muscle is Blank______.

inhibited, stimulated

Increased arterial blood pressure reduces Na+ reabsorption by Blank______. Multiple select question. activating the renin-angiotensin-aldosterone system inhibiting the renin-angiotensin-aldosterone system stimulating pressure natriuresis inhibiting the release of vasopressin

inhibiting the renin-angiotensin-aldosterone system stimulating pressure natriuresis

Osmoreceptors respond to a decrease in plasma osmolarity by Blank______. Multiple choice question. stimulating aldosterone production inhibiting vasopressin secretion stimulating vasopressin secretion inhibiting aldosterone production

inhibiting vasopressin secretion

Routes by which body water is gained include Blank______. urine insensible routes menstrual flow (potentially, in women) liquids and moist foods sweat and feces metabolic condensation reactions

liquids and moist foods metabolic condensation reactions

Diuretics that act on the ascending loop of Henle are termed ______ diuretics.

loop

The region of the kidney where the renal interstitium normally has the greatest osmolarity is called the renal _______

medulla

The most important thirst stimulus under normal physiological conditions is the increase in plasma _____

osmolarity

Water reabsorption from the proximal tubule occurs by a specific type of diffusion known as

osmosis

Afferent signals from stretch receptors activated by the pressure of urine in the bladder reflexively stimulate the ___________ division of the autonomic nervous system, causing contraction of the bladder, and inhibit the __________division of the autonomic nervous system, resulting in relaxation of the internal urethral sphincter.

parasympathetic, sympathetic

Ca2+ reabsorption in the distal convoluted tubule and cortical collecting duct is stimulated by a peptide hormone called ________ hormone.

parathyroid

Hyperkalemia, which is an increase in plasma __________ concentration, can cause abnormal rhythms of the heart (arrhythmias) and abnormalities in skeletal muscle contraction.

potassium

Of all of the ions regulated by the kidney, the one that must be the most tightly regulated in the extracellular fluid to maintain proper function of excitable tissues such as the brain, heart, and skeletal muscles is Blank______. Multiple choice question. potassium chloride sodium magnesium

potassium

The primary mechanism driving Na+ reabsorption is Blank______ surface of tubular epithelial cells. primary active transport at the basolateral secondary active transport at the luminal facilitated diffusion at the apical primary active transport at the apica

primary active transport at the basolateral

Most reabsorption of filtered calcium ions occurs in the Blank______. Multiple choice question. cortical collecting duct distal tubule medullary collecting duct proximal tubule loop of Henle

proximal tubule

Water excretion is the difference between the volume of water filtered and the volume _______

reabsorption

Atrial natriuretic peptide Blank______. Multiple select question. reduces blood volume by inhibiting the reabsorption of Na+ increases the reabsorption of water in the cortical collecting ducts is secreted by the atria of the heart in response to high blood volume reduces blood volume by causing the excretion of more K+ is secreted by the kidneys in response to stretching of the afferent arterioles

reduces blood volume by inhibiting the reabsorption of Na+ is secreted by the atria of the heart in response to high blood volume

The complete removal of substances from the blood plasma by excretion into the urine is called __________ ___________

renal clearance

When blood pressure increases, this inhibits the secretion of the enzyme Blank______ from the juxtaglomerular apparatus. Multiple choice question. renin aldosterone calmodulin angiotensin II

renin

The movement of substances from peritubular capillaries into the tubular lumen is referred to as tubular? accretion reabsorption filtration secretion

secretion

Most diuretics act to reduce the reabsorption of ________ and associated anions, which indirectly reduces the water reabsorption.

sodium

A decrease in arterial blood pressure Blank______ the renin-angiotensin-aldosterone system. Multiple choice question. has no effect inhibits stimulates

stimulates

Metabolic reactions are highly sensitive to the H+ concentration of the fluid in which they occur. This sensitivity is due to the influence that H+ has on the Blank______ structures of proteins, such as enzymes. Multiple choice question. secondary tertiary primary

tertiary

Hydrogen ions produced when tissue cell CO2 production generates carbonic acid do not normally constitute a net gain of H+ because Blank______. Multiple choice question. only the H+ produced in the kidney can alter arterial plasma H+ concentration the H+ is buffered by various plasma proteins so arterial plasma pH remains within normal limits the H+ combines with lactate to form pyruvate within active cells the H+ is reincorporated into H2O and the reaction reverses when CO2 is exhaled from the lungs

the H+ is reincorporated into H2O and the reaction reverses when CO2 is exhaled from the lungs

The primary site for K+ secretion in the nephron is Blank______. Multiple choice question. the ascending limb of the loop of Henle the cortical collecting duct the proximal convoluted tubule the descending limb of the loop of Henle Bowman's capsule

the cortical collecting duct

The hyperosmotic medullary interstitial fluid of the kidney is created by Blank______. the countercurrent multiplier system the subset of nephrons known as cortical nephrons the high concentration of antidiuretic hormone found in the renal medullary region the juxtamedullary apparatus the metabolism of glutamate

the countercurrent multiplier system

The H+ concentration of the extracellular fluid is Blank______. Multiple choice question. not very tightly regulated because the folding of proteins such as metabolic enzymes are not sensitive to pH tightly regulated because H+ is the main ion determining the osmolarity of the extracellular fluid tightly regulated because the folding of proteins such as metabolic enzymes is highly sensitive to pH not very tightly regulated because H+ isn't the main ion determining the osmolarity of the extracellular fluid

tightly regulated because the folding of proteins such as metabolic enzymes is highly sensitive to pH

Cells of the medullary collecting duct reabsorb Blank______. Multiple select question. urea calcium glucose water potassium

urea, water

Diuretics are drugs that increase the volume of _______

urine

Physiological control of water excretion mainly occurs by way of Blank______-mediated control over water reabsorption. Multiple choice question. vasopressin pH renin aldosterone

vasopressin

When body fluid osmolarity increases above normal, secretion of the hormone Blank______, which has the effect of reducing the osmolarity toward normal. Multiple choice question. vasopressin is decreased aldosterone is decreased aldosterone is increased vasopressin is increased

vasopressin is increased

When aldosterone concentration in the blood is high Blank______. Multiple choice question. the amount of Na+ reaching the distal nephron exceeds the tubular maximum for reabsorption, so excretion increases virtually no Na+ reaches the distal nephron, because all filtered Na+ gets reabsorbed in the proximal tubule virtually all of the Na+ reaching the distal nephron gets reabsorbed virtually none of the Na+ reaching the distal nephron gets reabsorbed

virtually all of the Na+ reaching the distal nephron gets reabsorbed

Regulation of Na+ excretion is primarily used to maintain homeostasis of extracellular fluid Blank______; regulation of water excretion is primarily used to maintain homeostasis of extracellular fluid Blank______. Multiple choice question. osmolarity; volume volume; osmolarity

volume; osmolarity

In the loop of Henle, cells of the descending limb passively reabsorb Blank______, and cells of the ascending limb reabsorb Blank______ by active transport. Multiple choice question. Na+; Cl- NaCl; water urea; urea water; NaCl

water; NaCl