Chapter 26 & 27 Urinary System and Water Balance
Match the causes of acid-base disorders to the acid-base problems that they cause: 1. Primary cause of respiratory alkalosis characterized by a pH > 7.45 and PCO2 < 35mm Hg
hyperventilation
What happens to pH when PCO2 increases above 45 mm Hg?
pH will fall below 7.35
Aldosterone
promotes sodium retention in the kidneys
You interpreting a patient's arterial blood gas (ABG) values. The sample has a pH of 7.34 with a Pco2 of 57 mm Hg and a normal HCO3 -. What is that patient's most likely diagnosis?
Acute respiratory acidosis
The myogenic mechanism of renal autoregulation primarily involves smooth muscle in which blood vessels?
Afferent arterioles
Which hormone plays a central role in determining the rate of sodium reabsorption and potassium secretion?
Aldosterone
Which of these hormones causes the kidney to increase the body's content of sodium?
Aldosterone
Which of the following statements about aldosterone is NOT correct?
Aldosterone increases sodium reabsorption by increasing the number of Na+-K+ ATPase pumps in the luminal membrane of the proximal tubule
A drop in blood pH will be compensated for by __________.
Excreting more hydrogen ions and fewer bicarbonate ions
Which of these effects is NOT produced by sympathetic activation?
Increased glomerular filtration rate
Changes that occur in the urinary system with aging include all of the following except
Increased sensitivity to ADH
What four factors shown result in an increased blood volume?
Increased sodium retention, increased fluid consumption, increased fluid retention, and constriction of systemic veins
The pontine storage center controls micturition by
Increasing contraction of the external urethral sphincter and reducing detrusor muscle activity
Which of the following is a renal response to acidosis?
Increasing secretion of hydrogen atoms
Aldosterone-sensitive portions of the distal convoluted tubule and collecting duct allow for the exchange of which ions?
Reabsorption of sodium ions in exchange for potassium ions
In the event of a severe increase in systemic blood pressure, what mechanism would increase GFR?
Release of ANP and BNP
Which of these organs is NOT part of the urinary system?
Vagina
Which of the following values is not used to diagnose an acid-base disorder from an arterial blood gas sample?
Venous blood pH
Which class of acid will have an increased concentration in someone who is suffocating?
Volatile acids
Match the causes of acid-base disorders to the acid-base problems that they cause: 3. A metabolic alkalosis characterized by PCO2 > 45 mm Hg and an elevated HCO3-
Vomiting
The proximal convoluted tubule cells are
cuboidal cells with microvilli
Which of the following is NOT associated with the renal hilum?
Urethra
A drowning victim will likely experience a period of ________ until resuscitation begins.
Acute respiratory acidosis
Under normal conditions, glomerular filtration depends on three main pressures. From the list below, what are these three main pressures? 1. glomerular hydrostatic pressure 2. capsular hydrostatic pressure 3. capsular colloid osmotic pressure 4. blood colloid osmotic pressure 5. urinary bladder hydrostatic pressure
1, 2, and 4
Approximately ________ liters of glomerular filtrate enter glomerular capsules each day.
180
The renal threshold for glucose is approximately ________ mg/dl.
180
Calculate the net filtration pressure if capillary hydrostatic pressure is 60 mm Hg, capillary osmotic pressure is 25 mm Hg, and capsular hydrostatic pressure is 10 mm Hg.
25 mm Hg
What is the proper order for the structures of the renal corpuscle through which a substance travels during filtration? 1. filtration slit (slit pore) 2. capsular space 3. basement membrane 4. fenestrated endothelium
4, 3, 1, 2
In overhydration, what would be the levels of ADH (high, normal, or low) and what would be the osmolarity of the urine?
ADH-- low; 100 mOsm (urine)
Antidiuretic hormone (ADH) causes __________.
A decrease in urine volume but an increase in solute concentration
An increase in the metabolism of this cell would result in which of the following?
A rise in blood buffer capacity
In severe dehydration or blood loss, what would be the levels of ADH and what would be the urine flow rate?
ADH -- high; low urine flow rate (0.25ml/min)
Which of the following statements about ADH (antidiuretic hormone) is correct?
ADH is released by the posterior pituitary gland
What is the primary regulatory mechanism that maintains glomerular filtration rate (GFR)?
Autoregulation
Which of the following substances is not normally found in filtrate?
Blood cells and large particles
Sheila has been exercising at peak performance for about 60 minutes. She did not hydrate as effectively as she should have and as a result, her urine is deep yellow and low in volume. Which of the following is the most likely mechanism affecting this?
Blood colloid osmotic pressure
Which organ is responsible for regulating the partial pressure of carbon dioxide in body fluids?
Brain
A substance that can release or absorb a hydrogen ion is known as a(n) __________.
Buffer
Insoluble deposits that form within the urinary tract from calcium salts, magnesium salts, or uric acid are called kidney stones or renal
Calculi
Maintenance of normal fluid homeostasis requires all of these EXCEPT __________.
Caloric balance
Which of the following is not an electrolyte?
Carbohydrate
Which of the following buffer systems is the most important in the extracellular fluid?
Carbonic acid-bicarbonate buffer system
You are interpreting a patient's arterial blood gas (ABG) values. The sample has a pH of 7.46 with a Pco2 of 33 mm of Hg and a low HCO3 -. What is the patient's most likely diagnosis?
Chronic respiratory alkalosis
The detrusor muscle
Compresses the urinary bladder and expels urine through the urethra
Which of the following descriptions best fits the acid-base disorder respiratory alkalosis?
Consequence of hyperventilation
Eighty percent of nephrons in the human kidney are located in the ________ and have short nephron loops.
Cortex
The majority of glomeruli are located in the ________ of the kidney.
Cortex
Which hormone does not play a role in regulating fluid and electrolyte balance?
Cortisol
Secretion of hydrogen ion by the PCT is by the process of
Countertransport
What process provides ammonia for buffering the pH of tubular fluid?
Deamination of amino acids
Your doctor has diagnosed you with prostatitis, an inflammation and swelling involving the prostate gland. One of your primary symptoms is
Dribbling urination
Match the causes of acid-base disorders to the acid-base problems that they cause: 5. A chronic (compensated) respiratory acidosis characterized by PCO2 > 50mm Hg and an increased HCO3-
Emphysema
The release of atrial naturetic peptides from the heart will cause the body to
Excrete sodium ions and decrease ECF
Which of the following formulas will allow you to calculate correctly the net filtration pressure (NFP)? (Hint: CsHP is capsular hydrostatic pressure.)
FP = GHP - (CsHP + BCOP)
Hyperventilation usually leads to a substantial __________ in the partial pressure of __________ in body fluids.
Fall; carbon dioxide
A rise in the partial pressure of carbon dioxide will cause a __________ in pH and a __________ in blood bicarbonate levels.
Fall; rise
The filtration barrier in the renal corpuscle consists of which three layers?
Fenestrated endothelium of glomerulus, basement membrane of glomerulus, and podocyte filtration slits
Match the causes of acid-base disorders to the acid-base problems that they cause: 2. An acute respiratory alkalosis characterized by PCO2 < 35mm Hg and a normal or slightly decreased HCO3-
Fever
What physiological process occurs at the glomerulus?
Filtration
The condition called ________ is especially dangerous because the ureters or renal blood vessels can become twisted or kinked during movement.
Floating kidney
Which of the following statements is false regarding fluid and electrolyte balance?
Fluctuations in diet will affect babies less because they have so much water content
The main force that causes filtration in a nephron is
Glomerular hydrostatic pressure
Which of the following best describes the passive force that creates filtrate?
Glomerular hydrostatic pressure (GHP)
You have been diagnosed with lupus erythematosus, a very severe autoimmune disorder with a wide variety of associated organ-related problems. Your doctor is particularly worried about how this will affect your kidney function. He says that you are susceptible to ________ because of the lupus.
Glomerulonephritis
________ is/are an inflammatory disorder of the glomeruli that affects the filtration mechanism of the kidneys.
Glomerulonephritis
What is the primary driving force (pressure) that produces glomerular filtration?
Hydrostatic pressure of blood (blood pressure)
Prolonged aldosterone stimulation of the distal convoluted tubule may result in
Hypokalemia
Match the causes of acid-base disorders to the acid-base problems that they cause: 6. Primary cause of respiratory acidosis characterized by a pH < 7.35 and a PCO2 > 50mm Hg
Hypoventilation
All of the following would result in an increase in renin release except
Increased blood volume
A drug that inhibits angiotensin converting enzyme (ACE) may lead to all of the following except
Increased fluid retention
Which of these is NOT a property of countercurrent multiplication?
It is opposed by the vasa recta
Which of these statements about the detrusor muscle is FALSE?
It moves urine through the urethra by peristalsis
Nephrons located close to the medulla with long nephron loops are called ________ nephrons.
Juxtamedullary
In response to respiratory alkalosis, the
Kidneys retain more hydrogen ions
The two organs that play an important role in maintaining acid-base balance are the
Lungs and kidneys
A person who consumes large amounts of sodium bicarbonate (baking soda) to settle an upset stomach risks
Metabolic alkalosis
What structure connects the proximal convoluted tubule to the distal convoluted tubule?
Nephron loop
Where does most nutrient reabsorption occur?
Nephron loop, descending thin limb
If the osmotic pressure in the glomerular capillaries increased from 28 mm Hg to 35 mm Hg, would net filtration increase or decrease?
Net filtration would decrease
Which of these is NOT part of the maintenance of balance in body fluids?
Nutrient balance
Water molecules move across cells by
Osmosis
Capillaries that surround the proximal convoluted tubules are
Peritubular capillaries
Reabsorbed water and solutes enter into the
Peritubular fluid
What is the most abundant anion in the intracellular fluid?
Phosphate
Match the causes of acid-base disorders to the acid-base problems that they cause: 4. An acute respiratory acidosis characterized by PCO2 > 50mm Hg and a normal HCO3-
Pneumothorax
Blood colloid osmotic pressure (BCOP) in the glomerulus is generated by
Presence of albumin proteins in blood plasma
All of the following processes are functions of the urinary system EXCEPT __________.
Production of urea
Which substance would be found in higher concentration if the membrane were damaged?
Protein
The majority of water is reabsorbed by osmosis in the
Proximal convoluted tubule
The primary function of the proximal convoluted tubule is
Reabsorption of ions, organic molecules, vitamins and water
The given scenario can occur in a person having a panic attack. In the midst of the attack, which of the following compensatory mechanisms can help maintain pH within the normal range?
Release of hydrogen ions by the buffer systems within body fluids
In which region of the kidney is a glomerulus located?
Renal cortex
Which of the following GFR-regulating mechanisms is initiated by cells of the juxtaglomerular complex?
Renin-angiotensin system
Hypoventilation leads to
Respiratory acidosis
The kidney does all of the following EXCEPT __________.
Secrete excess albumin
The process that transports solutes, including many drugs, into the tubular fluid is called
Secretion
Which of these nephron transport processes does NOT show saturation at high solute values?
Simple diffusion
Tubular reabsorption involves all of the following except
Stem cell movements
Which of the choices below best describes the autonomic mechanism for regulating GFR?
Sympathetic fibers override local controls to decrease the GFR
Which of the following statements is INCORRECT in regard to understanding fluid balance and electrolyte balance?
The body's content of water or electrolytes will decrease if dietary gains exceed losses to the environment
What part is not considered part of the nephron?
The collecting duct
Which of these is NOT a property of intracellular fluid (ICF)?
The concentration of sodium ions exceeds that of potassium ions
Which of these is NOT an aspect of the micturition reflex arc?
The diameter of the urethra increases
Where does secretion mostly occur?
The distal convoluted tubule
Where would penicillin be secreted?
The distal convoluted tubule
Which area is sensitive to aldosterone?
The distal convoluted tubule
Which area(s) allow variable water reabsorption and is/are sensitive to the hormone ADH?
The distal convoluted tubule and collecting duct
Administration of a medication in the elderly can result in a much higher dosage than the clinician might intend because
The elderly have less water content in the body
What type of epithelium is found lining the ureters, the urinary bladder, and the proximal portion of the urethra?
Transitional
If the micturition reflex is primarily controlled by parasympathetic innervation, then how is it that you have voluntary control of when you choose to urinate?
The external urethral sphincter is under skeletal muscle control. When it is voluntarily relaxed, the internal urethral sphincter will open, allowing the flow of urine
In which of the structures does reabsorption of organic substrates occur?
The renal tubule
Which of the choices below best describes the glomerular filtration rate (GFR)?
The volume of filtrate created by the kidneys per minute
Which of the following is true of electrolytes?
They are ionic compounds
The elderly are at greater risk of acid-base disturbance because of __________.
Tissue hypoxia, reduced renal compensation, and emphysema
A person with emphysema will exhibit signs of
chronic respiratory acidosis
Angiotensin II produces a coordinated elevation in the ECF volume by all of the following mechanisms except
increasing PNS activity
What is the osmolarity of the filtrate at the end of the proximal tubule?
isotonic -- 300 mOsm
The ureters extend from the __________.
renal pelvis to the urinary bladder
What enzyme is released by the juxtaglomerular complex to regulate GFR?
renin