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