Quiz 2

10. The final concentration of the urine is determined within the a. Collecting ducts b. Distal convoluted tubule c. Loop of Henle d. Proximal convoluted tubules

a

11. Which of the following solutes are present in the largest molar amounts in the urine? a. Urea, chloride, and sodium b. Urea, creatinine, and sodium c. Creatinine, uric acid and ammonium d. Urea, uric acid and ammonium

a

12. The concentration of which substances provides the best means of distinguishing urine from other body fluids? a. Creatinine and urea b. Glucose and protein c. Uric acid and ammonia d. Water and electrolytes

a

2. Ultrafiltration of plasma occurs in glomeruli located in the renal a. Cortex b. Medulla c. Pelvis d. Ureter

a

25. The glomerular filtration rate is controlled by: a. The renal blood flow b. The renal plasma flow c. The countercurrent mechanism d. Hormones (aldosterone, vassopression)

a

27. Which of the following frequently occurs after a bacterial infection of the skin or throat? a. Acute glomerulonephritis b. Chronic glomerulonephritis c. Membranous glomerulonephritis d. Rapidly progressive glomerulonephritis

a

31. Generalized loss of proximal tubular function is a characteristic of a. Fanconi's syndrome b. Nephrotic syndrome c. Renal glucosuria d. Renal tubular acidosis

a

34. Approximately 75% of the renal calculi that form in patients contain: a. Calcium b. Cysteine c. Oxalate d. Uric acid

a

35. Which of the following hereditary diseases results in the accumulation and excretion of large amounts of homogentisic acid : a. Alkaptonuria b. Melanuria c. Phenylketonuria d. Tyrosinuria

a

4. Filtration of protein is prevented in the glomerulus by: a. Hydrostatic pressure b. Oncotic pressure c. Renin d. Capillary pores

a

8. The process solely responsible for water reabsorption throughout the nephron is: a. Osmosis b. The urea cycle c. The countercurrent exchange mechanism d. The countercurrent multiplier mechanism

a

9. Antidiuretic hormone regulates the reabsorption of a. Water in the collecting tubules b. Sodium in the collecting tubules c. Sodium in the distal convoluted tubule d. Water and sodium in the loop of Henle

a

38. Case study: following overnight fluid deprivation, the urine-to-serum osmol ratio in a patient who is experiencing polyuria and polydipsia is 1:1. The ratio remains the same when a second specimen is tested at 10 AM. Vasopressin is then administered subcutaneously to the patient, and the fluid deprivation is continued until 2 PM, when another specimen is tested. a. What disorder do these symptoms and initial laboratory results indicate? _______________________________________________________________________ b. If the urine-to-serum osmol ratio on the 2 PM specimen is 3:1, what is the underlying cause of the patient's disorder? _____________________________________________________ ______________________________________________________________________ c. If the ratio on the 2 PM specimen remains 1:1. What is the underlying cause of the patient's disorder? ______________________________________________________________________

a. diabetes insipidus b. neurogenic diabetes insipid is because the body can respond to ADH, but is having a hard time producing or secreting it on its own c. nephrogenic diabetes insipidus because the problem is a lack of renal response to ADH

20. A fluid deprivation test involves the measurement of serum and urine: a. Density b. Osmolality c. Specific gravity d. Volume

b

22. The volume of plasma cleared per minute in excess of that required for solute elimination is called the: a. Creatinine clearance b. Free-water clearance c. Osmolar clearance d. Renal clearance

b

24. Which of the following situations results in an erroneous creatinine clearance measurement? a. A 24-hour urine collection from an individual on a vegetarian diet b. A 24-hour urine collection maintained at room temperature throughout the collection c. A plasma sample drawn at the beginning instead of during the 24-hour urine collection d. Creatinine determinations made using the nonspecific alkaline picrate method (Jaffe)

b

3. The type of nephron responsible for renal concentration is the : a. Cortical b. Juxtaglomerular

b

32. Which of the following formed elements when found in urine sediment is most indicitiove of an upper urinary tract infection? a. Bacteria b. Casts c. Erythrocytes d. Leukocytes

b

33. Eosinophiluria, fever, and skin rash are characteristic clinical features of: a. Acute pyelonephritis b. Acute interstitial nephritis c. Acute glomerulonephritis d. Chronic glomerulonephritis

b

37. Porphyria is characterized by the body's attempt to: a. Increase heme degradation b. Increase heme formation c. Decrease globin synthesis d. Decrease iron catabolism

b

6. The fluid leaving the glomerulus has a specific gravity of : a. 1.005 b. 1.010 c. 1.015 d. 1.020

b

1. How many nephrons are found in the average kidney? a. 13,000 b. 130,000 c. 1.3 million d. 13 million

c

13. What is the definition of the osmolality of a solution? a. The density of the solute particles per liter of solvent b. The mass of solute particles per kilogram of solvent c. The number of solute particles per kilogram of solvent d. The weight of solute particles per liter of solvent

c

14. The osmolality of a solution containing 1.0 mole of urea is equal to that of a solution containing a. 1.0 mole of HCL b. 1.0 mole of H2PO4 c. 0.5 mole of NaCl d. 0.5 mole of glucose

c

15. Serum osmolality remains relatively constant, whereas the urine osmolality ranges from a. One-third to one-half that of serum b. One-third to equal that of serum c. One to three times that of serum d. Three to five times that of serum

c

16. Osmolality is a measure of solute a. Density b. Mass c. Number d. Weight

c

17. Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (>1.040). Which of the following substances could account for such a high value? a. Creatinine b. Glucose c. Mannitol d. Protein

c

18. The daily volume of urine excreted normally ranges from: a. 100 -500 ml/day b. 100 -1800 ml/day c. 500 - 1800 ml/day d. 1000 -3000 ml/day

c

21. A fluid deprivation test is used to a. Determine the renal plasma flow b. Investigate the cause of oliguria c. Assess renal concentrating ability d. Measure the glomerular filtration rate

c

23. Which of the following is an endogenous substance used to measure glomerular filtration rate: a. Urea b. Inulin c. Creatinine d. p-aminohippurate

c

28. Which of the following disorders is the major cause of nephrotic syndrome in adults? a. IgA nephropathy b. Membranoproliferative glomerulonephritis c. Membranous glomerulonephritis d. Rapidly progressive glomerulonephritis

c

29. Chronic renal failure often develops in each of the following disorders except: a. Amyloidosis b. Diabetes mellitus c. Diabetes insipidus d. Systemic lupus erythematosus

c

36. Which of the following features is not a characteristic of diabetes insipidus? a. Polyuria b. Polydipsia c. Increased production of ADH d. Urine with a low specific gravity

c

7. Which of the tubules is impermeable to water: a. Proximal convoluted tubule b. Descending loop of Henle c. Ascending loop of Henle d. Distal convoluted tubule

c

19. The excretion of less than 400 ml/day is called: a. Anuria b. Hypouria c. Nocturia d. Oliguria

d

26. Clinical features that are characteristic of glomerular damage include all of the following except: a. Edema b. Hematuria c. Proteinuria d. Polyuria

d

30. When a patient has the nephrotic syndrome, microscopic examination of the urine sediment often reveals a. Granular casts b. Leukocyte casts c. Red cell casts d. Waxy casts

d

5. The hormone aldosterone is responsible for: a. Hydrogen ion secretion b. Potassium secretion c. Chloride retention d. Sodium retention

d