Deck 14: The Kidneys and Regulation of Water and Inorganic Ions

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سؤال
Where do Na+/K+ ATPase pumps play an active role in reabsorbing Na+?

A)in Bowman's capsule epithelial cells,facing the interior of Bowman's space
B)in the basolateral membrane of cells of the cortical collecting duct
C)in the apical membrane of epithelial cells of the proximal tubule
D)in the luminal membrane of epithelial cells of the distal convoluted tubule
E)in the basolateral membrane of endothelial cells of peritubular capillaries
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سؤال
Which is TRUE regarding renal tubular reabsorption?

A)Reabsorption of Na+ from the proximal tubule occurs as a result of water reabsorption.
B)Reabsorption of glucose saturates at a maximum transport rate.
C)Urea reabsorption cannot occur at any point along the nephron.
D)Toxic substances are removed from the body by reabsorption from peritubular capillaries into the proxmial tubule.
E)Reabsorption of Na+ only occurs from nephron regions that come after the descending limb of the loop of Henle.
سؤال
Which correctly describes a basic renal process?

A)Fluid is filtered from Bowman's capsule into the glomerulus.
B)Substances are secreted from the tubule into the peritubular capillaries.
C)Substances are reabsorbed from the capillaries into the tubular lumen.
D)Substances are actively secreted from glomerular capillaries into Bowman's capsule.
E)Fluid moves by bulk flow from glomerular capillaries into Bowman's space.
سؤال
Which of the following does NOT correctly describe kidney function?

A)They contribute significantly to long-term regulation of arterial blood pressure by maintaining the proper plasma volume.
B)They produce urine of a constant composition at all times,in order to maintain homeostasis of extracellular fluid.
C)They excrete metabolic waste products.
D)They assist in maintaining proper acid-base balance in the body.
E)They secrete hormones.
سؤال
Which is TRUE about the juxtaglomerular apparatus?

A)It is composed of parts of the ascending limb of the loop of Henle and the efferent arteriole.
B)It is composed of glomerular capillaries and the macula densa.
C)It is the site of renin secretion.
D)It is created by the the junction between the proximal tubule and the afferent arteriole.
E)It is composed of cells that secrete atrial natriuretic peptide and cells that secrete norepinephrine.
سؤال
Which of the following is TRUE about how water is handled by the nephron?

A)Water is filtered out of glomerular capillaries by bulk flow.
B)Water is actively reabsorbed from the proximal tubule,and Na+ follows down its diffusion gradient.
C)Water is actively secreted into the descending loop of Henle.
D)The permeability of the ascending limb of the loop of Henle is modified by vasopressin.
E)Vasopressin inserts pumps in the collecting duct membrane that move water against its concentration gradient.
سؤال
Constriction of the ________ decreases hydrostatic pressure in _________.

A)afferent arterioles,glomerular capillaries
B)efferent arterioles,proximal convoluted tubules
C)renal vein,peritubular capillaries
D)efferent arterioles,glomerular capillaries
E)efferent arterioles,Bowman's capsule
سؤال
Which is NOT a transport mechanism typically seen in renal tubular epithelial cells?

A)cotransport proteins in the luminal membrane of the proximal tubule that move Na+ and glucose from the proximal tubule into epithelial cells
B)transport proteins that move glucose by facilitated diffusion from inside of proximal tubule cells into the renal interstitial fluid
C)ion channels that allow Na+ to move by diffusion from the lumen of the proximal tubule into epithelial cells
D)Na+-K+ ATPase pumps in the luminal membrane of proximal tubule epithelial cells that move Na+ from inside the cell into the tubule and K+ from the tubule lumen into the cell
E)countertransport proteins that move Na+ into proximal tubule epithelial cells while moving H+ from the cells into the lumen
سؤال
Which equation is equal to the net glomerular filtration pressure?

A)= hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule - osmotic pressure due to protein in Bowman's capsule
B)= osmotic pressure due to protein in plasma - hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule
C)= hydrostatic pressure in glomerular capillaries + hydrostatic pressure in Bowman's capsule + osmotic pressure due to protein in plasma
D)= hydrostatic pressure in glomerular capillaries + hydrostatic pressure in Bowman's capsule - osmotic pressure due to protein in plasma
E)= hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule - osmotic force due to proteins in plasma
سؤال
Which of the following is least likely to be filtered into Bowman's capsule in a normal,healthy person?

A)glucose
B)plasma protein
C)sodium
D)urea
E)bicarbonate ion
سؤال
Which of the following statements concerning the process of glomerular filtration is correct?

A)The hydrostatic pressure in Bowman's space opposes filtration.
B)The glomerular filtration rate is limited by a transport maximum.
C)All of the plasma that enters the glomerular capillaries is filtered.
D)The osmotic force due to plasma proteins favors filtration.
E)The hydrostatic pressure in glomerular capillaries opposes filtration.
سؤال
Which one of the following substances is LEAST dependent on the kidney for regulation of its plasma concentration?

A)water
B)Na+
C)K+
D)HPO4-
E)glucose
سؤال
Which correctly describes the composition of the glomerular filtrate?

A)It is identical to urine,but has a much smaller flow rate.
B)It is identical to urine,but has a much larger flow rate.
C)It is identical to blood plasma,except it lacks red blood cells.
D)It is highly similar to plasma,except it contains plasma proteins.
E)It is highly similar to plasma,except it does not contain plasma proteins.
سؤال
Which of the following describes tubular reabsorption in the kidney?

A)the movement of substances from the peritubular capillaries into the tubular fluid
B)the movement of substances from the proximal tubule into the loop of Henle
C)transepithelial transport from the lumen of the tubule into renal interstitial fluid
D)movement of Na+,Cl- and water from glomerular capillaries into Bowman's capsule
E)transport of solutes from the renal medullary interstitium into the collecting duct
سؤال
Which of the following substances undergo renal tubular secretion?

A)Ca2+
B)Na+
C)K+
D)H20
سؤال
Which is true for a man who is in balance for total body water?

A)he must ingest more water than is lost in the urine
B)he must ingest more water than is lost by all output pathways combined
C)he must ingest less water than is lost in the urine
D)the water filtered into Bowman's capsule must be 100% reabsorbed
E)the amount ingested plus that metabolically produced must equal the amount of water in the urine
سؤال
The amount of a substance that is excreted in the urine is equal to the amount that is ________ plus the amount that is ________ minus the amount that is ________.

A)filtered; reabsorbed; secreted
B)reabsorbed; filtered; secreted
C)secreted; reabsorbed; filtered
D)filtered; secreted; reabsorbed
E)reabsorbed; secreted; filtered
سؤال
Compared to the normal plasma osmolarity,the tubular fluid is ________ as it enters Bowman's space,______ at the beginning of the loop of Henle,______ at the tip of the loop and ________ at the beginning of the distal convoluted tubule.

A)isosmotic; hyperosmotic; hyperosmotic; isosmotic
B)isosmotic; isosmotic; hypoosmotic; hypoosmotic
C)isosmotic; isosmotic; hyperosmotic; hypoosmotic
D)isosmotic; isosmotic; hypoosmotic; hyperosmotic
E)isosmotic; isosmotic; hyperosmotic; isosmotic
سؤال
All of the following substances are present in proximal tubular fluid in the kidney,but which one is NOT normally present in urine?

A)Ca2+
B)H+
C)K+
D)HPO4-
E)glucose
سؤال
Which is NOT a function of the kidneys in maintaining homeostasis?

A)regulation of extracellular fluid osmolarity
B)regulation of blood hydrogen ion concentration
C)regulation of blood glucose concentration
D)regulation of extracellular fluid volume
E)regulation of blood K+ concentration
سؤال
Which would occur as a result of a decrease in the total body content of Na+?

A)an increase in plasma volume,which induces an increase in GFR and Na+ reabsorption rate
B)a decrease in plasma volume,which induces an increase in GFR and Na+ reabsorption rate
C)an increase in plasma volume,which induces an increase in GFR and a decrease in Na+ reabsorption rate
D) a decrease in plasma volume,which induces a decrease in GFR and Na+ reabsorption rate
E) a decrease in plasma volume,which induces a decrease in GFR and an increase in Na+ reabsorption rate
سؤال
Which is NOT true about the countercurrent multiplier system of the kidney?

A)It creates a hyperosmolar medullary interstitium that allows the kidneys to form hypertonic urine.
B)The descending loop of Henle is permeable to water.
C)There is active transport of sodium and chloride out of the ascending limb of the loop of Henle.
D)The ascending loop of Henle is not permeable to water.
E)The fraction of filtered NaCl reabsorbed from the ascending limb equals the fraction of filtered water reabsorbed from the descending limb.
سؤال
What region of the nephron reabsorbs about two-thirds of filtered Na+ and Cl-?

A)ascending loop of Henle
B)glomerulus
C)proximal convoluted tubule
D)distal convoluted tubule
E)collecting duct
سؤال
Which would result from ingesting a large amount of salt?

A)urine osmolarity would decrease
B)atrial natriuretic factor secretion would decrease
C)firing by hypothalamic osmoreceptors would decrease
D)secretion of atrial natriuretic factor would increase
E)secretion of vasopressin would decrease
سؤال
Which is TRUE about the hormone vasopressin (also known as antidiuretic hormone,ADH)?

A)It is a peptide hormone released from the adrenal gland.
B)It triggers insertion of aquaporins into the apical membranes of collecting duct cells.
C)It promotes the excretion of more water in the urine.
D)It stimulates the excretion of K+ in the urine.
E)It's main function is to trigger the secretion of aldosterone.
سؤال
In the presence of aldosterone,which nephron region reabsorbs the greatest fraction of the filtered Na+?

A)proximal tubule
B)macula densa
C)descending limb of the loop of Henle
D)distal convoluted tubule
E)cortical collecting duct
سؤال
Which of the following would cause a decrease in the excretion of Na+ and water?

A)increased hydrostatic pressure in the afferent renal arterioles
B)increased mean arterial blood pressure
C)increased atrial distension
D)decreased aldosterone secretion
E)decreased atrial natriuretic peptide secretion
سؤال
Which of the following statements regarding renal handling of Na+ is correct?

A)In the proximal tubule,Na+ is actively transported across the luminal membrane of the tubular epithelial cells.
B)Atrial natriuretic factor increases Na+ reabsorption.
C)In the absence of aldosterone,Na+ will be secreted by the cortical collecting ducts.
D)Na+ is actively reabsorbed in the ascending limb of the loop of Henle.
E)Without vasopressin,the collecting duct is impermeable to Na+.
سؤال
Water and NaCl reabsorbed from the loop of Henle directly re-enter what blood vessels?

A)vasa recta
B)afferent arterioles
C)efferent arterioles
D)cortical peritubular capillaries
E)collecting ducts
سؤال
Which of the following organs is the main site of aldosterone secretion?

A)kidneys
B)adrenal glands
C)systemic and pulmonary blood vessels
D)liver
E)the atria of the heart
سؤال
In what segment of the nephron is the greatest fraction of filtered water reabsorbed?

A)the proximal tubule
B)the ascending limb of the loop of Henle
C)the distal convoluted tubule
D)the collecting ducts
E)the descending limb of the loop of Henle
سؤال
In which region of the nephron does the fractional reabsorption of water vary the most in response to variation in the state of hydration?

A)the glomerulus
B)the proximal convoluted tubule
C)the loop of Henle
D)the distal convoluted tubule
E)the collecting duct
سؤال
Which correctly describes renin?

A)It is secreted by juxtaglomerular cells in renal afferent arterioles.
B)Its secretion is enhanced by high levels of Na+ in the macula densa.
C)Its secretion is stimulated by elevated blood pressure in the renal afferent arterioles.
D)It acts on the adrenal cortex to stimulate aldosterone secretion.
E)It is secreted by the liver in response to low blood pressure.
سؤال
Which would occur if a person lost the ability to synthesize vasopressin?

A)The ability to reabsorb water in the proximal tubule would be lost.
B)The excretion of glucose in the urine would increase.
C)The urine would become hypoosmotic compared to plasma.
D)The urine production would decrease dramatically,and the urine osmolarity would be hypertonic compared to plasma.
E)Blood pressure would increase significantly.
سؤال
How does the renal countercurrent multiplier mechanism allow the creation of a concentrated urine?

A)It transports NaCl from the medullary interstitium into the collecting duct,which directly increases the osmolarity of the urine.
B)It transports urea from the medullary interstitium into the collecting duct,which directly increases the osmolarity of the urine.
C)By concentrating NaCl in the renal medullary interstitium,it allows water to be reabsorbed from the collecting ducts when vasopressin is present.
D)By pumping NaCl and urea into the ascending limb of the loop of Henle,it raises the solute load,which turns into a concentrated urine once water is extracted from the collecting duct.
E)When anti-diuretic hormone is present,it stimulates the pumping of NaCl from the medullary interstitium and water follows,concentrating the urine.
سؤال
Which of the following would be most likely to increase GFR?

A)sympathetic stimulation of afferent arteriolar smooth muscle
B)constricting efferent arterioles
C)a decrease in plasma volume
D)an increase in the concentration of plasma proteins
E)increased secretion of renin
سؤال
In the condition diabetes mellitus,why does glucose appear in the urine?

A)The plasma concentration of glucose becomes so high that it diffuses from peritubular capillaries into the proximal tubule,down its concentration gradient.
B)The filtered load of glucose becomes greater than the tubular maximum for its reabsorption.
C)Without the hormone insulin,glucose cannot enter proximal tubule epithelial cells.
D)The rate of tubular secretion of glucose becomes greater than the sum of glucose filtration and reabsorption.
E)Without insulin,the glomerular filtration barrier becomes extremely leaky to glucose,which is not normally fiterable.
سؤال
Which of these is deficient in the disease,diabetes insipidus?

A)ACTH
B) vasopressin
C) atrial natriuretic factor
D) angiotensin II
E) insulin
سؤال
What is the rate-limiting (regulated)step for stimulating the secretion of aldosterone?

A)conversion of angiotensin I to angiotensin II in the blood
B)secretion of angiotensinogen by the liver
C)conversion of angiotensinogen to angiotensin I in the blood
D)secretion of ACTH by the anterior pituitary
E)secretion of angiotensin II by the kidney
سؤال
Which of the following most accurately describes the renal transport of Na+?

A)Na+ is actively transported in all segments of the tubule.
B)Primary active transport of Na+ allows for secondary active transport of glucose and H+ in the proximal tubule.
C)Most of the Na+ transport occurs in the distal convoluted tubule and collecting ducts.
D)Na+ is actively secreted into the nephron lumen by cells in the cortical collecting ducts.
E) Na+ is actively transported across the luminal membrane of proximal tubule cells in exchange for K+,by Na+/K+ ATPase pumps.
سؤال
Which of the following most accurately describes the actions of aldosterone?

A)Aldosterone increases Na+ secretion and K+ reabsorption in the cortical collecting ducts.
B)Aldosterone increases Na+ reabsorption and K+ secretion in the proximal tubule.
C)Aldosterone decreases Na+ reabsorption and K+ secretion in the cortical collecting ducts.
D)Aldosterone increases Na+ secretion and K+ reabsorption in the proximal tubule.
E)Aldosterone increases Na+ reabsorption and K+ secretion in the cortical collecting ducts.
سؤال
Which of these directly results from hypoventilation?

A)metabolic acidosis
B)respiratory acidosis
C)metabolic alkalosis
D)respiratory alkalosis
سؤال
Most of the reabsorption of filtered calcium is unregulated and occurs in the ________,but an additional amount can be reabsorbed in the _________,depending on the plasma concentration of parathyroid hormone.

A)proximal convoluted tubule,distal convoluted tubule
B)distal convoluted tubule,proximal convoluted tubule
C)proximal convoluted tubule,descending loop of Henle
D)distal convoluted tubule,medullary collecting ducts
E)distal convoluted tubule,renal corpuscle
سؤال
When blood Ca2+ levels fall below normal,in what ways do the kidneys help restore them toward normal?

A)by increasing 1,25-dihydroxyvitamin D3 formation,decreasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
B)by increasing 1,25-dihydroxyvitamin D3 formation,increasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
C)by decreasing 1,25-dihydroxyvitamin D3 formation,increasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
D)Increasing 1,25-dihydroxyvitamin D3 formation and increasing secretion of parathyroid hormone
E)by increasing renal secretion of parathyroid hormone and increasing bone resorption
سؤال
Which of the following statements about renal control of blood acid/base balance is TRUE?

A)Increased metabolism of glutamine by renal tubular cells increases the plasma bicarbonate concentration.
B)Excretion in the urine of hydrogen bound to phosphate buffers decreases plasma bicarbonate concentration.
C)H+ that binds to filtered bicarbonate in the tubular fluid is excreted in the urine.
D)When hypoventilation occurs at the lungs,the kidneys compensate by reducing glutamine metabolism.
E)The kidneys compensate for a metabolic alkalosis by increasing CO2 production.
سؤال
Which stimulates vasopressin secretion?

A)increased plasma osmolarity
B)increased plasma volume
C)ingestion of alcohol
D)decreased aldosterone secretion
E)increased pressure in afferent arterioles
سؤال
Which of the following types of drugs would inhibit spontaneous emptying of the bladder (incontinence)?

A)drugs that enhance the effects of parasympathetic neurons on the detrusor muscle
B)drugs that block the effects of parasympathetic neurons on the detrusor muscle
C)drugs that inhibit the effects of sympathetic neurons on the internal urethral sphincter
D)drugs that inhibit the effects of somatic neurons on the bladder
E)drugs that inhibit the action of sympathetic neurons on the external urethral sphincter
سؤال
How would the kidneys respond to hypoventilation?

A)increasing secretion of H+ and increasing production of newHCO3-
B)increasing secretion of H+ and decreasing reabsorption of HCO3-
C)decreasing secretion of H+ and increasing production of new HCO3-
D)decreasing secretion of H+ and decreasing reabsorption of HCO3-
E)increasing excretion of CO2
سؤال
Which of the following statements regarding Ca2+ homeostasis is true?

A)Parathyroid hormone directly stimulates Ca2+ reabsorption by the kidneys.
B)Parathyroid hormone directly stimulates Ca2+ absorption from the GI tract.
C)In the absence of parathyroid hormone,plasma Ca2+ levels would be abnormally low,resulting in the hyperpolarization of nerve and muscle membranes.
D)When plasma Ca2+ increases above normal,the secretion of parathyroid hormone increases.
E)Vitamin D decreases the renal tubular reabsorption of Ca2+.
سؤال
Which would result in the greatest stimulation of aldosterone secretion?

A)increasing plasma K+ concentration and decreasing plasma angiotensin II concentration
B)decreasing plasma K+ concentration and increasing plasma angiotensin II concentration
C)increasing plasma Na+ concentration and increasing plasma volume
D)increasing plasma K+ concentration and increasing plasma angiotensin II concentration
E)decreasing plasma Na+ concentration and decreasing plasma angiontensin II concentration
سؤال
Which of these would result in an increase in the osmolarity of urine?

A)increased levels of vasopressin in the plasma
B)increased levels of aldosterone in the plasma
C)decreased transport of Na+ and Cl- by the ascending limb of the loop of Henle
D)ingestion of a large volume of pure water
E)decreased urea permeability of the medullary collecting duct
سؤال
If a patient with pulmonary disease began to hypoventilate,how would plasma levels of [H+],HCO3-,and PCO2 be changed,compared to normal?

A)increased [H+],increased PCO2,and increased [HCO3-]
B)increased [H+],increased PCO2,and decreased [HCO3-]
C)increased [H+],decreased PCO2,and decreased [HCO3-]
D)decreased [H+],increased PCO2,and decreased [HCO3-]
E)decreased [H+],decreased PCO2,and decreased [HCO3-]
سؤال
The loss of 0.5 L of sweat would stimulate a greater increase in vasopressin secretion than the loss of an equal amount of blood plasma over the same period of time.This statement is:

A)true,because sweat is hyperosmotic to plasma.
B)true,because sweat is hypoosmotic to plasma.
C)false,because sweat is hypoosmotic to plasma.
D)false,because sweat is isosmotic to plasma.
E)false,because sweat is hyperosmotic to plasma.
سؤال
After prolonged exertion in a hot climate,baroreceptors would ________ firing,leading to ________ secretion of ________ and thus ________ renal reabsorption of ________.

A)increase; increased; renin; increased; Na+
B)decrease; increased; renin; decreased; Na+
C)decrease; increased; vasopressin; increased; water
D)increase; decreased; vasopressin; decreased; water
E)decrease; decreased; vasopressin; increased; water
سؤال
A man with hypertension takes a diuretic that is not potassium-sparing,and he does not increase his ingestion of potassium.Which of the following side-effects would the drug be most likely to cause?

A)increased blood volume
B)hyperpolarized neuronal cell membranes
C)hyperkalemia
D) cardiac arrhytmia
E) All of these side effects would occur.
سؤال
What change in renal regulation of H+ would help compensate for a metabolic acidosis?

A)a decrease in the filtered load of H+
B)an increase in the urinary pH
C)a decrease in the tubular production of ammonia
D)a decrease in the amount of H+ secreted in the proximal tubule
E)an increase in the production of new plasma HCO3-
سؤال
Which of the following symptoms would a patient with a deficiency of parathyroid hormone be most likely to experience?

A)low plasma calcium levels and decreased muscular excitability
B)low plasma calcium levels and increased muscular excitability
C)high plasma calcium levels and decreased muscular excitability
D)high plasma calcium levels and increased muscular excitability
E)high plasma calcium levels and abnormally weak bones
سؤال
Which of the following drugs is least likely to decrease blood pressure?

A)a drug that interferes with aldosterone synthesis
B)a drug that is an agonist of atrial natriuretic factor
C)a drug that decreases sympathetic stimulation of renal arterioles
D)a drug that enhances the activity of angiotensin-converting enzyme
E)a drug that decreases liver production of angiotensinogen
سؤال
Which would you observe in a person experiencing metabolic acidosis?

A)decreased renal secretion of hydrogen ion
B)decreased renal reabsorption of bicarbonate ion
C)increased plasma PCO2
D)decreased urinary pH
E)decreased urinary ammonium
سؤال
Which would NOT be caused by a decrease in plasma Ca2+ levels in an otherwise normal person?

A)an increase in plasma parathyroid hormone levels
B)an increase in plasma 1,25-dihydroxyvitamin D3 levels
C)an increase in nerve and muscle excitability
D)a decrease in the filtered load of Ca2+
E)an increase in bone density
سؤال
The distal convoluted tubules drain directly into the renal pelvis,which in turn drains into the ureter,a tube that carries urine to the bladder.
سؤال
Total-body balance of water and Na+ is largely maintained by regulating urinary loss of these substances.
سؤال
The countercurrent mechanism of the kidney enables the formation of hypertonic urine.
سؤال
If water intake (ingestion)is decreased,the kidney can decrease the amount of water excreted in urine by increasing the amount of water reabsorbed at the renal corpuscle.
سؤال
A person lacking vasopressin would have to drink 180 L of water per day to make up for the water lost in the urine.
سؤال
The three basic processes of kidney function are filtration from the glomerulus into Bowman's capsule,secretion from the tubule into the peritubular capillaries,and reabsorption from the capillaries into the tubular lumen.
سؤال
Large amounts of protein in a person's urine indicate that the person is eating a high-protein diet.
سؤال
A consequence of lack of vasopressin is excretion of sugar in the urine,which occurs in the condition diabetes mellitus.
سؤال
Most of the body's water is located inside cells,whereas most of the body's Na+ is in the interstitial fluid and plasma.
سؤال
The kidneys regulate the plasma concentrations of water,sodium,and glucose.
سؤال
Water,sodium,and glucose all undergo tubular reabsorption,but urea does not.
سؤال
The total solute concentration in the extracellular fluid is mainly dependent upon the concentration of Na+ in the extracellular fluid.
سؤال
The anatomic arrangement of juxtamedullary nephrons in the kidneys is such that the glomerulus,proximal tubule,and distal convoluted tubule are in the renal cortex,while the loop of Henle and collecting ducts lie mainly in the renal medulla.
سؤال
The walls of the ascending limb of the loop of Henle are freely permeable to water.
سؤال
Voluntary control of micturition involves controlling somatic motor input to the muscles of the external urethral sphincter.
سؤال
Only substances that are filtered by the kidneys can be excreted by them.
سؤال
The filtered load of water in an average person is approximately 180 L/day.
سؤال
Water absorption from the proximal tubule is mainly driven by the active reabsorption of Na+.
سؤال
In healthy individuals,the amount of glucose present in urine will be virtually zero because the amount of glucose reabsorption from the filtrate back into the blood prevents excretion.
سؤال
The spinal reflex for micturition involves stretch receptors in the wall of the bladder that send messages about distension to sympathetic,parasympathetic,and motor neurons in the spinal cord.
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Deck 14: The Kidneys and Regulation of Water and Inorganic Ions
1
Where do Na+/K+ ATPase pumps play an active role in reabsorbing Na+?

A)in Bowman's capsule epithelial cells,facing the interior of Bowman's space
B)in the basolateral membrane of cells of the cortical collecting duct
C)in the apical membrane of epithelial cells of the proximal tubule
D)in the luminal membrane of epithelial cells of the distal convoluted tubule
E)in the basolateral membrane of endothelial cells of peritubular capillaries
B
2
Which is TRUE regarding renal tubular reabsorption?

A)Reabsorption of Na+ from the proximal tubule occurs as a result of water reabsorption.
B)Reabsorption of glucose saturates at a maximum transport rate.
C)Urea reabsorption cannot occur at any point along the nephron.
D)Toxic substances are removed from the body by reabsorption from peritubular capillaries into the proxmial tubule.
E)Reabsorption of Na+ only occurs from nephron regions that come after the descending limb of the loop of Henle.
B
3
Which correctly describes a basic renal process?

A)Fluid is filtered from Bowman's capsule into the glomerulus.
B)Substances are secreted from the tubule into the peritubular capillaries.
C)Substances are reabsorbed from the capillaries into the tubular lumen.
D)Substances are actively secreted from glomerular capillaries into Bowman's capsule.
E)Fluid moves by bulk flow from glomerular capillaries into Bowman's space.
E
4
Which of the following does NOT correctly describe kidney function?

A)They contribute significantly to long-term regulation of arterial blood pressure by maintaining the proper plasma volume.
B)They produce urine of a constant composition at all times,in order to maintain homeostasis of extracellular fluid.
C)They excrete metabolic waste products.
D)They assist in maintaining proper acid-base balance in the body.
E)They secrete hormones.
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5
Which is TRUE about the juxtaglomerular apparatus?

A)It is composed of parts of the ascending limb of the loop of Henle and the efferent arteriole.
B)It is composed of glomerular capillaries and the macula densa.
C)It is the site of renin secretion.
D)It is created by the the junction between the proximal tubule and the afferent arteriole.
E)It is composed of cells that secrete atrial natriuretic peptide and cells that secrete norepinephrine.
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6
Which of the following is TRUE about how water is handled by the nephron?

A)Water is filtered out of glomerular capillaries by bulk flow.
B)Water is actively reabsorbed from the proximal tubule,and Na+ follows down its diffusion gradient.
C)Water is actively secreted into the descending loop of Henle.
D)The permeability of the ascending limb of the loop of Henle is modified by vasopressin.
E)Vasopressin inserts pumps in the collecting duct membrane that move water against its concentration gradient.
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7
Constriction of the ________ decreases hydrostatic pressure in _________.

A)afferent arterioles,glomerular capillaries
B)efferent arterioles,proximal convoluted tubules
C)renal vein,peritubular capillaries
D)efferent arterioles,glomerular capillaries
E)efferent arterioles,Bowman's capsule
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8
Which is NOT a transport mechanism typically seen in renal tubular epithelial cells?

A)cotransport proteins in the luminal membrane of the proximal tubule that move Na+ and glucose from the proximal tubule into epithelial cells
B)transport proteins that move glucose by facilitated diffusion from inside of proximal tubule cells into the renal interstitial fluid
C)ion channels that allow Na+ to move by diffusion from the lumen of the proximal tubule into epithelial cells
D)Na+-K+ ATPase pumps in the luminal membrane of proximal tubule epithelial cells that move Na+ from inside the cell into the tubule and K+ from the tubule lumen into the cell
E)countertransport proteins that move Na+ into proximal tubule epithelial cells while moving H+ from the cells into the lumen
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9
Which equation is equal to the net glomerular filtration pressure?

A)= hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule - osmotic pressure due to protein in Bowman's capsule
B)= osmotic pressure due to protein in plasma - hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule
C)= hydrostatic pressure in glomerular capillaries + hydrostatic pressure in Bowman's capsule + osmotic pressure due to protein in plasma
D)= hydrostatic pressure in glomerular capillaries + hydrostatic pressure in Bowman's capsule - osmotic pressure due to protein in plasma
E)= hydrostatic pressure in glomerular capillaries - hydrostatic pressure in Bowman's capsule - osmotic force due to proteins in plasma
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10
Which of the following is least likely to be filtered into Bowman's capsule in a normal,healthy person?

A)glucose
B)plasma protein
C)sodium
D)urea
E)bicarbonate ion
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11
Which of the following statements concerning the process of glomerular filtration is correct?

A)The hydrostatic pressure in Bowman's space opposes filtration.
B)The glomerular filtration rate is limited by a transport maximum.
C)All of the plasma that enters the glomerular capillaries is filtered.
D)The osmotic force due to plasma proteins favors filtration.
E)The hydrostatic pressure in glomerular capillaries opposes filtration.
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12
Which one of the following substances is LEAST dependent on the kidney for regulation of its plasma concentration?

A)water
B)Na+
C)K+
D)HPO4-
E)glucose
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13
Which correctly describes the composition of the glomerular filtrate?

A)It is identical to urine,but has a much smaller flow rate.
B)It is identical to urine,but has a much larger flow rate.
C)It is identical to blood plasma,except it lacks red blood cells.
D)It is highly similar to plasma,except it contains plasma proteins.
E)It is highly similar to plasma,except it does not contain plasma proteins.
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14
Which of the following describes tubular reabsorption in the kidney?

A)the movement of substances from the peritubular capillaries into the tubular fluid
B)the movement of substances from the proximal tubule into the loop of Henle
C)transepithelial transport from the lumen of the tubule into renal interstitial fluid
D)movement of Na+,Cl- and water from glomerular capillaries into Bowman's capsule
E)transport of solutes from the renal medullary interstitium into the collecting duct
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15
Which of the following substances undergo renal tubular secretion?

A)Ca2+
B)Na+
C)K+
D)H20
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16
Which is true for a man who is in balance for total body water?

A)he must ingest more water than is lost in the urine
B)he must ingest more water than is lost by all output pathways combined
C)he must ingest less water than is lost in the urine
D)the water filtered into Bowman's capsule must be 100% reabsorbed
E)the amount ingested plus that metabolically produced must equal the amount of water in the urine
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17
The amount of a substance that is excreted in the urine is equal to the amount that is ________ plus the amount that is ________ minus the amount that is ________.

A)filtered; reabsorbed; secreted
B)reabsorbed; filtered; secreted
C)secreted; reabsorbed; filtered
D)filtered; secreted; reabsorbed
E)reabsorbed; secreted; filtered
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18
Compared to the normal plasma osmolarity,the tubular fluid is ________ as it enters Bowman's space,______ at the beginning of the loop of Henle,______ at the tip of the loop and ________ at the beginning of the distal convoluted tubule.

A)isosmotic; hyperosmotic; hyperosmotic; isosmotic
B)isosmotic; isosmotic; hypoosmotic; hypoosmotic
C)isosmotic; isosmotic; hyperosmotic; hypoosmotic
D)isosmotic; isosmotic; hypoosmotic; hyperosmotic
E)isosmotic; isosmotic; hyperosmotic; isosmotic
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19
All of the following substances are present in proximal tubular fluid in the kidney,but which one is NOT normally present in urine?

A)Ca2+
B)H+
C)K+
D)HPO4-
E)glucose
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20
Which is NOT a function of the kidneys in maintaining homeostasis?

A)regulation of extracellular fluid osmolarity
B)regulation of blood hydrogen ion concentration
C)regulation of blood glucose concentration
D)regulation of extracellular fluid volume
E)regulation of blood K+ concentration
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21
Which would occur as a result of a decrease in the total body content of Na+?

A)an increase in plasma volume,which induces an increase in GFR and Na+ reabsorption rate
B)a decrease in plasma volume,which induces an increase in GFR and Na+ reabsorption rate
C)an increase in plasma volume,which induces an increase in GFR and a decrease in Na+ reabsorption rate
D) a decrease in plasma volume,which induces a decrease in GFR and Na+ reabsorption rate
E) a decrease in plasma volume,which induces a decrease in GFR and an increase in Na+ reabsorption rate
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22
Which is NOT true about the countercurrent multiplier system of the kidney?

A)It creates a hyperosmolar medullary interstitium that allows the kidneys to form hypertonic urine.
B)The descending loop of Henle is permeable to water.
C)There is active transport of sodium and chloride out of the ascending limb of the loop of Henle.
D)The ascending loop of Henle is not permeable to water.
E)The fraction of filtered NaCl reabsorbed from the ascending limb equals the fraction of filtered water reabsorbed from the descending limb.
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23
What region of the nephron reabsorbs about two-thirds of filtered Na+ and Cl-?

A)ascending loop of Henle
B)glomerulus
C)proximal convoluted tubule
D)distal convoluted tubule
E)collecting duct
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24
Which would result from ingesting a large amount of salt?

A)urine osmolarity would decrease
B)atrial natriuretic factor secretion would decrease
C)firing by hypothalamic osmoreceptors would decrease
D)secretion of atrial natriuretic factor would increase
E)secretion of vasopressin would decrease
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25
Which is TRUE about the hormone vasopressin (also known as antidiuretic hormone,ADH)?

A)It is a peptide hormone released from the adrenal gland.
B)It triggers insertion of aquaporins into the apical membranes of collecting duct cells.
C)It promotes the excretion of more water in the urine.
D)It stimulates the excretion of K+ in the urine.
E)It's main function is to trigger the secretion of aldosterone.
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26
In the presence of aldosterone,which nephron region reabsorbs the greatest fraction of the filtered Na+?

A)proximal tubule
B)macula densa
C)descending limb of the loop of Henle
D)distal convoluted tubule
E)cortical collecting duct
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27
Which of the following would cause a decrease in the excretion of Na+ and water?

A)increased hydrostatic pressure in the afferent renal arterioles
B)increased mean arterial blood pressure
C)increased atrial distension
D)decreased aldosterone secretion
E)decreased atrial natriuretic peptide secretion
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28
Which of the following statements regarding renal handling of Na+ is correct?

A)In the proximal tubule,Na+ is actively transported across the luminal membrane of the tubular epithelial cells.
B)Atrial natriuretic factor increases Na+ reabsorption.
C)In the absence of aldosterone,Na+ will be secreted by the cortical collecting ducts.
D)Na+ is actively reabsorbed in the ascending limb of the loop of Henle.
E)Without vasopressin,the collecting duct is impermeable to Na+.
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29
Water and NaCl reabsorbed from the loop of Henle directly re-enter what blood vessels?

A)vasa recta
B)afferent arterioles
C)efferent arterioles
D)cortical peritubular capillaries
E)collecting ducts
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30
Which of the following organs is the main site of aldosterone secretion?

A)kidneys
B)adrenal glands
C)systemic and pulmonary blood vessels
D)liver
E)the atria of the heart
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31
In what segment of the nephron is the greatest fraction of filtered water reabsorbed?

A)the proximal tubule
B)the ascending limb of the loop of Henle
C)the distal convoluted tubule
D)the collecting ducts
E)the descending limb of the loop of Henle
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32
In which region of the nephron does the fractional reabsorption of water vary the most in response to variation in the state of hydration?

A)the glomerulus
B)the proximal convoluted tubule
C)the loop of Henle
D)the distal convoluted tubule
E)the collecting duct
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33
Which correctly describes renin?

A)It is secreted by juxtaglomerular cells in renal afferent arterioles.
B)Its secretion is enhanced by high levels of Na+ in the macula densa.
C)Its secretion is stimulated by elevated blood pressure in the renal afferent arterioles.
D)It acts on the adrenal cortex to stimulate aldosterone secretion.
E)It is secreted by the liver in response to low blood pressure.
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34
Which would occur if a person lost the ability to synthesize vasopressin?

A)The ability to reabsorb water in the proximal tubule would be lost.
B)The excretion of glucose in the urine would increase.
C)The urine would become hypoosmotic compared to plasma.
D)The urine production would decrease dramatically,and the urine osmolarity would be hypertonic compared to plasma.
E)Blood pressure would increase significantly.
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35
How does the renal countercurrent multiplier mechanism allow the creation of a concentrated urine?

A)It transports NaCl from the medullary interstitium into the collecting duct,which directly increases the osmolarity of the urine.
B)It transports urea from the medullary interstitium into the collecting duct,which directly increases the osmolarity of the urine.
C)By concentrating NaCl in the renal medullary interstitium,it allows water to be reabsorbed from the collecting ducts when vasopressin is present.
D)By pumping NaCl and urea into the ascending limb of the loop of Henle,it raises the solute load,which turns into a concentrated urine once water is extracted from the collecting duct.
E)When anti-diuretic hormone is present,it stimulates the pumping of NaCl from the medullary interstitium and water follows,concentrating the urine.
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36
Which of the following would be most likely to increase GFR?

A)sympathetic stimulation of afferent arteriolar smooth muscle
B)constricting efferent arterioles
C)a decrease in plasma volume
D)an increase in the concentration of plasma proteins
E)increased secretion of renin
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37
In the condition diabetes mellitus,why does glucose appear in the urine?

A)The plasma concentration of glucose becomes so high that it diffuses from peritubular capillaries into the proximal tubule,down its concentration gradient.
B)The filtered load of glucose becomes greater than the tubular maximum for its reabsorption.
C)Without the hormone insulin,glucose cannot enter proximal tubule epithelial cells.
D)The rate of tubular secretion of glucose becomes greater than the sum of glucose filtration and reabsorption.
E)Without insulin,the glomerular filtration barrier becomes extremely leaky to glucose,which is not normally fiterable.
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38
Which of these is deficient in the disease,diabetes insipidus?

A)ACTH
B) vasopressin
C) atrial natriuretic factor
D) angiotensin II
E) insulin
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39
What is the rate-limiting (regulated)step for stimulating the secretion of aldosterone?

A)conversion of angiotensin I to angiotensin II in the blood
B)secretion of angiotensinogen by the liver
C)conversion of angiotensinogen to angiotensin I in the blood
D)secretion of ACTH by the anterior pituitary
E)secretion of angiotensin II by the kidney
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40
Which of the following most accurately describes the renal transport of Na+?

A)Na+ is actively transported in all segments of the tubule.
B)Primary active transport of Na+ allows for secondary active transport of glucose and H+ in the proximal tubule.
C)Most of the Na+ transport occurs in the distal convoluted tubule and collecting ducts.
D)Na+ is actively secreted into the nephron lumen by cells in the cortical collecting ducts.
E) Na+ is actively transported across the luminal membrane of proximal tubule cells in exchange for K+,by Na+/K+ ATPase pumps.
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41
Which of the following most accurately describes the actions of aldosterone?

A)Aldosterone increases Na+ secretion and K+ reabsorption in the cortical collecting ducts.
B)Aldosterone increases Na+ reabsorption and K+ secretion in the proximal tubule.
C)Aldosterone decreases Na+ reabsorption and K+ secretion in the cortical collecting ducts.
D)Aldosterone increases Na+ secretion and K+ reabsorption in the proximal tubule.
E)Aldosterone increases Na+ reabsorption and K+ secretion in the cortical collecting ducts.
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42
Which of these directly results from hypoventilation?

A)metabolic acidosis
B)respiratory acidosis
C)metabolic alkalosis
D)respiratory alkalosis
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43
Most of the reabsorption of filtered calcium is unregulated and occurs in the ________,but an additional amount can be reabsorbed in the _________,depending on the plasma concentration of parathyroid hormone.

A)proximal convoluted tubule,distal convoluted tubule
B)distal convoluted tubule,proximal convoluted tubule
C)proximal convoluted tubule,descending loop of Henle
D)distal convoluted tubule,medullary collecting ducts
E)distal convoluted tubule,renal corpuscle
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44
When blood Ca2+ levels fall below normal,in what ways do the kidneys help restore them toward normal?

A)by increasing 1,25-dihydroxyvitamin D3 formation,decreasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
B)by increasing 1,25-dihydroxyvitamin D3 formation,increasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
C)by decreasing 1,25-dihydroxyvitamin D3 formation,increasing tubular phosphate reabsorption,and increasing tubular Ca2+ reabsorption
D)Increasing 1,25-dihydroxyvitamin D3 formation and increasing secretion of parathyroid hormone
E)by increasing renal secretion of parathyroid hormone and increasing bone resorption
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45
Which of the following statements about renal control of blood acid/base balance is TRUE?

A)Increased metabolism of glutamine by renal tubular cells increases the plasma bicarbonate concentration.
B)Excretion in the urine of hydrogen bound to phosphate buffers decreases plasma bicarbonate concentration.
C)H+ that binds to filtered bicarbonate in the tubular fluid is excreted in the urine.
D)When hypoventilation occurs at the lungs,the kidneys compensate by reducing glutamine metabolism.
E)The kidneys compensate for a metabolic alkalosis by increasing CO2 production.
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46
Which stimulates vasopressin secretion?

A)increased plasma osmolarity
B)increased plasma volume
C)ingestion of alcohol
D)decreased aldosterone secretion
E)increased pressure in afferent arterioles
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47
Which of the following types of drugs would inhibit spontaneous emptying of the bladder (incontinence)?

A)drugs that enhance the effects of parasympathetic neurons on the detrusor muscle
B)drugs that block the effects of parasympathetic neurons on the detrusor muscle
C)drugs that inhibit the effects of sympathetic neurons on the internal urethral sphincter
D)drugs that inhibit the effects of somatic neurons on the bladder
E)drugs that inhibit the action of sympathetic neurons on the external urethral sphincter
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48
How would the kidneys respond to hypoventilation?

A)increasing secretion of H+ and increasing production of newHCO3-
B)increasing secretion of H+ and decreasing reabsorption of HCO3-
C)decreasing secretion of H+ and increasing production of new HCO3-
D)decreasing secretion of H+ and decreasing reabsorption of HCO3-
E)increasing excretion of CO2
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49
Which of the following statements regarding Ca2+ homeostasis is true?

A)Parathyroid hormone directly stimulates Ca2+ reabsorption by the kidneys.
B)Parathyroid hormone directly stimulates Ca2+ absorption from the GI tract.
C)In the absence of parathyroid hormone,plasma Ca2+ levels would be abnormally low,resulting in the hyperpolarization of nerve and muscle membranes.
D)When plasma Ca2+ increases above normal,the secretion of parathyroid hormone increases.
E)Vitamin D decreases the renal tubular reabsorption of Ca2+.
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50
Which would result in the greatest stimulation of aldosterone secretion?

A)increasing plasma K+ concentration and decreasing plasma angiotensin II concentration
B)decreasing plasma K+ concentration and increasing plasma angiotensin II concentration
C)increasing plasma Na+ concentration and increasing plasma volume
D)increasing plasma K+ concentration and increasing plasma angiotensin II concentration
E)decreasing plasma Na+ concentration and decreasing plasma angiontensin II concentration
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51
Which of these would result in an increase in the osmolarity of urine?

A)increased levels of vasopressin in the plasma
B)increased levels of aldosterone in the plasma
C)decreased transport of Na+ and Cl- by the ascending limb of the loop of Henle
D)ingestion of a large volume of pure water
E)decreased urea permeability of the medullary collecting duct
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52
If a patient with pulmonary disease began to hypoventilate,how would plasma levels of [H+],HCO3-,and PCO2 be changed,compared to normal?

A)increased [H+],increased PCO2,and increased [HCO3-]
B)increased [H+],increased PCO2,and decreased [HCO3-]
C)increased [H+],decreased PCO2,and decreased [HCO3-]
D)decreased [H+],increased PCO2,and decreased [HCO3-]
E)decreased [H+],decreased PCO2,and decreased [HCO3-]
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53
The loss of 0.5 L of sweat would stimulate a greater increase in vasopressin secretion than the loss of an equal amount of blood plasma over the same period of time.This statement is:

A)true,because sweat is hyperosmotic to plasma.
B)true,because sweat is hypoosmotic to plasma.
C)false,because sweat is hypoosmotic to plasma.
D)false,because sweat is isosmotic to plasma.
E)false,because sweat is hyperosmotic to plasma.
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54
After prolonged exertion in a hot climate,baroreceptors would ________ firing,leading to ________ secretion of ________ and thus ________ renal reabsorption of ________.

A)increase; increased; renin; increased; Na+
B)decrease; increased; renin; decreased; Na+
C)decrease; increased; vasopressin; increased; water
D)increase; decreased; vasopressin; decreased; water
E)decrease; decreased; vasopressin; increased; water
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55
A man with hypertension takes a diuretic that is not potassium-sparing,and he does not increase his ingestion of potassium.Which of the following side-effects would the drug be most likely to cause?

A)increased blood volume
B)hyperpolarized neuronal cell membranes
C)hyperkalemia
D) cardiac arrhytmia
E) All of these side effects would occur.
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56
What change in renal regulation of H+ would help compensate for a metabolic acidosis?

A)a decrease in the filtered load of H+
B)an increase in the urinary pH
C)a decrease in the tubular production of ammonia
D)a decrease in the amount of H+ secreted in the proximal tubule
E)an increase in the production of new plasma HCO3-
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57
Which of the following symptoms would a patient with a deficiency of parathyroid hormone be most likely to experience?

A)low plasma calcium levels and decreased muscular excitability
B)low plasma calcium levels and increased muscular excitability
C)high plasma calcium levels and decreased muscular excitability
D)high plasma calcium levels and increased muscular excitability
E)high plasma calcium levels and abnormally weak bones
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58
Which of the following drugs is least likely to decrease blood pressure?

A)a drug that interferes with aldosterone synthesis
B)a drug that is an agonist of atrial natriuretic factor
C)a drug that decreases sympathetic stimulation of renal arterioles
D)a drug that enhances the activity of angiotensin-converting enzyme
E)a drug that decreases liver production of angiotensinogen
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59
Which would you observe in a person experiencing metabolic acidosis?

A)decreased renal secretion of hydrogen ion
B)decreased renal reabsorption of bicarbonate ion
C)increased plasma PCO2
D)decreased urinary pH
E)decreased urinary ammonium
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60
Which would NOT be caused by a decrease in plasma Ca2+ levels in an otherwise normal person?

A)an increase in plasma parathyroid hormone levels
B)an increase in plasma 1,25-dihydroxyvitamin D3 levels
C)an increase in nerve and muscle excitability
D)a decrease in the filtered load of Ca2+
E)an increase in bone density
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61
The distal convoluted tubules drain directly into the renal pelvis,which in turn drains into the ureter,a tube that carries urine to the bladder.
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62
Total-body balance of water and Na+ is largely maintained by regulating urinary loss of these substances.
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63
The countercurrent mechanism of the kidney enables the formation of hypertonic urine.
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64
If water intake (ingestion)is decreased,the kidney can decrease the amount of water excreted in urine by increasing the amount of water reabsorbed at the renal corpuscle.
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65
A person lacking vasopressin would have to drink 180 L of water per day to make up for the water lost in the urine.
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66
The three basic processes of kidney function are filtration from the glomerulus into Bowman's capsule,secretion from the tubule into the peritubular capillaries,and reabsorption from the capillaries into the tubular lumen.
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67
Large amounts of protein in a person's urine indicate that the person is eating a high-protein diet.
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68
A consequence of lack of vasopressin is excretion of sugar in the urine,which occurs in the condition diabetes mellitus.
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69
Most of the body's water is located inside cells,whereas most of the body's Na+ is in the interstitial fluid and plasma.
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70
The kidneys regulate the plasma concentrations of water,sodium,and glucose.
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71
Water,sodium,and glucose all undergo tubular reabsorption,but urea does not.
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72
The total solute concentration in the extracellular fluid is mainly dependent upon the concentration of Na+ in the extracellular fluid.
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73
The anatomic arrangement of juxtamedullary nephrons in the kidneys is such that the glomerulus,proximal tubule,and distal convoluted tubule are in the renal cortex,while the loop of Henle and collecting ducts lie mainly in the renal medulla.
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74
The walls of the ascending limb of the loop of Henle are freely permeable to water.
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75
Voluntary control of micturition involves controlling somatic motor input to the muscles of the external urethral sphincter.
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76
Only substances that are filtered by the kidneys can be excreted by them.
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77
The filtered load of water in an average person is approximately 180 L/day.
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78
Water absorption from the proximal tubule is mainly driven by the active reabsorption of Na+.
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79
In healthy individuals,the amount of glucose present in urine will be virtually zero because the amount of glucose reabsorption from the filtrate back into the blood prevents excretion.
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80
The spinal reflex for micturition involves stretch receptors in the wall of the bladder that send messages about distension to sympathetic,parasympathetic,and motor neurons in the spinal cord.
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