Deck 16: Renal Failure and Its Effects on the Cardiopulmonary System

Question 1

Into what structure does the distal convoluted tubule empty?

A) ureter
B) ascending limb of loop of Henle
C) descending limb of loop pf Henle
D) collecting duct

Answer 1

D

Question 2

The renal vein eventually joins what structure in the abdominal cavity?

A) peritubular capillaries
B) arcuate vein
C) interlobular veins
D) inferior vena cava

Answer 2

D

Question 3

What is the funnel shaped structure formed within the kidney from the expansion of the ureter?

A) renal pelvis
B) hilum
C) medulla
D) renal papillae

Answer 3

A

Question 4

Into what vessels does the renal artery divide?

A) interlobular arteries
B) interlobar arteries
C) afferent arterioles
D) arcuate arteries

Question 5

What is the approximate number of nephrons in an adult kidney?

A) 3 million
B) 1 million
C) 100,000
D) 300,000

Question 6

What is the first subdivision of the renal pelvis called?

A) major calyx
B) renal pyramid
C) papillary duct
D) minor calyx

Question 7

Into which vessels do the efferent arterioles branch?

A) arcurate arteries
B) peritubular capillaries
C) interlobular arteries
D) interlobar arteries

Question 8

Which structures compose the renal corpuscle?

A) medulla and Bachmann's capsule
B) glomerulus and Bachmann's capsule
C) medulla and Bowman's capsule
D) glomerulus and Bowman's capsule

Question 9

What is the average length and width of kidney in an adult?

A) 12cm long and 3 cm wide
B) 12 cm long and 6 cm wide
C) 6 cm long and 3 cm wide
D) 6 cm long and 12 cm wide

Question 10

In which portion of the kidney are the proximal convoluted tubules located?

A) medulla
B) cortex
C) renal pelvis
D) hilum

Question 11

Which of the following are components of the nephron? Glomerulus
Papillary ducts
Loop of Henle
Distal tubule

A) I, III, and IV only
B) I, II, III, and IV
C) III and IV only
D) I and III only

Question 12

What structure is formed from the interlobular veins?

A) renal vein
B) peritubular capillaries
C) arcuate vein
D) interlobar vein

Question 13

Into what vessels do the interlobar arteries divide at the base of the renal pyramids?

A) interlobular arteries
B) afferent arterioles
C) arcuate arteries
D) peritubular capillaries

Question 14

What is the term for the outer one-third of the kidney?

A) cortex
B) pelvis
C) medulla
D) calyx

Question 15

What is the term for the middle two-thirds of the kidney?

A) medulla
B) pelvis
C) calcyx
D) cortex

Question 16

What are the functional units of the kidneys called?

A) nephron
B) medulla
C) cortex
D) glomerulus

Question 17

Where do the renal arteries and renal veins enter and exit through the kidneys?

A) from the superior portion of the kidneys
B) from the posterior portion of the kidneys
C) from the inferior portion of the kidneys
D) from the hilum

Question 18

Where is urine stored until it is discharged from the body?

A) major calyces
B) urethra
C) bladder
D) ureter

Question 19

From which structure does the descending limb of the loop of Henle originate?

A) peritubular capillary
B) collecting duct
C) proximal convoluted tubule
D) renal pyramid

Question 20

Into what vessels do the interlobular arteries branch?

A) afferent arterioles
B) arcuate arteries
C) efferent arterioles
D) peritubular capillaries

Question 21

Which substance is reabsorbed by active transport by the proximal tubule?

A) glucose
B) K+
C) water
D) H+

Question 22

Under normal conditions, what is the osmotic pressure of the plasma?

A) 55 mm Hg
B) 30 mm Hg
C) 5 mm Hg
D) 15 mm Hg

Question 23

What portion of the urea in glomerular filtrate is reabsorbed by the blood?

A) 99%
B) 50%
C) 100%
D) <1%

Question 24

What percentage of the glucose in glomerular filtrate is reabsorbed into the blood?

A) 99%
B) 50%
C) 100%
D) < 1%

Question 25

Where does urine formation begin?

A) renal pelvis
B) renal corpuscle
C) loop of Henle
D) collecting duct

Question 26

On the average, how many liters of fluid are filtered by the glomeruli each day in the adult?

A) 60
B) 180
C) 30
D) 125

Question 27

What are the most important substances transported into the tubules by means of secretion?

A) H+ and K+
B) H+ and Na+
C) Na+ and K+
D) glucose and water

Question 28

What volume of fluid is filtered per minute by the glomeruli?

A) 125 mL/min
B) 15 mL/min
C) 60 mL/min
D) 30 mL/min

Question 29

What is the net filtration pressure in the glomeruli?

A) 55 mm Hg
B) 10 mm Hg
C) 30 mm Hg
D) 75 mm Hg

Question 30

Approximately how many nephrons are juxtamedullary nephrons?

A) 2 in 5
B) 3 in 5
C) 1 in 5
D) 4 in 5

Question 31

Which ions account for over 90% of the positively charged ions in extracellular fluid?

A) Ca+
B) Mg+
C) Na+
D) K+

Question 32

What is the normal osmolality of glomerular filtrate?

A) 1200 mOsm/L
B) 150 mOsm/L
C) 300 mOsm/L
D) 600 mOsm/L

Question 33

Where does the filtrate go after leaving the glomerular capillaries?

A) minor calyces
B) renal pelvis
C) Bowman's capsule
D) loop of Henle

Question 34

What substance regulates the permeability of the collecting ducts?

A) phosphate
B) ADH
C) Mg+
D) K+

Question 35

Which substance is reabsorbed by osmosis in the proximal tubule?

A) water
B) H+
C) glucose
D) K+

Question 36

What is the average adult's urine output in an hour?

A) 90 mL
B) 60 mL
C) 15 mL
D) 30 mL

Question 37

What is the approximate hydrostatic pressure in the glomerular capillary?

A) 15 mm Hg
B) 5 mm Hg
C) 55 mm Hg
D) 30 mm Hg

Question 38

Which structures produce and release ADH?

A) medulla and pituitary gland
B) hypothalamus and pituitary gland
C) pituitary gland and adrenal glands
D) hypothalamus and adrenal glands

Question 39

What is the normal range for specific gravity of urine?

A) 1.00 -1.002
B) 1.012-1.033
C) 1.030 - 1.30
D) 1.003 - 1.030

Question 40

What is the approximate osmolality of the juxtamedullary nephrons?

A) 1200 mOsm/L
B) 300 mOsm/L
C) 150 mOsm/L
D) 600 mOsm/L

Question 41

When the pH of extracellular fluids is acidic, how will the kidneys respond?

A) They will retain H+
B) They will excrete H+ into the urine.
C) The kidneys have no role in H+ regulation.
D) They will excrete more HCO₃^- into the urine

Question 42

How are elevated levels of calcium, magnesium, or phosphate ions regulated by the kidneys?

A) increased levels result in decreased reabsorption and elimination into the urine
B) increased levels result in decreased reabsorption and stimulation of the respiratory centers in the medulla
C) increased levels result in increased reabsoption and stimulation of ADH
D) increased levels result in increased reabsoption and stimulation of aldosterone

Question 43

What are the second most prevalent bacterial infections in the United States?

A) respiratory tract infections
B) skin infections
C) urinary tract infections
D) bone infections

Question 44

Where are the stretch receptors known as volume receptors located?

A) atria of the heart
B) bladder
C) kidneys
D) carotid arteries

Question 45

What causes the body to increase the amount of water by secretion of ADH and stimulation of thirst?

A) the magnesium level in the body gets too high
B) the potassium level in the body gets too high
C) the sodium level in the body gets too high
D) the calcium level in the body gets too high

Question 46

What effect does an increased K+ level have on the adrenal cortex?

A) inhibits ADH secretion from the adrenal cortex
B) stimulates increased ADH secretion from the adrenal cortex
C) stimulates increased aldosterone secretion from the adrenal cortex
D) inhibits aldosterone secretion from the adrenal cortex

Question 47

How would left ventricular failure affect renal perfusion and urine output?

A) Renal perfusion would decrease but urine output would not be affected
B) Renal perfusion and urine output would increase
C) Renal perfusion and urine output would decrease
D) Renal perfusion would decrease and urine output would increase

Question 48

What changes occur in the renal system when the blood volume increases?

A) glomerular pressure rises and the volume of urine produced would increase
B) glomerular pressure rises and the volume of urine produced would decrease
C) the glomerular pressure falls and the urine production would decrease
D) the glomerular pressure falls and the urine production would increase

Question 49

Congenital disorders, infections, obstructive disorders, inflammation and immune responses, and neoplasms are the most common causes of what?

A) heart failure
B) lung failure
C) renal failure
D) respiratory failure

Question 50

What is the normal systemic capillary pressure?

A) 5 mm Hg
B) 17 mm Hg
C) 25 mm Hg
D) 35 mm Hg

Question 51

What is the normal extracellular potassium concentration?

A) 1.5 - 3 mEq/L
B) 4 - 6.5 mEq/L
C) 5-7.5 mEq/L
D) 3.5 - 5 mEq/L

Question 52

Cancer of the kidneys accounts for what percent of all cancers?

A) 8%
B) 12%
C) 1-2%
D) 5%

Question 53

Approximately what percent of newborns have life-threatening renal malformations?

A) 3%
B) 6%
C) 15%
D) 10%

Question 54

Which of the following are functions of the renal system in acid base balance?
I. Regulate excretion of H+
II. Regulate reabsorption of bicarbonate ions
III. Regulate excretion of PCO₂

A) I only
B) I, II, and III
C) I and II only
D) II only

Question 55

When the extracellular fluids become too alkaline, how do the kidneys respond?

A) They trigger the respiratory centers to hyperventilate
B) They excrete HCO3- into the urine
C) They excrete HCO3- into the blood
D) They add PCO2 into the blood

Question 56

Which of the following can cause kidney inflammation?
I. Radiation
II. Drugs
III. Altered immune response

A) I and II only
B) II and III only
C) I, II, and III
D) I only

Question 57

What percent of all cancers of early childhood can be attributed to Wilms' tumors?

A) 70%
B) 15%
C) 35%
D) 50%

Question 58

Which of the following are predisposing factors to urinary flow obstruction? Calculi
Pregnancy
Infection and inflammation
Prostatic hypertrophy

A) I, III, and IV only
B) I and IV only
C) I, II, III, and IV
D) I and III only

Question 59

How would the body respond to a systemic capillary pressure of 22 mm Hg?

A) In response to the elevated pressure, fluid would be absorbed from the interstitial spaces to increase blood volume
B) 22 mm Hg is the normal systemic capillary pressure so no changes in blood volume would occur
C) In response to the elevated pressure, fluid would leak into the tissue spaces lowering the blood volume
D) In response to the decreased pressure, fluid would be absorbed from the interstitial spaces to increase blood volume

Question 60

What is one of the earliest clinical manifestations of prerenal failure?

A) a rapid rise in urine output
B) a sharp reduction in urine output
C) a sudden retention of HCO₃-
D) a sudden drop in K+

Question 61

Which of the following are classified as postrenal abnormalities?
I. Ureteral calculi
II. Bladder outlet obstruction
III. Fluid sequestration

A) I, II, and III
B) I and II only
C) III only
D) I only

Question 62

How does advanced renal failure affect K+ ion and H+ ion levels?

A) Both are decreased
B) Both are increased
C) H+ is decreased and K+ is increased
D) K+ is decreased and H+ is increased

Question 63

How does positive pressure ventilation affect urinary output?

A) It impedes venous return which stimulates aldosterone release and decreases urinary output
B) It enhances venous return which stimulates alsosterone release and increases urinary output
C) It impedes venous return which stimulates ADH release and decreases urinary output
D) It enhances venous return which stimulates ADH release and increases urinary output

Question 64

What percent of patients with chronic renal failure experience platelet abnormalities and bleeding disorders?

A) 10%
B) 20%
C) 5%
D) 40%

Question 65

Which of the following are classified as renal conditions? Acute pyelonephritis
Ureteral obstruction
Hypovolemia
Renal ischemia

A) IV only
B) I and IV only
C) II only
D) III and IV only

Question 66

Approximately what percent of persons with chronic renal failure develop pericarditis?

A) 20%
B) 10%
C) 50%
D) 40%

Question 67

What is the general term for abnormalities that impair blood flow to the kidneys?

A) kidney stones
B) renal conditions
C) prerenal conditions
D) postrenal conditions

Question 68

How are RBC levels affected by chronic renal failure?

A) Erythropoietin production is reduced and the toxic waste accumulation suppresses bone marrow's ability to produce RBCs
B) The electrolyte abnormalities breakdown the RBCs and cause anemia
C) The renal acidemia breaks down the RBCs and the fragments impair the bone marrow's ability to produce new RBCs
D) The level of erythropoietin level is stimulated from the chronic hypoxemia so polycythemia results

Question 69

Which hormone is produced in the kidneys to stimulate bone marrow to produce RBCs?

A) ADH
B) erythryopoietin
C) aldosterone
D) ANP

Question 70

What effect, if any, does negative pressure ventilation have on renal function?

A) It decreases urinary output
B) It enhances renal calculi formation
C) It increases urinary output
D) It increases the incidence of renal bacterial infections

Question 71

Which acid base abnormality can result from elevated plasma Cl^- ion levels?

A) hypochloremic alkalosis
B) hyperchloremic acidosis
C) hypochloremic acidosis
D) hyperchloremic alkalosis

Question 72

How does fluid sequestration impact the kidneys?

A) Fluid sequestration leads to fluid retention resulting in an increase in urine output resulting in prerenal failure
B) Fluid sequestration leads to hypovolemia leading to a sharp reduction in urine output and prerenal failure
C) Fluid sequestration leads to an elevated BP, increases urine output, and leads to prerenal failure
D) Fluid sequestration leads to fluid retention causing a drop in ADH release, an increased urine output, and prerenal failure

Question 73

Which of the following are prerenal abnormalities? I. Prostatic hypertrophy
II. Renal ischemia
III. Septicemia
IV. Heart failure

A) II, III, and IV
B) III and IV only
C) I and II only
D) I, II, III, and IV