Deck 20: Integrative Physiology II: Fluid and Electrolyte Balance

Question 1

Water reabsorption by the kidneys is a result of

A) both passive and active transport processes.
B) cotransport with ions.
C) exchange with ions.
D) osmosis.

Answer 1

D

Question 2

The hormone vasopressin

A) is secreted by the anterior pituitary gland in response to changes in blood osmolarity.
B) stimulates the kidneys to retain sodium ions.
C) stimulates the kidneys to conserve water.
D) stimulates the kidneys to produce a large volume of urine.
E) All of the answers are correct.

Answer 2

C

Question 3

The primary osmoreceptors are located in the

A) pons.
B) kidney.
C) stomach.
D) hypothalamus.
E) medulla.

Answer 3

D

Question 4

Granular cells secrete

A) angiotensinogen.
B) angiotensin I.
C) aldosterone.
D) renin.
E) angiotensin converting enzyme.

Question 5

The two organ systems that work together to regulate most aspects of the body's water balance are

A) digestive and respiratory.
B) urinary and respiratory.
C) cardiovascular and respiratory.
D) urinary and cardiovascular.
E) digestive and cardiovascular.

Question 6

When a body is dehydrated, water in the urinary bladder

A) can be returned to the circulation directly.
B) can be returned to the circulation after moving back into the kidneys.
C) will still be expelled from the body in the urine.

Question 7

The hormone that regulates water reabsorption by the kidneys

A) decreases water permeability throughout the kidney tubules.
B) increases water permeability throughout the kidney tubules.
C) only decreases water permeability in certain portions of the kidney tubules.
D) only increases water permeability in certain portions of the kidney tubules.

Question 8

Why do patients taking loop diuretics need to take supplemental potassium?

A) They cause active secretion of potassium in the loop of Henle.
B) They inhibit the reabsorption of potassium as well as sodium in the loop of Henle.
C) They inhibit intestinal absorption of potassium.
D) They cause active reabsorption of potassium in the distal convoluted tubule.

Question 9

Most body water is located in

A) plasma.
B) interstitial fluid.
C) cells.
D) lumens of organs open to the outside.

Question 10

When venous return is increased, stretch receptors in the atria of the heart are activated.This results in

A) secretion of vasopressin.
B) inhibition of vasopressin secretion.
C) increased glomerular filtration.
D) decreased urine production.
E) increased thirst.

Question 11

The primary route for water loss from the body is the ________ system.

A) respiratory
B) urinary
C) digestive
D) integumentary
E) cardiovascular

Question 12

Shrinkage of hepatocytes in the liver causes them to cause which of the following?

A) glycogen production only
B) glycogen breakdown only
C) protein synthesis only
D) both glycogen production and protein synthesis
E) both glycogen breakdown and protein breakdown

Question 13

Why is sodium actively reabsorbed in the nephron?

A) to decrease osmolarity inside the nephron
B) to make urine less concentrated
C) to increase passive reabsorption of water
D) to decrease blood pressure

Question 14

The primary route for ion loss from the body is the ________ system.

A) respiratory
B) urinary
C) digestive
D) integumentary
E) cardiovascular

Question 15

The hormone that directly controls water reabsorption by the kidneys is

A) vasopressin.
B) aldosterone.
C) epinephrine.
D) ANP.
E) angiotensin.

Question 16

Kidneys respond relatively ________ to changes in blood volume.

A) slowly
B) quickly

Question 17

Osmoreceptors depolarize after they ________ in response to ________ plasma osmolarity.

A) shrink, decreased
B) shrink, increased
C) swell, decreased
D) swell, increased

Question 18

Kidneys regulate

A) water loss only.
B) water gain only.
C) both water loss and gain.

Question 19

When baroreceptors in the carotid and aortic bodies register increased blood pressure, this results in

A) secretion of vasopressin.
B) inhibition of vasopressin secretion.
C) increased glomerular filtration.
D) decreased urine production.
E) increased thirst.

Question 20

Cell volume (and therefore cell function)in most cells is dependent upon careful regulation of

A) volume of extracellular fluid.
B) blood pressure.
C) osmolarity of extracellular fluid.
D) permeability of cell membranes.
E) resting membrane potential.

Question 21

Which of the following is NOT True about angiotensin II?

A) increases cardiac output
B) activates parasympathetic output
C) is a potent vasoconstrictor
D) elevates blood pressure
E) stimulates thirst

Question 22

Atrial natriuretic peptide

A) increases GFR.
B) inhibits release of renin.
C) stimulates release of renin.
D) increases GFR and inhibits release of renin.
E) increases GFR and stimulates release of renin.

Question 23

ACE converts

A) renin to angiotensinogen.
B) angiotensinogen to angiotensin I.
C) angiotensin I to angiotensin II.
D) angiotensin II to aldosterone.
E) renin to aldosterone.

Question 24

Drugs that treat hypertension by preventing Angiotensin I from becoming Angiotensin II are called

A) ACE inhibitors.
B) beta blockers.
C) calcium channel blockers.
D) diuretics.

Question 25

Which of the following is most likely to be observed in a patient with compensated respiratory alkalosis?

A) respiratory rate increases
B) tidal volume increases
C) kidneys conserve bicarbonate
D) kidneys secrete fewer hydrogen ions
E) body retains less carbon dioxide

Question 26

The enzyme renin is responsible for the activation of

A) angiotensin I.
B) cortisol.
C) erythropoietin.
D) atrial natriuretic peptide.
E) adrenaline.

Question 27

Symptoms of low plasma pH may include

A) CNS depression only.
B) confusion and disorientation only.
C) numbness, tingling, or muscle twitches only.
D) CNS depression and confusion and disorientation.
E) CNS depression; confusion and disorientation; and numbness, tingling, or muscle twitches.

Question 28

Stimuli for the activation of the RAS pathway include

A) low blood pressure in arterioles in the nephron only.
B) a decrease in fluid flow through the distal tubule only.
C) high blood pressure in the renal artery only.
D) low blood pressure in arterioles in the nephron and a decrease in fluid flow through the distal tubule.
E) low blood pressure in arterioles in the nephron, a decrease in fluid flow through the distal tubule, and high blood pressure in the renal artery.

Question 29

The primary role of the carbonic acid-bicarbonate buffer system is to

A) buffer stomach acid.
B) buffer carbonic acid formed by carbon dioxide.
C) prevent pH changes caused by organic and fixed acids.
D) buffer the urine.
E) increase the amount of carbonic acid during ventilation.

Question 30

Aldosterone

A) is secreted in response to elevated levels of sodium in the blood.
B) promotes sodium retention in the kidneys.
C) helps decrease blood volume.
D) increases the concentration of sodium in urine.
E) functions in pH regulation.

Question 31

Decreased ECF volume causes

A) sympathetic output from the cardiovascular control center to increase.
B) parasympathetic output from the cardiovascular control center to increase.
C) the force of ventricular contraction to decrease.
D) arteriolar vasodilation.
E) sympathetic output from the cardiovascular control center to increase and arteriolar vasodilation.

Question 32

The most important factor affecting the pH of plasma is the concentration of

A) lactic acid.
B) ketone bodies.
C) organic acids.
D) carbon dioxide.
E) hydrochloric acid.

Question 33

Angiotensin I is converted to angiotensin II by enzymes primarily located in the

A) kidneys.
B) liver.
C) heart.
D) lungs.
E) blood vessels.

Question 34

A hormone that helps to regulate the sodium ion concentration of the blood is

A) cortisol.
B) parathormone.
C) thymosin.
D) somatotropin.
E) aldosterone.

Question 35

The osmolarity in the deepest part of the loop of Henle is ________ mOsM.

A) 1200
B) 100
C) 300
D) 900
E) None of these answers are correct.

Question 36

Angiotensin II stimulates

A) thirst only.
B) vasoconstriction only.
C) synthesis and release of aldosterone.
D) thirst and vasoconstriction.
E) thirst, vasoconstriction, and synthesis and release of aldosterone.

Question 37

Thirst is

A) controlled by centers in the hypothalamus.
B) triggered by decreased osmolarity.
C) relieved only when plasma osmolarity is increased.
D) controlled by centers in the hypothalamus and triggered by increased osmolarity.
E) controlled by centers in the hypothalamus, triggered by increased osmolarity, and relieved only when plasma osmolarity is decreased.

Question 38

An increase in plasma potassium levels is properly called

A) hypernatremia.
B) hyperpotassemia.
C) hyperpotasseplasmia.
D) hyperkalemia.
E) hypercalcemia.

Question 39

Excess potassium ions are eliminated from the body by the

A) sweat glands.
B) kidneys.
C) liver.
D) digestive system.
E) spleen.

Question 40

Which of the following concerning the hormone atrial natriuretic peptide is False?

A) produced by cells in the heart
B) promotes sodium loss at the kidneys
C) reduces blood pressure
D) suppresses vasopressin secretion
E) increases aldosterone secretion

Question 41

A rise in angiotensin II levels would result in increased

A) blood pressure.
B) retention of sodium ions at the kidney.
C) water retention.
D) blood volume.
E) All of these effects.

Question 42

The normal pH range for most body fluids is ________.

A) 7 to 8
B) 7.5 to 8
C) 7.25 to 7.75
D) 7.38 to 7.42

Question 43

When the pH of body fluids begins to fall, proteins will

A) become more active.
B) lose three-dimensional structure.
C) fold into tertiary structures.
D) not be affected.

Question 44

The anatomical arrangement of the kidney that allows transfer of solutes from one blood vessel to another is called the

A) countercurrent exchange system.
B) portal system.
C) capillaries.
D) countercurrent heat exchanger.

Question 45

A person who suffers from hyperventilation will exhibit signs of

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 46

The enzyme that catalyzes the conversion of H₂O and CO₂ to H₂CO₃ is called

A) carbonic anhydrase.
B) bicarbonate ion.
C) carbonic acid.
D) renin.

Question 47

When the pH rises above 7.42, a state of ________ exists.

A) acidosis
B) alkalosis
C) equilibrium
D) homeostasis

Question 48

AQP2 water pores are added to the cell membrane by ________ and withdrawn by ________ in a process known as ________.

A) exocytosis, endocytosis, membrane recycling
B) endocytosis, exocytosis, membrane recycling
C) membrane recycling, exocytosis, endocytosis
D) membrane recycling, endocytosis, exocytosis

Question 49

Abnormal fat and amino acid metabolism may lead to the condition called

A) ketoacidosis.
B) lactic acidosis.
C) metabolic alkalosis.
D) respiratory acidosis.

Question 50

________ interstitial osmolarity allows urine to be concentrated.

A) High medullary
B) Low medullary
C) High cortex
D) Low cortex

Question 51

Prolonged vomiting of the stomach's contents can result in

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 52

If sodium increases in the ECF, water will move from

A) cells to the ECF, and cells will swell.
B) the ECF to cells, and cells will swell.
C) cells to the ECF, and cells will shrink.
D) the ECF to cells, and cells will shrink.

Question 53

A person who suffers from emphysema will exhibit signs of

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 54

Renal tubule cells in the kidney medulla are constantly exposed to high extracellular osmolarity.How do they maintain normal cell volume?

A) They synthesize organic solutes as needed to match the osmolarity.
B) They synthesize water molecules through increased metabolism to offset volume loss.
C) They maintain a water-impermeable membrane.
D) They add or remove aquaporins as needed.

Question 55

Normal removal of excess water in urine is known as

A) diuresis.
B) diuretics.
C) osmotic diuresis.
D) filtration.

Question 56

Paracrine feedback from the ________ in the distal tubule to the granular cells stimulates release of ________.

A) sympathetic neurons, epinephrine
B) granular cells, renin
C) liver, angiotensinogen
D) macula densa, renin

Question 57

A buffer

A) moderates changes in pH.
B) always increases pH.
C) always decreases pH.
D) binds or releases bicarbonate ions.

Question 58

The ________ cells of the distal nephron are interspersed among the principal cells and contribute to acid-base regulation.

A) endothelial
B) intercalated
C) endocrine
D) granular

Question 59

The RAS pathway begins with secretion of

A) angiotensin converting enzyme.
B) renin.
C) angiotensinogen.
D) aldosterone.
E) vasopressin.

Question 60

How do kidneys alter urine concentration?

Question 61

The most potent stimulus for vasopressin release is

A) plasma osmolarity.
B) blood volume.
C) blood pressure.
D) low potassium.

Question 62

The cellular mechanisms for renal handling of H⁺ and HCO₃⁻ involve several membrane transporters; name three.

Question 63

Rachel, a nursing student, has been caring for burn patients.She notices that they consistently show elevated levels of potassium in their urine and wonders why.What would you tell her?

Question 64

In response to a rapid increase of organic acid in the body, you would expect to observe

A) increased alveolar ventilation.
B) decreased blood pressure.
C) decreased heart rate.
D) increased blood pH.

Question 65

Diagram the reactions and interactions of the renin-angiotensin system (RAS).Which condition is the primary stimulus for its activation?

Question 66

Mr.Gregory comes to the doctor with high blood pressure.Tests show that he also has elevated levels of renin in his blood and atherosclerotic plaques that have nearly blocked blood flow through his renal arteries.Mr.Gregory is puzzled.Explain to him how decreased blood flow in his renal arteries could cause renin secretion to increase.Map the pathways through which elevated renin causes high blood pressure for Mr.Gregory.

Question 67

What are oropharynx receptors, which hormone do they suppress, and how is it known that they exist? If a person stranded on a desert island drank seawater to try to quench his thirst, how would this affect the oropharynx receptors?

Question 68

What are the two mechanisms of bicarbonate reabsorption in the proximal tubule?

Question 69

Two hours before major surgery is to begin, the patient experiences "jitters," an elevated heart rate and blood pressure.These symptoms are the result of

A) sympathetic activation.
B) decreased levels of epinephrine in the blood.
C) decreased activity of sympathetic centers in the hypothalamus.
D) increased parasympathetic activity.
E) All of these mechanisms.

Question 70

Fred suffers from chronic emphysema.Blood tests show that his pH is normal but his bicarbonate levels are elevated significantly.How can this be?

Question 71

How does decreased blood pressure affect the following: granular cells, glomerulus, cardiovascular control center, hypothalamus? Indicate if decreased blood pressure directly affects the organ or tissue above or acts through a reflex pathway.If it acts through a reflex pathway, name the reflex.

Question 72

Dehydration may cause some ions to become concentrated.If a person was suffering from severe hyperkalemia, you would expect

A) the potassium ion concentration of the interstitial fluid to be less than normal.
B) the membrane potential of nerves and muscles to be more negative.
C) abnormal cardiac rhythms.
D) muscle weakness and increased strength of twitch contractions.
E) All of the answers are correct.

Question 73

Which effect would a decrease in pH have on the amount of potassium ion in the urine?

A) increase
B) decrease
C) no effect

Question 74

"Glucose, glucose, everywhere, nor any speck to utilize" is a phrase made up by one of the authors working on this test question.Similar to the irony of not being able to prevent dehydration by drinking seawater, people with untreated diabetes mellitus are unable to prevent starvation despite the large amount of glucose surrounding their cells; as if that isn't bad enough, dehydration is also a problem.Explain why there is glucose in the urine of such people, why glucose is not present in the urine of normal people, and why diabetics become dehydrated.

Question 75

An explorer has been lost in the desert for two days with very little water.As a result, you would expect to observe

A) elevated vasopressin levels.
B) decreased blood osmolarity.
C) normal urine production.
D) increased blood volume.
E) cells enlarged with fluid.

Question 76

Devising new food recipes is more successful when the chefs understand basic food chemistry.For example, to create a new cake recipe, one must understand the role of both acids and bases in leavening (rising, or trapping of tiny gas bubbles as dough is baking, to provide the characteristic texture).The principle is to incorporate baking soda (NaHCO₃)into an acidic batter, causing a chemical reaction resulting in gas production.Looking at the chemical formula, which gas do you think is formed? Summarize the chemical reaction that occurs in a cake batter that contains NaHCO₃ and vinegar or acetic acid (produces acetate when ionized: CH₃COO⁻ + H⁺).What would happen to your cake if you didn't use enough baking soda? What would happen if you forgot to acidify your batter with vinegar or a similar food acid?

Question 77

Which of the following leads to the lowest water loss during a day?

A) metabolism
B) feces
C) skin
D) lungs
E) kidneys

Question 78

Draw a map that shows the renal compensation for acidosis.Draw another map for alkalosis.

Question 79

"Water, water, everywhere, nor any drop to drink" is a phrase from the Rime of the Ancient Mariner by Samuel Taylor Coleridge.This poem describes an ocean ship unable to sail to land and running out of its supply of fresh water; sailors have long known that drinking seawater cannot prevent death from dehydration.What would result if the sailors attempted to alleviate their dehydration by drinking seawater? Justify your answer by describing kidney physiology.Why wouldn't reflexes, in response to dehydration, fully compensate? What does this illustrate about the force allowing kidneys to retain water under more normal conditions?

Question 80

When the pH of the extracellular fluid declines, the kidneys

A) excrete more sodium ions.
B) excrete more bicarbonate ions.
C) reabsorb more potassium ions.
D) reabsorb more hydrogen ions.
E) reabsorb less water.