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

Question 1

What are the functional units of the kidneys called?

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

Answer 1

A

Question 2

Into what vessels do the interlobular arteries branch?

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

Answer 2

A

Question 3

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

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

Answer 3

A

Question 4

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

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

Question 5

After waste products leave the renal pelvis,what is the next structure they enter?

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

Question 6

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

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

Question 7

What structure is formed from the interlobular veins?

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

Question 8

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

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

Question 9

Into what structure does the distal convoluted tubule empty?

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

Question 10

Where do the ureters exit from the kidneys?

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

Question 11

Into which vessels do the efferent arterioles branch?

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

Question 12

What structure is formed from the interlobar vein?

A) renal vein
B) arcuate vein
C) interlobular veins
D) peritubular capillaries

Question 13

What is the first subdivision of the renal pelvis called?

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

Question 14

Into what vessels does the renal artery divide?

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

Question 15

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

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

Question 16

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

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

Question 17

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

Question 18

Which structures compose the renal corpuscle?

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

Question 19

Which of the following are components of the nephron?
I)Glomerulus
II)Papillary ducts
III)Loop of Henle
IV)Distal tubule

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

Question 20

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

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

Question 21

What is the approximate hydrostatic pressure in the glomerular capillary?

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

Question 22

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

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

Question 23

Which substance is reabsorbed by osmosis in the proximal tubule?

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

Question 24

What substance regulates the permeability of the collecting ducts?

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

Question 25

Where does urine formation begin?

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

Question 26

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

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

Question 27

What is the normal range for specific gravity of urine?

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

Question 28

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

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

Question 29

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 30

Where does the filtrate go after leaving the glomerular capillaries?

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

Question 31

Which structures produce and release ADH?

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

Question 32

What is the net filtration pressure in the glomeruli?

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

Question 33

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

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

Question 34

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 35

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

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

Question 36

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

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

Question 37

What is the normal osmolality of glomerular filtrate?

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

Question 38

Approximately what percentage of the nephrons are juxtamedullary nephrons?

A) 20%
B) 80%
C) 60%
D) 10%

Question 39

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

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

Question 40

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

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

Question 41

What is the normal extracellular potassium concentration?

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

Question 42

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

A) glomerular pressure rises and the volume of utine 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 43

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

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

Question 44

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

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

Question 45

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 increased reabsoption and stimulation of ADH
C) increased levels result in increased reabsoption and stimulation of aldosterone
D) increased levels result in decreased reabsorption and stimulation of the respiratory centers in the medulla

Question 46

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

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

Question 47

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

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

Question 48

How do kidneys control an elevated sodium level in the extracellular fluid?

A) by increasing the secretion of ADH and stimulating thirst
B) by decreasing the secretion of ADH and stimulating thirst
C) by increasing the secretion of aldosterone and stimulating thirst
D) by increasing the secretion of aldosterone and decreasing the secretion of ADH

Question 49

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

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

Question 50

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

Question 51

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

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

Question 52

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

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

Question 53

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

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

Question 54

Which of the following are predisposing factors to urinary flow obstruction?
I)Calculi
II)Pregnancy
III)Infection and inflammation
IV)Prostatic hypertrophy

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

Question 55

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

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

Question 56

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

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

Question 57

Which acid base abnormality would be a clinical manifestation of severe renal failure?

A) metabolic acidosis
B) metabolic alkalosis
C) respiratory acidosis
D) respiratory alkalosis

Question 58

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

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

Question 59

What is the normal systemic capillary pressure?

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

Question 60

Where are the stretch receptors known as volume receptors located?

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

Question 61

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 62

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

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

Question 63

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

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

Question 64

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

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

Question 65

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

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

Question 66

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

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

Question 67

How does positive pressure ventilation affect urinary output?

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

Question 68

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

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

Question 69

Which of the following are classified as renal conditions?
I)Acute pyelonephritis
II)Ureteral obstruction
III)Hypovolemia
IV)Renal ischemia

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

Question 70

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

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

Question 71

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

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

Question 72

How does fluid sequestration impact the kidneys?

A) Fluid sequestration leads to hypovolemia leading to a sharp reduction in urine output and prerenal failure
B) Fluid sequestration leads to fluid retention resulting in an increase in urine output resulting in 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 hormone is produced in the kidneys to stimulate bone marrow to produce RBCs?

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