APP - Urinary

1) The renal corpuscle consists of:
A) the proximal and distal convoluted tubules.
B) the glomerulus and the glomerular (Bowman's) capsule.
C) the descending and ascending limbs of the loop of Henle.
D) all the renal pyramids.
E) the glomerulus and the vase recta.

2) Sympathetic nerves from the renal plexus are distributed to the:
A) renal blood vessels.
B) convoluted tubules.
C) renal pyramids.
D) collecting ducts.
E) both renal blood vessels and convoluted tubules.

3) Which of the following lists the nephron regions in the correct order of fluid flow?
A) glomerular capsule, distal convoluted tubule, loop of Henle, proximal convoluted tubule
B) proximal convoluted tubule, loop of Henle, distal convoluted tubule, glomerular capsule
C) glomerular capsule, proximal convoluted
tubule, loop of Henle, distal convoluted tubule
D) loop of Henle, glomerular capsule, proximal convoluted tubule, distal convoluted tubule
E) distal convoluted tubule, loop of Henle, proximal convoluted tubule, glomerular capsule

4) Which of the following lists the vessels in the correct order of blood flow?
A) efferent arteriole, glomerulus, afferent arteriole, peritubular capillaries
B) peritubular capillaries, efferent arteriole, glomerulus, afferent arteriole
C) afferent arteriole, efferent arteriole, peritubular capillaries, glomerulus
D) afferent arteriole, glomerulus, efferent arteriole, peritubular capillaries
E) efferent arteriole, afferent arteriole, glomerulus, peritubular capillaries

5. The main function of the kidneys is to
A. Form urea from the metabolic break-down of proteins
B. Eliminate the excess water formed in metabolic processes
C. Excrete extra-cellular fluid such as lymph
D. Eliminate acid-forming carbon dioxide resulting from metabolism
E. Regulate the composition of the blood and hence of the whole internal environment.

6. Bowman’s capsule is
A. The ball of capillaries from which the liquid part of the blood filters
B. Another name for the kidney nephron
C. The connective tissue envelope surrounding the outside of the kidney
D. A double-walled funnel surrounding a glomerulus
E. All answers are correct.

7. The unit excretory structure of the kidney is
A. The renal pyramid
B. The glomerulus
C. The nephron
D. The neuron
E. The collecting duct.

8) The part of a juxtamedullary nephron that is in the renal medulla is the:
A) glomerulus only.
B) glomerular (Bowman's) capsule only.
C) renal corpuscle.
D) loop of Henle.
E) entire nephron.

9) The cells making up the proximal and distal convoluted tubules are:
A) stratified squamous epithelial cells.
B) simple squamous epithelial cells.
C) simple cuboidal epithelial cells.
D) transitional epithelial cells.
E) smooth muscle cells.

10) Podocytes are cells specialized for filtration that are found in the:
A) walls of the vasa recta.
B) ascending limb of the loop of Henle.
C) urinary bladder.
D) visceral layer of the glomerular capsule.
E) collecting duct.

11) The surface of glomerular capillaries available for filtration is regulated by:
A) mesangial cells.
B) macula densa cells.
C) juxtaglomerular cells.
D) renin.
E) ADH.

12) ALL of the following are factors in the glomerular filter EXCEPT :
A) slit membranes.
B) basal laminae.
C) endothelial cells.
D) fenestrations.
E) microvilli.

13 ) If the diameter of the efferent arteriole is smaller than the diameter of the afferent arteriole, then:
A) blood pressure in the glomerulus stays low.
B) blood pressure in the glomerulus stays high.
C) there must be an abnormal blockage in the peritubular capillaries.
D) the endothelial capsular membrane filters less blood than normal.
E) capsular hydrostatic pressure increases to levels higher than glomerular blood hydrostatic
pressure.

14) Glomerular filtrate contains:
A) everything in blood.
B) everything in blood except cells and proteins.
C) water and electrolytes only.
D) water and waste only.
E) water only.

15) Filtration of blood in the glomeruli is promoted by:
A) blood colloid osmotic pressure.
B) blood hydrostatic pressure.
C) capsular hydrostatic pressure.
D) both blood hydrostatic pressure and capsular hydrostatic pressure.
E) both blood colloid osmotic pressure and capsular hydrostatic pressure.

16) Which of the following pressures is highest in the renal corpuscle under normal circumstances?
A) blood colloid osmotic pressure
B) capsular hydrostatic pressure
C) capsular colloid osmotic pressure
D) glomerular blood hydrostatic pressure
E) None is higher than the others; all pressures are equal under normal circumstances.

17) An obstruction in the proximal convoluted tubule decreases glomerular filtration rate because:
A) blood hydrostatic pressure in the glomerulus decreases when blood can't flow through the tubule.
B) osmotic pressure in the glomerular capsule increases due to leakage of more proteins into the filtrate.
C) hydrostatic pressure in the glomerular capsule increases, which decreases net filtration pressure.
D) hydrostatic pressure in the glomerular capsule decreases due to leakage of more filtrate into the peritubular space.
E) release of renin decreases as fluid flow to the macula densa decreases.

18) The function of the macula densa cells is to:
A) prevent water reabsorption in the ascending limb of the loop of Henle.
B) prevent over distension of the urinary bladder.
C) add bicarbonate ions to the tubular fluid in the proximal convoluted tubule.
D) monitor NaCl concentration in the tubular fluid.
E) produce the carrier molecules used to actively transport ions into the peritubular space.

19) In the myogenic mechanism of renal autoregulation:
A) renin causes contraction of macula densa cells to increase GFR.
B) smooth muscle in afferent arterioles triggers vasoconstriction to decrease GFR.
C) norepinephrine causes vasoconstriction of afferent arterioles to decrease GFR.
D) atrial natriuretic peptide causes relaxation of mesangial cells to increase GFR.
E) angiotensin II causes dilation of the proximal and distal convoluted tubules.

20) The function of atrial natriuretic peptide in renal autoregulation of GFR is to stimulate:
A) renin secretion.
B) conversion of angiotensin I to angiotensin II.
C) relaxation of glomerular mesangial cells.
D) constriction in afferent and efferent arterioles.
E) reabsorption of sodium ions.

21) If sympathetic stimulation to afferent and efferent arterioles decreases, then GFR:
A) doesn't change because the arterioles each have the same diameter.
B) increases because the afferent arterioles dilate, but the efferent arterioles don't change.
C) increases because both vessels are less constricted.
D) decreases because both vessels constrict.
E) doesn't change because the vessels do not have receptors for sympathetic neurotransmitters.

22) The most important function of the juxtaglomerular (JG) apparatus is to:
A) secrete water and sodium into the tubular fluid.
B) release renin in response to a drop in renal blood pressure or blood flow.
C) make sure that the diameter of the efferent arteriole is kept larger then that of the afferent arteriole.
D) produce antidiuretic hormone in response to increased glomerular filtration rate (GFR).
E) produce chemicals that change the diameter of the loop of Henle.

23) If there were an obstruction in the renal artery, one might expect to see:
A) a decrease in glomerular filtration rate (GFR).
B) an increase in the release of renin.
C) an increase in glomerular filtration rate (GFR).
D) Both B and C are correct.
E) Both A and B are correct.

24 ) As substances are reabsorbed in the proximal convoluted tubules of the kidneys, they move from:
A) filtered fluid to epithelial cells, to intersitial fluid to peritubular capillaries.
B) filtered fluid to interstitial fluid, to epithelial cells, to peritubular capillaries.
C) peritubular capillaries to interstitial fluid, to epithelial cells, to filtered fluid.
D) vasa recta to epithelial cells, to interstitial fluid, to filtered fluid.
E) peritubular capillaries to epithelial cells, to interstitial fluid, to filtered fluid.

25. The uptake of substances from the lumen of the kidney tubules if known as
A. Tubular filtration
B. Tubular secretion
C. Tubular reabsorption
D. All answers are correct

26. Given the following conditions, glomerular blood hydrostatic pressure 75 mm Hg, capsular hydrostatic pressure 15 mm Hg, blood osmotic pressure 25 mm Hg, the effective filtration pressure would be _____mm Hg.
A. 40.
B. 65
C. 25.
D. 0
E. 35.

27. Most reabsorption of substances from the glomerular filtrate occurs in the
A. Proximal tubule
B. Loop of Henle
C. Collecting tubule
D. Distal tubule
E. Bowman’s capsule

28. Which of the following substances is normally almost completely reabsorbed by the tubules of the nephron?
A. Creatinine
B. Glucose
C. Phosphate
D. Sodium.
E. urea.

29) The transport maximum is the:
A) highest the glomerular filtration rate can increase without inhibiting kidney function.
B) greatest percentage of plasma entering the glomerulus that can become filtrate.
C) upper limit of reabsorption due to saturation of carrier systems.
D) steepest any concentration gradient can become.
E) fastest rate at which fluid can flow through the renal tubules.

30) Most water is reabsorbed in the proximal convoluted tubule by obligatory reabsorption , which means that:
A) water is moving up its own gradient.
B) water is "following" sodium and other ions/molecules to maintain osmotic balance.
C) the carrier that transports sodium cannot do so without binding water first.
D) the proximal convoluted tubule cannot physically hold the volume of water that enters from the glomerular capsule, so water is reabsorbed because of hydrostatic pressure.
E) the rate of water reabsorption never changes, regardless of water intake.

31) Obligatory reabsorption of water occurs in the:
A) proximal convoluted tubule.
B) distal convoluted tubule.
C) ascending limb of the loop of Henle.
D) descending limb of the loop of Henle.
E) both A and D are correct.

32) Facultative reabsorption of water is regulated by:
A) angiotensin II.
B) epinephrine.
C) ADH.
D) mesangial cells.
E) calcitriol.

21) If sympathetic stimulation to afferent and efferent arterioles decreases, then GFR:
A) doesn't change because the arterioles each have the same diameter.
B) increases because the afferent arterioles dilate, but the efferent arterioles don't change.
C) increases because both vessels are less constricted.
D) decreases because both vessels constrict.
E) doesn't change because the vessels do not have receptors for sympathetic neurotransmitters.

34) Principal cells in the distal convoluted tubules:
A) secrete renin.
B) monitor sodium and chloride ion concentrations in tubular fluid.
C) secrete hydrogen ions when pH in the extracellular fluid is low.
D) filter large proteins.
E) respond to ADH and aldosterone.

35) The significance of secretion of ammonium (NH4+) ions by the tubule cells is:
A) it triggers the release of renin.
B) it results from generation of new bicarbonate ions that can be reabsorbed to help maintain pH.
C) it keeps the ascending limb of Henle's loop from reabsorbing water.
D) it carries urea across the endothelium of the vasa recta.
E) there is no apparent function for this type of secretion.

36) If the level of aldosterone in the blood increases, then:
A) more potassium is excreted in the urine.
B) more sodium is excreted in the urine.
C) blood pressure will drop.
D) glomerular filtration rate will drop.
E) First B, then C, then D.

37 ) The amount of potassium secreted by principal cells is increased by which of the following?
A) high levels of sodium ions in tubular fluid
B) low levels of potassium in plasma
C) the action of mesangial cells
D) increased ADH
E) Both A and D are correct.

38) A role of intercalated cells is to:
A) secrete renin.
B) secrete erythropoietin.
C) reabsorb water in response to ADH.
D) reabsorb sodium ions in response to aldosterone.
E) excrete hydrogen ions when pH is too low.

39) The action of ADH on principal cells is to:
A) increase production of sodium ion pumps.
B) increase insertion of aquaporin 2 vesicles into apical membranes.
C) increase the number of microvilli in their membranes.
D) decrease the number of aquaporin 1 vesicles in basolateral membranes.
E) do nothing because principal cells do not have ADH receptors.

40) Urine that is hypotonic to blood plasma is produced when:
A) levels of aldosterone are high.
B) levels of antidiuretic hormone are high.
C) levels of antidiuretic hormone are low.
D) plasma concentration of sodium ions is high.
E) levels of both aldosterone and antidiuretic hormone are high.

41) The concentration of solutes in tubular fluid is greatest in the:
A) glomerular (Bowman's) capsule.
B) proximal convoluted tubule.
C) hairpin turn of the loop of Henle.
D) ascending limb of the loop of Henle.
E) distal convoluted tubule.

42) The renal clearance of a large protein such as albumin would be closest to which of the following values?
A) the rate of renal blood flow
B) the total blood volume entering both kidneys each minute
C) the average glomerular filtration rate
D) the transport maximum for glucose
E) zero

43) The permeability of the collecting ducts to water is regulated by:
A) aldosterone.
B) renin.
C) antidiuretic hormone.
D) atrial natriuretic peptide.
E) angiotensinogen.

44) The countercurrent mechanism in the loop of Henle builds and maintains an osmotic gradient in the renal medulla. Which of the following is NOT a contributing factor.?
A) Fluid flows in opposite directions in the ascending and descending limbs of the loop of Henle.
B) Chloride ions passively diffuse from the interstitial fluid into the thick portion of the ascending limb.
C) The thick portion of the ascending limb is impermeable to water.
D) The descending limb is permeable to water.
E) Fluid in the descending limb is in osmotic equilibrium with the surrounding interstitial fluid.

45) Cells that have receptors for aldosterone include:
A) podocytes.
B) intercalated cells in the collecting ducts.
C) cells in the thick ascending limb of the loop of Henle.
D) cells in the proximal convoluted tubules.
E) cells in the distal convoluted tubules

46) The effect of aldosterone on the principal cells of the distal convoluted tubule is to:
A) increase the synthesis of sodium pumps.
B) increase the cells' permeability to water.
C) increase retention of potassium ions.
D) increase the cells' secretion of antidiuretic hormone.
E) trigger the release of renin.

47) The normal daily volume of urine produced is:
A) under 200 ml.
B) 200minus400 ml.
C) 1000minus2000 ml.
D) 3 liters.
E) 180 liters.

48) Urea recycling in the renal medulla refers to the:
A) conversion of urea to ammonia by the tubule cells.
B) conversion of ammonia to ammonium ions by the tubule cells.
C) conversion of urea into amino acids in the vasa recta.
D) mechanism by which urea leaves the collecting duct and re enters the loop of Henle, thus helping to maintain the hypertonic conditions of the interstitial spaces.
E) mechanism by which urea leaves the collecting ducts and enters the vasa recta, thus helping to maintain the correct blood volume in the vasa recta.

49. Clearance refers to
A. The volume of plasma from which a substances is entirely removed per minute
B. The amount of solute passed into the urine per minute
C. The amount of fluid passed across all the glomeruli per minute
D. The amount of solvent in the blood divided by the total volume
E. All answers are correct.

50) Which of the following would be in the highest concentration in normal urine?
A) albumin.
B) bilirubin.
C) creatinine.
D) acetoacetic acid.
E) urobilinogen.

51. Match: Tubular maximum
A. Juxtaglomerular apparatus
B. Loop of Henle
C. Proximal convoluted tubule
D. Distal convoluted tubule
E. Collecting duct

53. Match: Aldosterone acts on
A. Juxtaglomerular apparatus
B. Loop of Henle
C. Proximal convoluted tubule
D. Distal convoluted tubule
E. Collecting duct

54. Match: Renin is associated with
A. Juxtaglomerular apparatus
B. Loop of Henle
C. Proximal convoluted tubule
D. Distal convoluted tubule
E. Collecting duct

55. Match: Glomeruli are located in
A. Cortex of the kidney
B. Capsule of the kidney
C. Medulla of the kidney
D. Pelvis of the kidney
E. Renal Hilus

56. Match: Distal convoluted tubules are located in the
A. Cortex of the kidney
B. Capsule of the kidney
C. Medulla of the kidney
D. Pelvis of the kidney
E. Renal Hilus

57. Match: Loop of Henle is located in the
A. Cortex of the kidney
B. Capsule of the kidney
C. Medulla of the kidney
D. Pelvis of the kidney
E. Renal Hilus

58. Match: Ureter exits from the
A. Cortex of the kidney
B. Capsule of the kidney
C. Medulla of the kidney
D. Pelvis of the kidney
E. Renal Hilus

59. Juxtaglomerular apparatus produces
A. Aldosterone
B. Parathyroid hormone
C. Antidiuretic hormone
D. Renin
E. Angiotensin II

60. Associated with the hypothalamus
A. Aldosterone
B. Parathyroid hormone
C. Antidiuretic hormone
D. Renin
E. Angiotensin II

61. Causes reabsorption of water
A. Aldosterone
B. Parathyroid hormone
C. Antidiuretic hormone
D. Renin
E. Angiotensin II

62. ACE is associated with
A. Aldosterone
B. Parathyroid hormone
C. Antidiuretic hormone
D. Renin
E. Angiotensin II

63. Used to measure glomerular filtration rate
A. Creatinine
B. Urea
C. Inulin
D. Calcium
E. All answers are correct

64. Catabolism of creatine phosphate from skeletal muscle
A. Creatinine
B. Urea
C. Inulin
D. Calcium
E. All answers are correct

65. Parathyroid hormones acts upon
A. Creatinine
B. Urea
C. Inulin
D. Calcium
E. All answers are correct

66. Breakdown product of proteins
A. Creatinine
B. Urea
C. Inulin
D. Calcium
E. All answers are correct

67. Parathyroid hormone acts upon
A. Glomerulus
B. Loop of Henle
C. Proximal Convoluted tubules
D. Distal convoluted tubules
E. Collecting duct

68. Maintains an osmotic gradient
A. Glomerulus
B. Loop of Henle
C. Proximal Convoluted tubules
D. Distal convoluted tubules
E. Collecting duct

69. Antidiuretic hormones acts on
A. Glomerulus
B. Loop of Henle
C. Proximal Convoluted tubules
D. Distal convoluted tubules
E. Collecting duct

70. Acted upon by norepinephrine
A. Glomerulus
B. Loop of Henle
C. Proximal Convoluted tubules
D. Distal convoluted tubules
E. Collecting duct

71) The kidneys help regulate blood pressure by secretion of the enzyme __________ and by adjusting __________.

72) The kidneys release two hormones: __________, which helps regulate calcium homeostasis, and __________ , which increases red blood cell production.

73) The functional units of the kidneys are the __________.

74) Blood flows into afferent arterioles from __________.

75) The tubules of the juxtamedullary nephrons are served by special capillaries called __________.

76) Most renal nerves originate in the __________ ganglion, and their function is to regulate __________.

77) Fluid flows from the ascending limb of the loop of Henle into the __________.

78) The juxtaglomerular apparatus consists of two parts: the __________ that detects the concentration of tubular fluid, and the __________ that secrete renin.
Answer: macula densa;
juxtaglomerular cells

79) The last portion of the distal convoluted tubule and the collecting duct are made up of __________ cells, which are the target cells for ADH and aldosterone, and __________ cells that have microvilli and help regulate acid base balance.

80) In tubular reabsorption, substances move from __________ to __________.

81) The footlike processes of podocytes are called __________ and the spaces between the processes are called __________.

82) Glomerular endothelial cells are leaky because they have large pores called ___________.

83) Norepinephrine causes __________ of afferent arterioles, which causes GFR to __________.

84) Angiotensin II causes __________ of the afferent arteriole and __________ of the efferent arteriole, which causes GFR to __________.

85) The hormone __________ increases capillary surface area available for filtration by causing relaxation of __________.

86) If there is a decrease in the delivery of sodium and chloride ions to macula densa cells, tubuloglomerular feedback causes GFR to ___________.

87) The 10"minus12" tubes carrying urine from the kidneys to the urinary bladder are the __________.

88) The mucosa of the urinary bladder includes __________ epithelium.

89) The smooth muscle layers surrounding the mucosa of the urinary bladder are collectively known as the __________.

90) The normal component of urine that is derived from the detoxification of ammonia produced as a result of deamination of proteins is __________.

91) The enzyme secreted by the juxtaglomerular cells in response to impulses from renal sympathetic nerves is __________.

92) The substrate for the enzyme secreted by juxtaglomerular cells is __________.

93) The blood vessels of surrounding the loop of Henle that help maintain the hypertonic conditions in the peritubular spaces of the renal medulla are called the __________.

94) The percentage of plasma in afferent arterioles that becomes glomerular filtrate is called the __________.

95) In the formula for calculating net filtration pressure, those forces opposing glomerular filtration are __________ and __________ .