Pbd Exam 5 Renal

Front 1

The waste product found in the blood that results from the metabolism of nitrogen-containing compounds is:
a. creatinine
b. uric acid
c. urea
d. bilirubin
e. none of the above

Back 1

c. urea

Front 2

The visceral layer of Bowman's Capsule is made up of ___________ cells (name)

Back 2

podocytes

Front 3

The hormone released from the kidney that stimulates the bone marrow to produce red blood cells is __________________.

Back 3

erythropoietin

Front 4

Which of the following is a function of renal mesangial cells:
a. secrete the enzyme renin
b. serve in a sensory capacity to monitor flow in the renal tubules
c. are phagocytic cells
d. form the glomerular filtration slits
e. all of the above

Back 4

c. are phagocytic cells

Front 5

Concerning renal handling of penicillin, which of the following is NOT true:
a. it is transported by the same protein that moves endogenous organic anions
b. this is an example of a maximal tubular transport capacity (TM) system
c. the transporters involved can be blocked by giving PAH
d. the system results in the amount of penicillin filtered exceeding the amount excreted
e. all of the above are true

Back 5

d. the system results in the amount of penicillin filtered exceeding the amount excreted

Front 6

Inulin is infused into a patient to obtain a constant plasma concentration of 4 mg/l. Urine is collected for 1 hour and has a volume of 100 ml. The urine inulin concentration is 360 mg/l. The clearance of inulin (put down your calculators) gives what valuable information about renal function: _____________________.

Back 6

GFR or glomerular filtration rate

Front 7

The minimum amount of water required to remove the waste products produced each day is referred to as _________________________.

Back 7

Obligatory water loss

Front 8

The major extracellular buffer system is the _______________.

Back 8

CO2-HCO3- or carbon dioxide/bicarb system

Front 9

True/False
An elevated level of uric acid in the plasma is referred to as azotemia.

Back 9

False. of nitrogenous waste in the plasma

Front 10

True/False
Secretion by the renal tubules represents a second pathway for substances carried in the plasma to enter the tubules.

Back 10

True

Front 11

The functional unit of the kidney is the ___________.

Back 11

nephron

Front 12

True/False
In the first part of the proximal tubule, sodium crosses the lumenal membrane by countertransport with H+.

Back 12

True

Front 13

True/False
Due to the characteristics of inulin, it is used to measure renal plasma flow.

Back 13

False. measure GFR.

Front 14

True/False
The units used to express clearance are volume of plasma per time.

Back 14

True

Front 15

True/False
Obligatory water loss refers to the minimum volume of urine that can be excreted to rid the body of metabolic waste.

Back 15

True

Front 16

If renal plasma flow is 519 ml/min, GFR is 115 ml/min, and the clearance of drug X is 95 ml/min, then drug X is:
a. not filtered
b. undergoing net reabsorption
c. undergoing net secretion
d. can not tell

Back 16

b. undergoing net reabsorption

Front 17

Concerning the Loop of Henle, which of the following is NOT true:
a. the ascending limb pumps sodium out of the lumen
b. the descending limb is permeable to water
c. this system is called the countercurrent multiplication system
d. all of the above are true

Back 17

d. all of the above are true

Front 18

Concerning the regulation of hydrogen ion balance, which of the following is TRUE:
a. the renal system is the fastest system for maintaining correct plasma pH
b. loss of colonic contents is equivalent to adding alkaline material to the body
c. the major extracellular buffer system is the CO2 - HCO3- system
d. none of the above are true

Back 18

c. the major extracellular buffer system is the CO2 - HCO3- system

Front 19

True/False
In the first part of the proximal tubule, sodium crosses the lumenal membrane by cotransport with H+.

Back 19

False. countertransport with H+.

Front 20

True/False
Due to the characteristics of para-aminohippuric acid (PAH), it is used to measure GFR.

Back 20

False. measure Renal Blood Flow.

Front 21

True/False
The definition of clearance of a substance is: the volume of plasma from which the substance is completely cleared by the kidneys per unit time.

Back 21

True

Front 22

True/False
The volume of obligatory water loss depends on the amount of metabolic waste produced and the kidney's ability to concentrate the urine.

Back 22

True

Front 23

If renal blood flow is 483 ml/min, GFR is 128 ml/min, and the clearance of drug X is 175 ml/min, then drug X is:
a. not filtered
b. undergoing net reabsorption
c. undergoing net secretion
d. can not tell

Back 23

c. undergoing net secretion

Front 24

Concerning the Loop of Henle, which of the following is NOT true:
a. the ascending limb pumps sodium out of the lumen
b. the descending limb is permeable to water
c. this system is called the countercurrent exchange system
d. all of the above are true

Back 24

c. this system is called the countercurrent exchange system

Front 25

Concerning the regulation of hydrogen ion balance, which of the following is TRUE:
a. the renal system is the fastest system for maintaining correct plasma pH
b. loss of colonic contents is equivalent to adding acidic material to the body
c. the major extracellular buffers are proteins and phosphate
d. none of the above are true

Back 25

b. loss of colonic contents is equivalent to adding acidic material to the body

Front 26

_______________ is released by the kidneys in response to low plasma sodium, reduced renal blood pressure, or increased outflow from renal sympathetic nerves.

Back 26

Renin

Front 27

The specialized cells that make up the visceral wall of Bowman's Capsule are called __________________.

Back 27

podocytes

Front 28

In the glomerular capillaries of an healthy individual, the Starling force that should be zero or close to zero is ________.

Back 28

Pi(t) or "tissue oncotic pressure" or "oncotic pressure in Bowman's Space."

Front 29

True/False
The units used to express clearance are volume of plasma per time.

Back 29

True

Front 30

True/False
If the FRACTION EXCRETED is less than one, then net secretion is taking place.

Back 30

False. more than one.

Front 31

True/False
Antidiuretic hormone increases the permeability of the collecting ducts for the kidneys.

Back 31

True

Front 32

True/False
The major extracellular buffer system uses phosphates and proteins to buffer hydrogen ions.

Back 32

False. uses CO2-/HCO3- system to buffer hydrogen ions.

Front 33

A patient's arterial blood values are: pH = 7.48, [HCO3-] = 32 mEq/L, PCO2 = 46 mmHg.
This person is in a state of:
(a) __________________ , (b)_________________ (with / without) (c) __________________ (respiratory / renal) compensation.

Back 33

a. metabolic alkalosis
b. with
c. respiratory

Front 34

The diuretic that blocks sodium reabsorption in the thick ascending limb of the Loop of Henle is in the class of diuretics known as ______________________.

Back 34

Loop diuretics

Front 35

The renal tubule casts that are formed in the collecting ducts, contain dead cells, and are sometimes called "renal failure cast" are properly referred to as __________________________.

Back 35

Broad, granular cast

Front 36

True/False
Hematuria is always indicative of dysfunction of the glomerular filtration apparatus (barrier).

Back 36

False. Proteinuria is

Front 37

True/False
The radiologic exam used to evaluate the abdominal cavity is the retrograde pyelogram.

Back 37

False. evaluate the renal pelvis

Front 38

True/False
The class of diuretic that has the greatest potential of disturbing plasma pH is the thiazide class.

Back 38

False. Loop class.

Front 39

True/False
The macula densa consists of specialized vascular cells in the afferent and efferent arterioles that produce and store renin.

Back 39

False. The juxtaglomerular cells consists of.

Front 40

True/False
Constriction of the afferent arterioles would increase flux (GFR) out of the glomerular capillaries.

Back 40

False. decease flux.

Front 41

True/False
If the clearance of a drug is less than that of inulin, then there is net reabsorption of that drug.

Back 41

True

Front 42

True/False
Angiotensin II and aldosterone stimulate the release of antidiuretic hormone (ADH / vasopressin).

Back 42

True

Front 43

True/False
Creatinine is secreted by the renal tubules but in only very small amounts. Therefore, the clearance of creatinine tends to underestimate GFR.

Back 43

False. overestimate.

Front 44

True/False
Low levels of plasma protein would increase GFR.

Back 44

True

Front 45

The cells making up the visceral layer of Bowman's Capsule are referred to as ________________ (specific name).

Back 45

podocytes

Front 46

Plasma levels of urea are measured as ____________.

Back 46

Blood Urea Nitrogen (BUN)

Front 47

True/False
Angiotensin converting enzyme (ACE) cleaves angiotensin I (AI) to form angiotensin II (AII).

Back 47

True

Front 48

True/False
Filtered glucose crosses the luminal (apical) membrane of the tubular epithelial cells of the early segment of the proximal tubule by countertransort with sodium.

Back 48

False. cotransport with sodium.

Front 49

True/False
The ascending limb of the Loop of Henle is highly permeable to water.

Back 49

False. to sodium.

Front 50

True/False
Severe diarrhea can produce acidosis.

Back 50

True

Front 51

True/False
The reabsorption of filtered bicarb (HCO3-) depends on the tubular secretion of hydrogen ions.

Back 51

True

Front 52

True/False
The major extracellular buffer system utilizes phosphates and proteins.

Back 52

False. CO2-/HCO3- system.

Front 53

Reabsorption of water from the proximal renal tubules via the intercellular spaces between the tubular epithelial cells is referred to as movement through the ______________ pathway.

Back 53

Paracellular

Front 54

To determine if a substance is undergoing net secretion or reabsorption by the renal tubules, the clearance of that substance is compared to the clearance of inulin or creatinine and this ratio is referred to as __________________ .

Back 54

Fraction excreted

Front 55

True/False
Dietary sodium restriction can result in an upregulation of the inducible Cox 2 expression and the inhibition of renin release.

Back 55

False. and the resulting release of renin.

Front 56

Eccentric hypertrophy of the heart is usually associated with a pressure overload condition.

Back 56

False. Concentric hypertrophy.

Front 57

True/False
In addition to ACE another enzyme that can convert Angtiotensin I to Angiotensin II in man is the chymase enzyme.

Back 57

True

Front 58

True/False
Angiotensin II is important in the clotting system. It can inhibit the production of plasmin via its activation of a plasminogen activator inhibitor.

Back 58

True

Front 59

True/False
When systolic pressures exceed 160 mmHg, the risk of stroke is increased 2 fold.

Back 59

False. 4 fold.

Front 60

The kidney is important in volume and blood pressure control. It has a powerful negative feedback on pressure and the process by which the kidney performs this feet is called______________________.

Back 60

Pressure Diuresis

Front 61

In the two kidney, one-clip model of hypertension renin levels are initially elevated. Do they stay elevated or come back down to normal? Yes - (stay elevated). No – (return towards normal).

Back 61

Yes

Front 62

Nitric oxide can stimulate a vasodilatory action at the vascular smooth muscle. What is the second messenger for this action? _______________.

Back 62

cGMP

Front 63

True/False
Dietary sodium restriction can result in an upregulation of the inducible Cox 2 expression and the resulting release of renin.

Back 63

True

Front 64

True/False
Concentric hypertrophy of the heart is usually associated with a pressure overload condition.

Back 64

True

Front 65

True/False
Insulin, aldosterone, and epinephrine decrease the rate of uptake of potassium into the cells of the body.

Back 65

False. increase the rate.

Front 66

True/False
A patient with a plasma potassium level of 3.0 mEq/L would be considered hypokalemic.

Back 66

True

Front 67

True/False
The principle cells of the distal tubule reabsorb potassium into the tubule.

Back 67

False. secrete

Front 68

True/False
Thiazide diuretics, such as chlorothiazide, have as a site of action the ascending limb of the Loop of Henle.

Back 68

False. Loop diuretics, such as Furosemide,

Front 69

True/False
Plasma pH tends to decrease during sleep.

Back 69

True

Front 70

True/False
Hematuria is positive proof of failure of the glomerular filtration barrier.

Back 70

False. Proteinuria is

Front 71

True/False
Poststreptococcal diffuse proliferative glomerulonephritis is a common cause of the nephritic syndrome in children.

Back 71

True

Front 72

True/False
Long-term, high-dose use of analgesics can cause chronic glomerulonephritis.

Back 72

False. chronic pyelonephritis.

Front 73

Which of the following is NOT a characteristic of the Nephrotic Syndrome:
a. generalized edema
b. hyperalbuminemia
c. massive proteinuria
d. hyperlipiduria

Back 73

b. hyperalbuminemia

Front 74

A patient's arterial blood values are: pH = 7.48, [HCO3-] = 32 mEq/L, PCO2 = 46 mmHg. This person has (a) __________________ , (b)_________________(with or without) (c) __________________ (respiratory / renal) compensation.

Back 74

a. metabolic alkalosis
b. with
c. respiratory

Front 75

The diuretic that blocks sodium reabsorption in the thick ascending limb of the Loop of Henle is in the class of diuretics known as ______________________.

Back 75

Loop diuretics

Front 76

The renal tubule casts that are formed in the collecting ducts, contain dead cells, and are sometimes called "renal failure cast" are properly referred to as ______________.

Back 76

Broad, granular cast

Front 77

True/False
Hematuria always equates to dysfunction of the glomerular filtration apparatus.

Back 77

False. Proteinuria is

Front 78

True/False
The radiologic exam used to evaluate the renal pelvis is the retrograde pyelogram.

Back 78

True

Front 79

True/False
The syndrome characterized by acute onset, hematuria, RBC casts, hemoglobin casts, some oliguria, and azotemia that often follows a streptococcal infection in children is the nephrotic syndrome.

Back 79

False. nephritic syndrome.

Front 80

True/False
The inflammatory renal disorder that frequently occurs in children following a streptococcal infection is poststreptococcal diffuse proliferative glomerulonephritis.

Back 80

True

Front 81

True/False
The leading cause of renal-failure death is acute pyelonephritis.

Back 81

False. is chronic glomerulonephritis.

Front 82

True/False
The chymase enzyme is part of an alternative pathway for the conversion of angiotensinogen to angiotensin I.

Back 82

False. of angiotensin I to angiotensin II.

Front 83

True/False
Systemically, renin is the rate limiting enzyme in the renin-angiotensin system.

Back 83

True

Front 84

True/False
Angiotensin II may exert a positive feedback regulation on angiotensinogen via its action on the AT1 receptor.

Back 84

True

Front 85

True/False
The primary source of angiotensinogen for the systemic RAS is the kidney.

Back 85

False. is the liver.

Front 86

True/False
There are both short and long loop feedbacks to inhibit renin release. The long loop is an increase in BP while the short loop would be an increase in Ang II levels.

Back 86

True

Front 87

True/False
AT2 receptors are widely distributed in fetal tissue and usually act to increase the actions of AT1 receptor activation.

Back 87

False. decrease the actions

Front 88

What is considered the major reason that less than 35% of the patients with hypertension have their blood pressure controlled to 140/90 mmHg ________________.

Back 88

compliance

Front 89

True/False
Angiotensin II can facilitate the release of catecholamines, aldosterone and ADH.

Back 89

True

Front 90

True/False
Angiotensin II may exert a negative feedback regulation on angiotensinogen via its action on the AT1 receptor.

Back 90

False. positive feedback regulation.

Front 91

True/False
The primary source of aldosterone for the systemic RAS is the adrenal cortex.

Back 91

True

Front 92

True/False
The AT1 and the AT2 receptors both are of similar molecular weight, have 7 transmembrane regions and are bound by Ang II; however, once stimulated, their actions usually oppose each other.

Back 92

True

Front 93

True/False
Chronic ACE inhibition will block the breakdown of Ang 1-7.

Back 93

True

Front 94

True/False
The permeability of water is much greater in the ascending limb of the Loop of Henle than in the descending limb.

Back 94

False. less.

Front 95

True/False
Filtration fraction is defined as the ratio of glomerular filtration rate over (divided by) renal plasma flow.

Back 95

True

Front 96

True/False
For para-aminohippuric acid (PAH), the amount excreted by the kidneys equals the amount filtered plus the amount secreted.

Back 96

True

Front 97

True/False
Antidiuretic hormone (ADH) increases the permeability of the collecting duct to water.

Back 97

True

Front 98

True/False
Profuse diarrhea can result in metabolic acidosis.

Back 98

True

Front 99

True/False
Frequent urination during the night is referred to as oliguria.

Back 99

False. as polyuria.

Front 100

The minimum amount of urine required to remove the daily production of waste products is call the __________________________ (not volume).

Back 100

Obligatory Water Loss

Front 101

Plasma potassium levels greater than 5.5 mEq/L would be considered ____________ (term).

Back 101

Hyperkalemia

Front 102

True/False
An arterial blood sample reveals the following values: pH of 7.37, PCO2 = 50 mmHg, and HCO3- = 28 mEq/L. This patient has respiratory acidosis with renal compensation.

Back 102

True

Front 103

True/False
Potassium is secreted into the tubular fluid by the intercalated cells.

Back 103

False. reabsorbed

Front 104

True/False
Casts observed during a microscopic exam of a urine sample that appear as clear (transparent) cylinders are referred to as fatty cast.

Back 104

False. as hyaline cast.

Front 105

True/False
An intravenous pyelogram would be used to visualize problems associated with the renal pelvis.

Back 105

False. A retrograde pyelogram

Front 106

True/False
Diffuse proliferative glomerulonephritis (Diffuse PGN) is the most frequent of all glomerular lesions.

Back 106

True

Front 107

True/False
Plasma pH usually goes down in a patient with a fever.

Back 107

True

Front 108

The most potent class of diuretics that work by disrupting the countercurrent multiplier are the ________________ diuretics.

Back 108

Loop

Front 109

Hypoalbuminemia, massive proteinuria, and generalized edema would be associated with the ________________ syndrome.

Back 109

Nephrotic

Front 110

True/False
The kidneys play an important role in the degradation of the active form of Vitamin D to the inactive form.

Back 110

False. conversion of the inactive form of Vitamin D to the active form.

Front 111

True/False
If other variables remain constant, constriction of the efferent arterioles would increase glomerular capillary pressure.

Back 111

True

Front 112

True/False
Specialized epithelial cells of the ascending limb of the renal tubule, referred to collectively as the macula densa, produce and store renin in granules.

Back 112

False. as the juxtaglomerular cells,

Front 113

True/False
Autoregulation, via the myogenic mechanism, can regulate renal blood flow and, therefore, glomerular filtration rate (GFR), even under extreme conditions such as hemorrhage resulting in serious hypotension.

Back 113

False. but not under extreme conditions

Front 114

The hormone produced by the kidneys that stimulates bone marrow production of erythrocytes is ___________.

Back 114

erythropoietin

Front 115

The specialized epithelial cells that make up the visceral layer of Bowman's Capsule are referred to as ___________ (name of cell).

Back 115

podocytes

Front 116

______________ cells, found in association with the glomerulus, are phagocytic, have myofilaments, and lay down an extracellular matrix that supports the glomerular capillaries.

Back 116

Mesangial

Front 117

True/False
Atrial natriuretic hormone (ANH) and the natriuretic factor (quabain-like factor) both increase the sodium excretion by the same mechanism.

Back 117

False. by different mechanisms.

Front 118

True/False
Renin is the rate-limiting enzyme in the systemic renin-angiotensin system.

Back 118

True

Front 119

True/False
Individuals with the II (insertion) polymorphism for the non-coding region of the ACE enzyme have higher circulating levels of ACE and are more prone to cardiovascular diseases that do individuals with the DD (deletion) ACE polymorphism.

Back 119

False. lower circulating levels of ACE and are less prone

Front 120

True/False
Hepatocyte angiotensinogen mRNA can be upregulated by estrogen.

Back 120

True

Front 121

True/False
Kinins, prostaglandins and endothelins have natriuretic and diuretic actions on the kidney.

Back 121

False. Kinins and prostaglandins have

Front 122

True/False
The AT1 and the AT2 receptors are approximately the same size and both have 7 transmembrane regions. In general, their actions oppose each other.

Back 122

True

Front 123

_______________ is the process by which the kidney maintains long term volume and pressure control.

Back 123

Pressure Diuresis

Front 124

Blood pressure in a borderline hypertensive patient is about _______________

Back 124

140/90 mmHg

Front 125

True/False
The number 1 cause of renal failure deaths is acute pyelonephritis.

Back 125

False. is chronic glomerulonephritis.

Front 126

True/False
The renal disease associated with long-term, high-dose use of analgesics is chronic pyelonephritis.

Back 126

True

Front 127

True/False
The hereditary kidney disease that produces enormous kidneys containing large, fluid-filled cysts is hepatorenal syndrome.

Back 127

False. polycystic kidney disease.

Front 128

True/False
Angiotensin II can facilitate the release of ADH, aldosterone and catecholamines.

Back 128

True

Front 129

True/False
Kinins, prostaglandins and endothelins have diuretic and natriuretic actions on the kidney.

Back 129

False. Kinins and prostaglandins have

Front 130

True/False
Two enzymes can convert angiotensin I to angiotensin II: ACE and ACE2.

Back 130

False. ACE and chymase.

Front 131

True/False
Kinins can increase the production of plasmin, whereas Angiotensin II will reduce levels of plasmin by stimulation of PAI-1.

Back 131

True

Front 132

The activation of pro-renin to renin is mediated by the enzyme ________.

Back 132

cathepsin B

Front 133

True/False
If plasma glucose levels are above the maximal tubular transport capacity (TM), the amount of glucose excreted is equal to the amount filtered minus the amount reabsorbed.

Back 133

True

Front 134

True/False
The reabsorption of penicillin out of the renal tubules is enhanced by i,v, infusion of PAH, an organic anion that is transported by the same membrane transport system that moves penicillin.

Back 134

False. decreased by.

Front 135

True/False
An increase in plasma osmolarity results in the release of antidiuretic hormone and results in the production of a more concentrated urine.

Back 135

True

Front 136

True/False
During drug development, fraction excreted of the drug is calculated to determine if the drug is undergoing net secretion or net reabsorption.

Back 136

True

Front 137

Calculating the clearance of creatinine to determine GFR would __________ (over estimate, under estimate, be dead on) GFR.

Back 137

over estimate

Front 138

The minimum amount of urine required to remove the approximate 600 mOsm of waste material generated per day is referred to as ____________ (name, not amount).

Back 138

obligatory water loss

Front 139

The secretion of hydrogen ions in the proximal tubule to capture filtered bicarb ions is referred to as ____________.

Back 139

ion trapping

Front 140

True/False
The urine pH of a patient with a moderate fever can typically be expected to be lower than normal.

Back 140

True

Front 141

True/False
The diagnostic radiological examination used to evaluate the condition of the renal pelvis and related structures is the intravenous pyelogram.

Back 141

False. the retrograde pyelogram.

Front 142

True/False
Broad, granular casts seen during microscopic examination of a urine sample are considered benign.

Back 142

False. Hyaline casts

Front 143

True/False
The kidneys are responsible for the conversion of vitamin D to its active form.

Back 143

True

Front 144

True/False
Proteinura indicates disease of the renal tubules.

Back 144

False. of the glomerulus.

Front 145

True/False
Bowman's Capsule has an outer parietal layer made up of flattened epithelial cells and an inner visceral layer made up of fenestrated endothelial cells.

Back 145

False. visceral layer made up of podocytes.

Front 146

True/False
Blood levels of nitrogen-containing waste products resulting from the breakdown of muscle creatinine are measured as BUN.

Back 146

False. creatinine.

Front 147

True/False
Renal blood flow equals the difference between aortic pressure and renal venous pressure divided by renal vascular resistance.

Back 147

True

Front 148

True/False
Autoregulation serves to maintain renal blood flow at a relatively constant level as arterial blood pressure changes from approximately 80 or 90 mmHg up to 180 mHg.

Back 148

True

Front 149

True/False
Chronic renal disease may develop insidiously over many years due to the large functional reserve of the kidneys.

Back 149

True

Front 150

True/False
Antidiuretic hormone (ADH)/vasopressin is stored in and released from nerve terminal in the posterior lobe of the pituitary gland (neurohypophysis).

Back 150

True

Front 151

True/False
A decrease in plasma oncotic pressure often leads to the formation of generalized edema.

Back 151

True

Front 152

True/False
The principle causative organism of acute pyelonephritis is streptococcus.

Back 152

False. E. coli.

Front 153

True/False
Symptoms due to toxic levels of nitrogenous waste products in the blood is referred to azotemia.

Back 153

False. uremia.

Front 154

True/False
The condition resulting in renal shutdown on a purely function basis in which the kidneys are suitable for transplantation is hydronephrosis.

Back 154

False. is hepatorenal syndrome.

Front 155

True/False
Bladder cancer has a high incidence in individuals working with chemicals. smokers, and those with recurrent infections.

Back 155

True

Front 156

True/False
Which of the following do NOT make up part of the juxtaglomerular apparatus?
a. macula densa cells
b. juxtaglomerular cells
c. peritubular capillary endothelial cells
d. mesangial cells

Back 156

c. peritubular capillary endothelial cells

Front 157

True/False
The most frequent of all glomerular lesions is:
a. membranous nephropathy
b. rapidly progressive glomerulonephritis
c. diffuse proliferative glomemlonephritis
d. acute pyelonephritis
e. none of the above

Back 157

c. diffuse proliferative glomemlonephritis

Front 158

The three individuals listed below each have a total body water content of 42 L and produce urine in the following amounts and concentrations over the same period of time. Total body osrnoles are equal to 300 mOsm/Kg x 42L = 12,600 mOsm.
Jim: 1 L urine with osrnolality of 1200 mOsmL
Joe: 3L urine with osmolalify of 300 mOsrn/L
Jeb: 1L urine with osmolality of 150 mOsm/L
If none of these guys drink anything, whch one will have the highest plasma osmolality?
a. Jim
b. Joe
c. Jeb
d. all the same

Back 158

c. Jeb

Front 159

A patient is found to have a urine-to-plasma creatinine ratio of 70 and a urine flow rate of 120 mL per hour. The creatinine clearance is:
a. 220 ml/min
b. 180 ml/min
c. 140 ml/min
d. 100 ml/min

Back 159

c. 140 ml/min

Front 160

Which of the following concerning the renal handling of PENICILLIN is NOT true:
a. a tubular transport protein that secretes organic anions also moves penicillin
b. as plasma levels of penicillin go up. the amount secreted increases up to a point
c. if the plasma concentration of certain organic anions is increased, secretion of penicillin will be reduced
d. at all plasma concentrations, the amount filtered exceeds the amount excreted

Back 160

d. at all plasma concentrations, the amount filtered exceeds the amount excreted

Front 161

Which of the following concerning fraction excreted is NOT true:
a. compared the clearance of the substance to the clearance of inulin (Cx/Cin)
b. Requires that the volume of urine excreted be known
c. is uses to determine if net secretion or net reabsorption is taking place
d. can be calculated if the urine-to-plasma ratios for the concentrations of the substance and of inulin are known

Back 161

d. can be calculated if the urine-to-plasma ratios for the concentrations of the substance and of inulin are known

Front 162

Which of the following directly stimulates the release of aldosterone:
a. renin
b. AIP
c. ANP
d. angiotensin I
e. angiotensin II

Back 162

e. angiotensin II

Front 163

Macula densa cells are:
a. myocytes
b. endothelial cells
c. renin-secreting cells
d. epithelial cells
e. prinicipal cells

Back 163

d. epithelial cells

Front 164

Expansion of the extra-cellular fluid (ECF) volume increases plasma levels of:
a. aldosterone
b. aldosterone-induced protein
c. ADH
d. atrial natuiretic peptide
e. angiotensin II

Back 164

d. atrial natuiretic peptide

Front 165

Which of the following best describes the renal handling of an increase in exogenous nonvolatile acids
a. increased bicarbonate excretion
b. increased ammonia secretion
c. increased H2CO3 excretion
d. increased urinary volume
e. increased urinary pH

Back 165

e. increased urinary pH

Front 166

Concerning benign nephrosclerosis (BNS) which of the following is NOT true:
a. associated with benign essential hypertension
b. produces atrophied and pale kidneys
c. associated with rentinal hemorrhage and cerebrovascular accident
d. results in some functional impairment; severe kidney damage is rare

Back 166

b. produces atrophied and pale kidneys

Front 167

The nephrotic syndrome is characterized by:
a. generalized edema
b. injury of the glomerular capillary wall
c. hypoalbuminemia
d. cellular proliferation within the glomeruli
e. A-C are correct
f. A and C are correct
g. B and D are correct
h. A-D are correct

Back 167

f. A and C are correct
a. generalized edema
c. hypoalbuminemia

Front 168

Which of the following statements is/are TRUE concerning acute tubular necrosis (ATN)?
a. a rare but highly lethal disorder
b. can by produced by long-term, high-dose use of analgesics
c. can be produced by reflux of urine from the bladder
d. can be produced by diminished renal blood flow, poisoning, and endotoxins.
e. A-C are correct
f. A and C are correct
g. B and D are correct
h. A-D are correct

Back 168

d. can be produced by diminished renal blood flow, poisoning, and endotoxins.

Front 169

Which of the following is/are NOT part of the glomerular filtration barrier?
a. fenestrated capillary endothelium
b. slits produced by the arrangement of processes of the visceral epithelial cells of Bowman's capsule
c. glomerular basement membrane
d. mesangial cells
e. A-C are correct
f. A and C are correct
g. B and D are correct
h. A-D are correct

Back 169

d. mesangial cells

Front 170

Following hemorrhage and a large plasma volume loss, which of the following is/are TRUE?
a. no release of atrial natriuretic peptide (ANP); release of antidiuretic hormone (ADH/vasopressin)
b. large parasympathetic outflow; vasoconstriction of mainly efferent arterioles
c. release of aldosterone; decreased water and sodium excretion
d. decreased collecting tubule permeability; decreased angiotensin converting enzyme (ACE) activity
e. A-C are correct
f. A and C are correct
g. B and D are correct
h. A-D are correct

Back 170

f. A and C are correct
a. no release of atrial natriuretic peptide (ANP); release of antidiuretic hormone (ADH/vasopressin)
c. release of aldosterone; decreased water and sodium excretion

Front 171

Obligatory water loss is determined by:
a. the amount of nonvolatile metabolic waste products produced per day
b. the ability of the kidney to reduce GFR to conserve water
c. The ability of the kidney to concentrate the urine
d. the ability of the ascending limb of the loop of Henle to concentrate the tubular fluid within it
e. A-C are true
f. A and C are true
g. B and D are true
h. A-D are true

Back 171

f. A and C are true
a. the amount of nonvolatile metabolic waste products produced per day
c. The ability of the kidney to concentrate the urine

Front 172

Which of the following is/are TRUE concerning urolithiasis:
a. there is a familial tendency
b. the most common type of calculi consist of calcium compounds in an organic mix
c. commonly associated with urinary stasis
d. 80% are unilateral and often contain multiple calculi
e. A-C are true
f. A and C are true
g. B and D are true
h. A-D are true

Back 172

h. A-D are true
a. there is a familial tendency
b. the most common type of calculi consist of calcium compounds in an organic mix
c. commonly associated with urinary stasis
d. 80% are unilateral and often contain multiple calculi

Front 173

An example of autoregulation the
________________ mechanism serves to maintain constant renal blood flow and responds to stretch of vascular smooth muscle by contraction of vascular smooth muscle.

Back 173

myogenic

Front 174

Hydrogen ions (H+) secreted into the tubular lumen in excess of that needed to titrate the HCO3- filtered by the glomerulus combine with filtered phosphate and ammonia (intratubular buffers) and is excreted in the urine. This process is ______________.

Back 174

ion trapping

Front 175

The hereditary renal disease characterized by multiple, expanding. fluid-filled cavities found in both kidneys is ________________.

Back 175

polycystic kidney disease

Front 176

Calculus formation at any level of the urinary tract is referred to as _______________.

Back 176

urolithiasis

Front 177

The renal vascular component associated with the countercurrent exchange system is the ____________

Back 177

vasa recta

Front 178

A lower than normal production of urine is referred to as ____________

Back 178

oliguria

Front 179

The presence of red blood cells (gross or occult) in the urine is ________________

Back 179

hematuria

Front 180

Elevated blood levels of nitrogen-containing products resulting in overt symptoms is referred to as ________________.

Back 180

uremia

Front 181

Many compounds are secreted, as well as filtered, into the renal tubules (e.g. glucose). The point at which the membrane proteins are transporting their maximum amount is referred to as the threshold and the system is said to have a _________________.

Back 181

Tmax

Front 182

pH: 7.35
HCO3-: 16 mEq/L
PCO2: 30 mmHg
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis

Back 182

c. metabolic acidosis

Front 183

pH: 7.5
HCO3-: 24 mEq/L
PCO2: 24 mmHg
a. respiratory acidosis
b. respiratory alkalosis
c. metabolic acidosis
d. metabolic alkalosis

Back 183

b. respiratory alkalosis

Front 184

Acute pyelonephritis:
a. specific gravity
b. hereditary
c. honeymoon cystitis
d. metabolic waste

Back 184

c. honeymoon cystitis

Front 185

Polycystic kidney disease:
a. specific gravity
b. hereditary
c. honeymoon cystitis
d. metabolic waste

Back 185

b. hereditary

Front 186

BUN:
a. specific gravity
b. hereditary
c. honeymoon cystitis
d. metabolic waste

Back 186

d. metabolic waste

Front 187

Urinometer:
a. specific gravity
b. hereditary
c. honeymoon cystitis
d. metabolic waste

Back 187

a. specific gravity

Front 188

Urolithiasis:
a. calculi
b. long-term high dose analgesics
c. creatinine
d. angiotensin II

Back 188

a. calculi

Front 189

GFR:
a. calculi
b. long-term high dose analgesics
c. creatinine
d. angiotensin II

Back 189

c. creatinine

Front 190

Thirst:
a. calculi
b. long-term high dose analgesics
c. creatinine
d. angiotensin II

Back 190

d. angiotensin II

Front 191

Chronic pyelonephritis:
a. calculi
b. long-term high dose analgesics
c. creatinine
d. angiotensin II

Back 191

b. long-term high dose analgesics

Front 192

Calculate glomerular filtration rate (GFR):
Capillary hydraulic pressure (Pc): 59 mmHg
Tissue oncotic pressure (Pi(t): 0 mmHg
Tissue hydraulic pressure (Pt): 15 mmHg
Capillary oncotic pressure (Pi(c): 31.5 mmHg
Filtration coefficient (K): 10 ml/min/mmHg

Back 192

GFR = K((Pc+Pi(t))-(Pt+Pi(c)))
125 mL/min

Front 193

A patient undergoing renal evaluation was administered para-aminohippuric acid (PAH) intravenously to establish a stable plasma concentration of 0.10 mg/mL. While this concentration was maintained, 150 mL of urine was collected over a two hour period and was found to have a PAH concentration of 56 mg/mL.
Calculate the patient's effective renal plasma flow (ERPF):
a. 700 mL/min
b. 250 mL/min
c. 300 mL/min
d. 1000 mL/min

Back 193

ERPF = Upah * Volume / Ppah
a. 700 mL/min

Front 194

A patient undergoing renal evaluation was administered para-aminohippuric acid (PAH) intravenously to establish a stable plasma concentration of 0.10 mg/mL. While this concentration was maintained, 150 mL of urine was collected over a two hour period and was found to have a PAH concentration of 56 mg/mL.
Calculate this patient's renal blood flow (RBF) if his hematocrit is 45.
a. 425.25 mL/min
b. 5281 mL/min
c. 1272.7 mL/min
d. 582 mL/min

Back 194

RBF = RPF / 1 - Hematocrit
c. 1272.7 mL/min

Front 195

Capillary hydraulic pressure (Pc): 59 mmHg
Tissue oncotic pressure (Pi(t): 0 mmHg
Tissue hydraulic pressure (Pt): 15 mmHg
Capillary oncotic pressure (Pi(c): 31 mmHg
Filtration coefficient (K): 10 ml/min/mmHg
a. 110 mL/min
b. 125 mL/min
c. 75 mL/min
d. 80 mL/min

Back 195

GFR = K((Pc+Pi(t))-(Pt+Pi(c)))
b. 125 mL/min

Front 196

Urine flow - 60 mL/hr
Plasma creatinine - 4 mg/100 mL
Plasma sodium - 140 mEq/L
Plasma potassium - 4.2 mEq/L
Urine sodium - 70 mEq/L
Urine creatinine - 2 mg/mL
Filtration fraction - 20%
Hematocrit - 43%
Calculate GFR:
a. 25 mL/min
b. 50 mL/min
c. 75 mL/min
d. 100 mL/min

Back 196

GFR = Ucr * Vurine / Pcr
50 mL/min

Front 197

Urine flow - 60 mL/hr
Plasma creatinine - 4 mg/100 mL
Plasma sodium - 140 mEq/L
Plasma potassium - 4.2 mEq/L
Urine sodium - 70 mEq/L
Urine creatinine - 2 mg/mL
Filtration fraction - 20%
Hematocrit - 43%
GFR - 50 mL/min
Calculate amount of sodium reabsorbed/min:
a. 3.5 mEq/min
b. 5 mEq/min
c. 10 mEq/min
d. 1 mEq/min

Back 197

FILTERED – EXCRETED = REABSORBED
(GFR * P(Na)) - (U(Na) * GFR)
a. 3.5 mEq/min

Front 198

True/False
75% of the hypertensive patients in the US do have their blood pressure controlled with appropriate drug intervention.

Back 198

False. 34%

Front 199

True/False
The actions of kinins on endothelial cells can result in an increase in the production of plasmin, whereas angiotensin II actions on the endothelial cells can result in the generation of PAI-1, which will decrease the production of plasmin.

Back 199

True

Front 200

True/False
Pro-renin levels are normally higher in the plasma than renin levels and these substances may contribute to hypertrophy and fibrosis independent of Ang II.

Back 200

True

Front 201

True/False
Angiotensin II can facilitate the release of ADH, Aldosterone and catecholamines.

Back 201

True

Front 202

True/False
In the skin, the local renin angiotensin system may be involved in wound healing since levels of Ang II are elevated after injury.

Back 202

True

Front 203

True/False
Chronic ACE inhibition can elevate levels of Ang-(1-7) by resulting in an increase in the synthesis and a decrease in the degradation of the peptide.

Back 203

True

Front 204

True/False
AT2 receptors are widely distributed in fetal tissue, are re-expressed in times of injury and usually act in opposition to actions mediated by AT1 receptor activation.

Back 204

True

Front 205

Borderline hypertensive patients have a blood pressure of about _____________.

Back 205

140 / 90 mmHg

Front 206

The conversion of pro-renin to renin is mediated by the enzyme _____________.

Back 206

cathepsin B

Front 207

The___________ enzyme is part of an alternative pathway for the conversion of angiotensin I to angiotensin II.

Back 207

chymase

Front 208

True/False
Kinins, prostaglandins and endothelins have diuretic and natriuretic actions on the kidney.

Back 208

False. Kinins and prostaglandins have

Front 209

True/False
Eccentric hypertrophy of the heart is usually associated with a pressure overload condition, i.e. hypertension.

Back 209

False. Concentric.

Front 210

True/False
The major pathophysiological finding in pre-eclampsia that leads to the hypertensive condition is an elevated cardiac output.

Back 210

False. is elevated total peripheral resistance.

Front 211

True/False
In Conn’s syndrome plasma renin levels are normally elevated.

Back 211

False. aldosterone levels

Front 212

True/False
Hypoxemia of the bone marrow stimulates erythropoiesis.

Back 212

False. of the kidneys.

Front 213

True/False
The efferent arterioles receive blood from the glomerular capillaries.

Back 213

True

Front 214

Nitric oxide can stimulate a vasodilatory action at the vascular smooth muscle. What is the second messenger for this action? _______________

Back 214

cGMP

Front 215

_________ is the term that characterizes the discomfort in breathing that is brought on or aggravated when laying down.

Back 215

Orthopnea

Front 216

The kidney is important in long-term volume and blood pressure regulation. It achieves this by a process called ____________ ______________ .

Back 216

pressure diuresis

Front 217

True/False
Under extreme conditions, such as severe hemorrhage, parasympathetic stimulation would cause vasoconstriction of the afferent arterioles and reduce GFR as a survival strategy.

Back 217

False. sympathetic stimulation.

Front 218

True/False
Angiotensin II (AII) acts within the brain to stimulate drinking.

Back 218

True

Front 219

True/False
The macula densa serves as a sensory device in the tubuloglomerular feedback system.

Back 219

True

Front 220

True/False
The descending limb of the Loop of Henle of juxtamedullary nephrons penetrate deep into the medulla of the kidneys.

Back 220

True

Front 221

The _____________ cells found within Bowman’s Capsule are phagocytic, have myofilaments, and lay down a matrix that supports the glomerular capillaries.

Back 221

Mesangial

Front 222

Juxtaglomerular cells are specialized vascular cells in the afferent and efferent arterioles that produce and store ___________.

Back 222

Renin

Front 223

Tissue oncotic pressure associated with Bowman’s Space of a healthy kidney would be close to ___________ mmHg.

Back 223

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