Ch26 Test Questions & Answers Urinary System

Seeley's Anatomy and Physiology, 12e (VanPutte)

Chapter 26 Urinary System

1) What is/are the main excretory organ(s) of the body?

A) Skin

B) Lungs

C) Intestines

D) Kidneys

2) The kidney functions in

A) preventing blood loss.

B) white blood cell production.

C) synthesis of vitamin E.

D) excretion of metabolic wastes.

E) production of the hormone aldosterone.

3) Which of the following functions would not be performed by the kidney?

A) Urine storage

B) Excretion of waste

C) Maintenance of fluid balance

D) Regulate synthesis of vitamin D

E) Regulate synthesis of RBCs

4) Urine is carried from the kidneys to the urinary bladder by the ________.

A) urethra

B) ureter

C) calyces

D) renal columns

E) renal tubules

5) Arrange the following structures in correct sequence for urine flow.

(1) Ureter

(2) Renal pelvis

(3) Calyx

(4) Urinary bladder

(5) Urethra

A) 1, 2, 3, 4, 5

B) 3, 2, 1, 4, 5

C) 2, 4, 5, 3, 1

D) 3, 4, 1, 2, 5

E) 1, 3, 2, 4, 5

6) The kidney is protected from mechanical shock by ________.

A) the hilum

B) renal fascia

C) adipose tissue

D) renal capsule

E) renal cortex

7) Blood vessels, nerves, and the ureter enter and leave the kidney at the ________.

A) hilum

B) renal fascia

C) renal pelvis

D) renal capsule

E) renal pyramid

8) The ureter expands into the substance of the kidney as the ________.

A) hilum

B) renal pelvis

C) renal capsule

D) renal pyramid

E) renal corpuscle

9) The portion of the kidney that is composed of cone-shaped renal pyramids is called the ________.

A) cortex

B) medulla

C) pelvis

D) calyx

E) columns

10) Cortical tissue located between the pyramids is called the ________.

A) calyx tissue

B) renal papillae

C) renal columns

D) medullary rays

E) renal corpuscles

11) The tip of each renal pyramid is called a ________.

A) nephron

B) renal papilla

C) renal column

D) medullary ray

12) The renal papillae extend into the ________.

A) cortex

B) renal columns

C) minor calyces

D) major calyces

13) The structural and functional units of the kidney are called ________.

A) nephrons

B) renal papillae

C) renal pyramids

D) renal columns

E) renal tubes

14) The juxtamedullary nephrons

A) have long loops of Henle.

B) are found next to the renal capsule.

C) comprise 85% of all nephrons.

D) have their renal corpuscles located in the medulla.

E) have short loops of Henle.

15) Which of the following is NOT part of a nephron?

A) Loop of Henle

B) Collecting duct

C) Renal corpuscle

D) Proximal convoluted tubule

E) Distal convoluted tubule

16) The network of capillaries that is located in Bowman capsule is called the ________.

A) vasa recta

B) glomerulus

C) peritubular capillary

D) proximal convoluted capillary

E) efferent arteriole

17) The renal corpuscle consists of

A) the renal pelvis and the renal tubules.

B) the glomerulus and Bowman's capsule.

C) Bowman's capsule and the renal pelvis.

D) the proximal convoluted tubule and the glomerulus.

E) afferent and efferent arteriole.

18) Which of the following structures is a capillary?

A) Glomerulus

B) Loop of Henle

C) Collecting duct

D) Bowman capsule

E) Proximal convoluted tubule

19) The visceral layer of Bowman capsule

A) is part of the filtration membrane.

B) is called endothelium.

C) contains podocytes.

D) Both "is part of the filtration membrane" and "is called endothelium" are correct.

E) Both "is part of the filtration membrane" and "contains podocytes" are correct.

20) Which of the following layers of the filtration membrane is closest to the plasma?

A) Podocytes

B) Macula densa

C) Glomerular endothelium

D) The basement membrane

E) Parietal layer of Bowman capsule

21) The inner layer of Bowman capsule consists of specialized cells called ________.

A) nephrons

B) podocytes

C) nephrocytes

D) juxtamedullary cells

E) macula densa

22) The pores of the endothelial cells of the glomerular capillaries are called ________.

A) fenestrae

B) gap junctions

C) filtration slits

D) macula densa

E) membrane channels

23) Filtration slits is the name given to the

A) points where the afferent arterioles enter the renal corpuscle.

B) openings between the endothelial cells of the glomerular capillaries.

C) gaps between the podocyte processes in the visceral layer of Bowman capsule.

D) basement membrane of the glomerular endothelium.

E) active transport channels.

24) An obstruction in the afferent arteriole would reduce the flow of blood into the ________.

A) glomerulus

B) renal artery

C) macula densa

D) efferent arteriole

E) arcuate artery

25) The filtration membrane consists of the

A) capillary epithelium, podocytes, and macula densa.

B) podocytes, basement membrane, and macula densa.

C) basement membrane, capillary epithelium, and macula densa.

D) parietal layer and visceral layer.

E) podocytes, capillary endothelium, and basement membrane.

26) Choose the term that does not belong with the others.

A) Glomerulus

B) Macula densa

C) Juxtaglomerular cells

D) Juxtaglomerular apparatus

E) Afferent arteriole

27) The juxtaglomerular apparatus is composed of

A) juxtaglomerular cells and the macula densa.

B) podocytes and juxtaglomerular cells.

C) the macula densa and the filtration membrane.

D) juxtaglomerular cells and the filtration membrane.

E) glomerulus and Bowman capsule.

28) The portion of the nephron that empties into the collecting duct is the ________.

A) glomerulus

B) ascending loop of Henle

C) distal convoluted tubule

D) proximal convoluted tubule

E) descending loop of Henle

29) The renal corpuscle connects to the ________.

A) loop of Henle

B) collecting duct

C) distal convoluted tubule

D) renal convoluted tubule

E) proximal convoluted tubule

30) Which of the following is between the proximal and distal convoluted tubules?

A) The glomerulus

B) The loop of Henle

C) The distal convoluted tubule

D) The proximal convoluted tubule

E) Collecting duct

31) Urine drains from the nephron into the calyces through the ________.

A) loop of Henle

B) collecting duct

C) distal convoluted tubule

D) proximal convoluted tubule

E) Bowman capsule

32) Arrange the following in the sequence in which filtrate moves through them.

(1) Loop of Henle

(2) Bowman capsule

(3) Distal convoluted tubule

(4) Proximal convoluted tubule

A) 1, 2, 3, 4

B) 4, 2, 1, 3

C) 2, 4, 3, 1

D) 2, 4, 1, 3

E) 3, 4, 1, 2

33) Which type of cells form the proximal convoluted tubule?

A) Simple cuboidal epithelium with microvilli

B) Stratified squamous epithelium

C) Pseudostratified ciliated columnar epithelium

D) Simple columnar cells with microvilli and cilia

34) Choose the one that does not belong.

A) Loop of Henle

B) Glomerulus

C) Distal convoluted tubule

D) Proximal convoluted tubule

E) Bowman capsule

35) One feature of renal blood circulation that makes it unique is that

A) there is a double set of venules.

B) blood flows from arterioles into venules.

C) blood flows from venules into arterioles.

D) each nephron has at least two capillary networks.

E) the nephron is only associated with the glomerulus.

36) The vasa recta is a specialized portion of the ________.

A) glomerulus

B) afferent arteriole

C) efferent arteriole

D) peritubular capillary

E) interlobular artery

37) Which of these vessels gives rise to the peritubular capillary?

A) Glomerulus

B) Arcuate artery

C) Efferent arteriole

D) Interlobular artery

E) Afferent arteriole

38) Trace the path of a red blood cell from the renal artery to the glomerulus.

(1) Interlobar artery

(2) Interlobular artery

(3) Segmental artery

(4) Arcuate artery

(5) Afferent arteriole

A) 1, 2, 3, 4, 5

B) 1, 4, 2, 3, 5

C) 3, 1, 2, 4, 5

D) 2, 1, 3, 5, 4

E) 1, 4, 3, 2

39) The urinary bladder

A) stores urine until it is voided.

B) empties to the exterior via the ureters.

C) contains a muscle called the trigone.

D) is superior to the kidney.

E) filters urine.

40) Skeletal muscle that surrounds the urethra as it extends through the pelvic floor forms the ________.

A) trigone

B) lamina propria

C) external urinary sphincter

D) internal urinary sphincter

E) involuntary portion of bladder control

41) Urine formation involves

A) filtration of the plasma.

B) reabsorption from the filtrate.

C) secretion into the filtrate.

D) All of the choices are correct.

42) Formation of filtrate depends on a ________ gradient.

A) pressure

B) concentration

C) volume

D) temperature

E) osmotic

43) The active transport of substances into the filtrate is called tubular ________.

A) filtration

B) reabsorption

C) secretion

D) elimination

E) excretion

44) The part of the cardiac output that passes through the kidneys is the ________.

A) renal fraction

B) filtration fraction

C) clearance fraction

D) glomerular flow rate

E) cardiac fraction

45) The amount of filtrate produced per minute is called the ________.

A) renal fraction

B) filtration fraction

C) glomerular filtration rate

D) clearance fraction

E) renal rate

46) At the rate of 125 ml of filtrate/minute, estimate the amount of filtrate formed in 24 hours.

A) 45 liters

B) 90 liters

C) 125 liters

D) 180 liters

E) 200 liters

47) What percent of filtrate becomes urine?

A) Less than 1%

B) 5%

C) 10%

D) 80%

E) 90%

48) Plasma contains a much greater concentration of ________ than the glomerular filtrate.

A) urea

B) water

C) protein

D) sodium ions

E) glucose

49) Passage of proteins into Bowman capsule is prevented by

A) the size of the capillary pores.

B) the size of the filtration slits in the podocytes.

C) the size of the proteins.

D) All of the choices are correct.

50) In glomerulonephritis, the permeability of the filtration membrane increases, allowing proteins to cross the membrane. Which of the following would you expect to observe?

A) Increase in filtration volume

B) Anuria – no urine production

C) Necrosis of the renal corpuscle

D) Low protein levels in the filtrate

E) No change in the filtrate

51) Decreased blood colloid osmotic pressure affects renal function by

A) increasing net filtration pressure.

B) increasing capsular pressure.

C) increasing glomerular capillary pressure.

D) increasing blood pressure in the afferent arteriole.

E) None of the choices are correct.

52) The movement of fluid into Bowman capsule is opposed by ________.

A) filtration pressure

B) capsular hydrostatic pressure

C) glomerular capillary pressure

D) osmotic pressure of the medulla of the kidney

E) blood pressure

53) If the following hypothetical conditions exist in the nephron, calculate the net filtration pressure.

Glomerular capillary pressure = 80 mmHg

Blood colloid osmotic pressure = 20 mmHg

Capsular hydrostatic pressure = 10 mmHg

A) 110 mmHg

B) 90 mmHg

C) 50 mmHg

D) 30 mmHg

E) 20 mmHg

54) Which of the following pressures tends to force fluid from the glomerulus through the filtration membrane into Bowman capsule?

A) Tubular pressure

B) Capsular pressure

C) Colloid osmotic pressure

D) Glomerular capillary pressure

E) None of the choices are correct.

55) Which of the following events would increase filtration pressure?

A) Increase in capsular pressure

B) Constriction of the efferent arteriole

C) Increase in colloid osmotic pressure

D) Decrease in renal blood flow

E) Dilation of the efferent arteriole

56) In the myogenic mechanism of autoregulation, what is the response to an increase in blood pressure in the afferent arteriole?

A) Constriction of the glomerulus

B) Dilation of the afferent arteriole

C) Dilation of the efferent arteriole

D) Constriction of the afferent arteriole

57) What is the effect of intense sympathetic stimulation on the GFR?

A) GFR increases

B) GFR decreases

C) GFR is not affected

D) GFR increases, then decreases

58) When Na+ is actively transported from tubular cells to the interstitial fluid,

A) no energy is needed.

B) glucose and amino acids are countertransported at the same time.

C) Na+ concentration gradient is established between the tubule lumen and tubule cell.

D) water is countertransported by carrier molecules.

E) water is secreted.

59) Substances that are cotransported into proximal convoluted tubule cells include

A) urea with water.

B) K+ with amino acids.

C) amino acids with bicarbonate ions.

D) glucose molecules with Na+.

E) Cl− with K+.

60) Most water is reabsorbed from the filtrate in the ________.

A) proximal convoluted tubule

B) descending loop of Henle

C) ascending loop of Henle

D) distal convoluted tubule

E) collecting duct

61) The proximal convoluted tubule is

A) lined with epithelial cells that lack microvilli.

B) the site of glucose and amino acid reabsorption.

C) permeable to water if ADH is present.

D) impermeable to water.

E) the site of water secretion.

62) Arrange the following in correct order.

(1) Cotransport molecule binds to Na+ and glucose

(2) Establish Na+ concentration gradient between tubular cells and tubular lumen

(3) Sodium and glucose moved into tubular cell

(4) Active transport of Na+ from tubular cells to interstitial area

A) 2, 1, 3, 4

B) 4, 2, 1, 3

C) 1, 3, 4, 2

D) 2, 4, 1, 3

E) 1, 2, 3, 4

63) Glucose is usually completely reabsorbed from the filtrate by the time the filtrate has reached the

A) tip of the loop of Henle.

B) end of the collecting duct.

C) end of the distal convoluted tubule.

D) end of the proximal convoluted tubule.

E) beginning of the proximal convoluted tubule.

64) Water reabsorption by the renal tubules uses ________.

A) active transport

B) cotransport

C) solvent drag

D) osmosis

E) None of the choices are correct.

65) In the ascending limb of the loop of Henle,

A) water can easily enter or leave.

B) K+ and Cl− are cotransported with Na+ across the apical membrane.

C) Ca2+ are actively transported across the basal membrane.

D) K+ is concentrated in the filtrate.

E) the filtrate does not change.

66) Once inside the cells of the ascending limb, K+ and Cl− cross the basal membrane into the interstitial fluid by the process of ________.

A) facilitated diffusion

B) cotransport

C) counter transport

D) active transport

E) simple diffusion

67) Which of the following ions are cotransported across the wall of the proximal convoluted tubule, distal convoluted tubule, and the ascending limb of the loop of Henle?

A) sodium and bicarbonate

B) potassium and phosphate

C) sodium and chloride

D) bicarbonate and potassium

E) potassium and chloride

68) The collecting ducts and distal convoluted tubules

A) reabsorb glucose.

B) collect filtrate from Bowman capsule.

C) actively transport Na+ but not Cl−.

D) vary in their permeability to water relative to the amounts of ADH present.

E) do not alter their permeability to water.

69) The collecting duct becomes more permeable to water when

A) colloid osmotic pressure increases.

B) ADH production increases.

C) plasma osmolality decreases.

D) aldosterone production decreases.

E) ADH production decreases.

70) As ADH production declines,

A) glomerular filtration increases.

B) K+ reabsorption increases.

C) reabsorption of water increases.

D) the urine volume increases.

E) the blood volume increases.

71) When ADH binds to receptor sites on distal convoluted tubule cells,

A) filtrate volume increases.

B) filtrate osmolality decreases.

C) K+ is secreted from the cells.

D) the distal convoluted tubule is less permeable to water.

E) the distal convoluted tubule is more permeable to water.

72) Urea is

A) secreted into the filtrate by cells of the distal convoluted tubule.

B) diffuse out of the collecting ducts into the interstitial fluid of the medulla and then diffuse into the descending loop of Henle.

C) completely reabsorbed by the nephron.

D) actively transported into the filtrate by cells of the collecting duct.

E) None of the choices are correct.

73) Hydrogen ions are secreted into the filtrate by

A) both the proximal and distal convoluted tubules.

B) both the collecting duct and Bowman capsule.

C) both the loop of Henle and the distal convoluted tubule.

D) both the proximal convoluted tubule and the loop of Henle.

E) loop of Henle only.

74) Which of the following are most likely to be actively secreted into the distal convoluted tubule?

A) K+

B) Cl−

C) Bicarbonate ions

D) Amino acids

E) Na+

75) Potassium ions enter the lumen of the ________ by the process of active transport.

A) proximal convoluted tubule

B) renal corpuscle

C) loop of Henle

D) distal convoluted tubule

E) collecting duct

76) In the sodium-hydrogen antiport system,

A) both Na+ and H+ are transported into the tubular lumen.

B) both Na+ and H+ are transported into the tubular cell.

C) Na+ are transported into the cell; H+ are transported out of the cell.

D) Na+ are transported into the tubular lumen; H+ are transported into the cell.

E) Na+ are transported out of the cell; H+ are transported into the cell.

77) Tubular secretion occurs in which of the following structures?

A) Glomerulus

B) Urethra

C) Renal pelvis

D) Distal convoluted tubule

E) Collecting duct

78) Tubular reabsorption and tubular secretion differ in that

A) tubular secretion is a passive process; tubular reabsorption uses active transport.

B) tubular secretion adds materials to the filtrate; tubular reabsorption removes materials from the filtrate.

C) tubular reabsorption increases urine volume; tubular secretion decreases urine volume.

D) tubular reabsorption occurs in Bowman capsule; tubular secretion occurs in the peritubular capillary.

E) tubular secretion moves materials from the filtrate into the blood; tubular reabsorption moves materials from the blood into the filtrate.

79) Which of the following statements is true?

A) Most filtrate (99%) is eliminated as urine.

B) Normal filtrate contains a large amount of protein.

C) Reabsorption of water in the filtrate may be hormonally controlled.

D) Sodium ions are secreted into the filtrate of the proximal convoluted tubule.

E) Hormones play a minor role in fluid homeostasis.

80) The ability of the kidney to concentrate urine depends on

A) proximal convoluted tubule reabsorption.

B) a high medullary concentration gradient.

C) osmosis.

D) rapid removal of filtrate.

E) a low medullary concentration gradient.

81) The vasa recta

A) supplies blood to the glomerulus.

B) alters the cortical solute gradient.

C) collects excess water and solutes from the medullary interstitial fluid.

D) collects water and solutes reabsorbed from the proximal convoluted tubule.

E) surrounds the collecting duct.

82) The countercurrent multiplier system

A) is found in the collecting duct.

B) is assisted by hormones.

C) has fluid flowing in parallel tubes in opposite directions.

D) maintains the solute concentration of the medullary interstitial fluid.

E) Both "has fluid flowing in parallel tubes in opposite directions" and "maintains the solute concentration of the medullary interstitial fluid" is correct.

83) A countercurrent mechanism is in

A) the afferent and efferent arterioles.

B) the glomerulus and Bowman capsule.

C) the proximal and distal convoluted tubules.

D) the loop of Henle only.

E) both the loop of Henle and the vasa recta.

84) In which of the following locations is filtrate osmolality highest?

A) End of proximal convoluted tubule

B) Tip of the loop of Henle

C) End of distal convoluted tubule

D) Beginning of distal convoluted tubule

E) Descending loop of Henle

85) Which of the following helps maintain a high solute concentration in the kidney medulla?

A) High urea concentration in medulla

B) Active transport of solutes from ascending limb

C) The vasa recta

D) Functions of the loop of Henle

E) All of the choices are correct.

86) Which of the following would help maintain the medullary concentration gradient?

A) Movement of urea from the distal convoluted tubule to the proximal convoluted tubule

B) Urea movement from the collecting duct to medullary interstitial fluid

C) Movement of water from the ascending limb into the medullary interstitial fluid

D) Active transport of Na+ and Cl− from the medullary interstitial fluid into the collecting duct

E) Urea movement into the collecting duct

87) Starting from the collecting duct, indicate the order in which urea molecules move to maintain the medullary concentration gradient.

(1) Ascending limb

(2) Distal convoluted tubule

(3) Interstitial fluid

(4) Collecting duct

(5) Descending limb

A) 2, 5, 1, 4, 3

B) 1, 3, 5, 2, 4

C) 3, 5, 1, 2, 4

D) 4, 2, 1, 3, 5

E) 4, 3, 5, 1, 2

88) Which of the following statements concerning solute movement in the loop of Henle is true?

A) Only Na+ diffuses from the descending limb.

B) Solutes are actively transported from the ascending limb.

C) Na+ and Cl− ions are actively transported into the vasa recta.

D) The osmolality of the descending limb decreases as filtrate moves through.

E) Water moves by osmosis out of the ascending loop.

89) Which structure removes excess water and solutes from the kidney's medullary interstitial fluid?

A) Distal convoluted tubule

B) Collecting duct

C) Loop of Henle

D) Vasa recta

E) Proximal convoluted tubule

90) The kidney dialysis machine is an example of a mechanical ________ system.

A) active transport

B) countercurrent

C) cotransport

D) sorting

91) By the time filtrate reaches the tip of the loop of Henle, ________ of the filtrate volume has been reabsorbed.

A) 65%

B) 75%

C) 80%

D) 95%

E) 100%

92) The filtrate that drips from the renal papillae into the calyces

A) has a higher concentration of waste products (urea) than the original filtrate.

B) may have lost up to 99% of its original volume.

C) is called urine.

D) All of the choices are correct.

93) Filtrate reabsorption that occurs regardless of the concentration and volume of urine produced is referred to as ________.

A) active

B) obligatory

C) facultative

D) countercurrent

E) nonessential

94) Urine concentration and volume depend on water reabsorption in the ________.

A) proximal convoluted tubule

B) descending loop of Henle

C) ascending loop of Henle

D) distal convoluted tubule only

E) distal convoluted tubule and collecting ducts

95) Some lung cancers secrete large amounts of ADH. This causes increased water reabsorption in the ________.

A) proximal convoluted tubule

B) loop of Henle

C) distal convoluted tubule and collecting ducts

D) calyces

E) urethra

96) Which of the following situations increases the number of action potentials to the supraoptic region of the hypothalamus?

A) Increased blood velocity

B) Decreased renin production

C) Increased plasma osmolality

D) Decreased aldosterone secretion

E) Decreased plasma osmolality

97) Decreased ADH levels results in a urine high in ________.

A) K+

B) water content

C) glucose content

D) bicarbonate content

E) H+

98) Diabetes insipidus is the result of decreased ________ production.

A) ADH

B) insulin

C) aldosterone

D) angiotensin II

E) glucagon

99) Removal of the posterior pituitary will immediately cause

A) a decrease in urine volume.

B) an increase in urine volume.

C) no change in urine volume.

100) A 15% increase in blood pressure would result in which of the following changes in ADH secretion?

A) Increased secretion

B) Decreased secretion

C) No change in secretion

101) The juxtaglomerular apparatus secretes ________.

A) renin

B) ADH

C) oxytocin

D) aldosterone

E) angiotensin

102) Renin converts

A) angiotensin I to angiotensin II.

B) angiotensin II to angiotensin I.

C) angiotensinogen to angiotensin I.

D) angiotensin II to angiotensin III.

E) angiotensinogen to angiotensin II.

103) The kidneys produce renin when

A) the urine becomes acidic.

B) the peritubular capillaries dilate.

C) the blood pressure in the afferent arteriole decreases.

D) sodium chloride concentration in the distal convoluted tubule increases.

E) the blood pressure in the afferent arteriole increases.

104) Angiotensin II

A) is a potent vasodilator.

B) stimulates aldosterone secretion.

C) is formed from angiotensin I by the action of renin.

D) acts on the collecting ducts to increase reabsorption of water.

E) decreases blood pressure.

105) Which of the following is NOT an action of angiotensin II?

A) Vasoconstriction of arterioles

B) Increases thirst

C) Increases ADH secretion

D) Decreases peripheral resistance

E) Increases aldosterone secretion

106) Increased aldosterone causes increased ________.

A) urine volume

B) Na+ secretion

C) K+ secretion

D) reabsorption of H+

E) filtrate formation

107) Aldosterone targets cells in the ________.

A) proximal convoluted tubule

B) loop of Henle

C) distal convoluted tubule

D) glomerulus

E) collecting duct

108) Aldosterone exerts its effect on the kidney tubules by

A) increasing tubular renin production.

B) increasing tubular permeability.

C) increasing osmosis into the tubule cells.

D) increasing the synthesis of the transport proteins for Na+.

E) decreasing tubular permeability.

109) Lasix is a drug that blocks the reabsorption of Na+ in the ascending loop of Henle. The result of giving this drug would be

A) increased urine output.

B) decreased aldosterone production.

C) decreased osmolality of the filtrate.

D) increased osmolality of the urine.

E) decreased urine volume.

110) Consumption of alcohol increases urine production by

A) decreasing the blood pressure.

B) causing retention of Na+.

C) inhibiting the release of ADH from the posterior pituitary.

D) stimulating the release of aldosterone from the adrenals.

E) stimulating the release of ADH from the posterior pituitary.

111) ADH increases the permeability of the distal convoluted tubules and collecting ducts by

A) incorporating aquaporin-3 channels into the apical membrane.

B) increasing the number of Na+ − transport proteins in the membranes.

C) incorporating aquaporin-2 channels into the apical membrane.

D) decreasing the number of aquaporin-4 channels in the apical membrane.

112) Atrial natriuretic hormone

A) promotes the secretion of ADH.

B) is secreted by the posterior pituitary.

C) causes the formation of concentrated urine.

D) is secreted when atrial blood pressure increases.

E) is secreted when atrial blood pressure decreases.

113) Autoregulation in the kidney involves changes in the degree of ________.

A) constriction of afferent arterioles

B) sympathetic stimulation

C) aldosterone secretion

D) ADH secretion

E) None of the choices are correct

114) Intense sympathetic stimulation of the kidney

A) is necessary for normal kidney metabolism.

B) causes the release of epinephrine from the kidney.

C) decreases renal flow.

D) increases filtration rate.

E) does not alter filtration rate.

115) If extracellular fluid osmolality is 385 mOsm/kg, the kidneys will increase reabsorption of ________.

A) urea

B) water

C) Na+

D) K+

E) Cl−

116) Blood loss that occurs during surgery will stimulate cells in the

A) efferent arteriole.

B) wall of the right atrium.

C) proprioceptors.

D) juxtaglomerular apparatus.

E) None of the choices are correct.

117) Put the following in the correct order after the blood pressure increases.

(1) Decreased sympathetic stimulation

(2) Increase in glomerulus filtration rate

(3) Increase in arterial blood pressure

(4) Increase in urine production

(5) Afferent arterioles dilate

A) 1, 3, 5, 2, 4

B) 3, 2, 1, 5, 4

C) 2, 3, 5, 1, 4

D) 3, 1, 5, 2, 4

E) 3, 2, 5, 4, 1

118) When macula densa cells experience increased Na+ concentration in the filtrate, they respond by

A) increasing afferent arteriole constriction.

B) decreasing urine production.

C) decreasing renin secretion.

D) increasing aldosterone secretion.

E) increasing renin secretion

119) Decreased blood pressure in the afferent arterioles results in

A) increased renin secretion.

B) decreased ADH secretion.

C) suppression of thirst.

D) stimulation of the parasympathetic nervous system.

E) decreased renin secretion.

120) Stretch receptors in the atria are responsible for the secretion of ________.

A) ADH

B) renin

C) aldosterone

D) atrial natriuretic hormone

E) angiotensin

121) Increased secretion of atrial natriuretic hormone results in

A) increased thirst.

B) increased urine output.

C) increased blood pressure.

D) increased osmolality of the extracellular fluid.

E) decreased urine output.

122) A substance that is useful for determining the plasma clearance rate of the kidney is ________.

A) ADH

B) glucose

C) inulin

D) protein

E) ammonia

123) To calculate plasma clearance of any substance, it is necessary to know the

A) quantity of urine produced per minute.

B) concentration of the cleared substance in the urine.

C) concentration of the cleared substance in the blood.

D) All of the choices are correct.

124) A substance used to calculate plasma clearance must

A) pass freely through the filtration membrane of the renal corpuscle.

B) be readily reabsorbed.

C) be either a protein or a polysaccharide.

D) be secreted into the nephron.

E) be produced in the kidney.

125) Decreased plasma clearance can indicate ________.

A) hypertension

B) renal failure

C) decreased ADH secretion

D) decreased aldosterone secretion

E)  normal fluid balance

126) Drug companies use which of the following to help them calculate the duration of action of a medication?

A) Plasma clearance

B) Plasma osmolarity

C) Tubular maximum

D) Renal plasma flow

E) Glomerular filtration rate

127) Renal blood flow per minute can be calculated if you know the clearance calculation for ________ as well as the person's hematocrit.

A) ADH

B) PAH

C) insulin

D) aldosterone

E) glucose

128) Tubular load refers to the amount of a given substance that

A) is present in the blood as it enters the afferent arteriole of the nephron.

B) passes through the filtration membrane into the nephron each minute.

C) can be actively reabsorbed from the filtrate.

D) can be secreted into the filtrate.

E) None of the choices are correct.

129) When the tubular maximum for a substance is exceeded,

A) more of the substance is reabsorbed.

B) more of the substance is actively secreted.

C) less of the substance is filtered in the renal corpuscle.

D) the excess goes into the blood.

E) the excess remains in the urine.

130) If the tubular maximum for a particular amino acid is 200 mg/100 ml and the concentration of that amino acid in the blood is 100 mg/100 ml, the amino acid

A) will be actively secreted into the filtrate.

B) will be completely reabsorbed by the tubule cells.

C) will appear in the urine.

D) will not appear in the urine.

E) None of the choices are correct.

131) Diuretics that inhibit Na+ reabsorption are called ________.

A) xanthines

B) osmotic diuretics

C) thiazide diuretics

D) carbonic anhydrase inhibitors

E) ADH inhibitors

132) Urea and mannitol are examples of which of the following types of diuretics?

A) Osmotic diuretics

B) Thiazide diuretics

C) Potassium-sparing diuretics

D) Carbonic anhydrase inhibitors

E) ADH inhibitors

133) Diuretics that work by reducing H+ secretion and the reabsorption of HCO3- ions are classified as ________.

A) xanthines

B) osmotic diuretics

C) thiazide diuretics

D) carbonic anhydrase inhibitors

E) potassium-sparing diuretics

134) Urine flows through the ureters to the bladder as the result of ________.

A) gravity

B) a pressure gradient

C) a concentration gradient

D) peristaltic contractions

E) osmotic gradient

135) Where do the ureters enter the urinary bladder?

A) The anterosuperior surface

B) The anteroinferior surface

C) The posteromedial surface

D) The posterolateral surface

136) Which part of the urinary bladder expands very little during bladder filling?

A) The fundus

B) The trigone

C) The neck

D) Transitional epithelium

137) Which muscle is responsible for contraction of the urinary bladder during micturition?

A) Trigone

B) Internal urinary sphincter

C) Micturition muscle

D) Detrusor muscle

138) Which type of tissue is responsible for the expansion of the urinary bladder during filling?

A) Transitional epithelium

B) Stratified squamous epithelium

C) Pseudostratified columnar epithelium

D) Stratified columnar epithelium

139) Why is the external urinary sphincter under conscious control?

A) It is made of smooth muscle.

B) It is part of the detrusor muscle.

C) It is made of skeletal muscle.

D) It is made of adventitia.

140) How much urine would be in the urinary bladder to increase the pressure to an uncomfortable point? 

A) 100 mL

B) 300 mL

C) 400 mL

D) 500 mL

141) Voluntary micturition

A) involves higher brain centers.

B) involves control of the internal sphincter.

C) is a reflex action.

D) is common in infants.

E) involves control of smooth muscle.

142) Which of the following statements concerning the micturition reflex is false?

A) The micturition reflex is initiated by stretching the bladder wall.

B) Afferent signals are conducted to the sacral segments of the spinal cord by the pelvic nerves.

C) Efferent signals are sent to the bladder by sympathetic fibers in the pelvic nerve.

D) The micturition reflex usually produces a series of contractions of the urinary bladder.

E) The micturition reflex is modified by centers in the pons and cerebrum.

143) With aging, a loss of inhibitory action potentials to the sacral region of the spinal cord results in

A) increased bladder capacity.

B) voluntary micturition.

C) continuous dribbling of urine.

D) uncontrollable micturition.

E) lack of control of internal sphincter.

144) In glomerulonephritis, proteins, and white blood cells enter the filtrate resulting in

A) increased reabsorption of water.

B) increased reabsorption of Na+.

C) increased secretion of Na+.

D) increased urine output.

E) decreased urine output.

145) Which of the following conditions is characterized by inflammation of the renal medulla?

A) Pyelonephritis

B) Acute glomerulonephritis

C) Chronic glomerulonephritis

D) Acute renal failure

E) Chronic renal failure

146) Which of the following is NOT an effect of aging on the kidneys?

A) Decrease in kidney size

B) Loss of nephrons

C) Decreased response to hormonal control of urine volume

D) A marked decrease in the ability to maintain homeostasis

147) Effects of aging on the kidneys include all of the following, except

A) an increased ability to eliminate uric acid and creatine from the blood.

B) a gradual decrease in the size of the kidneys.

C) a gradual decrease in blood flow through the kidneys.

D) a loss of general function.

E) a decline in absorption and secretion.

148) In order to regulate the pH of extracellular fluid, the kidneys are able to adjust the excretion of ________.

A) H+

B) Ca2+

C) Na+

D) Mg2+

E) K+

149) The kidneys are located behind the ________ membrane on the posterior side of the ________ wall.

A) peritoneal; abdominal

B) peritoneal; pelvic

C) renal; abdominal

D) renal; pelvic

E) pleural; pelvic

150) Renal papillae drain into ________.

A) minor calyces

B) major calyces

C) the renal pelvis

D) renal columns

E) the ureter

151) All of the following are located in the renal cortex, except

A) collecting ducts.

B) renal corpuscles.

C) proximal convoluted tubules.

D) distal convoluted tubules.

E) afferent arteriole.

152) What are the arteries which diverge from the interlobar arteries near the base of the renal pyramid?

A) Arcuate

B) Peritubular

C) Segmental

D) Renal

E) Interlobular

153) All of the following are major processes essential to urine production, except ________.

A) micturition

B) filtration

C) tubular secretion

D) tubular reabsorption

154) What is tubular reabsorption?

A) The process where the nephron returns water and some filtered molecules to the blood.

B) The reabsorption of blood cells in the nephron into the body.

C) The passage of water and ions into the filtrate during filtration in the nephron.

D) The absorption of proteins into the filtrate which later becomes urine.

E) The transport additional solutes from the blood into the filtrate by tubule cells.

155) True or False? The filtration membrane prevents blood cells and proteins from entering the Bowman capsule on the basis of size and protein type.

156) Smooth muscle cells in the walls of the afferent and efferent arterioles dilate or constrict as needed in response to changes in blood pressure. This process of autoregulation is called the ________.

A) myogenic mechanism

B) tubular secretion

C) tubuloglomerular feedback

D) glomerular filtration

E) tubular reabsorption

157) Which of the following pairs of structures are the most similar in function?

A) Distal convoluted tubule and collecting duct.

B) Proximal convoluted tubule and distal convoluted tubule.

C) Distal convoluted tubule and ascending limb of the loop of Henle.

D) Ascending limb and descending limb of the loop of Henle.

158) The mechanism for concentration of urine is called the ________ mechanism.

A) countercurrent

B) filtration

C) secretion

D) reabsorption

E) concentration

159) Urine is prevented from flowing back into the ureters from the bladder by ________.

A) compression of the ureteral openings

B) the external urethral sphincter

C) the internal urethral sphincter

D) the ureteral sphincters

E) ureteral valves

160) The micturition reflex is initiated by the

A) stretching of the walls of the urinary bladder.

B) stretching of the walls of the ureters.

C) relaxation of the walls of the urinary bladder.

D) constriction of the external urinary sphincter.

E) relaxation of the external urinary sphincter.

161) A patient enters a hospital after a motorcycle accident. He complains of mid-back pain. X-rays reveal both rib and pelvic fractures. His emergency room examination includes urinalysis. Which of the following findings from the urinalysis would most likely suggest trauma to the kidneys from the accident, but not to the urinary bladder?

A) Pyuria

B) Hematuria

C) Albuminuria

D) Uremia

E) Phenylketonuria

162) Glucose and amino acids are reabsorbed from the glomerular filtrate by the ________.

A) renal corpuscle

B) proximal convoluted tubule

C) distal convoluted tubule

D) glomerular capillaries

E) collecting duct

163) Which of the following would reduce the glomerular filtration rate?

A) Vasoconstriction of the efferent arteriole

B) A drop in colloid osmotic pressure

C) Vasodilation of the afferent arteriole

D) Vasoconstriction of the afferent arteriole

E) An increase in osmotic pressure in the Bowman capsule

164) Which of the following is not reabsorbed by the proximal convoluted tubule?

A) Potassium

B) Sodium chloride

C) Hydrogen ions

D) Urea

E) Water

165) Total saturation of protein transporters for a given solute in the renal tubules would result in ________.

A) reabsorption of all the solute

B) a renal clearance of zero

C) a net filtration pressure of 1.0

D) appearance of that solute in the urine

E) absence of that solute from the urine

166) Which renal structure is responsible for producing hypertonic urine by reabsorbing water while allowing metabolic wastes and NaCl to pass through?

A) Glomerulus

B) Proximal convoluted tubule

C) Distal convoluted tubule

D) Collecting duct

E) Nephron loop

167) Which of the following induces renin secretion, constricts afferent arterioles, and reduces GFR and urine volume?

A) Aldosterone

B) Antidiuretic hormone

C) Parathyroid hormone

D) Norepinephrine

E) Angiotensin II

168) Assuming all other values are normal, calculate the net filtration pressure in a patient with a drop in capsular hydrostatic pressure to 8 mmHg.

A) 10 mm Hg out

B) 20 mm Hg out

C) 30 mm Hg out

D) 40 mm Hg out

E) 50 mm Hg out

169) A hospital patient produces 4 mL/min of urine with a urea concentration of 8 mg/mL. Venous blood draw reveals urea concentration of 0.4 mg/mL. What is the percentage of cleared urea from glomerular filtrate?

A) 40%

B) 56%

C) 64%

D) 72%

E) 80%

170) Which two substances are most useful for determining a patient's glomerular filtration rate?

A) Insulin and glucose

B) Inulin and creatinine

C) Sodium and water

D) Albumin and inulin

E) Insulin and urea