Download Renal MCQs – Physiology

Renal MCQs – Physiology
January 2007
1.
Secretion of K+ by the distal tubule will be decreased by
a.
b.
c.
d.
e.
2.
The following blood gas picture is most consistent with: pH = 7.56; pCO2 =
20mmHg; pO2 = 100mmHg; bicarb = 25mmol/
a.
b.
c.
d.
e.
3.
Sepsis
Emphysema
Prolonged vomiting
Bicarbonate ingestion
2 week residence at high altitude
The principal buffer in interstitial fluid is
a.
b.
c.
d.
e.
4.
Metabolic alkalosis
A high K+ diet
Hyperaldosteronism
Spironolactone administration
Thiazide diuretic administration
Carbonic acid
Hb
Phosphate
Other proteins
Compounds containing histidine
Regarding absorption of Na+ in the proximal tubule
a.
b.
c.
d.
e.
The proximal tubule reabsorbs 80% of the filtered sodium load
Absorption of Na+ causes increasing hypertonicity in the tubule lumen
Absorption is powered by the Na+/H+ ATPase
Shares a common carrier with glucose
All of the above are true
5.
Which of the following agents does not cause contraction of the mesangial
cells in the glomerulus?
a.
b.
c.
d.
e.
6.
The lower pH limit of the urine is
a.
b.
c.
d.
e.
7.
The Loops of Henle act as counter current exchangers
Solutes diffuse out of vessels conducting blood toward the cortex
Water diffuses out of ascending vessels
Water diffuses into the collecting ducts
Counter current exchange is passive and can operate even if counter
current multiplication ceases
Which of the following is most permeable to water?
a.
b.
c.
d.
e.
10.
Alcohol
Carbamazepine
 extracellular fluid volume
Angiotensin I
Lying supine
With respect to the counter current system
a.
b.
c.
d.
e.
9.
1.0
3.5
4.5
6.0
7.0
ADH (vasopressin) secretion is increased by
a.
b.
c.
d.
e.
8.
Angiotensin I
Noradrenaline
Histamine
Dopamine
Vasopressin
Thin ascending Loop of Henle
Distal convoluted tubule
Thin descending Loop of Henle
Cortical portion of collecting tubule
Thick ascending limp of Loop of Henle
pH 7.16; pCO2 = 24mmHg; pO2 = 100mmHg; bicarbonate = 6mmol/; K+ =
3.4mmol/
Which of the following is MOST likely to cause the above picture
a.
b.
c.
d.
e.
Cyanide poisoning
Hyperventilation
Liquorice ingestion
Addison’s disease
Conn’s syndrome
11.
Metabolic alkalosis can be caused by all of the following EXCEPT
a.
b.
c.
d.
e.
12.
The consumption of oxygen by the kidney
a.
b.
c.
d.
e.
13.
Release of renin
Secretion of aldosterone
Secretion of ADH
Release of natriuretic hormone
Production of Angiotensin II
GFR would be increased by
a.
b.
c.
d.
e.
16.
50ml/min
125ml/min
150ml/min
200ml/min
362ml/min
An increase in the concentration of plasma potassium causes an increase in
a.
b.
c.
d.
e.
15.
Decreases as blood flow increases
Is regulated by erythropoietin
Remains constant as blood flow increases
Directly reflects the level of sodium transport
Is greatest in the medulla
If the plasma concentration of a freely filterable substance that is neither
secreted nor reabsorbed is 0.12gmg/ml, its urine concentration is 25mg/ml,
and urine formation 1.0ml/min – the GFR is
a.
b.
c.
d.
e.
14.
Hyperaldosteronism
Hyperventilation
Hypokalaemia
Volume depletion
Vomiting
Constriction of the afferent arteriole
A decrease in afferent arteriolar pressure
Compression of the renal capsule
A decrease in the concentration of plasma protein
A decrease in renal blood flow
The greatest amount of hydrogen ion secreted by the proximal tubule is
associated with
a.
b.
c.
d.
e.
Excretion of potassium ion
Excretion of hydrogen ion
Reabsorption of calcium ion
Reabsorption of bicarbonate ion
Reabsorption of phosphate ion
17.
All of the following comparisons between the distal nephron and the proximal
tubule are correct EXCEPT
a.
b.
c.
d.
e.
18.
Urinary volume is increased by all of the following EXCEPT
a.
b.
c.
d.
e.
19.
c.
d.
e.
It produces its effect by activating cAMP
It produces its effects by increasing membrane permeability to
potassium
It causes an increased reabsorption of hydrogen ion
It has its main effect on the proximal tubule
It is secreted in response to an increase in BP
The ability of the kidney to excrete a concentrated urine will increase if
a.
b.
c.
d.
e.
21.
Sympathetic stimulation
Diabetes insipidus
Diabetes mellitus
Increased renal arterial pressure
Infusion of mannitol
Which one of the following statements about aldosterone is correct?
a.
b.
20.
The distal nephron is less permeable to hydrogen ion than is the
proximal tubule
The distal nephron is more responsive to aldosterone than is the
proximal tubule
The distal nephron has a more negative intraluminal potential than
does the proximal tubule
The distal nephron secretes more potassium than does the proximal
tubule
The distal nephron secretes more hydrogen ion than does the
proximal tubule
The
The
The
The
The
permeability of the proximal tubule to water decreases
rate of blood flow through the medulla decreases
rate of flow through the Loop of Henle increases
activity of the Na-K pump in the Loop of Henle decreases
permeability of the collecting duct to water decreases
Which of the following returns closest to normal during chronic respiratory
acidosis
a.
b.
c.
d.
e.
Alveolar ventilation
Arterial PCO2
Arterial PO2
Plasma concentration of bicarbonate
Arterial concentration of hydrogen ion
22.
Renal correction of hyperkalaemia will result in
a.
b.
c.
d.
e.
23.
In controlling the synthesis and secretion of aldosterone – which of the
following factors is LEAST important
a.
b.
c.
d.
e.
24.
Respiratory alkalosis
Mixed metabolic and respiratory alkalosis
Metabolic acidosis
Respiratory acidosis
Metabolic alkalosis
The TMg for women (transport maximum for glucose) in the kidney is about
a.
b.
c.
d.
e.
27.
Its production in the kidney  during chronic alkalosis
The walls of the renal tubules are impermeable to NH3
The walls of the renal tubules are impermeable to NH4+
Its acid base reaction has a low pKa
None of the above
pH 7.67, PO2 120mmHg on O2; PCO2 60mmHg and bicarbonate 36mmol/l on
a blood gas is indicative of
a.
b.
c.
d.
e.
26.
Renin
Angiotensin II
Concentration of plasma Na+
ACTH
Concentration of plasma K+
Ammonia is an effective and important urinary buffer for which of the
following reasons
a.
b.
c.
d.
e.
25.
Alkalosis
Increased secretion of HCO3Acidosis
Increased secretion of H+
Increased excretion of Na+
75mg/min
100mg/min
150mg/min
300mg/min
500mg/min
A loss of function mutates in the gene of which of the following proteins is
associated with nephrogenic diabetes insipidus
a.
b.
c.
d.
e.
Aquaporin
Aquaporin
Aquaporin
Aquaporin
Aquaporin
-1
-2
-3
-4
-5
28.
Dehydration increases the plasma concentration of all of the following
EXCEPT
a.
b.
c.
d.
e.
29.
Calculate the anion gap from these results –
Na+ 142; K+ 3.5mmol/l; glucose 6mm0l/l; chloride 110mm0l/l; bicarbonate =
10mmol/l; urea = 7.0mmol/l
a.
b.
c.
d.
e.
30.
Vasopressin
Angiotensin II
Aldosterone
Noradrenaline
Atrial natriuretic peptide
10
15
17
22
29
Regarding water excretion
a.
b.
c.
d.
e.
At least 87% of filtered water in kidney is reabsorbed
Urine concentration ca get as high as 1400mosm/kg
About 5% of filtered water is removed in the distal tubule
Aquaporin -1 plays a major role in water conservation, although it is
unaffected by vasopressin
All of the above are correct
Renal Acid Base Physiology – Jan 05
Answers
1.
C
2.
E
3.
A
4.
E
5.
D
6.
C
7.
B
8.
B
9.
C
10.
A
11.
B
12.
D
13.
D
14.
B
15.
D
16.
D
17.
E
18.
A
19.
B
20.
B
21.
E
22.
C
23.
D
24.
C
25.
E
26.
D
27.
B
28.
E
29.
D
30.
E