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Roxy, Joanne, Amber, Matt, Becky Chapter 26 Questions 1. What is NOT a function of the Urinary System? A) To help regulate blood pressure, pH, and glucose levels B) transport urine from kidneys to urinary bladder C) maintain blood osmolarity D) urethra discharges urine from body E) urinary bladder stores urine and expels it into urethra Rational: p. 1066, the chart explains that the urinary system functions as A,C, D, and E; while the transportation of urine from the kidneys to the urinary bladder is maintained by the ureters (it is not directly transported from the kidneys to the urinary bladder as they are separated by the ureters) 2. What is the deep layer of the kidney? A) adipose capsule B) renal fascia C) renal hilum D) hilus E) renal capsule Rational: on p. 1067, the external anatomy of the kidneys. It states that the deep layer is the renal capsule which protects the kidney from trauma and holds it in place. The renal fascia is the superficial layer, the renal hilum or hilus is where the ureter emerges from the kidney, and the adipose capsule is the middle layer which protects the kidney and holds it in place. 3. What is the disease that is developed mostly in thin people whose adipose capsule or renal fascia is deficient also called “floating kidney”? A) Nephroptosis B) Glycosuria C) Diuretics D) Urinary Incontinence E) Nephrotic syndrome Rational: p. 1069 the clinical connection. Glycosuria is where some glucose is found within the urine (associated with diabetes mellitus). Diuretics are substances that slow renal reabsorption of water and cause an elevated urine flow (dieresis). Urinary Incontinence is the inability to control urination and Nephrotic syndrome is in which protein is found in the urine (proteinuria) or high blood levels of cholesterol, phospholipids and triglycerides are present in the urine (hyperlipidemia). 4. What is the scientific study of the anatomy, physiology, and pathology of the kidney? A) Urology B) Urologist C) Nephrology D) All of the above E) None of the above Rational: p. 1065; it states that Nephrology is the scientific study of anatomy, physiology, and pathology of the kidneys. 5. Which organ does the most work in the Urinary System? A) Urinary bladder B) Urethra C) Rectum D) Uterus E) Kidneys Rational: p. 1067; the start of Overview of Kidney Functions states that the kidneys are the organs that do the majority of the work in the urinary system. 6. What regulating factor increases the Glomerular Filtration Rate (GFR)? A) Myogenic mechanism B) Neural regulation C) Angiotensin II D) Atrial natriuretic peptide (ANP) E) Tubuloglomerular feedback Rational: The answer can be found on page 1081 Table 26.2 the reason why myogenic mechanism is NOT the answer is because it decreases the effect of the GFR. Neural regulation also decreases the effect of GFR as it is a negative feedback loop. Angiotensin II is a vasoconstrictor that narrows arterioles and reduces the renal blood flow which decreases GFR Tubuloglomerular feedback is a part of the renal autoregulation which decreases the GFR along with myogenic mechanism. 7. Which of the following is NOT true about Nephrons? A) They are constant at birth B) If diseased, new nephrons will form to comply C) Due to nephron individual growth, it can increase the kidneys size D) Nephrons can adapt to handle larger-than-normal loads. E) These are the functional units of the kidneys Rational: On page 1076, on the last paragraph before the next section, it states the following; Nephrons are constant from birth, kidney size is due to the growth of individual nephrons, nephrons can also adapt to handle larger-than-normal loads, and from the page 1071 they are the functional units of the kidneys. However it states that if nephrons are diseased cannot create new ones to comply. 8. Which of the following processes are needed to produce urine? A) Tubular secretion, basal lamina, and Glomerular filtration B) Tubular secretion, Glomerular filtration, Tubular reabsorption C) Glomerular filtration, Tubular reabsorption, Tubular absorption D) Glomerular filtration, Tubular secretion, and Tubular absorption E) None of the above are to help produce urine. Rational: Page 1076, overview of renal physiology states the order; Glomerular filtration, tubular reabsorption, and tubular secretion. 9. What is the correct order in which the fluid flows through to the collecting ducts? A) Glomerular capsule, renal tubule, and to the collecting duct B) Renal tubule, glomerular capsule, and the collecting duct C) Collecting duct, renal tubule, to the glomerular capsule D) Glomerular capsule, collecting duct, and renal tubule E) Renal tubule, collecting duct, and glomerular capsule. Rational: pg. 1074, end of histology paragraph it states that fluid flows through the glomerular capsule, renal tubule, and then the collecting duct. 10. Which of the following mechanisms does NOT control the glomerular filtration rate? A) Renal Autoregulation B) Tubuloglomerular feedback C) Angiotensin II D) Atrial natriuretic peptide E) Tubular reabsorption Rational: pg. 1080 end of first paragraph states three mechanisms that control GFR; renal autoregulation, neural regulation, and hormonal regulation (which includes Angiotensin II and atrial natriuretic peptide). 11. What does the presence of excess albumin in the urine indicate? A) Glucosuria B) Cirrhosis C) E. coli D) Acute inflammation of urinary organs due to disease E) Increased permeability of filtration membranes due to injury (albuminuria) Answer: E Rational p.1095 on table 26.6, it states that albuminuria is in which there is a presence of excessive albumin in the urine which could mean an increase in permeability of the filtration membranes. 12. The volume of blood that is cleaned or cleared of a substance per unit of time is A) Renal plasma flow B) Inulin C) Renal plasma clearance D) Countercurrent exchange E) Filtration Answer: C Rational is found on p.1094 on renal plasma clearance. It cannot be Inulin because that is the plant polysaccharide that easily passes the filter and is not reabsorbed or secreted. Countercurrent exchange is the process by which solutes and water are passively exchanged between the blood of the vasa recta and interstitial fluid of the renal medulla. Filtration is the general process in which water and small solutes are able to pass through the capillaries and into the renal capsule before going on to the renal tubule and collecting ducts (p. 1077). Renal plasma flow is the amount of plasma that passes through the kidneys in one minute. 13. Each of the two ureters transports urine from the ________ of one kidney to the urinary bladder. A) Internal urethral orifice B) Renal pelvis C) Trigone D) Detrusor muscle E) Micturition center Answer: B Rational is found on p.1096 the first paragraph underneath ureters. Internal urethral orifice is the opening into the urethra (1097). Trigone is the small triangular area in the floor of the urinary bladder, Detrusor muscle which is also the muscularis that surrounds the mucosa of the urinary bladder. Micturition center is within the sacral spinal cord segments S2 and S3 that trigger the micturition reflex which allows urination. 14. The ________ is a hollow, distensible organ situated in the pelvic cavity posterior to the pubic symphysis. A) Uterus B) Vas deferens C) Urinary bladder D) Trigone E) Urethra Answer C Rational is found on p.1097, the first paragraph of the urinary bladder. The uterus is only present in females and is part of the reproductive system, vas deferens is a duct which is a part of the reproductive system that conveys sperm during sexual arousal (p. 1138). Trigone is the floor of the urinary bladder and the urethra is the small tube leading from the internal urethral orifice to the exterior of the body (1099) 15. High levels of ________ may indicate diabetes mellitus, anorexia, starvation or too little carbohydrate in diet. A) Glucose B) Erythrocytes C) Bilirubin D) Ketone bodies E) Microbes Answer D Rational is found on p.1095, on table 26.6. Glucose while is a sign closely associated with diabetes mellitus it is not present in anorexia or starvation. Erythrocytes (blood cells) could me kidney disease, menstrual blood, or tumors. Bilirubin within urine could state bilirubinuria which could state a disease/disorder and Microbes within the urine could mean urinary tract infections. Pages 1096 – 1109 16. Out of the following procedures, which can be used to evaluate urinary bladder problems like cancer and infections? A) Intravenous Pyelogram B) Polyuria C) Cystoscopy D) Peritoneal Dialysis E) Kidney Transplant Rational: Page 1097 – clinical connection; Intravenous Pyelogram is a radiograph of the kidneys, ureters, and urinary bladder. Polyuria is excessive urine formation, peritoneal dialysis is in which the peritoneum of the abdominal cavity is used as the dialysis membrane to filter the blood. Kidney transplants are the removal of the disease kidney and are replaced with a donor’s. 17. Of the following, which is NOT true about the ureters? A) They are retroperitoneal like the kidneys B) Curve medially and pass obliquely through the wall of the posterior aspect of the urinary bladder. C) Has a physiological valve that compresses the oblique openings into ureters and prevents the backflow of urine. D) They have anatomical valves, like veins or the heart that help prevent backflow of urine and shunt the urine into the ureters E) Has three layers of tissues; mucosa, lamina propria, and muscularis (including the adventitia Rational: page 1096, ureter’s first, second, and third paragraphs (as well as fourth) all of the follow is true but anatomical valves. 18. Which of the following is not an effect of aging with the urinary system? A) Both kidneys shrink in size as one ages B) Both kidneys increase in size throughout the years C) Kidneys have decreased blood flow D) The kidneys filter less blood E) Blood vessels could become easily damaged or decrease in number over the years Rational: Page 1103, Aging and the Urinary System. All the following are true but as with age, both kidneys shrink in size instead of increase in size (unless there is a disease or disorder stating otherwise). 19. Which type of function does not belong with its specific waste management system? A) Body Buffers – fluids bind excess hydrogen ions, which prevent an increase in the acidity of body fluids B) Blood – Provides pickup and delivery of wastes as well as oxygen and CO 2 C) Liver – the site for metabolic recycling (amino acids into glucose) as well as conversion of toxins to less toxic ones D) Sudoriferous Glands – through the sweat we eliminate excess CO2, heat and water, including small amounts of salts and urea. E) Gastrointestinal Tract – through micturition AND defecation, the GI tract excretes not only solids, undigested foods, and wastes, but; some water, salt, and heat are managed. Rational: Page 1100, Focus on Homeostasis. All of the following are true but the Gastrointestinal Tract, since it is only responsible for defecation and absorption of nutrients. 20. Of the following, which is NOT a contribution of the urinary system to the other systems? A) Along with the gastrointestinal tract, the kidneys help play a part in the final absorption process before eliminating the wastes through urine. B) Kidneys participate in synthesis of calcitriol and release erythropoietin C) Along with the lungs, kidneys adjust the pH of body fluids D) Kidneys also help adjust the blood calcium, which is needed for muscle contractions E) Kidneys regular the volume, composition, and pH of body fluids by removing wastes and excess substances through the urine Rational: P. 1102, Focus on Homeostasis. All of the following are true but the urinary system does NOT have any absorption processes. It merely reabsorbs then secretes the fluids as urine. 21. What is the significance of the absence of Na+ pumps in apical membranes? A) It ensures that reabsorption of Na+ is a one way process B) It ensures that no absorption of Na+ takes place. C) To help reduce the energy used by the Na+ and K+ pumps. D) It ensures that reabsorption of Na+ and K+ is a two way process. E) To increase the energy used by Na+ and K+ pumps. Rational: p. 1083, left column second paragraph, it states that the absence of sodium-potassium pumps in the apical membranes ensures that reabsorption of Na+ is a one way process. Most sodium ions that cross the apical membrane will be pumped into interstitial fluid at the base and sides of the cell. There has to be reabsorption of Na+ so B is wrong. Energy is neither reduced nor increased by Na+ and K+ pumps because it only uses about 6% of the total ATP consumption of the body. (C and E are wrong) Reabsorption of Na+ is only a one way process and not a two way process between Na+ and K+. 22. Where specifically in the kidney does the largest amount of reabsorption take place? A) Within the Glomerulus B) Proximal Convoluted tubules C) Loop of Henle D) Medulla of the Kidneys E) Distal Convoluted Tubules Rational: p. 1081 states that the volume of fluid entering the proximal convoluted tubules is where reabsorption takes place and that this is where they have the largest contribution of reabsorption. It is not located within the glomerulus (p. 1069) that is the ball-shaped capillary network that is a part of the glomerular filtration. Loop of Henle is where the proximal and distal convoluted tubules meet and where they receive the blood supply from the peritubular capillaries or the vasa recta within the juxtamedullary nephrons. Medulla of the kidneys holds the juxtamedullary nephron’s Loop of Henle and makes up only 15% of the total nephrons found within the kidneys. (p. 1073) distal convoluted tubules have some reabsorption (p 1093) but it transports the fluid into the collecting ducts where it will be excreted as urine. 23. What is a symporter? A) Primary active transporters that moves two or more substances in opposite directions across a membrane. B) Primary active transporters that moves two or more substances in the same direction across a membrane. C) Secondary active transports that move two or more substances in the opposite direction across a membrane. D) Secondary active transporters that move two or more substances in the same direction across a membrane. E) An active transporter that moves only one substance in one direction against its gradient. Rational: on p. 1083 it states that Primary active transporters get energy from the hydrolysis of ATP used to “pump” a substance across its membrane. Na+/K+ pumps are examples (which is NOT a symporter) Secondary active transporters are broken down into Symporters and Antiporters; Symporters move two or more substances in the same direction across a membrane and Antiporters move two or more substances in different directions across the membrane. 24. Which of the following is false in how Angiotensin II affects the renal physiology? A) It decreases the glomerular filtration rate by causing vasoconstriction of the afferent arterioles. B) It enhances reabsorption of Na+, Cl-, and water in the proximal convoluted tubules by stimulating the activity of Na+/H+ antiporters. C) Stimulates the release of Aldosterone D) Stimulates the principal cells in the collecting ducts to reabsorb more Na+ and Cl- and to secrete more K+ E) Causes an increase in blood volume and blood pressure systemically. Rational: p. 1087 A, B, C, and E are all true in regards to how Angiotensin II affects not only the renal physiology but the body as a whole. Stimulating the principal cells in the collecting ducts is what Aldosterone does, not Angiotensin II. 25. Of the following hormones, which controls whether or not urine is diluted or concentrated? A) Aldosterone B) Angiotensin II C) Atrial natriuretic peptide (ANP) D) Parathyroid Hormone (PTH) E) Antidiuretic Hormone (ADH)/Vasopressin Rational: on p. 1088 and 1089 it states that ADH controls whether dilute or concentrated urine is formed. In the absence of such urine is very dilute and in high levels of ADH stimulation of reabsorption of more water in the blood causes more concentrated urine. Aldosterone simply increases secretion of K+ and reabsorption of Na+/Cl- which in turn increases water and blood volume/blood pressure. Angiotensin II increases reabsorption of Na+ and other solutes (including water) which increases blood pressure and blood volume. Parathyroid hormone only increases the reabsorption of Ca 2+ while ANP increases urine output, excretion of Na+ and decreases blood volume/pressure. Chapter 27 Questions BichHong Do, Lu Wang, Margot Garrido, Brittney Collins, Erin Hamilton, Abel Silacan Essay choices: Detail the various regulations of the body (dehydration, renal Na and Cl reabsorption, blood pH) - see pages 1113 and 1121 Blood electrolyte Imbalances, page 1119 1. Which of the following is not a function of the ions that are formed during dissociation of electrolytes? a.) Carrying electrical current and producing action potentials and graded potentials b.) Cofactors for enzyme activity c.) Increasing polarity of cellular molecules allowing for easy transport within blood d.) Controlling the osmosis of water between fluid compartments e.) Maintaining the acid-base balance The answer can be found on page 1115, first paragraph beneath the section title for 27.2. It is listed in the text that ions formed when electrolytes dissolve and dissociate serve four general functions. “A” is true because ions carry electrical current. “B” is true because as we have seen before, ions do serve as cofactors. A famous example is iron, which is a cofactor of cytochrome of the heme group in red blood cells. “D” is true because ions are confined to fluid compartments and are more numerous than nonelectrolytes. “E” is true because according to acid-base theory, positive and negative ions affect pH. Obviously, “C” is the right answer and not a function of ions because blood transport has nothing to do with ion polarity. 2. For which of these ions does the value of mEq/liter not equal to the number of mmol/liter? a.) Bicarbonate b.) Sodium c.) Potassium d.) Phosphate e.) Chloride The answer can be found at the end of page 1115 and the beginning of page 1116. The number of mEq/liter is equal to the number of mmol/liter for ions with a single positive/negative charge and mEq/liter is twice the number of mmol/liter for ions with two positive or negative charges. Thus answer “D” phosphate is the only one that has a charge of two and the only one in which the value of mEq/liter not equal to mmol/liter. 3. Which of the following is not true of bicarbonate ions? a.) They are the second most prevalent extracellular anions b.) They exchange with sodium ions to maintain the balance of ions in extracellular fluid c.) The concentration of bicarbonate ions increases as blood flows through systemic capillaries d.) Kidneys are main regulators of bicarbonate concentration e.) Concentration of bicarbonate decreases as carbon dioxide is exhaled The answer can be found on page 1117 on the bicarbonate section. All of the other answers were mentioned within the text. The reason “B” is wrong and thus the answer is because bicarbonate exchanges with chloride ions, not sodium ions. 4. Which of the following is most abundant in extracellular fluids? a.) Na+ b.) K+ c.) Mg2+ d.) HPO42e.) Protein anions The answer is on page 1116, on figure 27.6. All of the answers are abundant in intracellular fluid EXCEPT for sodium, which is more abundant in extracellular fluid. 5. These people are all at risk for fluid and electrolyte imbalances excepta.) Infants b.) Military personnel c.) Athletes d.) Diabetics e.) Young Adults The answer is on page 1118, in the last paragraph on the left. It says that people at risk for fluid imbalances are those who depend on other for fluid and food- answer “A”; those who are in extremely hot environments- answer “B” and “C”; and those who are chronic diseases- answer “D”. Thus “E” is the right answer because young adults are not at risk for fluid imbalances. 6. Interstitial Fluid can be found in all of the following EXCEPT: A. lymph B. cerebrospinal fluid C. plasma D. synovial fluid E. aqueous humor Plasma is extracellular fluid, not interstitial fluid. Interstitial fluid makes up 80% of ECF; plasma a mere 20%. (1111) 7. Which is a way that water is gained in the body? A. Ingestion of solid food B. Absorbed via diffusion from the small intestine C. Electrons accepted by oxygen during anaerobic cellular respiration D. Dehydration synthesis reactions E. Menstrual flow Dehydration synthesis reactions are a way to gain water through metabolic synthesis. (1112) 8. Most solutes are: A. K+ B. Electrolytes C. Monosaccharides D. Organic compounds E. In dilute urine Most solutes are electrolytes, inorganic compounds, that dissociate into ions. (1112) 9. Water is exits the body through all of the following except: A. Kidneys excrete urine B. Skin secretes sweat C. Lungs exhale water vapor D. Small intestine excretes feces E. Menstrual cycle D would be correct if it said the “GI tract” in lieu of “small intestine.” (1112) 10. The thirst center in the __________ governs the urge to drink. A. Thalamus B. Osmoreceptors C. Pituitary gland D. Parathyroid E. Hypothalamus The answer to this question is found on page 1112. 11. In which of these compartments is Na+ concentration the lowest? A. interstitial fluid B. plasma C. intracellular fluid D. lymph E. extracellular fluid (Reference: Page 1111) 12. All of these are effects of antidiuretic hormone EXCEPT A. increased water reabsorption in the distal convoluted tubules collecting ducts B. reduced urine osmolarity C. increased permeability of the distal convoluted tubules and collecting ducts to water D. reduced urine output E. increased urine osmolarity (Reference: Page 1113) 13. Which condition is caused by water output exceeding water intake? A. water intoxication B. ADH hyposecretion C. dehydration D. increased blood volume E. decreased blood volume (Reference: Page 1112) 14. Body water is lost through each of these organs EXCEPT the A. Kidneys B. Lungs C. Skin D. Muscles E. Urine (Reference: Page 1112) 15. Which buffer system is an important regulator of pH in the cytosol of a cell? a. Protein buffer system b. Phosphate buffer system c. Carbonic buffer system d. Ammonia buffer system e. Carbonate buffer system P.1121- Because the concentration of phosphates is highest in the intracellular fluid, the phosphate buffer system is an important regulator of pH in cytosol. 16. What mechanism results in the elimination of acids other than carbonic acid from the body? a. Exhalation of carbon dioxide b. Potein buffer system c. Kidney excretion of hydrogen ions d. Phosphate buffer system e. carbonic acid-bicarbonate buffer system p1118- The excretion of hydrogen ions is the only way to eliminate acids other than carbonic acid. Buffer systems can make a strong acid or strong base weaker but do not eliminate the acid or base. 17. Where does the normal systemic arterial blood pH fall? a. Between 7.35 and 7.45 b. Between 7.25 and 7.35 c. Between 7.45 and 7.55 d. Between 7.15 and 7.25 e. Between 7 and 7.10 P 1118- Normal blood pH falls between 7.35 and 7.45. Maintenance of this level is critical normal cellular function 18. What characteristic of the typical American diet has the potential to increase the acidity of the blood? a. High fat content b. High sugar content c. High sodium content d. High protein content e. High fiber content P1118- Proteins have a three dimensional shape and are very sensitive to pH changes. A diet high in protein results in cellular metabolism producing more acids than bases. 19. What component of proteins act like an acid when pH rises by releasing hydrogen ions? a. Amino group b. Carbon c. Hydrogen d. Carboxyl group e. Carbonic Acid P 1120- The carboxyl group releases hydrogen ions that are then able to react with any excess hydroxide ions and form water. 20. Which of the following are not related to aging and fluid electrolyte and acid base balance? A. Metabolic Rate B. Body surface Area C. Dehydration and hypematermia D. Functional development of the kidneys E. Proportion and distribution of water P.1125 The differences are related to the following conditions: Proportion and distribution of water, metabolic rate, functional development of the kidney, body surface area, breathing rate, and ion concentration. Metabolic rate- metabolic rate of infants is about double that of adults. This can results in the production of more metabolic wastes and acid. Body Surface Area- the ratio of body surface area to body volume of infants is about three times greater than that adults. Breathing rate- the higher breathing rate of infants causes greater water loss from the lungs. Ion concentration- newborns have higher K+ and CL- concentration than adults. 21. What decreased HCO3 and decreases PH below 7.35 if no compensation? A. Respiratory Alkalosis B. Metabolic Acidosis C. Metabolic Alkalosis D. Respiratory Acidosis E. Acidosis P.1125 Respiratory alkalosis- decreased Pco2 and increased pH if no compensation Metabolic Acidosis- decreased HCO3 and decreased Ph if no compensation Metabolic Alkalosis- increased HCO3 and increased pH if no compensation Respiratory Alkalosis- increased HCO3 and increased pH if no compensation Acidosis-May occur due to impaired ability of the lungs and kidney to compensate for acid- base imbalances. 22. Which of the following disorders are not age related change in adults and electrolyte? A. Dehydration and hypernatremia B. Hyponatremia C. Hypokalemia D. Iron concentration E. Acidosis p.1125 Dehydration and hypernatremia often occur due to inadequate fluid intake or loss of more water than Na in urine. Hyponatremia- may occur due to inadequate intake of Na elevated loss of na in urine, vomit, or diarrhea. Hypokalemia- often occurs in older adults who chronically use laxatives to relieve constipation or who take K+ depleting diuretic drugs for treatment of hypertension or heart disease. Iron concentration- newborns have higher K+ and cl concentrations than adults. Acidosis- may occur due to impaired ability of the lungs and kidney to compensate for acid base imbalances. 23. This is often occurs in older adults who chronically use laxatives to relieve constipation or who take K+ depleting diuretic drugs for treatment? A. Hypokalemia B. Hyponatremia C. Hypernatremia D. Hyperokalenmia E. Hypertension P.1125 Hyponatremia- may occur due to inadequate intake of Na elevated loss of na in urine, vomit, or diarrhea. Hypokalemia- often occurs in older adults who chronically use laxatives to relieve constipation or who take K+ depleting diuretic drugs for treatment of hypertension or heart disease. Hypertension- High blood pressure Hypernatremia - often occur do to inadequate fluid intake or loss of water than na. 24. ______________ is the physiological response to acid-base imbalance that acts to normalized arterial blood pH. A. Compensation B. Renal compensation C. Respiratory compensation D. Brain compensation E. Monetary compensation Rationale: (p.1123 under Acid-base imbalances) B. Renal compensation is a form of compensation and term used when hyperventilation or hypoventilation help bring blood pH back to normal. C. Renal compensation is the changes in secretion of hydrogen ions and reabsorption of bicarbonate. D and E they are made up choices 25. Decrease movement of CO2 from the blood to the alveoli of the lung to the atmosphere causes the buildup of the following elements EXCEPT. (p.1123 under respiratory acidosis) A. CO2 B. HPO4-2 C. H2CO3 D. H+ E. None of the above Rationale: (p.1122 under kidney excretion of H+) B. HPO4-2(Monohydrogen phosphate ions) is the most plentiful buffer in the tubular fluid of the collecting duct. 26. What is the important regulator of blood pH and the most abundant buffer in the extracellular fluid? A. Protein B. Phosphates C. Kidneys D. Buffer system E. Carbonic acid-bicarbonate (p.1123 under table 27.3) Rationale (p.1123 table 27.3) A. protein is the most abundant buffer in body cell and blood. B. Phosphates important buffer in intracellular fluid and urine. C. Kidneys - renal tubules secretes H+ into urine and reabsorb HCO3 so it is not lost in urine. D. Buffer system is consist most of a weak acid and its salt, which function as a weak base. They prevent drastic changes in body fluid changes. 27. What is the MOST frequent cause of metabolic alkalosis? A. vomiting/loss of hydrochloric acid (p.1124 above clinical connection) B. Certain diuretics C. Severe dehydration D. Taking antacid E. Endocrine disorder Rationale: B,C,D,E are other causes of metabolic disorder but the most frequent cause of metabolic alkalosis is vomiting/loss of hydrochloric acid. 28. Is an acid-base imbalance where systemic arterial blood Pco2 drop below 35 mmHg. A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory Alkalosis (p.1123) D. Respiratory acidosis E. Alkalosis Rationale (p.1123) A. Metabolic Acidosis systemic arterial blood HC03 drops below 22mEq/liter. B. Metabolic alkalosis systemic arterial blood HCO3 concentration is above 26mEq/liter. D. Respiratory acidosis is an abnormally high Pco2 in systemic arterial blood- above 45mEq/liter. E. Alkalosis is a condition in which blood pH is higher than 7.45 REPRODUCTIVE SYSTEM - CHAPTER 28 QUESTIONS AMANDA HUYNH, TUYEN PHAM, NGOC VU, AND ALBA Which hormone initiates the changes in puberty? (page 1160) FSH ICSH Testosterone GnRH (beginning the cycle) LH Which hormone thickens the lining of the uterus? FSH (stimulate seminiferous tubules) Estrogen LH ICSH Progesterone (increase glycogen) Which hormone causes the uterus to increase glycogen? (page 1160) Progesterone FSH LH Estrogen GnRH The shedding and bleeding of the deciduas during menses is directly caused by low level of ____ (Page 1161) FSH LH Sex steroids (estrogen) GnRH ICSH The mature follicle is also called a _______________ (Page 1161) Graafian follicle Granulosa cell Primary follicle Secondary follicle Stromal cell During ovulation, the oocyte passes into the __________ Uterine tube Uterus Ovary Urethra Cervical canal Which of these is NOT a function of ESTROGEN?( page 1161) Decrease adipose (increase adipose, secondary female sex characteristic) Breast development Increase skin blood vessels Enlarge clitoris Increase blood cholesterol level What area experiences the greatest changes in a menstrual cycle? Vagina Perimetrium Cervix Endometrium Uterus Which factor causes the act of ovulation? Blood pressure LH level (causes ovulation) FSH level (begins follicle development) Estrogen Testosterone Where is the majority of progesterone produced? Graafian follicle Corpus luteum Secondary follicle Adrenal cortex Primordial follicle Which hormone is produced throughout the menstrual cycle? (page 1161) FSH LH Estrogen Progesterone Oxytocin Which factor will inhibit the secretion of estrogen? (page 1161) FSH (rising levels of estrogen cause an inhinition of FSH production by negative feedback) LH Estrogen Progesterone Testosterone Which factor is will inhibit LH secretion? FSH Progesterone Estrogen (inhibit FSH) LH(inhibit by increase estrogen) ADH Which structure is formed following ovulation? Graafian follicle Secondary oocyte Corpus luteum Coronal radiate Primary follicle All of the following are true about breast cancer treatment EXCEPT: (page 1172) Staging which shows the size and spread of malignancy Identifying the present of BCRA (Breast cancer tumor marker) predicting risk for optimum treatment (this is screening for breast cancer not a treatment phase) Performing breast sparing surgery (lumpectomy) Incorporating chemotherapy as an adjunct to surgery Hormone therapy Which statement is true regarding to testosterone level? Increase risk of prostate cancer Little or no libido can indicate the sign of low testosterone Testosterone promotes aggregation and violence Abstinence increases testosterone level in men Increase during female puberty AIDS virus can be transmitted under specific condition and through infected bodily fluid EXCEPT: Blood Feces Semen Plasma Breast milk The most effective method of treating HIV virus is targeted at limiting replication of cells by the administration of which type of medication? Antifungal Antiretroviral Antiviral Antibiotic Antidepressant Which statement is true about breasts and their functions: page 1158 Breasts are supported by and attached to the chest wall, resting on the scapular chest muscle. The ejection of milk is stimulating by prolactin hormone The areola deliver milk via the opening of the nipple Fibrosis, cyst, mastitis contribute more than 70% added risk to developing breast cancer The major hormones affecting breast are progesterone, estrogen, and prolactin About half of people who become infected with HIV are: Develop abnormal discharge from penis and vagina within a few days Experience flu-like symptoms within a few weeks Develop a rash within 3-10 days Develop genital warts (Genital herpes not HIV infected patients) Develop chancre during primary stage (Syphilis not HIV) At what age, the hormone-directed changes start to occur? (page 1170) 15 10 12 18 21 The puberty is marked by _______________(page 1170) Pulse or burst of ADH Pulse or burst of Hgh Pulse or burst of TSH Pulse or burst of LH &FSH Pulse or burst of ACTH &MSH Which section of the brain the leptin may signal for reproductive function? Cerebellum Medulla oblongata Pituitary Gland Hypothalamus Thalamus Which method is 100% reliable for preventing pregnancy? (page 1165) Surgical sterilization Spermicides Hormonal methods Complete abstinence Period abstinence All of the following are the benefits of oral contraceptives, EXCEPT: Regulation the length of menstrual cycle Reduce hypertension Decrease menstrual flow Reduce the risk of endometriosis Provide protection , endometrial, ovarian cancer Which method can provide the protection against sexual transmitted disease (STDs) Intrauterine device (IUD) Spermicides Hormonal therapy Barrier method (practice safe sex) Oral contraceptives All of the following are true about oral contraceptive , EXCEPT: Contains hormones designed to prevent pregnancy COCs action is to inhibit ovulation by suppressing the gonaldotropins hormones FSH and LH Block implantation in the uterus Inhibit the transportation of sperm and ova in the uterine tubes Contains estrogen and progesterone, act by inhibiting FSH and LH (page 1166) All embryos have the following external structure, EXCEPT: (page 1169) Urethra grove Clitoris Genital tubercle Labioscrotal swelling Urethral (urogenital) folds Which of the following hormone that combined oral contraceptives (COCs) suppress in order to prevent pregnancy? (Page 1166) Progesterone and estrogen FSH %LH Testosterone Prolactin and oxytocin Inhibin and relaxin Which of the following is NOT the result of menopause? Increase bone mineral density Decline production of estrogen Insomnia Atrophy of ovaries and breasts The tip of the sperm is called the________________ Head Acrosom Tail Progesterone is secreted from a female’s ____________ to help the implanted embryo and continue the pregnancy: Corpus luteum (progesterone, estrogen, inhibin, relaxin) Mesoderm Endoderm Thyroid Ovary (estrogen) Ovulation occurs in which of the following phase? (page 1162 fig 28.24) Menstrual Secretory Proliferation Follicle Postovulatory phase Where does spermatogenesis occur? Seminiferous tubules Corpus spongiosoma Prostate gland Scrotum Epididymis Where does fertilization occur? Page1151 Ovaries Vagina Fallopian tubes (ampulla of uterine tubes) Infundibulum Urethra Which of the following anchor the ovary to the pelvic wall? (page 1143) Broad ligament Suspensory ligament Mesovarium Ovian ligament Hilum Which muscles responses to the regulation of temperature of the testes? Page1130 Bulbospongiosus muscle Dartos and cremaster muscles Gluteus maximus muscle Ischiocavernosus Multifidus