18 Oct The Urinary System

The Urinary System

 

1. In life threatening starvation, the kidneys synthesize glucose by           .

 

A. secreting erythropoietin

 

B. secreting renin

 

C. deaminating amino acids

 

D. contributing to calcium homeostasis

 

E. producing uric acid

 

2. A byproduct of protein catabolism,     constitutes approximately one-half of all nitrogenous waste.

 

A. urea

 

B. creatinine

 

C. uric acid

 

D. azotemia

 

E. ammonia

 

3. Which organ system excretes nitrogenous wastes?

 

A. The urinary system

 

B. The cardiovascular system

 

C. The integumentary system

 

D. The digestive system

 

E. The respiratory system

 

4. Which organ system does not excrete waste?

 

A. The urinary system

 

B. The cardiovascular system

 

C. The integumentary system

 

D. The digestive system

 

E. The respiratory system

 

5. Which of the following is not a function of the kidneys?

 

A. They regulate osmolarity of the body fluids.

 

B. They fight osteoporosis by synthesizing vitamin D.

 

C. They help control blood pressure.

 

D. They release waste into the bloodstream.

 

E. They indirectly increase oxyhemoglobin.

 

6. The    is not an organ of the urinary system.

 

A. urethra

 

B. liver

 

C. ureter

 

D. urinary bladder

 

E. kidney

 

7. Which of the following is not true about the anatomy of the urinary system?

 

A. The kidneys are retroperitoneal.

 

B. The ureters connect the kidneys to the urinary bladder.

 

C. The urethra of males is longer than the urethra of females.

 

D. The kidneys are at equal heights within the pelvic cavity.

 

E. The right kidney is located more inferiorly than the left kidney.

 

8. The medial concavity of the kidney is called the            , which admits the renal nerves, blood vessels, lymphatic vessels, and ureter.

 

A. medulla

 

B. corpuscle

 

C. cortex

 

D. hilum

 

E. capsule

 

9. 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

 

0. The    innervation of the kidneys reduces urine production, while the function of its     innervation is unknown.

 

A. sympathetic; parasympathetic

 

B. parasympathetic; sympathetic

 

C. central; peripheral

 

D. peripheral; central

 

E. enteric; somatic

 

11. The innermost connective tissue layer protecting the kidney and assisting in staving off infection isknown as the       .

 

A. perirenal fat capsule

 

B. renal fascia

 

C. hilum

 

D. fibrous capsule

 

E. renal medulla

 

12. A single lobe of a kidney is comprised of        .

 

A. two calyces and a renal pelvis

 

B. one pyramid and the overlying cortex

 

C. one major calyx and all of its minor calyces

 

D. a renal medulla and two renal columns

 

E. one collecting duct and all nephrons that drain into it

 

13. A renal pyramid voids urine into the .

 

A. minor calyx

 

B. major calyx

 

C. renal medulla

 

D. renal papilla

 

E. ureter

 

14. Which of the following correctly traces blood flow from the renal artery into the renal cortex?

 

A. Arcuate a. ? interlobar a. ? afferent arteriole ? interlobular a.

 

B. Interlobar a. ? interlobular a. ? segmental a. ? arcuate a.

 

C. Segmental a. ? interlobar a. ? arcuate a. ? interlobular a.

 

D. Afferent arteriole ? interlobular a. ? arcuate a. ? interlobar a.

 

E. Segmental a. ? arcuate a. ? interlobar a. ? interlobular a.

 

15. The transition from an afferent arteriole to an efferent arteriole occurs in the             .

 

A. glomerulus

 

B. medulla

 

C. cortical radiate veins

 

D. peritubular capillaries

 

E. vasa recta

 

16. The average person has approximately          nephrons per kidney.

 

A. 1.2 million

 

B. 2.4 million

 

C. 3.6 million

 

D. 4.8 million

 

E. 5.6 million

 

17. Which of the following correctly traces blood flow from the renal cortex to the renal vein?

 

A. Interlobular v. ? interlobar v. ? segmental v. ? renal v.

 

B. Arcuate v. ? interlobar v. ? segmental v. ? renal v.

 

C. Interlobar v. ? interlobular v. ? arcuate v. ? renal v.

 

D. Segmental v. ? arcuate v. ? interlobar v. ? renal v.

 

E. Interlobular v. ? arcuate v. ? interlobar v. ? renal v.

 

18. Blood plasma is filtered in the             .

 

A. renal tubule

 

B. renal corpuscle

 

C. renal capsule

 

D. renal column

 

E. renal calyx

 

19. Which of the following form the inner layer of the glomerular capsule and wrap around the capillaries of the glomerulus?

 

A. Macula densa cells

 

B. Mesangial cells

 

C. Nephrocytes

 

D. Podocytes

 

E. Monocytes

 

20. Which of the following is not composed of cuboidalepithelium?

 

A. The thin segment of the nephron loop

 

B. The thick segment of the nephron loop

 

C. The collecting duct

 

D. The proximal convoluted tubule

 

E. The distal convoluted tubule

 

21. Which of the following are primarily responsible for maintaining the salinity gradient of the renal medulla?

 

A. Cortical nephrons

 

B. Juxtamedullary nephrons

 

C. Collecting ducts

 

D. Proximal convoluted tubules

 

E. Distal convoluted tubules

 

22. In the nephron, the fluid that immediately precedes urine is known as           .

 

A. plasma

 

B. glomerular filtrate

 

C. tubular fluid

 

D. renal filtrate

 

E. medullary filtrate

 

23. 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

 

24. In a healthy kidney, very little             is filtered by the glomerulus.

 

A. amino acids

 

B. electrolytes

 

C. glucose

 

D. vitamins

 

E. protein

 

25. Which of the following would reduce the glomerular filtration rate?

 

A. Vasoconstriction of the efferent arteriole

 

B. A drop in oncotic pressure

 

C. Vasodilation of the afferent arteriole

 

D. Vasoconstriction of the afferent arteriole

 

E. An increase in osmotic pressure in the glomerular capsule

 

 

 

26. The mechanism of stabilizing the GFR based on the tendency of smooth muscle to contract when stretched is known as                .

 

 

 

 

 

A. renal autoregulation

 

B. the myogenic mechanism

 

C. tubuloglomerular feedback

 

D. sympathetic control

 

E. the renin-angiotensin-aldosterone mechanism

 

27. In response to a drop in overall blood pressure,         stimulates constriction of the glomerular inlet and even greater constriction of the outlet.

 

A. azotemia

 

B. sodium chloride

 

C. parathyroid hormone

 

D. aldosterone

 

E. angiotensin II

 

28. 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

 

29. Renin hydrolyzes angiotensinogen, which is released from the           , to form angiotensin I.

 

A. lungs

 

B. kidneys

 

C. liver

 

D. heart

 

E. spleen

 

30. Because of the great deal of active transport that occurs here, the    of one’s nephrons collectively account for about 6% of one’s daily resting ATP and caloric consumption.

 

A. proximal convoluted tubules

 

B. distal convoluted tubules

 

C. loops of Henle

 

D. collecting ducts

 

E. glomeruli

 

31. Which of the following is not reabsorbed by the proximal convoluted tubule?

 

A. Potassium

 

B. Sodium chloride

 

C. Hydrogen ions

 

D. Urea

 

E. Water

 

32. 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

 

33. Which of the following is a direct result of antidiuretic hormone?

 

A. Decreased urine volume

 

B. Decreased urine molarity

 

C. Increased urine volume

 

D. Increased urine salinity

 

E. Increased urine acidity

 

34. Aldosterone acts on the        .

 

A. proximal convoluted tubule

 

B. medullary portion of the collecting duct

 

C. descending limb of the nephron loop

 

D. distal convoluted tubule

 

E. glomerulus

 

35. Natriuretic peptide inhibits   reabsorption by the collecting duct, which           urine output.

 

A. K+; increases

 

B. NaCl;

 

decreases

 

C. NaCl; increases

 

D. K+; decreases

 

E. Ca2+; increases

 

36. In the thick segment of the ascending limb of the nephron loop, K+ reenters the cell from the interstitial fluid via the                . K+ is then secreted into the tubular fluid.

 

A. Na+-K+ pump

 

B. countercurrent multiplier

 

C. countercurrent exchange

 

D. vasa recta

 

E. juxtaglomerular apparatus

 

37. Which of the following is not a method by which natriuretic peptides reduce blood volume and pressure?

 

A. Increasing glomerular filtration rate

 

B. Inhibiting renin and aldosterone secretion

 

C. Inhibiting the action of ADH on the kidney

 

D. Inhibiting NaCl reabsorption by the collecting duct

 

E. Preventing sodium loss in the urine

 

38. Hypocalcemia stimulates       .

 

A. a decrease in aldosterone production

 

B. secretion of parathyroid hormone

 

C. secretion of renin

 

D. an increase in blood urea nitrogen

 

E. vasoconstriction of the afferent arterioles

 

39. 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

 

40. The urine is most likely to be hypotonic when the     .

 

A. body’s water volume is high

 

B. body’s pH is low

 

C. output of antidiuretic hormone is high

 

D. output of natriuretic peptides is high

 

E. person is lost and deprived of drinking water

 

41. Which of the following does not contribute to water conservation?

 

A. The collecting duct

 

B. The countercurrent multiplier

 

C. The countercurrent exchange system

 

D. Diuretics

 

E. The length of the nephrons

 

42. The countercurrent multiplier recaptures      and is based on fluid flowing in the           direction in two adjacent tubules.

 

A. potassium; same

 

B. calcium; opposite

 

C. calcium; same

 

D. sodium; opposite

 

E. sodium; same

 

43. The overall purpose of the countercurrent exchange system is to      .

 

A. supply salt and urea to the renal medulla

 

B. supply nutrients and oxygen to the renal cortex

 

C. supply nutrients and oxygen to the renal medulla

 

D. remove metabolic wastes from the renal cortex

 

E. remove metabolic wastes from the renal medulla

 

44. 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

 

45. Normal urine from a healthy person should not contain          .

 

A. creatinine

 

B. urobilin

 

C. glucose

 

D. ammonia

 

E. magnesium

 

46. The pigment responsible for the color of urine is called           .

 

A. monochrome

 

B. urochrome

 

C. cyanochrome

 

D. multichrome

 

E. pyuria

 

47. To meet the definition of polyuria, the minimum daily output of urine is         .

 

A. 0.5 L

 

B. 1.0 L

 

C. 1.5 L

 

D. 2.0 L

 

E. 3.0 L

 

48. Prior to chemical tests for glycosuria, clinicians checked for sweetness of the urine as a sign of

 

 A. diabetes insipidus

 

B. acute glomerulonephritis

 

C. diabetes mellitus

 

D. renal calculus

 

E. pyelitis

 

49. Loop diuretics reduce body water content by acting on the   .

 

A. feedback loop between the kidney and posterior pituitary gland

 

B. countercurrent multiplier system

 

C. countercurrent exchanger system

 

D. aquaporins of the collecting duct

 

E. thirst mechanism and water intake

 

50. 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%

 

51. 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

 

52. Creatinine has a renal clearance of 140 mL/min. Why is this?

 

A. It is absorbed by the nephron loop.

 

B. It is secreted by the glomerulus.

 

C. It is absorbed by the renal tubules.

 

D. It is secreted by the renal tubules.

 

E. It is produced in the pulmonary tissue.

 

53. Which of the following is not found in the ureter?

 

A. Adventitia

 

B. Two layers of smooth muscle

 

C. Three layers of smooth muscle

 

D. Transitional epithelium

 

E. Skeletal muscle

 

54. The muscle is located in the urinary bladder.

 

A. detrusor

 

B. distractor

 

C. pubococcygeu s

 

D. corpus spongiosum

 

E. corpus cavernosum

 

55. The is not a portion of the urethra.

 

A. external urethral orifice

 

B. internal urethral sphincter

 

C. prostatic urethra

 

D. membranous urethra

 

E. spongy urethra

 

56. Micturition is another term for           .

 

A. the production of nitrogenous wastes

 

B. glomerular filtration

 

C. the countercurrent multiplier process

 

D. inflammation of the urinary bladder

 

E. the elimination of urine

 

True / False Questions

 

57. The ureters pass anterior to the bladder and enter it from below. True   False

 

58. Albuminuria is a common sign of diabetes mellitus.

 

True   False

 

59. Diseases that affect the descending corticospinal tracts may limit inhibition of the sacral somaticmotor neurons and thus could result in urinary incontinence.

 

True   False

 

60. Ethyl (drinking) alcohol stimulates the secretion of ADH, thereby reducing reabsorption by the collecting duct.

 

True   False

 

61. Parathyroid hormone increases phosphate excretion by the proximal convoluted tubule as well as promotes synthesis of calcitriol.

 

True   False

 

62. The countercurrent multiplier mechanism for water conservation was discovered by limiting studies to humans and thus hypothesizing how form determines function.

 

True   False

 

63. The thick segment of the nephron loop is impermeable to water. True   False

 

64. Glomerular filtration occurs because glomerular oncotic pressure overrides glomerular blood pressure. True   False

 

65. Angiotensin-converting enzyme is found only in the kidneys and converts angiotensinogen to angiotensin I.

 

True   False

 

66. Cells in the cleft between the afferent and efferent arterioles and among capillaries of the glomerulus are known as mesangial cells.

 

True   False

 

67. Glomerular capillaries suffer little damage from hypertension because of the protective influence of the afferent arterioles.

 

True   False

 

68. The fenestrated endothelium of the capillary has pores small enough to exclude blood cells from the filtrate.

 

True   False

 

69. The most toxic of our metabolic wastes are nitrogenous wastes. True   False

 

70. Stimulation of sympathetic fibers of the renal plexus increases renal blood flow.

 

True   False