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Chapter 26 Urinary System

front 1

1) The urinary system does all of the following except
A) excreting excess albumin molecules.
B) regulating blood volume.
C) helping to stabilize blood pH.
D) eliminating organic waste products.
E) regulating plasma concentrations of electrolytes.

back 1

A) excreting excess albumin molecules.

front 2

2) Functions of the urinary system include all of the following except
A) regulation of blood volume and blood pressure.
B) regulation of plasma concentration of certain ions.
C) helping to stabilize blood pH.
D) conservation of valuable nutrients.
E) storage of fat-soluble vitamins.

back 2

E) storage of fat-soluble vitamins.

front 3

3) The urinary function of elimination occurs through the
A) liver.
B) glomerulus.
C) kidney.
D) ureter.
E) urethra.

back 3

E) urethra.

front 4

4) Urine is carried to the urinary bladder by
A) blood vessels.
B) lymphatics.
C) the ureters.
D) the urethra.
E) the calyces.

back 4

C) the ureters.

front 5

5) Each of the following organs is part of the urinary system except the
A) kidney.
B) urinary bladder.
C) rectum.
D) ureter.
E) urethra.

back 5

C) rectum.

front 6

6) Urine is temporarily stored in the
A) urethra.
B) urinary bladder.
C) kidney.
D) ureter.
E) trigone.

back 6

B) urinary bladder.

front 7

7) Urine is carried from the urinary bladder to the outside of the body by the
A) urethra.
B) glomerulus.
C) convoluted tubule.
D) ureter.
E) collecting duct.

back 7

A) urethra.

front 8

8) Which of the following activities is not related to kidney function?
A) control of hydrogen ion and pH in the blood
B) control of wastes in the blood
C) lipid digestion
D) regulation of blood pressure
E) maintenance of various blood ion concentrations

back 8

C) lipid digestion

front 9

9) The excretory functions of the urinary system are performed by the
A) urethra.
B) ureters.
C) glomerulus.
D) urinary bladder.
E) kidneys.

back 9

E) kidneys.

front 10

10) When the bladder is full, urine is eliminated through the process known as
A) beta-oxidation.
B) defecation.
C) emesis.
D) micturition.
E) segmentation.

back 10

D) micturition.

front 11

11) A glomerulus is
A) the expanded end of a nephron.
B) a knot of capillaries within the renal corpuscle.
C) the source of erythropoietin.
D) attached to the collecting duct.
E) the horseshoe-shaped segment of the nephron.

back 11

B) a knot of capillaries within the renal corpuscle.

front 12

12) All of the following are true of the kidneys except that they are
A) located in a position that is retroperitoneal.
B) surrounded by a fibrous capsule.
C) located partly within the pelvic cavity.
D) held in place by the renal fascia.
E) covered by peritoneum.

back 12

C) located partly within the pelvic cavity.

front 13

13) The prominent indentation on the medial surface of the kidney is the
A) calyx.
B) pelvis.
C) ureter.
D) hilum.
E) pyramid.

back 13

D) hilum.

front 14

14) The renal sinus is
A) the innermost layer of kidney tissue.
B) part of a renal pyramid.
C) an internal cavity lined by the fibrous capsule.
D) a large branch of the renal pelvis.
E) a renal corpuscle.

back 14

C) an internal cavity lined by the fibrous capsule.

front 15

15) The outermost layer of the kidney is the
A) renal cortex.
B) renal medulla.
C) major calyx.
D) fibrous capsule.
E) renal pelvis.

back 15

D) fibrous capsule.

front 16

16) The cavity of the kidney that receives urine from the calyces is called the
A) renal papilla.
B) renal pelvis.
C) renal medulla.
D) renal cortex.
E) renal sinus.

back 16

B) renal pelvis.

front 17

17) Blood leaves the glomerulus through a blood vessel called the
A) afferent arteriole.
B) efferent arteriole.
C) vasa recta.
D) interlobular arteriole.
E) renal vein.

back 17

B) efferent arteriole.

front 18

18) The condition called ________ is especially dangerous because the ureters or renal blood
vessels can become twisted or kinked during movement.
A) polycystic kidney disease
B) floating kidney
C) pyelonephritis
D) renal calculi
E) renal failure

back 18

B) floating kidney

front 19

19) The ________ delivers urine to a minor calyx.
A) nephron loop (loop of Henle)
B) distal convoluted tubule
C) papillary duct
D) renal corpuscle
E) ureter

back 19

C) papillary duct

front 20

20) Typical renal blood flow is about ________ ml/min under resting conditions.
A) 500
B) 800
C) 1200
D) 1800
E) 2500

back 20

C) 1200

front 21

21) In the renal corpuscle, the visceral layer is a layer of specialized cells called
A) glomerulocytes.
B) juxtaglomerular cells.
C) tubular cells.
D) macula densa cells.
E) podocytes.

back 21

E) podocytes.

front 22

22) What is the proper order for the structures of the renal corpuscle through which a substance travels during filtration?
1. filtration slit (slit pore)
2. capsular space
3. basement membrane
4. fenestrated endothelium
A) 4, 3, 2, 1
B) 4, 1, 2, 3
C) 4, 3, 1, 2
D) 3, 1, 4, 2
E) 2, 4, 3, 1

back 22

C) 4, 3, 1, 2

front 23

23) Capillaries that surround the proximal convoluted tubules are
A) proximal capillaries.
B) corticoradiate capillaries.
C) vasa recta capillaries.
D) efferent arterioles.
E) peritubular capillaries.

back 23

E) peritubular capillaries.

front 24

24) ________ is/are an inflammatory disorder of the glomeruli that affects the filtration mechanism of the kidneys.
A) Glomerulonephritis
B) Floating kidney
C) Polycystic kidney disease
D) Pyelonephrosis
E) Kidney stones

back 24

A) Glomerulonephritis

front 25

25) Glomerulonephritis may occur as a consequence of an infection with the bacterium
A) Clostridium difficile.
B) varicella.
C) Streptococcus.
D) MRSA.
E) Salmonella.

back 25

C) Streptococcus.

front 26

26) ________ is an inherited abnormality that affects the development and structure of kidney tubules.
A) Glomerulonephritis
B) Polycystic kidney disease
C) Nephrolithiasis
D) Renal failure
E) Hematuria

back 26

B) Polycystic kidney disease

front 27

27) Renal columns are
A) internal cavities lined by the fibrous capsule.
B) expanded ends of the ureters.
C) the basic functional units of the kidney.
D) bundles of tissue that extend between pyramids from the cortex.
E) conical structures that are located in the renal medulla.

back 27

D) bundles of tissue that extend between pyramids from the cortex.

front 28

28) The expanded beginning of the ureter connects to the
A) renal sinus.
B) renal pelvis.
C) renal calyx.
D) renal hilum.
E) renal corpuscle.

back 28

B) renal pelvis.

front 29

29) Major calyces are
A) large branches of the renal pelvis.
B) expanded ends of nephrons.
C) basic functional layers of the kidney.
D) conical structures that are located in the renal medulla.
E) the expanded ends of renal pyramids.

back 29

A) large branches of the renal pelvis.

front 30

30) Glomerular (Bowmanʹs) capsule and the glomerulus make up the
A) renal pyramid.
B) nephron loop (loop of Henle).
C) renal corpuscle.
D) renal papilla.
E) collecting tubule system.

back 30

C) renal corpuscle.

front 31

31) The region known as the macula densa is part of
A) the proximal convoluted tubule.
B) the distal convoluted tubule.
C) the collecting duct.
D) the nephron loop (loop of Henle).
E) glomerular (Bowmanʹs) capsule.

back 31

B) the distal convoluted tubule.

front 32

32) The cells of the macula densa, the juxtaglomerular cells, and the extraglomerular mesangial cells form the
A) renal corpuscle.
B) filtration membrane.
C) nephron loop (loop of Henle).
D) juxtaglomerular complex.
E) afferent arteriole.

back 32

D) juxtaglomerular complex.

front 33

33) You have been diagnosed with lupus erythematosus, a very severe autoimmune disorder with a wide variety of associated organ-related problems. Your doctor is particularly worried about how this will affect your kidney function. He says that you are susceptible to ________ because of the lupus.
A) polycystic kidney
B) glomerulonephritis
C) cystitis
D) diabetes
E) renal calculi

back 33

B) glomerulonephritis

front 34

34) Filtrate first passes from the glomerular capsule to the
A) nephron loop (loop of Henle).
B) proximal convoluted tubule.
C) distal convoluted tubule.
D) collecting duct.
E) minor calyx.

back 34

B) proximal convoluted tubule.

front 35

35) The portion of the nephron that empties into the collecting duct is the
A) nephron loop (loop of Henle).
B) proximal convoluted tubule.
C) distal convoluted tubule.
D) papillary tubule.
E) calyx.

back 35

C) distal convoluted tubule.

front 36

36) Which of the following descriptions best matches the term renal papilla?
A) It releases renin.
B) It creates high interstitial NaCl concentration.
C) Final urine enters here.
D) Initial filtrate enters here.
E) It is the tip of the medullary pyramid.

back 36

E) It is the tip of the medullary pyramid.

front 37

37) The efferent arteriole of a nephron divides to form a network of capillaries within the cortex called the ________ capillaries.
A) peritubular
B) glomerular
C) vasa recta
D) cortical
E) efferent

back 37

A) peritubular

front 38

38) The primary function of the proximal convoluted tubule is
A) filtration.
B) reabsorption of ions, organic molecules, vitamins, and water.
C) secretion of acids and ammonia.
D) secretion of drugs.
E) adjusting the urine pH.

back 38

B) reabsorption of ions, organic molecules, vitamins, and water.

front 39

39) The following is a list of the blood vessels that carry blood to the kidney. In what order does blood pass through these vessels starting at the renal artery?
1. afferent arteriole
2. arcuate artery
3. interlobar artery
4. segmental artery
5. glomerulus
6. cortical radiate artery
7. efferent arteriole
8. peritubular capillary
A) 4, 6, 2, 3, 1, 5, 7, 8
B) 4, 3, 2, 6, 1, 5, 7, 8
C) 4, 3, 2, 6, 7, 5, 1, 8
D) 4, 6, 2, 3, 7, 5, 1, 8
E) 4, 3, 6, 2, 1, 5, 7, 8

back 39

B) 4, 3, 2, 6, 1, 5, 7, 8

front 40

40) The filtration barrier in the renal corpuscle consists of which three layers?
A) filtration slits, foot processes, and slit pores
B) fenestrations, matrix, and foot processes
C) fenestrated endothelium of glomerulus, basement membrane of glomerulus, and podocyte filtration slits
D) basement membrane of glomerulus, foot processes, and capsular outer layer
E) podocyte filtration slits, matrix cells in the glomerulus, and extraglomerular mesangial cells

back 40

C) fenestrated endothelium of glomerulus, basement membrane of glomerulus, and podocyte filtration slits

front 41

41) Eighty percent of nephrons in the human kidney are located in the ________ and have short nephron loops.
A) cortex
B) medulla
C) pyramids
D) capsule
E) pelvis

back 41

A) cortex

front 42

Nephrons located close to the medulla with long nephron loops are called ________ nephrons.
A) cortical
B) juxtaglomerular
C) vasa recta
D) juxtamedullary
E) Henle

back 42

D) juxtamedullary

front 43

43) The ________ is a capillary bed that parallels the nephron loop (loop of Henle).
A) glomerulus
B) peritubular capillary bed
C) afferent arteriolar bed
D) collecting duct
E) vasa recta

back 43

E) vasa recta

front 44

44) The majority of glomeruli are located in the ________ of the kidney.
A) vasa recta
B) medulla
C) cortex
D) pelvis
E) calyces

back 44

C) cortex

front 45

45) Which of the following components of the nephron is largely confined to the renal medulla?
A) glomerular (Bowmanʹs) capsule
B) distal convoluted tubule
C) collecting ducts
D) proximal convoluted tubule
E) glomerulus

back 45

C) collecting ducts

front 46

46) Each kidney has about ________ nephrons.
A) 100,000
B) 500,000
C) 1 million
D) 1.25 million
E) 5 million

back 46

D) 1.25 million

front 47

47) The majority of renal innervation is by the
A) parasympathetic nervous system.
B) vagus nerve.
C) somatic nervous system.
D) sympathetic nervous system.
E) enteric nervous system.

back 47

D) sympathetic nervous system.

front 48

48) The proximal convoluted tubule cells are
A) cuboidal cells with microvilli.
B) cuboidal cells without microvilli.
C) squamous cells.
D) columnar cells with microvilli.
E) columnar cell without microvilli.

back 48

A) cuboidal cells with microvilli.

front 49

49) The region of the nephron containing intercalated cells primarily associated with pH balance is the
A) glomerulus.
B) proximal convoluted tubule.
C) nephron loop.
D) collecting duct.
E) papillary duct.

back 49

D) collecting duct.

front 50

50) Modified smooth muscle cells in the wall of the afferent arteriole that secrete renin are called
A) macula densa cells.
B) juxtaglomerular cells.
C) extraglomerular mesangial cells.
D) podocytes.
E) principal cells.

back 50

B) juxtaglomerular cells.

front 51

51) Which of the following substances should not be filtered?
A) glucose
B) water
C) proteins
D) amino acids
E) fatty acids

back 51

C) proteins

front 52

52) The functional units of kidneys where blood is filtered and urine produced are called
A) pyramids.
B) nephrons.
C) calyces.
D) lobules.
E) lobes.

back 52

B) nephrons.

front 53

53) Glomerular blood flow is unique because it flows
A) through a glomerular portal vein.
B) directly from the renal artery into the glomerular capillaries.
C) from arteriole to capillary bed to arteriole.
D) from arteriole to capillary bed to vasa recta.
E) through the peritubular capillaries then into the glomerular capillaries.

back 53

C) from arteriole to capillary bed to arteriole.

front 54

54) An important structure for blood pressure regulation is the
A) collecting duct.
B) nephron loop.
C) papillary duct.
D) proximal convoluted tubule.
E) juxtaglomerular complex.

back 54

E) juxtaglomerular complex.

front 55

60) The filtration of plasma takes place in the
A) nephron loop (loop of Henle).
B) distal convoluted tubule.
C) papillary duct.
D) renal corpuscle.
E) ureter.

back 55

D) renal corpuscle.

front 56

61) Reabsorbed water and solutes enter into the
A) afferent arteriole.
B) efferent arteriole.
C) peritubular fluid.
D) tubular fluid.
E) glomerulus.

back 56

C) peritubular fluid.

front 57

62) ________ is the most abundant organic waste.
A) Glucose
B) Albumin
C) Carbon dioxide
D) Sodium
E) Urea

back 57

E) Urea

front 58

63) The process that transports solutes, including many drugs, into the tubular fluid is called
A) filtration.
B) reabsorption.
C) absorption.
D) excretion.
E) secretion.

back 58

E) secretion.

front 59

64) What physiological process occurs at the structure labeled ʺ1ʺ?
A) reabsorption
B) excretion
C) secretion
D) filtration
E) micturition

back 59

D) filtration

front 60

65) Where does most nutrient reabsorption occur?
A) 2
B) 3
C) 4
D) 5
E) 6

back 60

B) 3

front 61

66) Which area(s) allow variable water reabsorption and is/are sensitive to the hormone ADH?
A) 1
B) 3
C) 4
D) 5 and 6
E) 3 and 6

back 61

D) 5 and 6

front 62

67) Where would penicillin be secreted?
A) 6
B) 5
C) 4
D) 3
E) 3 and 4

back 62

B) 5

front 63

68) Where does secretion mostly occur?
A) 5
B) 1
C) 3
D) 4
E) 2

back 63

A) 5

front 64

69) Which area is sensitive to aldosterone?
A) 2
B) 1
C) 4
D) 3
E) 5

back 64

E) 5

front 65

70) Identify the structure labeled ʺ5.ʺ
A) proximal convoluted tubule
B) distal convoluted tubule
C) collecting duct
D) nephron loop
E) glomerulus

back 65

B) distal convoluted tubule

front 66

71) Identify the structure labeled ʺ6.ʺ
A) proximal convoluted tubule
B) distal convoluted tubule
C) collecting duct
D) nephron loop
E) glomerulus

back 66

C) collecting duct

front 67

72) The process of filtration is driven mainly by
A) active transport.
B) blood osmotic pressure.
C) blood hydrostatic pressure.
D) renal pumping.
E) solvent drag.

back 67

C) blood hydrostatic pressure.

front 68

73) Approximately ________ liters of glomerular filtrate enter glomerular capsules each day.
A) 480
B) 180
C) 125
D) 18
E) 1.8

back 68

B) 180

front 69

74) Under normal conditions, glomerular filtration depends on three main pressures. From the list below, what are these three main pressures?
1. glomerular hydrostatic pressure
2. capsular hydrostatic pressure
3. capsular colloid osmotic pressure
4. blood colloid osmotic pressure
5. urinary bladder hydrostatic pressure
A) 1, 2, and 3 are correct.
B) 2, 3, and 4 are correct.
C) 3, 4, and 5 are correct.
D) 1, 2, and 4 are correct.
E) 2, 4, and 5 are correct.

back 69

D) 1, 2, and 4 are correct.

front 70

75) Which of the following formulas will allow you to calculate correctly the net filtration pressure (NFP)? (Hint: CsHP is capsular hydrostatic pressure.)
A) FP = GHP + CsHP - BCOP
B) FP = GHP - (CsHP + BCOP)
C) FP = CsHP + GHP - BCOP
D) FP = BCOP - GHP + CsHP
E) FP = BCOP + (GHP - CsHP)

back 70

B) FP = GHP - (CsHP + BCOP)

front 71

76) Measurement of the functions of a nephron reveals a glomerular capillary pressure of 69 mm Hg, and a pressure in the capsular space of 15 mm Hg. Assuming that the blood colloid osmotic pressure is 30 mm Hg, and that essentially no plasma proteins are filtered by the glomerulus, what is the net filtration pressure in this case?
A) 30 mm Hg
B) 24 mm Hg
C) 69 mm Hg
D) 84 mm Hg
E) 99 mm Hg

back 71

B) 24 mm Hg

front 72

77) One mechanism the kidney uses to raise systemic blood pressure is to
A) increase secretion of renin by the juxtaglomerular complex.
B) decrease secretion of aldosterone.
C) increase release of angiotensin II by the adrenal glands.
D) increase filtration into glomerular (Bowmanʹs) capsule.
E) decrease urinary albumin concentration.

back 72

A) increase secretion of renin by the juxtaglomerular complex.

front 73

78) Calculate filtration pressure (FP) in a nephron with a glomerular hydrostatic pressure of 55
mm Hg, a blood colloid osmotic pressure of 25 mm Hg, and a capsular hydrostatic pressure of
15 mm Hg.
A) FP = 10 mm Hg
B) FP = 95 mm Hg
C) FP = 55 mm Hg
D) FP = 45 mm Hg
E) FP = 15 mm Hg

back 73

E) FP = 15 mm Hg

front 74

79) Blood colloid osmotic pressure (BCOP) in the glomerulus is generated by
A) blood pressure.
B) presence of albumin proteins in blood plasma.
C) constriction of the efferent arteriole.
D) protein in the filtrate.
E) filtrate in the capsular space.

back 74

B) presence of albumin proteins in blood plasma.

front 75

80) The main force that causes filtration in a nephron is
A) blood colloid osmotic pressure.
B) glomerular hydrostatic pressure.
C) osmotic pressure of the urine.
D) capsular hydrostatic pressure.
E) reabsorption in proximal convoluted tubule pulls filtrate from blood.

back 75

B) glomerular hydrostatic pressure.

front 76

81) Substances larger than ________ are normally not allowed to pass through the filtration membrane.
A) sodium ions
B) glucose
C) albumin
D) amino acids
E) urea

back 76

C) albumin

front 77

82) Sympathetic stimulation of the kidney can do all of the following except
A) produce powerful vasoconstriction of the afferent arterioles.
B) increase the glomerular filtration rate.
C) trigger renin release.
D) produce renal ischemia.
E) reduce blood flow to kidneys.

back 77

B) increase the glomerular filtration rate.

front 78

83) The filtration pressure at the glomerulus is equal to
A) glomerular hydrostatic pressure - (capsular hydrostatic pressure + interstitial fluid osmotic pressure).
B) capsular hydrostatic pressure + capsular colloid osmotic pressure + glomerular
hydrostatic pressure.
C) glomerular hydrostatic pressure - (capsular hydrostatic pressure + blood colloid osmotic pressure).
D) (capsular hydrostatic pressure + capsular colloid osmotic pressure) - glomerular
hydrostatic pressure.
E) glomerular hydrostatic pressure - (capsular hydrostatic pressure + capsular colloid osmotic pressure).

back 78

C) glomerular hydrostatic pressure - (capsular hydrostatic pressure + blood colloid osmotic pressure).

front 79

84) The amount of filtrate produced by the kidneys each minute is called the
A) net filtration pressure.
B) colloid pressure.
C) plasma volume.
D) kidney filtrate volume.
E) glomerular filtration rate.

back 79

E) glomerular filtration rate.

front 80

85) A drug that inhibits angiotensin converting enzyme (ACE) may lead to all of the following except
A) less secretion of aldosterone.
B) increased urinary loss of sodium.
C) reduction of blood pressure.
D) decreased sodium reabsorption.
E) increased fluid retention.

back 80

E) increased fluid retention.

front 81

86) All of the following would result in an increase in renin release except
A) decreased blood pressure at the glomerulus.
B) blockage in the renal artery.
C) increased blood volume.
D) stimulation of juxtaglomerular cells.
E) decreased osmotic concentration at the macula densa.

back 81

C) increased blood volume.

front 82

87) Immediate local responses of the kidney to changes in blood flow to maintain GFR occur via
A) autoregulation.
B) countercurrent multiplication.
C) hormonal regulation.
D) autonomic regulation.
E) cephalic reflexes.

back 82

A) autoregulation.

front 83

88) Damage to the glomerular filtration membrane allowing proteins into the capsular space would result in all of the following except
A) an increase in capsular colloid osmotic pressure.
B) a decrease in blood colloid osmotic pressure.
C) an increase in net filtration pressure.
D) an increase in GFR and fluid loss.
E) a decrease in capsular hydrostatic pressure.

back 83

E) a decrease in capsular hydrostatic pressure.

front 84

89) Tubular reabsorption involves all of the following except
A) active transport.
B) facilitated diffusion.
C) cotransport.
D) countertransport.
E) stem cell movements.

back 84

E) stem cell movements.

front 85

90) Reabsorption of filtered glucose from the lumen in the PCT is largely by means of
A) diffusion.
B) facilitated diffusion.
C) active transport.
D) cotransport.
E) countertransport.

back 85

D) cotransport.

front 86

91) Secretion of hydrogen ion by the PCT is by the process of
A) diffusion.
B) facilitated diffusion.
C) active transport.
D) cotransport.
E) countertransport.

back 86

E) countertransport.

front 87

92) Chloride ion is reabsorbed in the thick ascending limb by
A) simple diffusion.
B) facilitated diffusion.
C) active transport.
D) cotransport with Na and K ions.
E) countertransport for bicarbonate ion.

back 87

D) cotransport with Na and K ions.

front 88

93) The renal threshold for glucose is approximately ________ mg/dl.
A) 75
B) 90
C) 100
D) 140
E) 180

back 88

E) 180

front 89

94) The concentration at which all of the carriers in renal tubules for a given substance are
saturated is the
A) tubular maximum.
B) hydrostatic threshold.
C) blood colloid maximum.
D) osmotic pressure.
E) renal threshold.

back 89

A) tubular maximum.

front 90

95) The ________ is the plasma concentration at which a specific compound will begin appearing in the urine.
A) tubular maximum
B) hydrostatic threshold
C) blood colloid maximum
D) osmotic pressure
E) renal threshold

back 90

E) renal threshold

front 91

96) The process of ________ involves a carrier protein that can transport a molecule across the cell membrane down its concentration gradient.
A) simple diffusion
B) facilitated diffusion
C) osmosis
D) bulk transport
E) active transport

back 91

B) facilitated diffusion

front 92

97) A transport mechanism that can move a substance against a concentration gradient by using cellular energy is
A) simple diffusion.
B) facilitated diffusion.
C) osmosis.
D) bulk transport.
E) active transport.

back 92

E) active transport.

front 93

98) In the process of ________, two substances are moved across a cell membrane in the same direction without directly using cellular energy. One of the substances can be moved against a concentration gradient by this process.
A) countertransport
B) cotransport
C) simple diffusion
D) active transport
E) co-osmosis

back 93

B) cotransport

front 94

99) Diuretics are used for all of the following reasons except
A) to reduce body weight.
B) to reduce water retention.
C) to reduce blood pressure.
D) to treat congestive heart failure.
E) to reduce glucose levels.

back 94

E) to reduce glucose levels.

front 95

100) The majority of water is reabsorbed by osmosis in the
A) proximal convoluted tubule.
B) nephron loop.
C) distal convoluted tubule.
D) collecting duct.
E) papillary duct.

back 95

A) proximal convoluted tubule.

front 96

101) The majority of cotransporters and countertransporters are linked to the reabsorption of what ion?
A) hydrogen
B) sodium
C) potassium
D) bicarbonate
E) chloride

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B) sodium

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102) Prolonged aldosterone stimulation of the distal convoluted tubule may result in
A) hypercalcemia.
B) hypocalcemia.
C) hypokalemia.
D) hyperkalemia.
E) alkalosis.

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C) hypokalemia.

front 98

103) Which of the following is not a normal constituent of urine?
A) hydrogen ions
B) urea
C) large proteins
D) amino acids
E) creatinine

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C) large proteins

front 99

104) The ________ test is often used to estimate the glomerular filtration rate.
A) inulin
B) glucose tolerance
C) CBC or complete blood count
D) specific gravity
E) creatinine clearance

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E) creatinine clearance

front 100

105) Basically, what occurs in the countercurrent multiplier process?
A) Sodium is pumped into the blood while potassium is actively transported out of the blood back into the tissues.
B) A higher sodium concentration is produced in the renal medulla that osmotically draws out water, reducing it within the tubules and the urine.
C) Glucose and sodium are cotransported from urine back into blood.
D) Creatinine is actively transported out of the blood into urine.
E) Uric acid is excreted into the kidney tubules while urea is reabsorbed in the nephron loop.

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B) A higher sodium concentration is produced in the renal medulla that osmotically draws out water, reducing it within the tubules and the urine.

front 101

106) The ability to form concentrated urine depends on the functions of the
A) proximal convoluted tubule.
B) distal convoluted tubule.
C) collecting duct.
D) nephron loop (loop of Henle).
E) nephron loop, distal convoluted tubule and the collecting duct.

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E) nephron loop, distal convoluted tubule and the collecting duct.

front 102

107) The mechanism for producing a concentrated urine involves all of the following except
A) the secretion of antidiuretic hormone (ADH) by the posterior pituitary gland.
B) aquaporins being inserted into the membranes of the collecting duct cells.
C) a high concentration of NaCl in the interstitial fluid that surrounds the collecting ducts.
D) an increase in facultative water reabsorption.
E) obligatory water reabsorption in the proximal convoluted tubule.

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E) obligatory water reabsorption in the proximal convoluted tubule.

front 103

108) A patient excretes a large volume of very dilute urine on a continuing basis. This is may be due to
A) excessive ADH secretion.
B) absence of ADH.
C) hematuric oliguria.
D) overproduction of aldosterone.
E) dilation of the afferent arterioles.

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B) absence of ADH.

front 104

109) Antidiuretic hormone
A) increases the permeability of the collecting ducts to water.
B) is secreted in response to low potassium ion in the blood.
C) causes the kidneys to produce a larger volume of very dilute urine.
D) is secreted by the anterior pituitary.
E) release is insensitive to the osmolarity of interstitial fluid.

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A) increases the permeability of the collecting ducts to water.

front 105

110) If a urine sample is distinctly yellow in color, which of the following will be true?
A) Its pH is below normal.
B) It will have the odor of ammonia.
C) It will contain large amounts of urobilin.
D) It will contain excess chloride ion.
E) It will have a high pH.

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C) It will contain large amounts of urobilin.

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111) When the level of ADH (antidiuretic hormone) decreases,
A) a concentrated urine is produced.
B) less urine is produced.
C) the osmolarity of the urine decreases.
D) permeability to water in the collecting system increases.
E) water reabsorption increases in the nephron loop.

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C) the osmolarity of the urine decreases.

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112) As the filtrate passes through the renal tubules, approximately what percentage is reabsorbed and returned to the circulation?
A) 1
B) 38
C) 63
D) 74
E) 99

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E) 99

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113) In response to increased levels of aldosterone, the kidneys produce
A) a larger volume of urine.
B) urine with a higher concentration of sodium ions.
C) urine with a lower concentration of potassium ions.
D) urine with a lower concentration of sodium ions.
E) urine with less glucose.

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D) urine with a lower concentration of sodium ions.

front 109

114) Which of the following is a not a true statement regarding the countercurrent multiplication
system?
A) The thin limb of the nephron loop is permeable to water.
B) The thick limb of the nephron loop is permeable to solutes.
C) Osmotic concentration in the nephron loop decreases as fluid flows toward the bottom of the loop.
D) Tubule fluid arrives at the DCT at about 100 mOsm/L.
E) The maximum solute concentration is about 1200 mOsm/L.

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C) Osmotic concentration in the nephron loop decreases as fluid flows toward the bottom of the loop.

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115) Excess release of natriuretic peptides would cause
A) a large volume of concentrated urine.
B) a large volume of dilute urine.
C) a small volume of concentrated urine.
D) a small volume of dilute urine.
E) a small volume of urine void of sodium.

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B) a large volume of dilute urine.

front 111

116) The final composition of urine is represented by which of the following statements?
A) Urine = substances reabsorbed + substances secreted.
B) Urine = substances filtered + substances reabsorbed + substances secreted.
C) Urine = substances secreted - substances reabsorbed - substances filtered.
D) Urine = substances filtered - substances reabsorbed + substances secreted.
E) Urine = substances reabsorbed - substances secreted - substances filtered.

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D) Urine = substances filtered - substances reabsorbed + substances secreted.

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117) The ureters and urinary bladder are lined by ________ epithelium.
A) stratified squamous
B) pseudostratified columnar
C) simple cuboidal
D) transitional
E) simple columnar

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D) transitional

front 113

118) The detrusor muscle
A) moves urine along the ureters by peristalsis.
B) compresses the urinary bladder and expels urine through the urethra.
C) functions as the internal urinary sphincter.
D) functions as the external urinary sphincter.
E) surrounds the renal pelvis.

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B) compresses the urinary bladder and expels urine through the urethra.

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119) The inability of the kidneys to excrete adequately to maintain homeostasis is
A) glomerulonephritis.
B) polycystic kidney disease.
C) calculi.
D) renal failure.
E) hematuria.

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D) renal failure.

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120) The area of the urinary bladder bounded by the openings of the two ureters and the urethra is called the
A) renal pelvis.
B) JG apparatus.
C) pyramid.
D) trigone.
E) vasa recta.

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D) trigone.

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121) Insoluble deposits that form within the urinary tract from calcium salts, magnesium salts, or uric acid are called kidney stones or renal
A) calculi.
B) plaque.
C) caries.
D) otoliths.
E) lithotrophs.

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A) calculi.

front 117

122) You complain to the doctor about constant pain and discomfort in the low back area. What test might logically be recommended?
A) an MRI
B) a pyelogram
C) a liver biopsy
D) an angiogram
E) a liver enzyme assay

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B) a pyelogram

front 118

123) The pontine storage center controls micturition by
A) stimulating bladder contractions.
B) increasing contraction of the detrusor muscle.
C) relaxing the internal urethral sphincter.
D) increasing contraction of the external urethral sphincter and reducing detrusor muscle activity.
E) stimulating the voiding reflex.

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D) increasing contraction of the external urethral sphincter and reducing detrusor muscle activity.

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124) Which of the following statements is false regarding micturition?
A) When you relax the external urethral sphincter, the internal sphincter will relax.
B) Urination will be completed despite voluntary opposition.
C) Parasympathetic nervous control is involved with the micturition reflex.
D) Stretch receptors in the bladder are stimulated by the warm temperature of the urine.
E) Bladder contractions can force open the internal urethral sphincter.

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D) Stretch receptors in the bladder are stimulated by the warm temperature of the urine.

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125) Changes that occur in the urinary system with aging include all of the following except
A) a decline in the number of functional nephrons.
B) a reduction in the GFR (glomerular filtration rate).
C) increased sensitivity to ADH.
D) problems with the micturition reflex.
E) loss of sphincter muscle tone.

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C) increased sensitivity to ADH.

front 121

126) Your doctor has diagnosed you with prostatitis, an inflammation and swelling involving the
prostate gland. One of your primary symptoms is
A) dribbling urination.
B) renal failure.
C) hematuria.
D) glycosuria.
E) large amounts of dilute urine.

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A) dribbling urination.

front 122

127) Each of the following organ systems excretes wastes to some degree except the ________ system.
A) urinary
B) integumentary
C) digestive
D) endocrine
E) respiratory

back 122

D) endocrine

front 123

1) In which region of the kidney is a glomerulus located?
A) fibrous capsule
B) renal hilum
C) medullary pyramid
D) renal cortex
E) renal medulla

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D) renal cortex

front 124

2) What structure connects the proximal convoluted tubule to the distal convoluted tubule?
A) renal corpuscle
B) collecting duct
C) papillary duct
D) glomerular capsule
E) nephron loop

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E) nephron loop

front 125

3) What four factors shown result in an increased blood volume?
A) increased sodium retention, increased fluid consumption, increased fluid retention, and constriction of systemic veins
B) decreased cardiac output, decreased fluid retention, decreased sodium retention, and systemic vasodilation
C) increased glomerular hydrostatic pressure, increased blood colloid osmotic pressure, decreased capsular hydrostatic pressure, decreased capsular colloid osmotic pressure
D) decreased glomerular hydrostatic pressure, decreased blood colloid osmotic pressure, increased capsular hydrostatic pressure, increased capsular colloid osmotic pressure
E) increased sodium excretion, increased potassium retention, decreased fluid
consumption, increased fluid retention

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A) increased sodium retention, increased fluid consumption, increased fluid retention, and constriction of systemic veins

front 126

4) Aldosterone-sensitive portions of the distal convoluted tubule and collecting duct allow for the exchange of which ions?
A) reabsorption of hydrogen ions in exchange for chloride ions
B) reabsorption of chloride ions in exchange for hydrogen ions
C) reabsorption of sodium ions in exchange for potassium ions
D) reabsorption of potassium ions in exchange for sodium ions
E) reabsorption of bicarbonate ions in exchange for hydrogen ions

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C) reabsorption of sodium ions in exchange for potassium ions

front 127

5) ADH creates a (small or large) volume of (dilute or concentrated) urine.
A) small; dilute
B) small; concentrated
C) large; dilute
D) large; concentrated

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B) small; concentrated

front 128

6) The (ureter or urethra) transports urine to the bladder.
A) ureter
B) urethra

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A) ureter