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Question 1

Which of the following electrolyte imbalances can develop due to hyperaldosteronism?

a) Hyponatremia
b) Hypocalcemia
c) Hypochloremia
d) Hypomagnesemia
e) Hypokalemia

Answer 1

e) Hypokalemia

Question 2

What would tend to decrease plasma potassium concentration by causing a shift of potassium from the extracellular fluid into the cells?

a) Strenuous exercise
b) B-adrenergic blockade
c) Insulin excess
d) Aldosterone deficiency
e) Acidosis

Answer 2

c) Insulin excess

Question 3

Which one does not stimulate renin secretion from the juxtaglomerular apparatus?

a) Decrease in arterial pressure
b) An increase in the activity of renal sympathetic nerves
c) Decreased GFR and flow to macula densa
d) Excess sweating
e) Increased NaCl delivery to macula densa

Answer 3

e) Increased NaCl delivery to macula densa

Question 4

Which one corresponds to an increase in plasma H+ , a decrease in plasma HCO3-, and a decrease in plasma CO₂ concentration?

a) Metabolic alkalosis
b) Respiratory acidosis

C) Metabolic acidosis

d) Normal condition
e) Respiratory alkalosis

Answer 4

C) Metabolic acidosis

Question 5

Which sentence is not correct?

a) Vasa recta has no role to maintain the medullary hypertonicity
b) Vasa recta works as a counter-current exchange system
c) The kidneys may form concentrated urine, still containing little amount of sodium chloride
d) Increased medullary blood flow may decrease the ability of the kidneys to concentrate the urine.
e) Medullary blood flow is low

Answer 5

a) Vasa recta has no role to maintain the medullary hypertonicity

Question 6

In the examination of arterial blood gas analysis pH=7.2: plasma HCO3- 29 mmol/L: plasma pCO₂ = 75 mmHg. What is this patient’s acid-base disorder?

a) Respiratory alkalosis with renal compensation.
b) Respiratory acidosis with partial renal compensation
c) Acute metabolic acidosis without respiratory compensation
d) Metabolic acidosis with partial respiratory compensation
e) Acute respiratory acidosis without renal compensation.

Answer 6

b) Respiratory acidosis with partial renal compensation

Question 7

Which one does not cause prerenal acute renal injury?

a) Myocardial infarction
b) Thrombosis of renal artery or vein

C) Anaphylactic shock

d) Hemorrhage
e) Acute glomerulonephritis

Answer 7

e) Acute glomerulonephritis

Question 8

In an adult with a regular diet, in which part of the tubules the potassium is absorbed most?

a) Proximal convoluted tubule
b) Assending loop of Henle
c) Distal tubule
d) Medullary collecting duct
e) Descending loop of Henle

Answer 8

a) Proximal convoluted tubule

Question 9

Which of the following statements inhibits growth hormone secretion?

a) Exercising
b) Testosterone
c) Obesity
d) Trauma
e) Starvation

Answer 9

c) Obesity

Question 10

Which one of the following blood-gas values is consistent with metabolic acidosis?

A) PaCO₂(mmHg): 25, HCO3 (mM): 30, pH: 7.3

B) PaCO₂ (mmHg): 35, HCO3 (mM): 20, pH: 7.3

C) PaCO₂ (mmHg): 40, HCO3(mM): 25, pH: 7.4

D) PaCO₂ (mmHg): 50, HCO3(mM): 30, pH: 7.1

E) PaCO₂ (mmHg) 60, HCO3 (mM): 20, pH: 7.1

Answer 10

B) PaCO₂ (mmHg): 35, HCO3 (mM): 20, pH: 7.3

Question 11

Which part of the tubule is not permeable to water?

A) Proximal convoluted tubule

B) Thick ascending limb of Henle’s loop

C) Descending thin limb of Henle’s loop

D) Distal convoluted tubule

E) Medullary collecting duct

Answer 11

B) Thick ascending limb of Henle’s loop

Question 12

Which substance is totally reabsorbed after it undergoes glomerular filtration?

A) Amino acids

B) Bicarbonate ions

C) Creatinine

D) Inulin

E) Urea

Answer 12

A) Amino acids

Question 13

Which substance has higher concentration in uremic plasma compared with dialysis fluid?

A) Ca++

B) Creatinine

C) HCO3-

D) Glucose

E) Mg++

Answer 13

B) Creatinine

Question 14

Some cells secrete chemicals into the extracellular fluid that act on same cells in the same tissue. Which of the following refers to this type of regulation?

A) Neural

B) Endocrine

C) Neuroendocrine

D) Paracrine

E) Autocrine

Answer 14

E) Autocrine

Question 15

Which one does not stimulate renin secretion from the juxtaglomerular apparatus?

a) Decreased GFR and flow to macula densa
b) An increase in the activity of renal sympathetic nerves
c) Excess sweating
d) Decrease in arterial pressure
e) Increased NaCl delivery to macula densa

Answer 15

e) Increased NaCl delivery to macula densa

Question 16

Which of the following tends to decrease potassium secretion by the cortical collecting tubule?

a) High sodium intake
b) Acute alkalosis
c) A diuretic that inhibits the action of aldosterone (e.g.. spironolactone)
d) Increased plasma potassium concentration
e) A diuretic that decreases proximal tubule sodium reabsorption

Answer 16

c) A diuretic that inhibits the action of aldosterone (e.g.. spironolactone)

Question 17

Which one is not correct about diabetes mellitus?

A), In type 2 diabetes mellitus insulin is usually present in plasma.

B) Weight loss is not useful in the treatment of type 2 diabetes mellitus.

C) In type 1 diabetes mellitus, insulin is absent.

D) Severe untreated insulin deficiency can cause coma and death.

E) The sulfonylureas lower plasma glucose by acting on the beta cells to stimulate insulin secretion.

Answer 17

B) Weight loss is not useful in the treatment of type 2 diabetes mellitus.

Question 18

Which clearence of an endogenic substance is used in clinics to follow the kidney functions?

A) Inulin

B) Para-amino-hippurate

C) Creatinine

D) Albumin

E) Glucose

Answer 18

C) Creatinine

Question 19

Which one is the most common cause of the end

stage renal disease?

A) Polycystic kidney disease

B) Hypertrophy of prostate

C) Hypertension

D) Glomerulonephritis

E) Diabetes mellitus

Answer 19

E) Diabetes mellitus

Question 20

Which one does not cause prerenal acute renal failure?

A) Hemorrhage

B) Acute glomerulonephritis

C) Myocardial infarction

D) Anaphylactic shock

E) Thrombosis of renal artery or vein

Answer 20

B) Acute glomerulonephritis

Question 21

Which osmotic diuretic is preferred to prevent or decrease the brain edema in clinical conditions such as stroke or cranial trauma?

A) Trianterene

B) Furosemide

C) Mannitol 20%

D) Acetazolamide

E) Spironolactone

Answer 21

C) Mannitol 20%

Question 22

The concentration of which substance is higher in the dialyzing fluid compared with the blood of the patient with renal failure?

A) Urea

B) Sodium

C) Potassium

D) Bicarbonate

E) Urate

Answer 22

D) Bicarbonate

Question 23

Which one is wrong related with the control of the bladder?

A) Detrusor muscle contraction is inhibited during micturition.

B) Parasympathetic stimulation causes contraction in detrussor muscle.

C) Sympathetic stimulation causes contraction in internal urethral sphincter.

D) Internal urethral sphincter is stimulated during filling.

E) Somatic motor stimulation causes contraction in external urethral sphincter,

Answer 23

A) Detrusor muscle contraction is inhibited during micturition.

Question 24

Which one cases hypokalemia?

A) Strenuons exercise

B) Disbetes mellitus

C) Metabolic alkalosis

D) Decreased aldosterone secration

E) Renal failure

Answer 24

C) Metabolic alkalosis

Question 25

Which one regarding the ADH bormone secretion and osmolarity is not correct? A) ADH is released from the posterior pituitary B) ADH is synthestand in the supraoptic and paraventricular nuclei of the hypothalamus C) When the water ingestion is decreased ADH secretin will be stimulated D) When blood osmolarity goes down ADH secretion will be inhibited E) Volume depletion increases the ADH secretion more than the increase in blood osmolarity

Answer 25

E) Volume depletion increases the ADH secretion more than the increase in blood osmolarity

Question 26

When the glomerular filtration rate starts to decrease for any reason, the concentration of which substance starts to increase first? A) Creatinine B) Urate C) Sodium D) Phosphate E) Chloride

Answer 26

A) Creatinine

Question 27

Which one increases the movement of potassium from the intracellular fluid to the extracellular fluid compartment ? A) Seremuous exercise B) Beta-adresergic stimuli C) Insulin D) Aldosterone E) Alkalosis

Answer 27

A) Seremuous exercise

Question 28

Which one is not seen in a patient with chronic renal failure? A) Acidosis B) Polycythemia C) Uremia D) Osteomalacia E) Water retention and development of edema

Answer 28

B) Polycythemia

Question 29

What is the obligatory urine volume per day in a normal 70-kilogram human? A) 0.25 L/day B) 0.10 L/day C) 1.0 L/day D) 1.5 L/day E) 0.5 L/day

Answer 29

E) 0.5 L/day

Question 30

Which one increases the movement of potassium from the extracellular fluid to the intracellular fluid compartiment? A) Strenuous exercise B) Cell lysis C) Insulin D) Acidosis E) Beta-blockade

Answer 30

C) Insulin

Question 31

Which substance has higher concentration in dialysis fluid compared with uremic plasma? A) Na+ B) Urea C) K+ D) Creatinine E) HCO3-

Answer 31

E) HCO3-

Question 32

Which diuretic is a loop diuretic inhibiting Na-K-CL co-transport in luminal membrane of the thick ascending loop of Henle? A) Mannitol 20% B) Spironolactone C) Acetazolamide D) Hydrochlorothiazide E) Furosemide

Answer 32

E) Furosemide

Question 33

Which change would you expect to find in a patient who developed acute renal failure after ingesting poisonous mushrooms that caused renal tubular necrosis? A) Increased plasma bicarbonate concentration B) Metabolic acidosis C) Decreased plasma potassium concentration D) Decreased blood urea nitrogen concentration E) Decreased hydrostatic pressure in Bowman’s cap- sule

Answer 33

B) Metabolic acidosis

Question 34

Which diuretic inhibits Na+-2CI--K+ cotransport in the loop of Henle as its primary action? A) Thiazide diuretic B) Furosemide C) Carbonic anhydrase inhibitor D) Osmotic diuretic E) Amiloride

Answer 34

B) Furosemide

Question 35

A 26-year-old construction worker is brought to the emergency department with a change in mental status after working a 10-hour shift on a hot summer day (average outside temperature was 97°F [36°C]). The man had been sweating profusely during the day but did not drink fluids. He has a fever of 102°F [39°C], a heart rate of 140 beats/min, and a blood pressure of 100/55 mm Hg in the supine position. Upon examination, he has no perspiration, appears to have dry mucous membranes, and is poorly oriented to person, place, and time. Assuming that his kidneys were normal yesterday. which set of hormone levels describes his condition, compared with normal? A) High ADH, high renin, low angiotensin II, low aldosterone B) Low ADH, low renin, low angiotensin II, low aldosterone C) High ADH, low renin, high angiotensin II, low aldosterone D) High ADH, high renin, high angiotensin II, high aldosterone E) Low ADH, high renin, low angiotensin II, high aldosterone

Answer 35

D) High ADH, high renin, high angiotensin II, high aldosterone

Question 36

Ezber If a radioimmunoassay is properly conducted and the amount of radioactive hormone bound to antibody is low, what would this result indicate? A) Plasma levels of endogenous hormone are high B) Plasma levels of endogenous hormone are low C) More antibody is needed D) Less radioactive hormone is needed

Answer 36

A) Plasma levels of endogenous hormone are high

Question 37

In a person with normal kidneys and normal lungs who has chronic metabolic acidosis, you would expect to find all of the following, compared with normal, except: A) Increased renal excretion of NH4CI B) Decreased urine pH C) Decreased urine HCO3excretion D) Increased plasma HCO3 concentration E) Decreased plasma Pco2

Answer 37

D) Increased plasma HCO3 concentration

Question 38

What would cause the greatest degree of hyperkalemia? A) Increase in potassium intake from 60 to 180 mmol/day in a person with normal kidneys and a normal aldosterone system B) Chronic treatment with a diuretic that inhibits the action of aldosterone C) Decrease in sodium intake from 200 to 100 mmol/day D) Chronic treatment with a diuretic that inhibits loop of Henle Na+-2CI--K+ co-transport E) Chronic treatment with a diuretic that inhibits sodium reabsorption in the collecting ducts

Answer 38

B) Chronic treatment with a diuretic that inhibits the action of aldosterone

Question 39

PTH does what directly? A) Controls the rate of 25-hydroxycholicalciferol formation B) Controls the rate of calcium transport in the mu- cosa of the small intestine C) Controls the rate of formation of calcium-binding protein D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys E) Stimulates renal tubular phosphate reabsorption

Answer 39

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

Question 40

PTH does what directly? A) Controls the rate of 25-hydroxycholicalciferol formation B) Controls the rate of calcium transport in the mu- cosa of the small intestine C) Controls the rate of formation of calcium-binding protein D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys E) Stimulates renal tubular phosphate reabsorption

Answer 40

D) Controls the rate of formation of 1,25-dihydroxy- cholicalciferol in kidneys

Question 41

Which change would you expect to find in a dehydrat- ed person deprived of water for 24 hours? A) Decreased plasma renin activity B) Decreased plasma antidiuretic hormone concentration C) Increased plasma atrial natriuretic peptide concentration D) Increased water permeability of the collecting duct

Answer 41

D) Increased water permeability of the collecting duct