OS 206 E3 Samplex 2010 Flashcards Preview

[OS 206] 3rd Exam > OS 206 E3 Samplex 2010 > Flashcards

Flashcards in OS 206 E3 Samplex 2010 Deck (126)
Loading flashcards...
1

This statement describes a normal kidney.

A. The superior pole of the right kidney is
palpable by bimanual examination,
B. Its lateral border is almost on the same plane
horizontally as the medial border.
C. It has an average size of 10 X 5 X 2.5 with
equal corticomedullary thickness on
ultrasound.
D. Its immediate covering after the fibrous
capsule is the perirenal fat layer.
E. It becomes retroperitoneal after it has
migrated to the posterior abdominal wall.

D

2

A patient sustained a stab wound in the right
subcostal area. On exploration, the kidney was
lacerated at its anteromedial surface. The
following are possible expected associated
injuries. Which is unlikely?

A. perforation of the hepatic flexure of the colon
B. perforation of the third part of the
duodenum
C. laceration of the inferior surface of the liver
D. transection of the renal pelvis

B

3

How is the renal pelvis related to the renal artery
and renal vein at the hilum of the kidney?

A. The renal vein is anterior to the renal
artery and renal pelvis.
B. The renal artery is mainly posterior to the
renal pelvis.
C. The renal vein is posterior to the renal artery.
D. There is no constant disposition of the
structures in the renal hilum

A

4

Dissection of extravasated blood from a lacerated
kidney will seep through the perirenal fat before it
contacts the Gerota's fascia. There will be a
preferential passage of the blood in this direction when the fascia remains intact.

A. medially across the midline to the other
kidney
B. inferiorly towards the pelvis
C. laterally into the posterior abdominal wall
D. superiorly into the hapatorenal fossa

A

5

This statement describes the renal pelvis.

A. It is formed by the union of the major and
minor calyces.
B. It is located mainly within the renal sinus.
C. It tapers distally as it merges distinctively
with the ureter.
D. It hardly becomes dilated in obstruction of
the middle third of the ureter.
E. It cannot be clearly delineated from the
ureter on contrast examination of the urinary
system.

B

6

The renal plexus of nerves has contributions from
the following EXCEPT

A. celiac ganglion and aortic plexus
B. celiac plexus
C. splanchnic nerves
D. testicular plexus

D

7

A 1.5 mm renal stone that has migrated down the
renal pelvis can most likely be radiologically
found to be impacted at which area?

A. L2 level
B. area of the urinary bladder
C. at the pelvic brim
D. at the level of the coccyx

B

8

The only true ligament that provides support for
the urinary bladder.

A. pubovesical ligament
B. puboprostatic ligament
C. median umbilical folds
D. middle umbilical ligament
E. A and B

E

9

An important landmark used to identify the
ureteral orifices when viewing the interior of the
bladder by means of an endoscope

A. interureteric fold
B. the vulva of the bladder
C. the apex of the trigone
D. torus tubarius
E. the junction of the smooth and wrinkled
mucosa

A

10

A prostatic malignancy may spread
hematogenously to the following areas. Which is
an unlikely site?

A. the lumbar vertebrae
B. the liver
C. the lungs
D. the sacral bones

B

11

The urinary bladder derives its nerve supply from
the following EXCEPT

A. pelvic splanchnic nerves
B. vesical plexus
C. sympathetic fibers from T11 to L2
D. sacral plexus

D

12

Normally when the bladder is distended, there is
no reflux of urine from the urinary bladder to the
ureters because of

A. the presence of a sphincter in the ureteral
orifice
B. the presence of a detrusor muscle in the
bladder
C. the oblique entry of the ureter into the
substance of the bladder wall
D. the insertion of the ureter into the upper part
of the bladder wall
E. the tonic contraction of the ureter itself

C

13

Blood filtered by the kidney will be excreted as
urine which will have this directional flow

A. minor calyx > renal papillae > renal pelvis >
renal sinus > ureter
B. minor calyx > major calyx > renal sinus >
renal pelvis > ureter
C. renal papillae > minor calyx > major calyx > renal sinus > renal pelvis
D. renal papillae > minor calyx > major calyx > renal pelvis > ureter
E. renal papillae > renal sinus > major calyx > renal pelvis > ureter

D

14

During left nephrectomy on removal of a
diseased kidney, the renal vein must be ligated
as far as possible from its drainage site to avoid
compromising the venous drainage of the other
structures that drain into the renal vein. These
would include the following EXCEPT

A. diaphragm
B testis
C. spleen
D. suprarenal gland

C

15

Which anatomic structure is usually not visible on
a contrast film of the abdomen?

A. Stomach
B. Psoas
C. Ureter
D. Bowel

C

16

In a normal adult, the kidneys usually lie along
the length of which vertebral bodies?\

A. T11 to L3
B. T9 to T12
C.L1 to L4
D. T10 to L1

A

17

Which statement is not true of phleboliths?

A. They are vascular structures seen in the face.
B. They have a radiolucent central area
surrounded by a more radiodense periphery
C. They may be mistaken for calculi.
D. They are calcified arteries.

D

18

The outline of the renal shadows are visible on a
plain film of the abdomen because of the:

A. low density of perirenal fat
B. uptake of contrast by the kidneys
C. low soft density of the tissues of the psoas
D. presence of surrounding bowel gas

A

19

The following layers of tissue surround each
kidney EXCEPT

A. renal capsule
B. fibrous tissue
C. perirenal fat
D. perirenal fascia or Gerota's fascia

B

20

Which statement is false regarding the normal
renal long axis orientation?

A. On the front plane the renal axis is oriented
downward and outward.
B. The kidneys are parallel to the lateral border of
the psoas muscle on either side.
C. In the lateral plane, the renal long axis is
oriented downward and anteriorly.
D. In the lateral plane, the lower renal pole is 2
– 3 cm posterior to the upper pole.

D

21

The isotope most common used for visualization
of the urinary tract on radiographic examination is

A. Calcium
B. Iodine
C. Strontium
D. Technicium

B

22

Stones tend to lodge and cause obstruction in the
following portions of the ureter EXCEPT in the:

A. ureteropelvic junction
B. ureterovesical junction
C. region of bifurcation of the illiac vessels
D. midportion of the ureter

D

23

Common findings on an intravenous spyelogram
in patients with hydronephrosis are the following
except:

A. flattening of the normal concavity of the calyx
B. reversal of the normal convexity of the papillae
C. atrophy of the renal pelvis
D. enlarged calyces

C

24

Which statement does not describe the perirenal
fascia?

A. It encloses the perirenal fat.
B. It is also known as Gerota's fascia.
C. It anchors the kidney to its surrounding
structures and to the abdominal wall.
D. It is the innermost of the three tissue layers
that surround the kidney.

D

25

The functional unit of the kidney is the:

A. renal corpuscle
B collecting tubule
C. Uriniferous tubule
D. juxtamedullary nephron

C

26

The visceral layer of the Bowman's capsule is
believed to originate from:

A. mesoderm
B. metanephros
C. endoderm
D. glomerular basement membrane

B

27

Which is/are true regarding mesangial cells?

A. contain actin and myosin
B. possess phagocytic functions
C. can contract and respond to angiotensin ll
D. all of the above

D

28

The glomerular endothelium is negatively
charged due to

A. podocalyxin
B. fibronectin
C. heparan sulphate
D. laminin

A

29

In minimal change disease, albumin is able to
pass through the glomerular filtration barrier. The
albumin passes through the glomeular filter in
this order:

A. podocyte > glomerular basement membrane > endothelium
B. endothelium > glomerular basement membrane > foot process
C. lamina rara externa > lamina densa > lamina rara interna
D. lamina rara interna > lamina densa > lamina rara externa

B

30

Which is not true regarding the renal caps

A. The parietal layer of Bowman's capsule is
lined by simple squamous epithelium
B. The visceral layer of Bowman's capsule is
lines by specialized stellate cells called
podocytes.
C. The efferent arteriorle has a wider diameter
than theafferent arteriole to allow a
pressure gradient to be maintained
across the glomerulos.
D. At the vascular pole, the podocyte layer of the
glomerular capillaries becomes continuos
with the parietal layerof the Bowman's
capsule.

C

31

Which is true regarding the renal tubule?

A. It extends from the renal capsule to the papilla.
B. It is lined by transitional epithelium.
C. It is capable only of selective reabsorption of
water and solute.
D. It has four distinct histophysiological
zones each one which performs different
functions.

D

32

Which is not characteristic of proximal tubule cell?

A. simple cuboidal
B. clear cytoplasm
C. brush borders
D. basolateral interdigitations

B

33

Which specialized cells of the juxtaglomerular
apparatus respond to changes in luminal sodium
chloride concentration and glomerular filtrate
volume?

A. macula densa in the distal convoluted
tubule
B. lacis cells in the junction between DCT and
affrent arteriole
C. juxtaglomerular cells of the afferent arteriole
D. all of the above

A

34

What type of epithelium lines a distended urinary
bladder?

A. cuboidal
B. columnar
C. transitional
D. stratified squamous

C

35

What structures in transitional epithelium provide
an effective osmotic barrier between the urine in
the bladder and the underlying connective
tissue?

A. desmosomes
B. pedicels
C. lysosomes
D. pinocytic vesicle

A

36

The synctial arrangement of the detrusor muscle
is important for

A. maintaining compliance during the filling phase
B. sustained and complete emptying during
voiding
C. prevention of urine from going back to the
kidneys
D. prevention of urine leakage during the storage
phase

B

37

The behavior of the lower of the lower urinary
tract organs during normal voiding

A. Detrusor relaxation coupled with sphincter
relaxation
B. Detrusor contraction coupled with sphincter
contraction
C. Detrusor contraction coupled with
sphincter relaxation
D. Detrusor relaxation coupled with sphincter
contraction

C

38

Damage to the pudendal nerves often results in

A. difficulty in urination
B. leakage of urine during coughing
C. continuous urinary leakage
D. frequent urination

B

39

During the storage phase , the following event occurs

A. detrusor muscle contracts
B. hyposgastric nerve stimulates the internal
urethral sphincter
C. the cerebral cortex sends inhibitory
impulses to the pons
D. trigonal muscle contracts

C

40

During the normal voiding phase, the following
events occur

A. pelvic floor muscles contracts
B. Pudendal nerve stimulates
rhabdomyosphincter
C. pelvic nerve sends signals to the detrusor
D. hypogastric nerve relaxes trigonal muscles

D

41

During the filling phase the inherent action of the
suprasacral spinal cord prevails manifesting as

A. Internal rethral sphincter is inhibited by the
hypogastric nerve
B. Detrusor contraction is inhibited
C.pudendal nerve stimulation of the pelvic
floor is inhibited
D. pelvic nerve stimulates the detrusor

C

42

The ability of the detrusor to maintain low
pressure as it fills up with urine is brought about
by

A. elastin content of the submucosal layer
B. fast conduction of its nerve impulses across its
gap junctions
C. syncitial arrangement of its fibers
D. constant inherent pelvic nerve stimulation

A

43

The earliest event during normal voiding is

A. Detrusor contraction
B. bladder neck relaxation
C. rhabdomyosphincter relaxation
D. pelvic floor muscle relaxation

B

44

The most important event occurring during stress
conditions to the bladder (e.g. coughing) which
prevents urinary leakage

A. detrusor relaxation
B. pelvic muscle floor relaxation
C. cortical inhibition of the pons
D. contraction of the rhabdomyopsphincter

D

45

The richly folded urethral epithelium and the
spongy tissue within the submucosa contribute to
this phenomenon that promotes continence
among women

A. reflex resting pressur of the urethra
B. urethrovesical angualtion
C. intrapelvic position of the urethra
D. urethral seal effect

D

46

The water content in the body is generally higher
in

A. females than males
B. a two-year old baby than a newborn
C. a lean than an obese person
D. an eighteen year old than a twenty-five year
old male

C

47

The interstitial fluid volume of a 70 kg male would
be about

A. 18 liters
B. 14.5 liters
C. 10.5 liters
D. 3.5 liters

C

48

Major difference between the composition of
interstitial fluid and that of plasma

A. higher sodium concentration in interstitial fluid
B. higher protein concentration in plasma
C. higher chloride concentration in plasma
D. higher calcium concentration in interstitial fluid

B

49

A patient has the following data:
Plasma [ Na+] 125 meq/L
[glucose] 108 mg/dl
BUN 140 mg/dl

What would be the above patient's plasma
osmolality?

A. 250 mosm/kg
B. 256 mosm/kg
C. 300 mosm/kg
D. 306 mosm/kg

D

50

A patient has the following data:
Plasma [ Na+] 125 meq/L
[glucose] 108 mg/dl
BUN 140 mg/dl

Which of the following is true with regarding the
above patient?

A. There will be a shift of water from ICF to ECF.
B. There will be a shift of water from ECF to ICF.
C. ADH release is stimulated
D. Aldosterone release is inhibited

B

51

What would be the effect of adding 1.5 liters of
distilled water to the intravascular compartment?

A. One half liter of infused distilled water would
shift to the ICF
B. One liter of the infused distilled water would
shift to the ICF
C. Both of the above
D. neither of the above

D

52

A five-year old boy with a two day history of
diarrhea and poor intake was brought to the
emergency room of the PGH. On initial physical
examination he had sunken eyeballs and dry
tongue and buccal mucosa. His last urine output
was noted at about 15 hours prior to consultation.
He was assessed to be in severe dehydration.
Which of the following would be a good choice of
intravenous fluid to effectively expand his fluid
ECF volume?

A. 5% dextrose solution
B. isotonic saline solution
C. half normal saline solution
D. any one of the above

B

53

Insensible water loss from the body includes

A. sweat
B. water from oxidation of food
C. water evaporating from the skin
D. stool

C

54

During prolonged heavy exercise, most of the
water loss from the body is through

A. urine excretion
B. sweating
C. the lungs
D. evaporation from the skin

B

55

Control of ECF osmolality is mainly mediated by

A. sympathetic nervous system
B. renin-angiotensin-aldosterone mechanism
C. antidiuretic hormone
D. atrial natriuretic hormone

C

56

Which of the following is true in a patient with
generalized edema?

A. his interstitial fluid volume is expanded
B. his total body sodium is increased
C. both of the above
D. neither of the above

C

57

The following roles are served by the renal blood
flow except

A. maintains the perfusion of the kidney even
at low blood pressures
B. delivers oxygen to the kidney
C. sustains filtration of urea
D. all of the above
E. none of the above

A

58

Which of the following organs receive/s perfusion
higher than the outer renal medulla?

A. heart
B. brain
C. liver
D. all of the above
E. none of the above

E

59

The greatest hydrostatic pressure drop is seen at
the level of the

A. arcuate artery
B. afferent arteriole
C. glomerular capillary
D. efferent arteriole

B

60

The most important determinant of the
concentration of plasma ultrafiltrate is

A. Kf
B. hydraulic pressure of Bowman's space
C. hydraulic pressure of glomerular capillary
D. plasma oncotic pressure

A

61

Which of the following offers the greatest
resistance to passage of plasma across the
glomerular membrane?

A. endothelial cell
B. basement membrane
C. epithelial cell
D. mesangium

B

62

The reason for the presence of large amounts of
albumin in the urine of a patient presenting with
edema is/are

A. increase in tubular pressure
B. contraction of the mesangial cell
C. loss of the negative charges in the
basement membrane
D. all of the above
E. none of the above

C

63

The glomerular filtrate as it enters Bowman's
capsule is

A. protein-free plasma
B. identical in composition to urine
C. contains only substances that are not needed
by the body
D. formed because of active transport process

A

64

The following can affect the filtration coefficient
except

A. surface area of the glomerular membrane
B. permeability of the glomerualr membrane
C. hydrostatic pressure of the Bowman's
capsule
D. contraction of the mesangial cells

C

65

The glomerular capillary blood pressure is 55 mmHg.
The tubular hydrostatic pressure is 15 mmHg.
The colloidal osmotic pressure is 30 mmHg.
The net filtration pressure is ___________ mm Hg.

A. -10
B. 10
C. 40
D. 70

B

66

The most dominant factor affecting glomerular
filtration under normal condition is the:

A. glomerular capillary hydrostatic pressure
B. plasma colloidal osmotic pressure
C. hydrostatic pressure of the Bowman's capsule
D. capillary surface area

A

67

Which of the following statements concerning the
process of glomerular filtration is correct?

A. Bowman's capsule hydrostatic pressure
opposes filtration
B. The glomerular filtration rate is limited by a
Tm.
C. All of the plasma that entered the glomerulus
is filtered.
D. It is greatly affected by small fluctuations in
blood pressure.

A

68

Which of the following factors would decrease the
GFR?

A. a fall in plasma protein concentration
B. an obstruction such as crystal deposits in
the tubules
C. vasodilation of the afferent arterioles
D. relaxation of the mesangial cells

B

69

Which condition will give the highest filtration
fraction?

A. constriction of the afferent arteriole and
constriction of the efferent arteriole
B. constriction of the afferent arteriole and
vasodilation of the efferent arteriole
C. vasodilation of the afferent arteriole and
vasodilation of the efferent arteriole
D. vasodilation of the afferent arteriole and
constriction of the efferent arteriole

D

70

You want to enhance the excretion of inulin.
Which of the following will you give?

A. concentration albumin
B. loop diuretic
C. low dose angiotensin
D. dextran

C

71

Which of the following is involved in the
autoregulation of GFR?

A. automatic constriction of the afferent
arteriole when it is stretched
B. increased delivery of Na+ and Cl- to the
macula densa causes vasodilation of the
afferent arteriole
C. sympathetically induced vasoconstriction of
the afferent arterioles
D. vasoactive chemicals released from the renal
nerves bring about afferent arteriolar
vasoconstriction

A

72

When arterial blood pressure is elevated above
normal, which of the following compensatory
changes in renal function occur as a result of the
baroreceptor reflex?

A. efferent arteriolar vasoconstriction
B. afferent arteriolar vasodilation
C. efferent arteriolar vasodilation
D. afferent arteriolar vasoconstriction

D

73

The juxtaglomerular apparatus:

A. is a region of specialized cells at a point
where the distal tubules come into
contact with the afferent and efferent
arterioles of the same nephron
B. secretes renin in response to plasma volume
expansion
C. is a site of sodium reabsorption in the kidneys
D. is controlled by the renal nerves

A

74

The following are actions of angiotensin ll except

A. stimulates thirst
B. increases peripheral resistance
C. enhances sodium excretion
D. causes water retention

C

75

Order from lowest to highest the plasma
clearance of the following substances. (Na+,
glucose, inulin, creatinine)

A.glucose, Na+, inulin, creatinine
B. Na+, glucose, creatinine, inulin
C. inulin, Na+, glucose, creatinine
D. Na+, inulin, creatinine, glucose

A

76

Which of the following provides the driving force
for solute transport along nephron segments of
the kidney?

A. the basolateral Na+-K+-ATPase pump
B. the apical Na+K+2Cl- carrier
C. the basolateral GLUT2 transporter
D. the apical Na+-H+ antiporter

A

77

Along the entire length of the proximal tubule, the
TF/P ratio is lowest for

A. chloride
B. glucose
C. sodium
D. phosphate

B

78

Sodium is reabsorbed in the apical membrane of
the proximal tubule cotransported with all of the
following except

A. glucose
B. amino acids
C. phosphate
D. hydrogen

D

79

Water reabsorption in the proximal tubule

A. occurs exclusively via the tight junctions
B. is driven by the transtubular osmotic
gradient created by solute reabsorption
C. is independent of solute reabsorption
D. is ADH independent

B

80

Which is true with regard to glucose reabsorption
in the kidney?

A. occurs by facilitated diffusion across the apical
membrane of the proximal tubule
B. basolateral transport is sodium dependent
C. renal threshold is the plasma glucose
concentration at which glucose will start
to appear in the urine
D. involves high affinity low capacity carriers in
the S1 and S2 segment

C

81

Which is true of the NaK2Cl cotransporter?

A. inhibited by furosemide
B. mutations cause classic Barter's syndrome
C. affinity for sodium and potassium is very high
D. all of the above

D

82

Most potent stimulus for antidiuretic hormone
secretion

A. increase in ECF osmolality
B. angiotensin ll
C. decrease in blood volume
D. decrease in pH

A

83

Which of the following statements regarding
cellular action of ADH is true?

A. ADH primarily affects the intercalated cells of
the proximal tubule
B. ADH attachment to apical membrane
receptors lead to cAMP activation which
leads to formation of water channels
C. Aquaporin2 water channels insert into the
apical membrane of collecting duct cells
rendering this segment water permeable
D. all of the above

C

84

Which of the following is not a necessary
component of the countercurrent mechanism?

A. straight segment of the proximal tubule
B. loop of henle
C. vasa recta
D. collecting tubule

A

85

With regard to sodium reabsorption in the distal
tubule

A. NaCl entry into the apical membrane is
mediated by the NaCl symporter
B. principal cells reabsorbs sodium and water
and secrete K+
C. sodium leaves the cell via the basolateral
Na+K+ATPase
D. all of the above

D

86

Potassium is important in all of the following
cellular mechanism with the exception of

A. cell excitability
B. cell volume control
C. DNA and protein synthesis
D. acid base balance regulation
E. none of the above

E

87

Acute cellular uptake of potassium is enhanced by

A. alpha catecholamines
B. hyperosmolality
C. insulin
D. cell damage
E. acidosis

C

88

The principal site of renal potassium excretion is
the

A. intercalated cells of the medullary collecting
duct
B. principal cells of the cortical collecting
duct
C. distal convoluted tubular cells
D. connecting segment cells

B

89

A hyperkalemic patient with a transtubular
potassium gradient of (TTKG) of less than 7.0 is
highly suggestive of

A. presence of simple renal hyperkalemia
B. hypoaldosteronism
C. increased ECF volume
D. increased sodium intake

B

90

In the thick ascending limb of the loop of Henle,
calcium reabsorption is by

A. passive diffusion through transcellular calcium
channels
B. Ca-Mg exchange mechanism
C. passive paracellular diffusion
D. Ca-Mg ATPase

C

91

Physiologic effects of parathyroid hormone
includes

A. reduces GFR and filtered load of calcium
B. inhibits NaHCO3 reabsorption in the proximal
tubule
C. increases Ca reabsorption in the distal
convoluted tubule
D. all of the above

D

92

Majority of plasma phosphate exist

A. in protein bound forms
B. complexed to Ca, Mg and Na
C. as ionized phosphate
D. in equal proportions of the above

C

93

Most of the filtered phosphate is reabsorbed in the

A. proximal tubule
B. thin descending limb of the loop of Henle
C. thick ascending limb of the loop of Henle
D. collecting duct

A

94

The urinary sediment that you would expect to find in nephrotic syndrome secondary to glomerulonephritis:

A. broad casts
B. white cell casts
C. RBC casts
D. oval cell bodies
E. hyaline casts

D

95

The urinary sediment that you would expect to find in acute pyelonephritis:

A. broad casts
B. white cell casts
C. RBC casts
D. oval cell bodies
E. hyaline casts

B

96

The urinary sediment that you would expect to find in acute glomerulonephritis:

A. broad casts
B. white cell casts
C. RBC casts
D. oval cell bodies
E. hyaline casts

C

97

The urinary sediment that you would expect to find in dehydration

A. broad casts
B. white cell casts
C. RBC casts
D. oval cell bodies
E. hyaline casts

E

98

The urinary sediment that you would expect to find in end stage renal disease:

A. broad casts
B. white cell casts
C. RBC casts
D. oval cell bodies
E. hyaline casts

A

99

Gary, 24 year old male weighing 60 kgs. Was referred to you for clearance prior to overseas
employment. He was noted to be hypertensive,
slightly pale with proteinuria by dipstick method
and sulphosalicylic method. Creatinine was 4.0
mg. 24 hour urine collection showed a urine
volume of 1000 ml, protein of 4.5 gms. And urine
creatinine of 120 mg/dl
.
How would you check for the adequacy of urine
collection?

A. urine output should be greater than 1000 ml in
24 hours
B. Gary should have a 24 hour creatinine
excretion of at least 1200 mg
C. The protein-creatinine ratio should be greater
than 2
D. All of the above findings should be present.

B

100

Gary, 24 year old male weighing 60 kgs. Was referred to you for clearance prior to overseas
employment. He was noted to be hypertensive,
slightly pale with proteinuria by dipstick method
and sulphosalicylic method. Creatinine was 4.0
mg. 24 hour urine collection showed a urine
volume of 1000 ml, protein of 4.5 gms. And urine
creatinine of 120 mg/dl

The computed creatinine clearance of Gary by 24
hour urine collection is

A. 10 ml/min
B. 20 ml/min
C. 30 ml/min
D. 40 ml/min

B

101

Gary, 24 year old male weighing 60 kgs. Was referred to you for clearance prior to overseas
employment. He was noted to be hypertensive,
slightly pale with proteinuria by dipstick method
and sulphosalicylic method. Creatinine was 4.0
mg. 24 hour urine collection showed a urine
volume of 1000 ml, protein of 4.5 gms. And urine
creatinine of 120 mg/dl

By Cockroft and Gault formula, the creatinine
clearance of Gary is

A. 15 ml/min
B. 20 ml/min
C. 25 ml/min
D. 35 ml/min

C

102

Gary, 24 year old male weighing 60 kgs. Was referred to you for clearance prior to overseas
employment. He was noted to be hypertensive,
slightly pale with proteinuria by dipstick method
and sulphosalicylic method. Creatinine was 4.0
mg. 24 hour urine collection showed a urine
volume of 1000 ml, protein of 4.5 gms. And urine
creatinine of 120 mg/dl

If Maria, a 30 year old, weighing 60kgs has the
same laboratory results as Gary's, what will be
creatinine clearance by Cockroft and Gault?

A. 15 ml/min
B. 20 ml/min
C. 25 ml/min
D. 35 ml/min

B

103

Which of the following patients will develop metabolic acidosis?

A. 88 year old with glaucoma receiving carbonic
anhydrase inhibitor
B. patient receiving spironolactone, an
aldosterone antagonist
C. end stage kidney disease patient
D. all of the above
E. none of the above

D

104

Of the following responses to an acid load, which
is the most delayed response?

A. CO2 formation
B. formation of NH4Cl
C. formation of H2PO4 ( Phosphoric acid)
D. reaction with reduced hemoglobin

B

105

What is the difference between venous and
arterial blood gas?

A. Venous blood gas has higher [HCO3+ ] and
lower [Cl- ]
B.Venous blood gas has lower [HCO3+ ] and
lower [Cl- ]
C. Venous blood gas has higher [HCO3+ ] and
higher [Cl- ]
D. Venous blood gas has lower [HCO3+ ] and
lower [Cl- ]

A

106

A patient has normal plasma [HCO3+ ]and a GFR
of 100 ml/min. What is the total filtered [HCO3+ ]
per day?

A. 3000 mmols
B.3240 mmols
C. 3456 mmols
D. 3565 mmols

C

107

Most of the secreted H+

A. is utilized to reclaim [HCO3+ ]
B. forms NH4
C. is seen in the urine as free H+
D. forms titrable acids

A

108

Na+ movement out of the cell via the Na+ K+
ATPase occurs in the:

A. proximal tubule
B. distal tubule
C. both
D. neither

C

109

Na+ H+ exchange occurs in the:

A. proximal tubule
B. distal tubule
C. both
D. neither

A

110

Na+ entry through channels occurs in the:

A. proximal tubule
B. distal tubule
C. both
D. neither

B

111

Aldosterone mediated processes occur in the:

A. proximal tubule
B. distal tubule
C. both
D. neither

B

112

HCO3+ Cl- exchanger is located in the:

A. proximal tubule
B. distal tubule
C. both
D. neither

B

113

countercurrent exchanger:

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

D

114

site of organic anion and cation secretion

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

A

115

reabsorbs 60 to 70% of filtered NaCl and
water

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

A

116

site of final urine osmolality modification

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

E

117

site of NaK2Cl transport

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

C

118

reabsorbs 15%of filtered water

A. proximal tubule
B. descending limb of loop of Henle
C. ascending limb of loop of Henle
D. vasa recta
E. collecting tubule

B

119

function: transport of sodium facilitated by aldosterone

A. proximal tubular cell
B. loop of Henle
C. distal tubular cell
D. collecting duct cell

C

120

function: ADH dependent water resorption

A. proximal tubular cell
B. loop of Henle
C. distal tubular cell
D. collecting duct cell

D

121

function: glucose resorption

A. proximal tubular cell
B. loop of Henle
C. distal tubular cell
D. collecting duct cell

A

122

function: diffusion of water

A. proximal tubular cell
B. loop of Henle
C. distal tubular cell
D. collecting duct cell

B

123

histological feature of distal tubular cell

A. simple squamous epithelium
B. columnar epithelium
C. prominent brush border
D. numerous mitochondria

D

124

histological feature of collecting duct cell

A. simple squamous epithelium
B. columnar epithelium
C. prominent brush border
D. numerous mitochondria

B

125

histological feature of proximal tubular cell

A. simple squamous epithelium
B. columnar epithelium
C. prominent brush border
D. numerous mitochondria

C

126

histological feature of loop of Henle

A. simple squamous epithelium
B. columnar epithelium
C. prominent brush border
D. numerous mitochondria

A