OS 206 E3 Samplex 2010

Question 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.

Answer 1

D

Question 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

Answer 2

B

Question 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

Answer 3

A

Question 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

Answer 4

A

Question 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.

Answer 5

B

Question 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

Answer 6

D

Question 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

Answer 7

B

Question 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

Answer 8

E

Question 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

Answer 9

A

Question 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

Answer 10

B

Question 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

Answer 11

D

Question 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

Answer 12

C

Question 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

Answer 13

D

Question 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

Answer 14

C

Question 15

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

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

Answer 15

C

Question 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

Answer 16

A

Question 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.

Answer 17

D

Question 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

Answer 18

A

Question 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

Answer 19

B

Question 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.

Answer 20

D

Question 21

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

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

Answer 21

B

Question 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

Answer 22

D

Question 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

Answer 23

C

Question 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.

Answer 24

D

Question 25

The functional unit of the kidney is the: A. renal corpuscle B collecting tubule C. Uriniferous tubule D. juxtamedullary nephron

Answer 25

C

Question 26

The visceral layer of the Bowman's capsule is believed to originate from: A. mesoderm B. metanephros C. endoderm D. glomerular basement membrane

Answer 26

B

Question 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

Answer 27

D

Question 28

The glomerular endothelium is negatively charged due to A. podocalyxin B. fibronectin C. heparan sulphate D. laminin

Answer 28

A

Question 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

Answer 29

B

Question 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.

Answer 30

C

Question 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.

Answer 31

D

Question 32

Which is not characteristic of proximal tubule cell? A. simple cuboidal B. clear cytoplasm C. brush borders D. basolateral interdigitations

Answer 32

B

Question 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

Answer 33

A

Question 34

What type of epithelium lines a distended urinary bladder? A. cuboidal B. columnar C. transitional D. stratified squamous

Answer 34

C

Question 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

Answer 35

A

Question 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

Answer 36

B

Question 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

Answer 37

C

Question 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

Answer 38

B

Question 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 ```

Answer 39

C

Question 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

Answer 40

D

Question 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

Answer 41

C

Question 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

Answer 42

A

Question 43

The earliest event during normal voiding is A. Detrusor contraction B. bladder neck relaxation C. rhabdomyosphincter relaxation D. pelvic floor muscle relaxation

Answer 43

B

Question 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

Answer 44

D

Question 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

Answer 45

D

Question 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 ```

Answer 46

C

Question 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

Answer 47

C

Question 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

Answer 48

B

Question 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

Answer 49

D

Question 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

Answer 50

B

Question 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

Answer 51

D

Question 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

Answer 52

B

Question 53

Insensible water loss from the body includes A. sweat B. water from oxidation of food C. water evaporating from the skin D. stool

Answer 53

C

Question 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

Answer 54

B

Question 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

Answer 55

C

Question 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

Answer 56

C

Question 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 ```

Answer 57

A

Question 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 ```

Answer 58

E

Question 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

Answer 59

B

Question 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

Answer 60

A

Question 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

Answer 61

B

Question 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 ```

Answer 62

C

Question 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

Answer 63

A

Question 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

Answer 64

C

Question 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

Answer 65

B

Question 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

Answer 66

A

Question 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.

Answer 67

A

Question 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

Answer 68

B

Question 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

Answer 69

D

Question 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

Answer 70

C

Question 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

Answer 71

A

Question 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

Answer 72

D

Question 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

Answer 73

A

Question 74

The following are actions of angiotensin ll except A. stimulates thirst B. increases peripheral resistance C. enhances sodium excretion D. causes water retention

Answer 74

C

Question 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

Answer 75

A

Question 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

Answer 76

A

Question 77

Along the entire length of the proximal tubule, the TF/P ratio is lowest for A. chloride B. glucose C. sodium D. phosphate

Answer 77

B

Question 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

Answer 78

D

Question 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 ```

Answer 79

B

Question 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

Answer 80

C

Question 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

Answer 81

D

Question 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

Answer 82

A

Question 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 ```

Answer 83

C

Question 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

Answer 84

A

Question 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

Answer 85

D

Question 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 ```

Answer 86

E

Question 87

Acute cellular uptake of potassium is enhanced by ``` A. alpha catecholamines B. hyperosmolality C. insulin D. cell damage E. acidosis ```

Answer 87

C

Question 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

Answer 88

B

Question 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

Answer 89

B

Question 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 ```

Answer 90

C

Question 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

Answer 91

D

Question 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

Answer 92

C

Question 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

Answer 93

A

Question 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 ```

Answer 94

D

Question 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 ```

Answer 95

B

Question 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 ```

Answer 96

C

Question 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 ```

Answer 97

E

Question 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 ```

Answer 98

A

Question 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.

Answer 99

B

Question 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

Answer 100

B

Question 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

Answer 101

C

Question 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

Answer 102

B

Question 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 ```

Answer 103

D

Question 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

Answer 104

B

Question 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- ]

Answer 105

A

Question 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

Answer 106

C

Question 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

Answer 107

A

Question 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

Answer 108

C

Question 109

Na+ H+ exchange occurs in the: A. proximal tubule B. distal tubule C. both D. neither

Answer 109

A

Question 110

Na+ entry through channels occurs in the: A. proximal tubule B. distal tubule C. both D. neither

Answer 110

B

Question 111

Aldosterone mediated processes occur in the: A. proximal tubule B. distal tubule C. both D. neither

Answer 111

B

Question 112

HCO3+ Cl- exchanger is located in the: A. proximal tubule B. distal tubule C. both D. neither

Answer 112

B

Question 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 ```

Answer 113

D

Question 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 ```

Answer 114

A

Question 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 ```

Answer 115

A

Question 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 ```

Answer 116

E

Question 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 ```

Answer 117

C

Question 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 ```

Answer 118

B

Question 119

function: transport of sodium facilitated by aldosterone A. proximal tubular cell B. loop of Henle C. distal tubular cell D. collecting duct cell

Answer 119

C

Question 120

function: ADH dependent water resorption A. proximal tubular cell B. loop of Henle C. distal tubular cell D. collecting duct cell

Answer 120

D

Question 121

function: glucose resorption A. proximal tubular cell B. loop of Henle C. distal tubular cell D. collecting duct cell

Answer 121

A

Question 122

function: diffusion of water A. proximal tubular cell B. loop of Henle C. distal tubular cell D. collecting duct cell

Answer 122

B

Question 123

histological feature of distal tubular cell A. simple squamous epithelium B. columnar epithelium C. prominent brush border D. numerous mitochondria

Answer 123

D

Question 124

histological feature of collecting duct cell A. simple squamous epithelium B. columnar epithelium C. prominent brush border D. numerous mitochondria

Answer 124

B

Question 125

histological feature of proximal tubular cell A. simple squamous epithelium B. columnar epithelium C. prominent brush border D. numerous mitochondria

Answer 125

C

Question 126

histological feature of loop of Henle A. simple squamous epithelium B. columnar epithelium C. prominent brush border D. numerous mitochondria

Answer 126

A