Questions Flashcards
A buffer pair (HA/A-) has a pK of 5.4. At a blood pH of 7.4, the concentration of HA is:
A. 1/100 that of A- B. 1/10 that of A- C. Equal to that of A- D. 10 times that of A- E. 100 times that of A-
A. 1/100 that of A-
Which of the following would produce an increase in the reabsorption of isosmotic fluid in the proximal tubule?
A. Increased filtration fraction
B. ECF volume expansion
C. Decreased peritubular capillary protein concentration
D. Increased peritubular capillary hydrostatic pressure
E. Oxygen deprivation
A. Increased filtration fraction
At plasma PAH concentrations below the transport maximum (Tm), PAH
A. Reabsorption is not saturated
B. Clearance equals inulin clearance
C. Secretion rate equals PAH excretion rate
D. Concentration in the renal vein is close to zero
E. Concentration in the renal vein equals PAH concentration in the renal artery
D. Concentration in the renal vein is close to zero
Experiments with inbred strains of mice have provided much of our knowledge of transplantation immunology. All mice of one inbred strain are genetically identical to one another and homozygous for all genes. Assume that strains A and B are inbred strains that differ from each other at all MHC gene loci but not at other loci. A mating of a strain A mouse with a strain B mouse (AxB) yields AxB F1 progeny. Which of the following skin grafts would not be rejected?
A. AxB F1 donor to A recipient B. AxB F1 donor to B recipient C. A donor to AxB F1 recipient D. B donor to A recipient E. A donor to B recipient
C. A donor to AxB F1 recipient
A rheumatologist orders lab tests to monitor a patient who is taking a medication that can result in kidney injury. The following results are obtained:
Urine osmolality = 450 mOsm/L
Plasma osmolality = 297 mOsm/L
Urine flow rate = 1.5 mL/min
Which of the following does NOT represent the patient’s free water clearance?
A. Excess solutes are being removed
B. Free water is being excreted
C. Free water is being conserved
D. Free water clearance is a negative value
B. Free water is being excreted
Hyponatremia can sometimes be seen in individuals whose ECF volume is decreased by more than 10%. Which of the following factors contributes to the development of hyponatremia in this situation?
A. Decreased levels of ADH
B. Elevated levels of natriuretic peptides
C. Increased excretion of sodium by the kidneys
D. Reduced excretion of solute-free water by the kidneys
E. Development of positive sodium balance
D. Reduced excretion of solute free water by the kidneys
A 42 y/o female is recovering in the hospital from a benign brain tumor. She develops SIADH, and her plasma [Na+] falls from 142 mEq/L to 128 mEq/L. Urine osmolality is 600 mOsm/Kg H2O. Administering 1 L of isotonic saline to this woman would result in which of the following changs in her plasma [Na] and urinary [Na] excretion?
A. No change in plasma sodium, decreased urinary Na excretion
B. Decreased plasma sodium, increased urinary Na excretion
C. Increased plasma [Na], no change in urinary Na excretion
D. Increased plasma [Na], decreased urinary Na excretion
B. Decreased plasma sodium, increased urinary Na excretion
Renin is produced and secreted from granules located in the:
A. Macula densa B. Mesangial cells C. Intercalated cells D. Afferent arterioles E. Interstitial cells
D. Afferent arterioles
About 4-6 days after you place a normal person on a low-sodium diet, which of the following will be observed?
A. Plasma renin and aldosterone are below normal
B. Plasma renin and aldosterone are above normal
C. Plasma sodium concentration is below normal
D. Plasma sodium concentration is normal
E. B and D are correct
E. B and D are correct
The tonicity of the urine as it enters the renal collecting duct is:
A. Isotonic
B. Hypotonic or isotonic, but never hypertonic
C. Hypotonic
D. Hypertonic
E. Hypertonic or isotonic, but never hypotonic
B. Hypotonic or isotonic, but never hypertonic
Which of the following might you expect to find associated with chronic renal failure?
A. Elevated hematocrit B. Abnormally low plasma creatinine concentration C. Decreased bone density D. Lower than normal PTH E. None of the above
C. Decreased bone density
A 70-year-old male with a body weight of 70 kg and a history of current lung cancer develops SIADH. He is admitted to the hospital and the following lab results are obtained. His vitals and physical exam are normal. There is no evidence of ECF volume contraction of ECF volume expansion. Assume the patient ingests approximately 80 mEq/day of Na+.
Serum Na = 120 mEq/L (135-147 normal)
Urine osmolality = 600 mOsm/kg H2O (500-800 normal)
Urine Na excretion = 80 mEq/day
Which of the following is the source of this patient’s hyponatremia?
A. He is reabsorbing too much Na
B. He is excreting too much Na
C. He is in a positive water balance
D. He is in a negative water balance
C. He is in a positive water balance
Which of the following is NOT one of the three effects that ADH exerts in the kidney?
A. Insertion of aquaporin 2 into apical membrane of the principal cells in late DT and CD
B. Increases activity of NKCC2 in TAL
C. Increases activity of Na/K pump in basolateral membrane
D. Increases urea permeability in inner medullary CD
C. Increases activity of Na/K pump in basolateral membrane
Which of the following will NOT lead to a decrease in flow of the tubular fluid and a decrease in Na delivery and Na concentration past the macula densa?
A. Decreased renal perfusion pressure
B. Vasodilation of the afferent arteriole
C. Reduced filtered load
D. Enhanced proximal fluid reabsorption
B. Vasodilation of the afferent arteriole
After eating 2 bags of salty pork rinds containing approximately 3 g of sodium, which of the following signals is crucial for the excess electrolyte content to be sent to vascular receptors and thus be eliminated from the body?
A. A decrease in effective arterial blood volume
B. A decrease in plasma oncotic pressure
C. A decrease in plasma osmolarity
D. An increase in effective arterial blood volume
E. An increase in plasma oncotic pressure
D. An increase in effective arterial blood volume
A 24 y/o woman is placed on overnight water restrcition. Before consuming any fluids the next morning, her urine flow rate is 1 mL/min. The tubular fluid with the lowest osmolarity will be found at which area?
A. PCT B. Late DT and CCD C. Medullary collecting duct D. Cortical TAL and early DT E. Medullary TAL
C. Medullary collecting duct
Which of the following is most likely to result in respiratory acidosis?
A. Patient with gastroenteritis who is vomiting profusely
B. Patient with diarrhea of about 2 days duration
C. Patient who overdosed on heroin and is breathing very slowly
D. Patient who recently moved to CO and is hiking in the mountains
C. Patient who overdosed on heroin and is breathing very slowly
A patient presents with prerenal azotemia. When asked what she’s been doing the last few days, she can’t remember. Her plasma osmolarity is 600 (normal = <295) and her plasma ADH is extremely low. Which of the following is most likely?
A. SIADH B. Nephrogenic diabetes insipidus C. Central diabetes insipidus D. Primary polydipsia E. Dehydration
C. Central diabetes insipidus
Furosemide is a loop diuretic that produces natriuresis. Which of the following is a potential complication with long-term use?
A. Hyponatremia B. Hypomagnesemia C. Hyperkalemia D. Hypercalcemia E. Hyperphosphatemia
B. Hypomagnesemia
A 3 y/o male pt is brought in by his mom after ingesting 0.5 L of ethylene glycol. You are concerned with which of the following complications?
A. Gastric ulcer B. Insulin deficiency C. Hypocalcemic tetany D. Hyperkalemia E. Cell lysis
C. Hypocalcemic tetany
A 43 y/o male with hx of chronic liver failure presents to the ED to get fluid off his abdomen. PE reveals jaundice and +fluid wave indicative of ascites. What changes likely occured in his angiotensin II, ADH, total extracellular Na, plasma Na, and TBW?
Ang II increased
ADH increased
Total extracellular Na increased
Plasma Na concentration decreased
TBW increased
32 y/o female presents with decreased urination for 1 week. She had a kidney transplant 2 years ago and did not have any problems before a week ago. This reaction to the graft is similar to what other reaction?
A. Arthrus reaction
B. Patient with hx of multiple blood transfusions
C. A patient receiving a PPD
D. A patient with a peanut allergy
C. A patient receiving a PPD
Acute metabolic acidosis tends to cause a ______ in intracellular K+ concentration and a(n) _______ in K+ secretion by the CCD
A. Increase, increase B. Increase, decrease C. Decrease, increase D. Decrease, decrease E. No change, increase F. No change, no change
D. Decrease, decrease
Which of the following nephron segments is the primary site of Mg reabsorption under normal conditions?
A. PT B. Descending LOH C. Ascending LOH D. DCT E. CD’s
C. Ascending LOH
