Chapter 25

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Chapter 25

  
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  • 1. 
    The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.
    • A. 

      Distal convoluted tubule

    • B. 

      Glomerular filtration membrane

    • C. 

      Collecting duct

    • D. 

      Loop of Henle


  • 2. 
    Urine passes through the ________.
    • A. 

      Renal hilum to the bladder to the ureter

    • B. 

      Pelvis of the kidney to ureter to bladder to urethra

    • C. 

      Hilum to urethra to bladder

    • D. 

      Glomerulus to ureter to renal tubule


  • 3. 
    Which of the following is not associated with the renal corpuscle?
    • A. 

      An efferent arteriole

    • B. 

      A vasa recta

    • C. 

      A fenestrated capillary

    • D. 

      A podocyte


  • 4. 
    An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.
    • A. 

      Decrease in the production of ADH

    • B. 

      Decrease in the concentration of the blood plasma

    • C. 

      Increase in the production of ADH

    • D. 

      Increase in the production of aldosterone


  • 5. 
    The urinary bladder is composed of ________ epithelium.
    • A. 

      Stratified squamous

    • B. 

      Pseudostratified columnar

    • C. 

      Transitional

    • D. 

      Simple squamous


  • 6. 
    The kidneys are stimulated to produce renin ________.
    • A. 

      When the specific gravity of urine rises above 1.10

    • B. 

      By a decrease in the blood pressure

    • C. 

      When the pH of the urine decreases

    • D. 

      When the peritubular capillaries are dilated


  • 7. 
    Which of the choices below is not a function of the urinary system?
    • A. 

      Helps maintain homeostasis by controlling the composition, volume, and pressure of blood

    • B. 

      Maintains blood osmolarity

    • C. 

      Regulates blood glucose levels and produces hormones

    • D. 

      Eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat


  • 8. 
    Which gland sits atop each kidney?
    • A. 

      Pancreas

    • B. 

      Pituitary

    • C. 

      Adrenal

    • D. 

      Thymus


  • 9. 
    The ________ artery lies on the boundary between the cortex and medulla of the kidney.
    • A. 

      Interlobar

    • B. 

      Cortical radiate

    • C. 

      Lobar

    • D. 

      Arcuate


  • 10. 
    The glomerulus differs from other capillaries in the body in that it ________.
    • A. 

      Is impermeable to most substances

    • B. 

      Has a basement membrane

    • C. 

      Has a blood pressure much lower than other organ systems

    • D. 

      Is drained by an efferent arteriole


  • 11. 
    The descending limb of the loop of Henle ________.
    • A. 

      Is freely permeable to sodium and urea

    • B. 

      Is not permeable to water

    • C. 

      Pulls water by osmosis into the lumen of the tubule

    • D. 

      Contains fluid that becomes more concentrated as it moves down into the medulla


  • 12. 
    Select the correct statement about the ureters.
    • A. 

      The ureter is innervated by parasympathetic nerve endings only.

    • B. 

      Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.

    • C. 

      The epithelium is stratified squamous like the skin, which allows a great deal of stretch.

    • D. 

      The ureters are capable of peristalsis like that of the gastrointestinal tract.


  • 13. 
    The fatty tissue surrounding the kidneys is important because it ________.
    • A. 

      Is necessary as a barrier between the adrenal glands and kidneys

    • B. 

      Stabilizes the position of the kidneys by holding them in their normal position

    • C. 

      Ensures adequate energy for the adrenal glands to operate efficiently

    • D. 

      Produces vitamin D


  • 14. 
    The renal corpuscle is made up of ________.
    • A. 

      The renal papilla

    • B. 

      The descending loop of Henle

    • C. 

      The renal pyramid

    • D. 

      Bowman's capsule and glomerulus


  • 15. 
    The functional and structural unit of the kidneys is the ________.
    • A. 

      Glomerular capsule

    • B. 

      Loop of Henle

    • C. 

      Basement membrane of the capillaries

    • D. 

      Nephron


  • 16. 
    The juxtaglomerular apparatus is responsible for ________.
    • A. 

      The secretion of drugs

    • B. 

      The secretion of acids and ammonia

    • C. 

      Regulating the rate of filtrate formation and controlling systemic blood pressure

    • D. 

      Reabsorption of organic molecules, vitamins, and water


  • 17. 
    The chief force pushing water and solutes out of the blood across the filtration membrane is ________.
    • A. 

      The thickness of the capillary endothelium

    • B. 

      Glomerular hydrostatic pressure (glomerular blood pressure)

    • C. 

      The size of the pores in the basement membrane of the capillaries

    • D. 

      The design and size of the podocytes


  • 18. 
    Which of the following statements describes the histology of the ureters?
    • A. 

      They are actually an extension of the visceral peritoneum.

    • B. 

      They are made up entirely of muscle tissue because they need to contract in order to transport urine efficiently.

    • C. 

      They are made up of several layers of endothelium.

    • D. 

      They are trilayered (mucosa, muscularis, and adventitia).


  • 19. 
    Which of the following statements is a false or incorrect statement?
    • A. 

      The male urethra serves both the urinary and reproductive systems at the same time.

    • B. 

      The male urethra is longer than the female urethra.

    • C. 

      The male urethra serves both the urinary and reproductive systems but at different times.

    • D. 

      The male urethra is a passageway for both urine and semen.


  • 20. 
    Which of the following acts as the trigger for the initiation of micturition (voiding)?
    • A. 

      The pressure of the fluid in the bladder

    • B. 

      The stretching of the bladder wall

    • C. 

      The sympathetic efferents

    • D. 

      Motor neurons


  • 21. 
    The filtration membrane includes all except ________.
    • A. 

      Basement membrane

    • B. 

      Renal fascia

    • C. 

      Glomerular endothelium

    • D. 

      Podocytes


  • 22. 
    The mechanism of water reabsorption by the renal tubules is ________.
    • A. 

      Solvent drag

    • B. 

      Osmosis

    • C. 

      Cotransport with sodium ions

    • D. 

      Active transport


  • 23. 
    Most electrolyte reabsorption by the renal tubules is ________.
    • A. 

      Hormonally controlled in distal tubule segments

    • B. 

      In the distal convoluted tubule

    • C. 

      Completed by the time the loop of Henle is reached

    • D. 

      Not Tm limited


  • 24. 
    The macula densa cells respond to ________.
    • A. 

      Changes in solute content of the filtrate

    • B. 

      Antidiuretic hormone

    • C. 

      Changes in pressure in the tubule

    • D. 

      Aldosterone


  • 25. 
    Which of the following is not reabsorbed by the proximal convoluted tubule?
    • A. 

      K+

    • B. 

      Glucose

    • C. 

      Na+

    • D. 

      Creatinine


  • 26. 
    The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________.
    • A. 

      Plasma protein

    • B. 

      Glucose

    • C. 

      Electrolytes

    • D. 

      Hormones


  • 27. 
    Alcohol acts as a diuretic because it ________.
    • A. 

      Increases secretion of ADH

    • B. 

      Inhibits the release of ADH

    • C. 

      Is not reabsorbed by the tubule cells

    • D. 

      Increases the rate of glomerular filtration


  • 28. 
    The function of angiotensin II is to ________.
    • A. 

      Constrict arterioles and increase blood pressure

    • B. 

      Decrease water absorption

    • C. 

      Decrease arterial blood pressure

    • D. 

      Decrease the production of aldosterone


  • 29. 
    A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________.
    • A. 

      Diabetes insipidus

    • B. 

      Diabetic acidosis

    • C. 

      Diabetes mellitus

    • D. 

      Coma


  • 30. 
    An important characteristic of urine is its specific gravity or density, which is ________.
    • A. 

      1.000-1.015

    • B. 

      1.041-1.073

    • C. 

      1.001-1.035

    • D. 

      1.030-1.040


  • 31. 
    Place the following in correct sequence from the formation of a drop of urine to its elimination from the body. 1.     major calyx 2.     minor calyx 3.     nephron 4.     urethra 5.     ureter 6.      collecting duct
    • A. 

      3, 6, 2, 1, 5, 4

    • B. 

      3, 1, 2, 6, 5, 4

    • C. 

      3, 1, 2, 6, 5, 4

    • D. 

      6, 3, 2, 1, 5, 4


  • 32. 
    Select the correct statement about the nephrons.
    • A. 

      Podocytes are the branching epithelial cells that line the tubules of the nephron.

    • B. 

      Filtration slits are the pores that give fenestrated capillaries their name.

    • C. 

      The parietal layer of the glomerular capsule is simple squamous epithelium.

    • D. 

      The glomerulus is correctly described as the proximal end of the proximal convoluted tubule.


  • 33. 
    What would happen if the capsular hydrostatic pressure were increased above normal?
    • A. 

      Filtration would increase in proportion to the increase in capsular pressure.

    • B. 

      Net filtration would decrease.

    • C. 

      Net filtration would increase above normal.

    • D. 

      Capsular osmotic pressure would compensate so that filtration would not change.


  • 34. 
    Which of the following is not a part of the juxtaglomerular apparatus?
    • A. 

      Granular cells

    • B. 

      Mesangial cells

    • C. 

      Podocyte cells

    • D. 

      Macula densa


  • 35. 
    Tubular reabsorption ________.
    • A. 

      By active mechanisms usually involves movement against an electrical and/or chemical gradient

    • B. 

      Includes substances such as creatinine

    • C. 

      By passive processes requires ATP to move solutes from the interior of the tubule to the blood

    • D. 

      Is a way for the body to get rid of unwanted waste


  • 36. 
    Which of the following is not a reason why substances are either not reabsorbed or are incompletely reabsorbed from the nephron?
    • A. 

      They are too large to pass through the fenestrations.

    • B. 

      They are extremely complex molecules.

    • C. 

      They are not lipid soluble.

    • D. 

      They lack carriers.


  • 37. 
    Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.
    • A. 

      Countertransport

    • B. 

      Facilitated diffusion

    • C. 

      Passive transport

    • D. 

      Secondary active transport


  • 38. 
    Which of the choices below is a function of the loop of Henle?
    • A. 

      Absorb electrolytes actively with an automatic absorption of water by osmosis

    • B. 

      Form a large volume of very concentrated urine or a small volume of very dilute urine

    • C. 

      Form a large volume of very dilute urine or a small volume of very concentrated urine

    • D. 

      None of these


  • 39. 
    Fetal kidneys do not have to work very hard because ________.
    • A. 

      The placenta allows the mother's urinary system to clear the waste from fetal blood

    • B. 

      there are no functional nephrons until after birth

    • C. 

      There is no way a fetus could excrete urine until the seventh month of development

    • D. 

      Fetuses do not have any waste to excrete


  • 40. 
    Which of the following best describes kidney function in older adults (70 years or older)?
    • A. 

      Kidney function decreases due to kidney atrophy.

    • B. 

      Only about 3% of older adults have any loss of kidney function.

    • C. 

      Kidney function remains the same throughout life, regardless of age.

    • D. 

      Only obese and diabetic older adults have any kidney dysfunction.


  • 41. 
    The factor favoring filtrate formation at the glomerulus is the ________.
    • A. 

      Glomerular hydrostatic pressure

    • B. 

      Capsular hydrostatic pressure

    • C. 

      Myogenic mechanism

    • D. 

      Colloid osmotic pressure of the blood


  • 42. 
    If the Tm for a particular amino acid is 120 mg/100 ml and the concentration of that amino acid in the blood is 230 mg/100 ml, the amino acid will ________.
    • A. 

      Be reabsorbed by secondary active transport

    • B. 

      Be actively secreted into the filtrate

    • C. 

      Appear in the urine

    • D. 

      Be completely reabsorbed by the tubule cells


  • 43. 
    If one says that the clearance value of glucose is zero, what does this mean?
    • A. 

      Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules.

    • B. 

      The glucose molecule is too large to be filtered out of the blood.

    • C. 

      Normally all the glucose is reabsorbed.

    • D. 

      The clearance value of glucose is relatively high in a healthy adult.


  • 44. 
    Excretion of dilute urine requires ________.
    • A. 

      The presence of ADH

    • B. 

      The presence of ADH

    • C. 

      Relative permeability of the distal tubule to water

    • D. 

      Transport of sodium and chloride ions out of the descending loop of Henle


  • 45. 
    Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?
    • A. 

      By secreting hydrogen ions into the filtrate

    • B. 

      By secreting sodium ions

    • C. 

      By producing new bicarbonate ions

    • D. 

      By reabsorbing filtered bicarbonate ions


  • 46. 
    In the ascending limb of the loop of Henle the ________.
    • A. 

      Thin segment is freely permeable to water

    • B. 

      Thick segment is permeable to water

    • C. 

      Thick segment moves ions out into interstitial spaces for reabsorption

    • D. 

      Thin segment is not permeable to sodium and chloride


  • 47. 
    Select the correct statement about urinary system development.
    • A. 

      The metanephric ducts will become the urethras.

    • B. 

      The mesonephros will develop into the kidneys.

    • C. 

      Kidneys develop from urogenital ridges.

    • D. 

      The pronephros (first tubule system) develops during the tenth week of gestation.


  • 48. 
    Which of the choices below does not describe the importance of tubular secretion?
    • A. 

      Ridding the body of excessive potassium ions

    • B. 

      Ridding the body of bicarbonate ions

    • C. 

      Eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes

    • D. 

      Disposing of substances not already in the filtrate, such as certain drugs


  • 49. 
    Which statement is correct?
    • A. 

      Most of the water passing through the kidney is eliminated as urine.

    • B. 

      Reabsorption of water is hormonally controlled.

    • C. 

      The excretion of sodium ions is one of the mechanisms that maintains the pH balance of the blood.

    • D. 

      Normal filtrate contains a large amount of protein.


  • 50. 
    What is the function of the juxtaglomerular apparatus?
    • A. 

      Help regulate blood pressure and the rate of excretion by the kidneys

    • B. 

      Help regulate water and electrolyte excretion by the kidneys

    • C. 

      Help regulate urea absorption by the kidneys

    • D. 

      Help regulate blood pressure and the rate of blood filtration by the kidneys


  • 51. 
    Which of the choices below is the salt level-monitoring part of the nephron?
    • A. 

      Vasa recta

    • B. 

      Principal cell

    • C. 

      Macula densa

    • D. 

      Loop of Henle


  • 52. 
    Which of the hormones below is responsible for facultative water reabsorption?
    • A. 

      Thyroxine

    • B. 

      ADH

    • C. 

      Atrial natriuretic peptide

    • D. 

      Aldosterone


  • 53. 
    Which of the choices below is not a glomerular filtration rate control method?
    • A. 

      Electrolyte levels

    • B. 

      Hormonal regulation

    • C. 

      Neural regulation

    • D. 

      Renal autoregulation


  • 54. 
    Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion?
    • A. 

      Angiotensin I and epinephrine

    • B. 

      Angiotensin II and ADH

    • C. 

      Angiotensin I and atrial natriuretic peptide

    • D. 

      Angiotensin II and aldosterone


  • 55. 
    Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate?
    • A. 

      Juxtaglomerular cells

    • B. 

      Mesangial cells

    • C. 

      Podocytes

    • D. 

      Macula densa cells


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