Block 6 Pace Quiz 2 Part 1
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Pace quiz 5, march 15 2012 renal module
Questions and Answers
- 1.
Stenosis of renal artery causes hypertension. The physician is interested to measure the renal blood flow (RBF) of a hypertensive patient to verify the significance of the stenosis of his renal artery. Which of the following clearances equals renal plasma flow (RPF), from which RBF can be estimated?
- A.
Glucose clearance
- B.
Inulin clearance
- C.
Creatinin clearance
- D.
Paraaminohipuric acid clearance
- E.
Urea clearance
Correct Answer
D. Paraaminohipuric acid clearanceExplanation
Paraaminohipuric acid clearance is used to estimate renal plasma flow (RPF), which can then be used to estimate renal blood flow (RBF). This is because paraaminohipuric acid is freely filtered by the glomerulus and is neither reabsorbed nor secreted by the renal tubules. Therefore, the clearance of paraaminohipuric acid can be used as an indicator of the rate at which plasma is being delivered to the kidneys, allowing for an estimation of RPF and subsequently RBF.Rate this question:
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- 2.
Patients seen in a refugee camp after a famine would be expected to be in negative nitrogen balance because:
- A.
Dietary nitrogen drops below the recommended daily allowance
- B.
Fecal nitrogen excretion exceeds urinary nitrogen excretion
- C.
Dietary nitrogen intake exceeds nitrogen loss
- D.
Diet contains more nonessential amino acids than essential amino acids
- E.
Nitrogen loss exceeds dietary nitrogen intake
Correct Answer
E. Nitrogen loss exceeds dietary nitrogen intakeExplanation
Patients seen in a refugee camp after a famine would be expected to be in negative nitrogen balance because nitrogen loss exceeds dietary nitrogen intake. This means that the amount of nitrogen being lost from the body through excretion (urine and feces) is greater than the amount of nitrogen being consumed through the diet. This imbalance can occur due to inadequate dietary intake, poor absorption of nutrients, or increased losses from the body. In the context of a famine, where food scarcity and malnutrition are common, it is likely that the patients are not able to consume enough nitrogen-containing foods to meet their body's needs, leading to a negative nitrogen balance.Rate this question:
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- 3.
A 5mo old female was transferred to an emergency room in a rapidly deteriorating condition. She was born in Ville de Saguenay (Quebec), birth was uneventful. However, she failed to thrive. Lab: Glutamic:pyruvic transaminase (GPT), aspartate aminotransferase (AST), ammonia and creatinine levels in blood were elevated, attending physicians noticed a strong cabbage-like smell originating from her. The most likely diagnosis is
- A.
Hyperlysinemia
- B.
Tyrosinemia I
- C.
Cystinuria
- D.
Methylmalonic aciduria
- E.
Glycine cleavage enzyme deficiency
Correct Answer
B. Tyrosinemia IExplanation
The elevated levels of GPT, AST, ammonia, and creatinine, along with the strong cabbage-like smell, suggest a metabolic disorder. Tyrosinemia I is a rare genetic disorder characterized by the deficiency of the enzyme fumarylacetoacetate hydrolase, which leads to the accumulation of toxic substances in the body, including tyrosine. This can cause liver dysfunction, failure to thrive, and the characteristic odor. Hyperlysinemia, cystinuria, methylmalonic aciduria, and glycine cleavage enzyme deficiency do not present with the same combination of symptoms and laboratory findings as seen in this case.Rate this question:
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- 4.
Dr Shams A substance that is filtered, but not secreted or reabsorbed (substance X), is infused into a volunteer until a steady state level of 0.1 mg/mL is achieved. The subject then empties his bladder and waits 1 hour, at which time he urinates again. The volume of urine in the second specimen is 60 mL, and the concentration of substance X is 10 mg/mL. What is the clearance of this substance and does the clearance measure glomerular filtration rate or renal plasma flow? Clearance (mL/min GFR RPF 1 30 X 2 30 X 3 100 X 4 100 X 5 300 X
- A.
1
- B.
2
- C.
3
- D.
4
- E.
5
Correct Answer
C. 3Explanation
The clearance of a substance is the volume of plasma from which the substance is completely removed per unit time. In this scenario, the concentration of substance X in the urine is 10 mg/mL, and the volume of urine is 60 mL. Therefore, the amount of substance X excreted in the urine is 10 mg/mL * 60 mL = 600 mg. The steady-state level of substance X in the plasma is 0.1 mg/mL. To achieve this level, 600 mg of substance X must be removed from the plasma. The clearance of substance X can be calculated by dividing the amount of substance X excreted in the urine (600 mg) by the time taken (1 hour = 60 minutes). Therefore, the clearance of substance X is 600 mg/60 min = 100 mL/min. Since clearance measures the rate at which a substance is removed from the plasma, it reflects the glomerular filtration rate (GFR). Therefore, the clearance of substance X measures the GFR.Rate this question:
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- 5.
A 40 yo male comes to his physician because of nodules on hands, elbows and Achilles tendons (see fig.). His own medical history is unremarkable; however, both his father and paternal grandfather have died from AMI in their early 50s. Physical exam: weight 84 kg, size 1.80m, BP 125/70mm Hg, other findings normal. Lab investigations on an o/n fasting blood sample result in the following (in mg/dL): Cholesterol 370 (≤ 200), LDL 300 (100–130), HDL 32 (29–60), triglycerides 189 (35–150), glucose 90 (70–110). The most likely diagnosis is:
- A.
Diabetes mellitus type I (DM-I)
- B.
Familial hypercholesterolemia (FH)
- C.
Maturity onset diabetes mellitus of the young (MODY)
- D.
Metabolic syndrome
- E.
Neurofibromatosis (NF)
Correct Answer
B. Familial hypercholesterolemia (FH)Explanation
The patient's presentation of nodules on hands, elbows, and Achilles tendons, along with a family history of early-onset myocardial infarction (AMI), suggests a diagnosis of familial hypercholesterolemia (FH). FH is an autosomal dominant disorder characterized by elevated levels of LDL cholesterol. The patient's lab results show significantly elevated cholesterol and LDL levels, which further support the diagnosis. Other options such as diabetes mellitus type I, MODY, metabolic syndrome, and neurofibromatosis are not consistent with the patient's clinical findings and lab results.Rate this question:
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- 6.
Which of the following structures is represented by the area labeled with an asterisk in the accompanying electron micrograph?
- A.
The lumen of a proximal convoluted tubule
- B.
Renal pelvis
- C.
The lumen of a glomerular capillary
- D.
Minor calyx
- E.
The urinary space
Correct Answer
E. The urinary spaceExplanation
The area labeled with an asterisk in the electron micrograph represents the urinary space. This is the space within the renal corpuscle where the filtrate from the glomerular capillaries collects before entering the proximal convoluted tubule. The other options, such as the lumen of a proximal convoluted tubule, renal pelvis, glomerular capillary, and minor calyx, do not accurately describe the area labeled with an asterisk in the electron micrograph.Rate this question:
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- 7.
Dr Buxbaum The DRI of Vitamin A for an 18a old is: EAR 625 µg/d, RDA 900µg/d and UL 2800µg /d. A patient of that group taking on average 950µg/d will suffer from symptoms of:
- A.
Poisoning with a probability of about 50 %
- B.
Poisoning with a probability of about 2%
- C.
Deficiency with a probability of about 98%
- D.
Deficiency with a probability of about 2 %
- E.
Deficiency with a probability of about 50%
Correct Answer
D. Deficiency with a probability of about 2 %Explanation
Based on the information provided, the patient is taking 950µg/d of Vitamin A, which is above the RDA (900µg/d) but below the UL (2800µg/d). The UL represents the maximum daily intake that is unlikely to cause adverse effects. Since the patient's intake is below the UL, it is unlikely that they will suffer from symptoms of poisoning. However, their intake is also above the RDA, which suggests that they are not deficient in Vitamin A. Therefore, the most likely scenario is that they have a sufficient intake of Vitamin A and are not deficient, with a probability of about 2%.Rate this question:
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- 8.
A 54-year-old male presents himself at an outpatient clinic complaining of weakness, lassitude and a weight loss of 20kg over the last 7mo. On Dr. E. Buxbaum examination pulse and respiratory rate, EKG and chest X-ray appeared normal. Blood pressure was 145/75 mm Hg, liver was firm and moderately enlarged (2 fingers below costal margin). Upon questioning the patient remarked that his skin had become darker over the last years, a change he attributed to working outdoors. He denied exposure to toxic chemicals or metal fumes. Lab results: Fasting blood glucose 7.6mM (3.9–6.1mM), Urine glucose(random) + (0), total serum bilirubin 20 µM (2.6–26µM), Haemoglobin 16.5 g/dl (14.0–18.0g/dl) Haematocrit 52% (40–54%), Methemoglobin 0 (0), Serum iron 43 µM (7.2–28.6µM), total iron binding capacity (TIBC) 56µM (47–77µM), aspartate aminotransferase (AST) 50U/l(5–34U/l), alanine aminotransferase (ALT) 45U/l(5–50U/l), Serum ferritin 463µg/l (20–250 µg/l). On the basis of these results a liver biopsy was performed. Microscopic examination revealed fatty vacuolisation of the hepatocytes and moderate deposits of hemosiderin in their cytoplasm. Your diagnosis would be
- A.
Hemochromatosis
- B.
Wilson’s disease
- C.
Menke’s kinky hair syndrome
- D.
Keshan-disease
- E.
Kashin-Beck disease
Correct Answer
A. HemochromatosisExplanation
The correct answer is Hemochromatosis. This is supported by the clinical findings of a firm and moderately enlarged liver, along with laboratory results showing elevated serum iron and ferritin levels. The presence of fatty vacuolisation of hepatocytes and hemosiderin deposits on liver biopsy further supports the diagnosis of hemochromatosis, a condition characterized by excessive iron absorption and deposition in various organs. This condition can lead to symptoms such as weakness, weight loss, and skin darkening, which are consistent with the patient's presentation.Rate this question:
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- 9.
Which of the following is the afferent limb of cremasteric reflex-?
- A.
Femoral branch of genitofemoral nerve
- B.
Lateral femoral cut. Nerve
- C.
Iliohypogastric nerve
- D.
Genital branch of genitofemoral nerve
- E.
Pudendal nerve
Correct Answer
A. Femoral branch of genitofemoral nerveExplanation
The afferent limb of the cremasteric reflex is the Femoral branch of genitofemoral nerve. This nerve carries sensory information from the skin of the upper anterior thigh and supplies the cremaster muscle, which is responsible for the reflexive elevation of the testicle. The other options listed are not directly involved in the cremasteric reflex.Rate this question:
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- 10.
Dr Yin A 5-lb newborn is dead soon after birth and autopsy shows renal agenesis. Which of the following most likely happened during this baby’s development?
- A.
Urachus failed to obliterate
- B.
Kidneys fused into one and failed to ascend
- C.
Ureteric bud failed to appear bilaterally
- D.
Pronephros failed to regress
- E.
Cysts developed in all segments of renal tubules
Correct Answer
C. Ureteric bud failed to appear bilaterallyExplanation
The most likely explanation for the baby's renal agenesis is that the ureteric bud failed to appear bilaterally. The ureteric bud is responsible for the formation of the ureters, renal pelvis, calyces, and collecting ducts. If it fails to appear, the kidneys will not develop properly, leading to renal agenesis.Rate this question:
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- 11.
Which of the following structures is shown in the following Electron micrograph?
- A.
Distal convoluted tubule
- B.
Visceral layer of Bowman’s capsule
- C.
Parietal layer of Bowman’s capsule
- D.
Proximal convoluted tubule
- E.
Thin limb of loop of Henle
Correct Answer
D. Proximal convoluted tubuleExplanation
The correct answer is the Proximal convoluted tubule. This is because the image shows a tubular structure with a brush border on the luminal side, which is a characteristic feature of the proximal convoluted tubule. The other options, such as the distal convoluted tubule and the thin limb of the loop of Henle, have different structural features that are not present in the given image.Rate this question:
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- 12.
Dr Dhiman A newborn boy is brought to his physician’s office by his mother, who reports that the baby is constantly crying and that his scrotum seems much bigger than it was at birth just 2 days ago. The physician suspects that the child is suffering from a hernia. The baby’s scrotal swelling is most likely the result of which kind of hernia?
- A.
Indirect inguinal hernia
- B.
Diaphragmatic hernia
- C.
Direct inguinal hernia
- D.
Femoral hernia
- E.
Hernia through Hesselbach’s triangle
Correct Answer
A. Indirect inguinal herniaExplanation
The scrotal swelling in a newborn boy, along with constant crying, suggests a hernia. In this case, the most likely type of hernia is an indirect inguinal hernia. Indirect inguinal hernias occur when a part of the intestine protrudes through the inguinal canal, which connects the abdomen to the scrotum. This type of hernia is more common in newborns and can cause scrotal swelling. Other types of hernias, such as diaphragmatic hernia, direct inguinal hernia, femoral hernia, or hernia through Hesselbach's triangle, are less likely to cause scrotal swelling in a newborn.Rate this question:
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- 13.
A 65-year-old man presents to your clinic complaining of abdominal pains. He notes that the pain normally starts 20 minutes after having a meal, and often lasts for about 90 minutes. He has also been having severe hematochezia (red blood in stool). Upon physical examination, the patient looks emaciated. Palpation of the abdomen reveals no evidence of peritonitis or bowel masses. Endoscopic survey shows he is suffering from ischemic colitis. To access the extent of the ischemia, an exploratory laparotomy is ordered and you observe an extensive damage in the hindgut region. You recommend a resection of the ischemic portion, and ligation of the Inferior Mesenteric Artery (IMA) at its origin. Which nerve is likely to be damaged and what function is likely to be compromised during the ligation of the IMA at its origin?
- A.
Greater splanchnic Transmit reflex sensation
- B.
Lesser splanchnic Promote digestion
- C.
Lumbar splanchnic Maintain tonus of internal sphincter muscles
- D.
Pelvic splanchnic Inhibit internal anal sphincter muscles
- E.
Sacral splanchnic Promote glandular secretion
Correct Answer
C. Lumbar splanchnic Maintain tonus of internal spHincter musclesExplanation
During the ligation of the Inferior Mesenteric Artery (IMA) at its origin, the lumbar splanchnic nerve is likely to be damaged. This nerve is responsible for maintaining the tonus of the internal sphincter muscles. Damage to the lumbar splanchnic nerve can lead to a loss of control over the internal sphincter muscles, potentially resulting in issues with bowel control and continence.Rate this question:
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- 14.
Dr Barremkala Portal hypertension is defined by a hepatic venous pressure gradient (HVPG) greater than 5 mmHg. It is usually caused by an increase in resistance in the portal-hepatic vascular bed due to obstruction to flow, which is related to cirrhosis in the vast majority of patients. What veins would contribute for by passing this obstruction?
- A.
Right gastric and esophageal veins
- B.
Middle rectal and inferior rectal veins
- C.
Left gastric and esophageal veins
- D.
Superior rectal and sigmoidal veins
- E.
Left gastromental and Splenic vein
Correct Answer
C. Left gastric and esopHageal veinsExplanation
In portal hypertension, there is increased resistance in the portal-hepatic vascular bed due to obstruction to flow, often related to cirrhosis. When there is obstruction in the portal vein, blood flow can be diverted through collateral veins to bypass the obstruction. The left gastric vein and esophageal veins are important collateral veins that contribute to bypassing the obstruction in portal hypertension. These collateral veins provide an alternative pathway for blood to flow from the portal system to the systemic circulation, helping to alleviate the increased pressure in the portal system.Rate this question:
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- 15.
A 48-year-old female patient presented with loin pain hematuria syndrome. The history revealed that the initial pain was intermittent followed by organic obstruction pain and there was no history of injury. Supine standard and ancillary imaging was normal. Upright intravenous urography, however, showed pelvi-ureteric junction kink. What is the most likely cause of her condition?
- A.
Cystic kidney
- B.
Dropped kidney
- C.
Horse shoe kidney
- D.
Duplex kidney
- E.
Infracted kidney
Correct Answer
B. Dropped kidneyExplanation
The most likely cause of the patient's condition is a dropped kidney. This is supported by the finding of a pelvi-ureteric junction kink on upright intravenous urography. A dropped kidney, also known as nephroptosis, occurs when the kidney descends from its normal position due to the lack of supporting structures. This can lead to symptoms such as loin pain and hematuria. The other options, such as cystic kidney, horse shoe kidney, duplex kidney, and infarcted kidney, do not align with the given information and are less likely to be the cause of the patient's condition.Rate this question:
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- 16.
Dr Kirera You decide to perform an endoscopic examination of a 50-year-old man who is complaining of generalized abdominal pain on left lower quadrant. Based on your endoscopic findings, which anatomical feature is most useful in distinguishing the ileum from the jejunum?
- A.
Ileum has smaller caliber compared to jejunum
- B.
Ileum has smaller circular folds compared to jejunum
- C.
Ileum has few lymphoid nodules compared to jejunum
- D.
Ileum has thinner walls compared to jejunum
- E.
Ileum mucosa has sparse vascular network compared to jejunum
Correct Answer
B. Ileum has smaller circular folds compared to jejunumExplanation
The correct answer is "Ileum has smaller circular folds compared to jejunum." This is because the circular folds, also known as plicae circulares, are prominent features of the small intestine that increase its surface area for absorption. The jejunum has larger and more numerous circular folds compared to the ileum. Therefore, the presence of smaller circular folds is a distinguishing anatomical feature of the ileum.Rate this question:
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- 17.
Numerous buffer systems are participating in buffering H+ during acid/base disturbances in the body. pK’ values of five buffer systems are listed below: Which one of the listed buffers would have the highest buffering capacity in ECF, if the concentrations of all buffers are equal?
- A.
Buffer 1
- B.
Buffer 2
- C.
Buffer 3
- D.
Buffer 4
- E.
Buffer 5
Correct Answer
A. Buffer 1Explanation
Buffer 1 would have the highest buffering capacity in the extracellular fluid (ECF) if the concentrations of all buffers are equal because it has the lowest pK' value among the listed buffers. A lower pK' value indicates a stronger buffer, meaning that Buffer 1 is better able to resist changes in pH by accepting or donating hydrogen ions.Rate this question:
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- 18.
Dr White Which of the following responses to a fall in arterial pressure accounts for the ability of the kidneys to autoregulate GFR?
- A.
Decreased resistance of the efferent arteriole
- B.
Decreased resistance of the afferent arteriole
- C.
Increased delivery of fluid to the end of the proximal tubule
- D.
Increase resistance of the afferent arteriole
- E.
Increased [NaCl] in tubular fluid at the macula densa
Correct Answer
B. Decreased resistance of the afferent arterioleExplanation
When there is a fall in arterial pressure, the kidneys are able to autoregulate the glomerular filtration rate (GFR) by decreasing the resistance of the afferent arteriole. The afferent arteriole is responsible for supplying blood to the glomerulus, where filtration occurs. By decreasing its resistance, more blood is able to flow into the glomerulus, increasing the GFR. This mechanism helps to maintain a stable GFR despite changes in systemic blood pressure, ensuring that the kidneys continue to function properly.Rate this question:
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- 19.
The graph below depicts the change in tubular fluid concentration of various substances along the length of the proximal tubule plotted as the tubular fluid-to-plasma concentration ratio (TF/P). Thus the TF/P = 1 for a substance that is at the same concentration in the tubular fluid and plasma (all substances that are freely filtered have a TF/P equal to 1 at the glomerulus). Which of the lines best depicts the TF/P ratio for Na+?
- A.
1
- B.
2
- C.
3
- D.
4
Correct Answer
C. 3Explanation
Line 3 best depicts the TF/P ratio for Na+. This is because the TF/P ratio for Na+ should be greater than 1 in the proximal tubule, indicating that Na+ is being reabsorbed from the tubular fluid into the plasma. Line 3 shows a gradual increase in the TF/P ratio for Na+ along the length of the proximal tubule, which is consistent with the reabsorption of Na+.Rate this question:
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- 20.
A 24-year-old male is being investigated for renal stone disease, estimation of his creatinin clearance gives a value of 75 mL/min (normal 125 mL/min). By what mechanism is the change in creatinine clearance likely to be occurring?
- A.
Dilation of the afferent arteriole
- B.
Decrease in renal nerve activity
- C.
Decrease in plasma oncotic pressure
- D.
Increase in renal blood flow
- E.
Increase in hydrostatic pressure in Bowman’s space
Correct Answer
E. Increase in hydrostatic pressure in Bowman’s spaceExplanation
The increase in hydrostatic pressure in Bowman's space is likely causing the change in creatinine clearance. This increased pressure can lead to a decrease in the filtration rate and clearance of creatinine. It can be caused by factors such as obstruction in the urinary tract or increased pressure in the glomerular capillaries. This can result in a decrease in the glomerular filtration rate and subsequently a decrease in creatinine clearance.Rate this question:
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- 21.
The transepithelial potential difference in the late part of the proximal tubule is orientated 1 – 2 mV lumen-positive. What is the mechanism that generates this voltage?
- A.
Secretory movement of potassium ions
- B.
Absorptive movement of bicarbonate ions
- C.
Secretory movement of hydrogen ions
- D.
Absorptive movement of phosphate ions
- E.
Absorptive movement of chloride ions
Correct Answer
E. Absorptive movement of chloride ionsExplanation
The correct answer is absorptive movement of chloride ions. In the late part of the proximal tubule, chloride ions are actively transported from the lumen into the epithelial cells. This movement of chloride ions creates a negative charge inside the cells, which in turn generates a positive transepithelial potential difference.Rate this question:
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- 22.
Dr Adebiyi A 29-year-old man who loved the sound of sea waves and regularly took long walks on the beach bare-footed complained of a pruritic and erythematous rash on his feet. He also experienced abdominal pain and diarrhea. Upon evaluation at the health clinic, it was found that he had a fever and was slightly anemic. Routine blood cultures were negative for bacteria but some parasite ova were found in his stool. What organism was most probably responsible for the disease?
- A.
Ascaris lumbicoides
- B.
Necator americanus
- C.
Enterobius vermicularis
- D.
Taenia saginata
- E.
Strongyloides stercoralis
Correct Answer
B. Necator americanusExplanation
The man's symptoms of pruritic and erythematous rash on his feet, abdominal pain, diarrhea, fever, and slight anemia, along with the presence of parasite ova in his stool, suggest a parasitic infection. Necator americanus, also known as hookworm, is a common cause of such symptoms. Hookworm infections are acquired by walking barefoot on contaminated soil, which allows the larvae to penetrate the skin. Once inside the body, the hookworms migrate to the intestines, causing abdominal symptoms and can lead to anemia due to blood loss. Therefore, Necator americanus is the most probable organism responsible for the disease.Rate this question:
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- 23.
A 29-year-old man is an avid diver and has taken part in several diving expeditions. He presented with a sudden onset of headache and stiff neck following a routine dive. Blood examination was negative for bacteria or parasites. However, examination of cerebrospinal fluid revealed the presence of actively motile amoebic trophozoites and a few neutrophils. What organism was most probably responsible for the disease?
- A.
Trypanosoma gambiense
- B.
Naegleria fowlerii
- C.
Entamoeba histolytica
- D.
Taenia solium
- E.
Balantidum coli
Correct Answer
B. Naegleria fowleriiExplanation
The presence of actively motile amoebic trophozoites in the cerebrospinal fluid suggests an infection caused by Naegleria fowlerii. Naegleria fowlerii is a free-living amoeba that is commonly found in warm freshwater environments, such as lakes and hot springs. It can enter the body through the nasal passages and then travel to the brain, causing a severe and often fatal infection known as primary amebic meningoencephalitis (PAM). Symptoms of PAM include headache, stiff neck, fever, and neurological deficits. Given the patient's history of diving in freshwater environments and the presence of amoebic trophozoites in the cerebrospinal fluid, Naegleria fowlerii is the most likely causative organism.Rate this question:
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- 24.
Dr LaVille A 16-year-old female is known to suffer from systemic lupus erythematosus. Blood analysis reveals autoantibodies which are produced against a membrane lipid in platelets, resulting in blood clotting disorders. This membrane lipid is most likely to be:
- A.
Phosphatidylserine
- B.
Phosphatidyl inositol
- C.
Dipalmitoylphosphatidylcholine
- D.
Cardiolipin
- E.
Platelet activating factor
Correct Answer
D. CardiolipinExplanation
In patients with systemic lupus erythematosus, autoantibodies are produced against various self-antigens. Cardiolipin is a phospholipid that is commonly targeted by autoantibodies in patients with lupus. These autoantibodies can lead to the formation of blood clots and cause blood clotting disorders. Therefore, the most likely membrane lipid targeted by autoantibodies in this patient is cardiolipin.Rate this question:
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.JPG "Which of the following structures is represented by the area labeled with an asterisk in the accompanying electron micrograph?")
.JPG "Which of the following structures is shown in the following Electron micrograph?")
.JPG "Numerous buffer systems are participating in buffering H+ during acid/base disturbances in the body. pK’ values of five buffer systems are listed below:
Which one of the listed buffers would have the highest buffering capacity in ECF, if the concentrations of all buffers are equal?")
.JPG "The graph below depicts the change in tubular fluid concentration of various substances along the length of the proximal tubule plotted as the tubular fluid-to-plasma concentration ratio (TF/P). Thus the TF/P = 1 for a substance that is at the same concentration in the tubular fluid and plasma (all substances that are freely filtered have a TF/P equal to 1 at the glomerulus). Which of the lines best depicts the TF/P ratio for Na+?")
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