Block 6 Renal Physiology BRS W Expl Prt 2

26 Questions | Total Attempts: 705

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Block 6 Renal Physiology BRS W Expl Prt 2 - Quiz

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Questions and Answers
  • 1. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased.   Which set of arterial blood values describes a patient with a 5-day history of vomiting?    pH                         HCO3-  (mEq/L)                    PCO2  (mm Hg)
    • A. 

      Ph=7.65 --------------- HCO3=48 -------------- CO2=45

    • B. 

      Ph=7.50 -------------- HCO3=15 -------------- CO2=20

    • C. 

      Ph=7.40 -------------- HCO3=24 -------------- CO2=40

    • D. 

      Ph=7.32 ------------- HCO3=30 -------------- CO2=60

    • E. 

      Ph=7.31 -------------- HCO3=16 -------------- CO2=33

  • 2. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased. Which set of arterial blood values describesa patient with untreated diabetes mellitus and increased urinary excretion of NH4+?   pH                         HCO3-  (mEq/L)             PCO2  (mm Hg)
    • A. 

      Ph=7.65 --------------- HCO3=48 -------------- CO2=45

    • B. 

      Ph=7.50 -------------- HCO3=15 -------------- CO2=20

    • C. 

      Ph=7.40 -------------- HCO3=24 -------------- CO2=40

    • D. 

      Ph=7.32 ------------- HCO3=30 -------------- CO2=60

    • E. 

      Ph=7.31 -------------- HCO3=16 -------------- CO2=33

  • 3. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased. Which set of arterial blood values describes a patient with chronic renal failure (eating a normal protein diet) and decreased urinary excretion of NH4+?   pH                          HCO3-  (mEq/L)             PCO2  (mm Hg)
    • A. 

      Ph=7.65 --------------- HCO3=48 -------------- CO2=45

    • B. 

      Ph=7.50 -------------- HCO3=15 -------------- CO2=20

    • C. 

      Ph=7.40 -------------- HCO3=24 -------------- CO2=40

    • D. 

      Ph=7.32 ------------- HCO3=30 -------------- CO2=60

    • E. 

      Ph=7.31 -------------- HCO3=16 -------------- CO2=33

  • 4. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased. Which set of arterial blood values describes a patient with partially compensated respiratory alkalosis after 1 month on a mechanical ventilator?          pH          HCO3-  (mEq/L)             PCO2  (mm Hg)
    • A. 

      Ph=7.65 --------------- HCO3=48 -------------- CO2=45

    • B. 

      Ph=7.50 -------------- HCO3=15 -------------- CO2=20

    • C. 

      Ph=7.40 -------------- HCO3=24 -------------- CO2=40

    • D. 

      Ph=7.32 ------------- HCO3=30 -------------- CO2=60

    • E. 

      Ph=7.31 -------------- HCO3=16 -------------- CO2=33

  • 5. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased. Which set of arterial blood values describes a heavy smoker with a history of emphysema and chronic bronchitis who is becoming increasingly somnolent?                 pH                 HCO3-  (mEq/L)                 PCO2  (mm Hg)
    • A. 

      Ph=7.65 --------------- HCO3=48 -------------- CO2=45

    • B. 

      Ph=7.50 -------------- HCO3=15 -------------- CO2=20

    • C. 

      Ph=7.40 -------------- HCO3=24 -------------- CO2=40

    • D. 

      Ph=7.32 ------------- HCO3=30 -------------- CO2=60

    • E. 

      Ph=7.31 -------------- HCO3=16 -------------- CO2=33

  • 6. 
    A man presents with hypertension and hypokalemia. Measurement of his arterial blood gases reveal a pH of 7.5 and a calculated HCO3- of 32 mEq/L. His serum cortisol and urinary vanillylmandelic acid (V'MA) are normal, his serum aldosterone is increased, and his plasma renin activity is decreased. Which of the following is the most likely cause of his hypertension?
    • A. 

      Cushing's syndrome

    • B. 

      Cushing's disease

    • C. 

      Conn's syndrome

    • D. 

      Renal artery stenosis

    • E. 

      Pheochromocytoma

  • 7. 
    Which of the following is an action of parathyroid hormone (PTH) on the renal tubule?
    • A. 

      Stimulation of adenylate cyclase

    • B. 

      Inhibition of distal tubule K ± secretion

    • C. 

      Inhibition of distal tubule Ca2+ reabsorption

    • D. 

      Stimulation of proximal tubular phosphate reabsorption

    • E. 

      Inhibition of production of 1,25-dihydroxycholecakiferol

  • 8. 
    A woman runs a marathon in 90F weather and replaces all volume lost in sweat by drinking distilled water. After the marathon, she will have
    • A. 

      Decreased total body water (TBW)

    • B. 

      Decreased hematocrit

    • C. 

      Decreased intracellular fluid (ICF) volume

    • D. 

      Decreased plasma osmolarity

    • E. 

      Increased intracellular osmolarity

  • 9. 
    Which of the following causes hyper-kalemia?
    • A. 

      Exercise

    • B. 

      Alkalosis

    • C. 

      Insulin injection

    • D. 

      Decreased serum osmolarity

    • E. 

      Treatment with B-agonists

  • 10. 
    Which of the following is a cause of metabolic alkalosis?
    • A. 

      Diarrhea

    • B. 

      Chronic renal failure

    • C. 

      Ethylene glycol ingestion

    • D. 

      Treatment with acetazolamide

    • E. 

      Hyperaldosteronism

    • F. 

      Salicylate poisoning

  • 11. 
    A patient is infused with para-aminohippuric acid (PAH) to measure renal blood flow (RBF). She has a urine flow rate of 1 ml/min, a plasma [PAH] of 1 mg/ml, a urine [PAH] of 600 mg/ml, and a hematocrit of 45%.   What is her effective RBF?
    • A. 

      600 ml/min

    • B. 

      660 ml/min

    • C. 

      1091 ml/min

    • D. 

      1333 ml/min

  • 12. 
    Which of the following substances has the highest renal clearance?
    • A. 

      Para-aminohippuric acid (PAH)

    • B. 

      Inulin

    • C. 

      Glucose

    • D. 

      Na+

    • E. 

      Cl-

  • 13. 
    Which of  the following ions has a higher concentration in intracellular fluid (ICF) than in extracellular fluid  (ECF)?
    • A. 

      Na+

    • B. 

      K+

    • C. 

      C1-

    • D. 

      HCO3-

    • E. 

      Ca2+

  • 14. 
    A woman has a plasma osmolarity of 300 mOsm/L and a urine osmolarity of 1200 mOsm/L.  The correct diagnosis is
    • A. 

      Syndrome of inappropriate antidiuretic hormone (SIADH)

    • B. 

      Water deprivation

    • C. 

      Central diabetes insipidus

    • D. 

      Nephrogenic diabetes insipidus

    • E. 

      Drinking large volumes of distilled water

  • 15. 
    A patient arrives at the emergency room with low arterial pressure, reduced tissue turgor, and the following arterial blood values: pH = 7.69 [HCO3-] = 57 mEq/L PCO2 = 48 mm Hg   Which of the following responses would also be expected to occur in this patient?
    • A. 

      Hyperventilation

    • B. 

      Decreased K+ secretion by the distal tubules

    • C. 

      Increased ratio of H 2PO4- to HPO4-2 in urine

    • D. 

      Exchange of intracellular 11 + for extra cellular K+

  • 16. 
    Which of the following would best distinguish an otherwise healthy person with severe water deprivation from a person with the syndrome of inappropriate antidiuretic hormone (SIADH)?
    • A. 

      Free-water clearance (CH2O)

    • B. 

      Urine osmolarity

    • C. 

      Plasma osmolarity

    • D. 

      Circulating levels of antidiuretic hormone (ADH)

    • E. 

      Corticopapillary osmotic gradient

  • 17. 
    Which of the following causes a decrease in renal Ca2+ clearance?
    • A. 

      Hypoparathyroidism

    • B. 

      Treatment with chlorothiazide

    • C. 

      Treatment with furosemide

    • D. 

      Extracellular fluid (ECF) volume expansion

    • E. 

      Hypermagnesemia

  • 18. 
    A patient has the following arterial blood values: pH = 7.52 PCO2 = 20 mm Hg [HCO3-] = 16 mEq/L   Which of the following statements about this patient is most likely to be correct?
    • A. 

      He is hypoventilating

    • B. 

      He has decreased ionized [Ca 2+] in blood.

    • C. 

      He has almost complete respiratory compensation.

    • D. 

      He has an acid-base disorder caused by overproduction of fixed acid.

    • E. 

      Appropriate renal compensation would cause his arterial [HCO 3-] to increase.

  • 19. 
    At which nephron site does the amount of K+ in tubular fluid exceed the amount of filtered K+ in a person on a high-K+ diet?        
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 20. 
    At which nephron site is the tubular fluid/plasma (TF/P) osmolarity lowest in a person who has been deprived of water?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 21. 
    At which nephron site is the tubular fluid inulin concentration highest during antidiuresis?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 22. 
    At which nephron site is the tubular fluid inulin concentration lowest?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 23. 
    At which nephron site is the tubular fluid glucose concentration highest?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 24. 
    The curves show the percentage of the filtered load remaining in tubular fluid at various sites along  the nephron. Which curve describes the inulin profile along the nephron?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

  • 25. 
    The curves show the percentage of the filtered load remaining in tubular fluid at various sites along  the nephron. Which curve describes the ALANINE  profile along the nephron?
    • A. 

      A

    • B. 

      B

    • C. 

      C

    • D. 

      D

    • E. 

      E

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