Pathophysiology Chapter 38 Structure and Function of the Renal and Urologic Systems

Chapter 38: Structure and Function of the Renal and Urologic Systems

MULTIPLE CHOICE

1.            What is the area of the kidneys that contains the glomeruli and portions of the tubules called?

a.            Medulla

b.            Cortex

c.             Pyramids

d.            Columns

2.            What is the functional unit of the kidney called?

a.            Glomerulus

b.            Nephron

c.             Collecting duct

d.            Pyramid

3.            What is the only surface inside the nephron where cells are covered with microvilli to increase the reabsorptive surface area called?

a.            Proximal convoluted tubules

b.            Distal tubules

c.             Ascending loop of Henle

d.            Descending loop of Henle

4.            What part of the kidney controls renal blood flow, glomerular filtration, and renin secretion?

a.            Macula densa

b.            Visceral epithelium

c.             Juxtaglomerular apparatus (JGA)

d.            Filtration slits

5.            Innervation of the bladder and internal urethral sphincter is supplied by which nerves?

a.            Peripheral nerves

b.            Parasympathetic fibers

c.             Sympathetic nervous system

d.            Tenth thoracic nerve roots

6.            How much urine accumulates in the bladder before the mechanoreceptors sense bladder fullness?

a.            75 to 100 mL

b.            100 to 150 mL

c.             250 to 300 mL

d.            350 to 400 mL

7.            What is the trigone?

a.            A smooth muscle that comprises the orifice of the ureter

b.            The inner mucosal lining of the kidneys

c.             A smooth triangular area between the openings of the two ureters and the urethra

d.            One of the three divisions of the loop of Henle

8.            The glomerular filtration rate is directly related to which factor?

a.            Perfusion pressure in the glomerular capillaries

b.            Diffusion rate in the renal cortex

c.             Diffusion rate in the renal medulla

d.            Glomerular active transport

9.            On average, what percent of cardiac output do the kidneys receive?

a.            10% to 20%

b.            15% to 20%

c.             20% to 25%

d.            30% to 35%

10.          What are blood vessels of the kidneys innervated by?

a.            Vagus nerve

b.            Sympathetic nervous system

c.             Somatic nervous system

d.            Parasympathetic nervous system

11.          When renin is released, it is capable of which action?

a.            Inactivation of autoregulation

b.            Direct activation of angiotensin II

c.             Direct release of antidiuretic hormone (ADH)

d.            Formation of angiotensin I

 12.         A student asks the professor to explain what effect natriuretic peptides have during heart failure when the heart dilates. Which response by the professor is best?

a.            Stimulates antidiuretic hormones

b.            Inhibits antidiuretic hormones

c.             Stimulates renin and aldosterone

d.            Inhibits renin and aldosterone

13.          What is the direct action of atrial natriuretic hormone?

a.            Sodium retention

b.            Sodium excretion

c.             Water retention

d.            Water excretion

14.          What term is used to identify the movement of fluids and solutes from the tubular lumen to the peritubular capillary plasma?

a.            Tubular secretion

b.            Ultrafiltration

c.             Tubular reabsorption

d.            Tubular excretion

15.          A patient’s urinalysis came back positive for glucose. What does the healthcare professional expect the patient’s blood glucose to be at a minimum?

a.            126 mg/dL

b.            150 mg/dL

c.             180 mg/dL

d.            200 mg/dL

16.          Which hormone is required for water to be reabsorbed in the distal tubule and collecting duct?

a.            Antidiuretic hormone

b.            Aldosterone

c.             Cortisol

d.            Adrenocorticotropic hormone

17.          Which glycoprotein protects against urolithiasis?

a.            Uromodulin

b.            Nephrin

c.             Urodilatin

d.            Cystatin

18.          What is the end product of protein metabolism that is excreted in urine?

a.            Glucose

b.            Ketones

c.             Bile

d.            Urea

19.          What is the action of urodilatin?

a.            Urodilatin causes vasoconstriction of afferent arterioles.

b.            It causes vasodilation of the efferent arterioles.

c.             Urodilatin inhibits antidiuretic hormone secretion.

d.            It inhibits salt and water reabsorption.

20.          The concentration of the final urine is determined by antidiuretic hormone (ADH), which is secreted by which gland?

a.            Posterior pituitary

b.            Thyroid

c.             Parathyroid

d.            Anterior pituitary

21.          What does the healthcare professional understand about urodilatin?

a.            Urodilatin inhibits sodium chloride and water reabsorption in the medullary part of the collecting duct.

b.            It inhibits antidiuretic hormone (ADH) to prevent water reabsorption in the medullary part of the collecting duct.

c.             Urodilatin is stimulated by a rise in blood pressure and an increase in extracellular volume.

d.            It is stimulated by a fall in blood pressure and a decrease in extracellular volume.

22.          What substance stimulates renal hydroxylation in the process of producing vitamin D?

a.            Erythropoietin

b.            Thyroid hormone

c.             Calcitonin

d.            Parathyroid hormone

23.          Which hormone is synthesized and secreted by the kidneys?

a.            Antidiuretic hormone

b.            Aldosterone

c.             Erythropoietin

d.            Angiotensinogen

24.          The student wants information about a patient’s renal function. What test does the healthcare professional tell the student to evaluate?

a.            Glomerular filtration rate

b.            Hourly urine output

c.             Serum blood urea nitrogen and creatinine

d.            The specific gravity of the solute concentration of the urine

25.          Which renal change is found in older adults?

a.            Sharp decline in glomerular filtration rate

b.            Sharp decline in renal blood flow

c.             Decrease in the number of nephrons

d.            Decrease in urine output

26.          A healthcare professional is caring for an older adult. Understanding age-related renal changes, what urinalysis finding would the professional view as normal for an older patient?

a.            pH 5.2

b.            Moderate protein

c.             Specific gravity 1.003

d.            Positive for white cell casts

27.          What process allows the kidney to respond to an increase in workload?

a.            Glomerular filtration

b.            Secretion of 1,25-dihydroxyvitamin D3

c.             Increased heart rate

d.            Compensatory hypertrophy

28.          Which process makes it possible for ureters to be transplanted successfully?

a.            Compensatory hypertrophy

b.            Erythropoietin secretion

c.             Peristalsis

d.            Collateral circulation

MULTIPLE RESPONSE

 

1.            Which structures are parts of the nephron? (Select all that apply.)

a.            Loop of Henle

b.            Renal corpuscle

c.             Proximal convoluted tubule

d.            Calyx

e.            Collecting duct

2.            Which forces create passive transport of water in the proximal tubule? (Select all that apply.)

a.            Peritubular capillary hydrostatic pressure

b.            Peritubular capillary oncotic pressure

c.             Interstitial hydrostatic pressure

d.            Interstitial osmotic pressure

e.            Peritubular capillary osmotic pressure

3.            Which hormones are produced by the kidney? (Select all that apply.)

a.            Renin

b.            Erythropoietin

c.             1,25-Dihydroxyvitamin D3

d.            Calcitonin

e.            Aldosterone

 4.           What information does the pathophysiology student learn about renal circulation? (Select all that apply.)

a.            The interlobar arteries travel down into the renal columns.

b.            The arcuate arteries branch to form the interlobar arteries.

c.             The arcuate arteries arch over the base of the pyramids.

d.            The interlobar arteries run parallel to the surface of the kidneys.

e.            The interlobar arteries run between the pyramids.