A.
inulin is a good GFR marker because it is freely
RENAL PHYSIOLOGY MCQ
You have 33 questions in this exam.
1. Concerning renal ontogeny:
A. the pronephros is a transitory kidney present during
the embryonic life of all vertebrates
B. the mesonephros is a functional yet transitory kidney
during intrauterine life of mammals
C. a main morphological difference between the
metanephros (permanent kidney) and the
mesonephros, is the development of the loop of Henle
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
2. The main barrier precluding the free passage of
albumin across the glomerular capillary walls is formed
by:
A. the fenestrated glomerular endothelium
B. anionic proteoglycan clusters within the glomerular
basement membrane
C. the filtration slits in between visceral epithelial cells
(podocytes)
D. none are correct
E. all are correct
Show answer
Correct Answer: B
3. Concerning the measurement of renal plasma flow
(RPF) and glomerular filtration rate(GFR):
filtered in the glomeruli and it is not reabsorbed, or
secreted, by the renal tubules
B. inulin concentration in the proximal tubule's lumen
increases progressively as water is reabsorbed in the
segment of the nephron
C. PAH (para-amino-hippuric acid)is a good marker of
renal plasma flow because it is freely filtered and is
rapidly secreted by the proximal tubule; as a result
very little PAH reaches the renal vein
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
4. Concerning the functional histology of the kidney:
A. the superficial nephrons have short loops of Henle;
thus, they have a low capacity to reabsorb salt (salt
losing nephrons)
B. the deep nephrons have long loops of Henle; thus
they have a high capacity to reabsorb salt and water
C. in dehydration, the blood flow to deep nephrons
tends to increase
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
5. The following factor(s) tend(s) to INCREASE the rate
of glomerular filtration (GFR):
A. decreased albumin concentration in plasma
B. vasodilation of the afferent (pre-glomerular)
arteriole
C. vasoconstriction of the efferent (post-glomerular)
arteriole Correct Answer: D
D. A and C are correct
E. all are correct

Show answer
8. Concerning the function of the proximal tubule:
Correct Answer: E A. most of the glomerular ultrafiltrate is reabsorbed in
the proximal tubule in an iso-osmotic fashion.
B. the concentration of PAH doesn't change much along
the length of the proximal tubule
C. under normal conditions, most of the filtered
glucose and bicarbonate are reabsorbed in the proximal
tubule
6. The following factor(s) tend(s) to INCREASE the rate D. A and C are correct
of glomerular filtration (GFR): E. all are correct
A. sympathetic stimulation (norepinephrine) of the
afferent arteriole
B. obstruction of the renal tubules, ureter or urethra
C. vasodilation of the efferent arteriole Show answer
D. none are correct
E. all are correct Correct Answer: D

Show answer

Correct Answer: D
9. Concerning metabolic energy (at production) for
renal transport:
A. the main substrate for proximal tubule is glucose
B. the cortical PO2 is about 10 mmHg
C. the papillary tissues normally generate ATP via
oxidative metabolism
7. Concerning the function of the glomerular mesangial D. A and C are correct
cells: E. all are correct
A. mesangial cells can contract and cause some
decrease in total glomerular filtration area
B. mesangial cells play a major role in systemic
angiotensin II production Show answer
C. mesangial cells are phagocytic and play a role in the
clearing of proteins and immune-deposits entrapped in Correct Answer: B
the mesangium
D. A and C are correct
E. all are correct

Show answer 10. Concerning water reabsorption by the proximal

tubule:
A. main driving forces for water reabsorption in the
proximal tubule are solute uptake and oncotic pressure
in peritubular capillaries
B. a significant amount of water uptake in the proximal
tubule is dependent on sodium uptake by the Na/H
antiports present in their luminal membrane
C. aquaporine-I (water channels) are abundantly
present in the cellular membranes of proximal tubule
cells
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
11. Concerning the THICK loop of Henle:
A. the thick segment of the loop has a very powerful
Na/K/2Cl pump that moves salt from the tubular
lumen into the peritubular space
B. water and urea move freely across the epithelium of
the thick ascending segment of the loop
C. following the administration of furosemide (lasix)
large volumes of diluted urine are produced
D. A and C are correct
E. all are correct
Show answer
Correct Answer: D
12. Concerning urinary concentration:
A. the thick loop of Henle generates most of the
osmotic gradient needed for reabsorption of water in
the collecting duct
B. the tubular urine that reaches the collecting duct is
generally hypotonic with respect to plasma
C. in the absence of ADH, urine is not concentrated
along the length of the collecting duct
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
13. Concerning the transport of urea in the different
segments of the nephron:
A. main tubular urea sound is the plasma via the
glomerular ultrafiltrate
B. the urea concentration in the lumen of the cortical
collecting ducts increases as water is reabsorbed
C. the thin loop of Henle and the medullary collecting
duct are permeable to urea
D. A and C are correct
E. all are correct
Show answer
Correct Answer: E
14. Concerning the macula densa:
A. the macula densa senses the total amount of sodium
chloride (sodium chloride concentration times volume)
of tubular urine being delivered by the loop of Henle
into the distal convoluted tubule
B. if the delivery of sodium chloride is lower than
normal the macula densa signals the afferent arteriole
(pre-glomerular) to release renin
C. renin release causes intravascular angiotensin
formation and indirectly aldosterone release
D. A and C are correct
E. all are correct
Show answer

Correct Answer: E
15. Concerning angiotensin II:
A. the exocrine renin-angiotensin-aldosterone system
includes angiotensinogen production by the liver, renin
secretion by the juxtaglomerular apparatus and
angiotensin-converting enzyme present at the luminal
surface of endothelial cells
B. aldosterone, but not AII, stimulate thirst and salt
appetite
C. angiotensin II induces marked increases in sodium
reabsorption by the loop of Henle and the collecting
duct
D. A and C are correct
E. all are correct
17. Within eight hours following large intravenous
aldosterone infusion the following is(are)clinically
evident:
A. unchanged sodium reabsorption by the collecting
duct
B. decreased potassium and hydrogen excretion in
urine
C. hypernatremia (high sodium in plasma),
hypokalemia (low potassium in plasma) and alkalosis
(low hydrogen ion activity in plasma)
D. A and C are correct
E. all are correct
Show answer
Correct Answer: C

Show answer

Correct Answer: A 18. Concerning arterial blood pressure regulation:

A. prostaglandins and dopamine and bradykinin are
vasodilators
B. ADH, angiotensin II and epinephrine are
vasoconstrictors
C. the vasodilator/vasoconstrictor ratio that regulates
total peripheral resistance plus cardiac stroke volume
16. Within an hour following intravenous angiotensin II and heart rate are determinants of blood pressure
infusion, the following is(are) clinically evident: D. all are correct
A. increased sodium uptake in the proximal tubular E. none are correct
epithelium
B. systemic vasoconstriction
C. increased plasma aldosterone
D. A and C are correct Show answer
E. all are correct
Correct Answer: E

Show answer

Correct Answer: E
 Show answer
19. Concerning cell volume regulation:
A. the Na/H and Cl/HCO3 antiports are involved in Correct Answer: C
hypertonic cell volume regulation
B. rapid efflux of cytoplasmic water is followed by
volume regulatory KCL efflux
C. KCL efflux is involved in hypotonic cell volume
regulation
D. A and C are correct
E. all are correct 22. Atrial natriuretic peptide
A. Increased H2O reabsorption
B. Decreased sodium reabsorption
C. AII formation
Show answer D. Increased sodium reabsorption
E. Decreased phosphate reabsorption
Correct Answer: D

Show answer

Correct Answer: B

20. Intravenous administration of 1.5 liters of isotonic

Ringer's solution to a healthy adult could cause:
A. increased cardiac output and renal blood flow
B. increased GFR
C. increased atrial natriuretic peptide and decreased
renin in plasma 23. ADH
D. A and C are correct A. Increased H2O reabsorption
E. all are correct B. Decreased sodium reabsorption
C. AII formation
D. Increased sodium reabsorption
E. Decreased phosphate reabsorption
Show answer

Correct Answer: E
Show answer

Correct Answer: A

21. Renin
A. Increased H2O reabsorption
B. Decreased sodium reabsorption
C. AII formation
D. Increased sodium reabsorption
E. Decreased phosphate reabsorption
24. AII
A. Increased H2O reabsorption
B. Decreased sodium reabsorption
C. AII formation
D. Increased sodium reabsorption
E. Decreased phosphate reabsorption
 27. All of the following occur within one hour of eating
a large acid load EXCEPT:
A. the acid load is immediately buffered by
Show answer intracellular proteins and phosphates as well as
extracellular bicarbonate
Correct Answer: D B. the lungs will begin eliminating CO2 generated as a
result of the acid load
C. the kidney will eliminate all the nonvolatile acids
and regenerate bicarbonate to replace all the
bicarbonate used in buffering
D. hemoglobin will buffer some of the protons

25. PTH
A. Increased H2O reabsorption
B. Decreased sodium reabsorption Show answer
C. AII formation
D. Increased sodium reabsorption Correct Answer: C
E. Decreased phosphate reabsorption

Show answer

Correct Answer: E 28. If the pH is 7.60 (H+ concentration = 25 nEq/L) and

the pCO2 is 40 mmHg, what is the HCO3-
concentration (in mEq/liter).
A. 10
B. 20
C. 30
D. 40
26. Which one of the following is correct about
nonvolatile acids.
A. they are not essential to eliminate from the body
B. we generate much greater amounts of nonvolatile Show answer
than volatile acids
C. they are fully buffered by bone Correct Answer: D
D. they are products of intermediary metabolism and
protein degradation
E. they are eliminated by the lungs

Show answer 29. A patient takes a drug overdose and becomes

comatose. His blood pCO2 was 40 mmHg ten minutes
Correct Answer: D ago, but you discover it is now 80 mmHg. Which one of
the following statements about this patient is correct.
A. the pH of his CSF is likely to fall more slowly than
the pH of his blood
B. the pH of his blood is likely to fall more slowly than
the pH of his CSF
C. the pH of the blood and CSF will not change because
he will rapidly eliminate bicarbonate in the urine in
response to the rise in pCO2
D. the pH of the blood and CSF will change to a similar
degree in this time period
Show answer
Correct Answer: B
30. Which one of the following statements is true about
the proximal tubule.
A. the Na+/K+ ATPase drives sodium into the cell from
the urine side of the tubule
B. Na+/H+ exchange is largely the mechanism by which
hydrogen ion secretion occurs
C. bicarbonate reabsorption is independent of carbonic
anhydrase activity
D. the pH in the lumen of the proximal tubule can
reach as low as about 5.0
Show answer
Correct Answer: B
31. A patient ingests antifreeze and needs to eliminate
the ingested acid. Renal elimination of the protons in
this excess acid is primarily accomplished by which of
the following mechanisms.
A. increased urinary ammonium excretion
B. increased urinary excretion of phosphates
C. hyperventilation
D. increased urinary free hydrogen ion concentration
E. increased urinary sulfate excretion
Show answer
Correct Answer: A
32. Renal ammonium ion excretion is increased by
aldosterone, elevated blood pCO2 and acidemia
A. true
B. false
Show answer
Correct Answer: A
33. Which one of the following statements is correct
with regard to net collecting duct hydrogen ion
secretion.
A. it is decreased by increased renal production of
ammonia
B. it is increased by increased reabsorption of sodium
through the apical sodium channel
C. it is not affected by the presence or absence of
titratable acids
D. aldosterone does not modify collecting duct
hydrogen ion secretion
Show answer
Correct Answer: B
Questions
Major Exam #5 -- Renal Physiology
(24 Questions)
1. For those substances that are actively
reabsorbed, the maximal amount that can be
transported per unit time by the kidney tubules:
A. depends on the maximum rate at which the
transport mechanism itself operates
B. is directly related to the plasma concentration
of the substance
C. is termed the tubular transport maximum
D. is dependent upon tubular load
E. A and C are correct.
2. If the clearance of Substance X is greater than
the clearance of inulin, it is most likely that
Substance X is:
A. bound to tubular proteins
B. bound to plasma proteins
C. secreted
D. reabsorbed
E. neither secreted nor reabsorbed
3. Co-transport of glucose:
A. is equivalent to a uniport for glucose
B. will not be affected if the Na+/K+ pump is
blocked
C. cannot move glucose against its concentration
gradient
D. is equivalent to an antiproton
E. depends on the interaction of Na+ with the
glucose carrier
4. The plasma concentration at which a particular
substance begins to appear in the urine is the:
A. transport maximum (Tm)
B. fractional excretion
C. filtered load
D. renal threshold
E. titration point
5. The volume of plasma needed each minute to
supply a substance at the rate at which it is
excreted in the urine is known as the:
A. diffusion constant of the substance
B. clearance of the substance
C. extraction ratio of the substance
D. tubular mass of the substance
E. filtration rate of the substance
6. Renin is produced and secreted from granules
located in the:
A. macula densa
B. mesangial cells
C. intercalated cells
D. afferent arteriole
E. interstitial cells
7. About 4 to 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.
8. A 100 kg man has a plasma osmolarity of 300
mOsM (milliosmolar). After he drinks 2 liters of
water (and before any fluid losses) his steady-state
plasma osmolarity would be approximately:
A. 270 mOsM
B. 280 mOsM
C. 290 mOsM
D. 300 mOsM
E. 321 mOsM
9. The normal human glomerular filtration rate
(GFR) is approximately (in mL/min):
A. 25
B. 50
C. 125
D. 300
E. 500
10. Which of the following statements is/are
correct?
A. Filtration fraction equals glomerular filtration
rate divided by renal plasma flow.
B. Tubular maximum secretion has a finite upper
limit, though it exhibits a phenomenon analogous
to the threshold phenomenon for reabsorption.
C. Clearance ratio equals renal clearance of one
substance divided by the clearance of another
substance.
D. Effective renal plasma flow is the volume of
plasma flow supplied to juxtamedullary
nephrons.
E. A, B, and C are correct.
11. The renal "countercurrent" mechanism is
dependent upon the anatomic relationship
between:
A. the distal tubule and the macula denza
B. the loop of Henle and the macula denza
C. the loop of Henle and the vasa recta
 D. the glomerulus and the afferent and efferent
arterioles
E. the glomerulus and the proximal tubule
12. If renal perfusion pressure does not change,
which of the following changes in afferent and
efferent arteriolar resistance would result in an
increase in renal blood flow but no change in
filtration fraction?
Afferent arteriolar
Efferent arteriolar resistance
resistance
A unchanged decreased
B decreased unchanged
C increased unchanged
D decreased decreased
E increased increased
13. An increase in the osmolality of the
extracellular fluid will:
A. stimulate the volume and osmoreceptors, and
stimulate ADH secretion
B. stimulate the volume and osmoreceptors, and
inhibit ADH secretion
C. inhibit the volume and osmoreceptors, and
stimulate ADH secretion
D. inhibit the volume and osmoreceptors, and
inhibit ADH secretion
E. cause no change in ADH secretion
14. Polyuria (diuresis) occurs in a diabetic patient
who has a GFR = 120 mL/min and a blood sugar =
350 mg/dL. This is indicative of:
A. losses of water and sodium which could be
prevented by administration of antidiuretic
hormone (ADH) and an aldosterone-like
mineralocorticoid
B. diuresis due to reduced active transport of
sodium out of the tubule because of diminished
+ +
activity of the Na /K ATPase
C. a cellular and extracellular over-hydration due
to water retention, caused by the glucose
D. an osmotic diuresis due to glucosuria, in which
water loss will exceed "salt" loss
E. B and D are correct.
15. 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
16. Which of the following might you expect to
find associated with chronic renal failure?
A. elevated packed cell volume (hematocrit)
B. abnormally low plasma creatinine
concentration
C. decreased bone density
D. lower than normal PTH (parathyroid hormone)
concentration
E. None of the above is correct.
17. The vasa recta:
A. are the straight portions of the proximal
tubules, found just proximal to the loops of Henle
B. extend from the efferent arterioles of the
superficial cortical nephrons
C. are the microvilli found on the cells of the
macula densa
D. comprise the capillary network found in the
medulla of the kidney
E. are the small straight segments of afferent
arterioles found directly next to the macula densa
18. The loops of Henle of the outer cortical
nephrons:
A. are functionally unimportant in the renal
conservation of sodium and water
B. do not contribute to the medullary osmotic
gradient
C. do not participate in the urinary diluting
mechanism
D. do not play any important role in overall renal
function and are simply unimportant vestiges of
evolutionary development
E. A and C are correct.
19. Ammonia produced by the kidneys comes
mainly from:
A. glutamine
B. glycine
C. leucine
D. alanine
E. B and D are correct.
20. Glomerular filtration produces an ultrafiltrate
of plasma:
A. in which the concentration of electrolytes is 1-E
equal to plasma 2-C
B. in which the concentration of protein is equal to 3-E
plasma 4-D
C. containing only those substances which must 5-B
be eliminated in the urine
D. A and B are correct. 6-D
E. B and C are correct. 7-E
21. Which of the following is NOT a function of 8-C
the kidneys? 9-C
A. regulation of extracellular volume 10 - E
B. regulation of plasma glucose concentration
C. regulation of arterial blood pressure 11 - C
D. excretion of the end products of protein 12 - B
metabolism 13 - A
E. excretion of foreign chemicals (e.g. 14 - D
pharmaceuticals, food additives, etc.) 15 - B
22. Which of the following does NOT contribute to
titratable acid when found in the urine? 16 - C
A. H2PO4- 17 - D
B. lactic acid 18 - B
C. beta-hydroxybutyric acid 19 - A
D. acetoacetic acid 20 - A
E. NH4+
23. Which of the following is NOT a function of 21 - B
the kidneys? 22 - E
A. regulation of extracellular osmolality 23 - D
B. regulation of acid-base balance 24 - A
C. excretion of end-products of muscle
metabolism 1. The term "renal autoregulation" refers in part to
D. activation of antidiuretic hormone the fact that
E. activation of vitamin D A. the kidney does not require blood flow to
24. Which of the following does NOT contribute to sustain its active transport
the formation of maximally concentrated urine? B. the kidney contains baroreceptors (pressure
A. active NaCl transport in the proximal receptors) that contribute to the regulation of
convoluted tubule cardiac output
B. active NaCl transport in the thick ascending C. renal blood flow is relatively constant over a
limb of the loop of Henle wide range of systemic arterial pressures
C. impermeability of the thick ascending limb of D. renal blood flow is not affected by activation of
the loop of Henle to water the sympathetic nerves that innervate the kidney
D. high water permeability of the collecting duct E. a combination of both C and D above
due to presence of ADH 2. The nerves that innervate the kidney are
E. presence of urea in the inner medullary essential for regulating which of the following?
interstitium A. Na-K-ATPase active transport pump rate
B. renal autoregulation of blood flow
Answer Key C. urine volume and tonicity (osmolality)
D. all of the above
E. none of the above
3. Which of the following would be expected to
cause renal inulin (or creatinine) clearance to
increase?
A. dilation of the afferent arteriole
B. dilation of the efferent arteriole
C. constriction of the afferent arteriole
D. constriction of the efferent arteriole
E. both A and D above
4. Kidney inflammation may result in the
appearance of albumin (a plasma protein) in the
urine because
A. more albumin enters the proximal tubule in the
glomerular filtrate
B. reabsorption of albumin from the proximal
tubule is inhibited
C. secretion of albumin into the distal tubule and
collecting ducts is increased
D. increased peritubular blood flow makes more
albumin available for diffusion into the tubule
E. reduced active transport of sodium ion reduces
cotransport of other substances, including
albumin
5. As blood passes along the glomerular capillaries
from the afferent to efferent arteriole, the net
filtration pressure (DP - Dp)
A. increases
B. decreases
C. first decreases, reaches a minimum about half
way along the capillary, then increases
D. first increases, reaches a maximum about half
way along the capillary, then decreases
E. remains constant
6. Sodium is actively reabsorbed from the renal
tubule in which of the following nephron
segments?
A. proximal tubule
B. distal tubule
C. thick ascending limb of the loop of Henle
D. all of the above
E. none of the above
7. The rate of water reabsorption from the
proximal tubule is determined primarily by the
A. rate of dissolved particle (solute) reabsorption
from the proximal tubule
B. concentration of ADH (antidiuretic hormone) in
the blood
C. osmotic pressure developed by plasma proteins
in the proximal tubule
D. active transport of water molecules by the
proximal tubule cells
E. passive filtration due to the high hydrostatic
pressure in the proximal tubule
8. Urea has a higher concentration in the fluid that
leaves the proximal tubule (and enters the loop of
Henle) than in blood plasma because
A. urea is synthesized by proximal tubule cells
B. urea is secreted into the proximal tubule
C. urea is reabsorbed from the proximal tubule
but at a lesser rate that water is reabsorbed
D. urea diffuses back into the proximal tubule
because of the high urea concentration in the renal
medulla
E. urea is actively transported into Bowman's
capsule from the glomerular capillaries
9. In the proximal tubule, penicillin is
A. actively secreted into the tubule
B. actively reabsorbed from the tubule
C. passively reabsorbed from the tubule
D. metabolized by the tubule cells
E. neither secreted nor reabsorbed nor
metabolized
10. At which sites would the concentration of
creatinine be expected to be highest? (Note:
assume the person is normally hydrated.)
A. glomerular filtrate
B. end of the proximal tubule
C. end of the loop of Henle
D. urine
E. the concentration would be the same in all of
the above, since creatinine is neither secreted or
reabsorbed
11. Suppose a person loses the function of half his
nephrons because of renal degenerative disease.
Assuming the person survives and reaches a new
steady state and that body urea production
remains normal, which of the following would be
expected to decrease below normal?
A. plasma urea concentration
B. renal urea excretion
C. renal urea clearance
D. urine urea concentration
E. all of the above
12. The following values are measured for
potassium ion in a human subject.
Plasma K+ 5 meq/liter
Urine K+ 50 meq/liter
Renal creatinine clearance 80 ml/min
Urine formation rate 1.5 ml/minute
This patient's potassium clearance is closest to
which of the following?
A. 5 ml/minute
B. 7.5 ml/minute
C. 15 ml/minute
D. 50 ml/minute
E. 75 ml/minute
13. Assuming the subject in the preceding
question is a normal adult, we can conclude that
most likely potassium is
A. filtered but not secreted or reabsorbed
B. secreted but not filtered or reabsorbed
C. reabsorbed but not secreted or filtered
D. filtered and secreted
E. filtered and reabsorbed