Deck 19: The Urinary System: Fluid and Electrolyte Balance

Question 1

The activity of the respiratory system can increase pH by

A)a hypoventilation- induced increase in PCO2.
B)a hypoventilation- induced decrease in PCO2.
C)a hyperventilation- induced decrease in PCO2.
D)a hyperventilation- induced increase in PCO2.
E)increasing the amount of carbonic acid in the blood.

Answer 1

C

Question 2

Under severe acidic conditions, the proximal tubules can convert into bicarbonate.

A)glycine
B)lysine
C)glutamine
D)glutamate
E)carbon monoxide

Answer 2

C

Question 3

In the early portion of the collecting duct (in cortical interstitial fluid), an increase in water permeability will result in a(n)

A)decrease in filtrate volume.
B)increase in filtrate volume.
C)efflux of urea from the tubule.
D)movement of water into the duct.
E)transport of sodium out of the tubule.

Answer 3

A

Question 4

Aldosterone increases the number of potassium channels where?

A)principal cells apical membrane
B)proximal tubule apical membrane
C)principal cells basolateral membrane
D)intercalated cells basolateral membrane
E)proximal tubule basolateral membrane

Question 5

A student in your physiology lab is thirsty and decides to sneak a drink of deionized or distilled water. The student drinks a fairly large quantity of this water in a short period of time. What will happen to the student's cells?

A)It is an isotonic solution, so water will enter and leave cells at the same rate.
B)It will make the cells hypovolemic.
C)It will cause the student's cells to shrink.
D)Water is water, so it will not do anything to the student's cells.
E)It will cause the student's cells to swell.

Question 6

What solute maintains the medullary interstitial fluid osmotic gradient?

A)sodium ions
B)urea
C)water
D)glucose
E)potassium ions

Question 7

Angiotensin II and atrial natriuretic peptide are able to alter the reabsorption of water through a similar pathway that involves altered

A)integration of aquaporin- 3 into the membrane.
B)Na+/K+ pump activity in the principal cells.
C)Na+/K+ pump activity in the intercalated cells.
D)release of antidiuretic hormone (ADH).
E)sodium channel expression on the apical membrane.

Question 8

The regulation of water and ion excretion occurs primarily within the

A)proximal tubules only.
B)late distal tubules only.
C)collecting ducts only.
D)both proximal tubules and late distal tubules.
E)both collecting ducts and late distal tubules.

Question 9

How does severe vomiting cause a metabolic alkalosis?

A)loss of phosphate
B)production of hydrogen ions
C)loss of hydrogen ions
D)production of bicarbonate
E)loss of bicarbonate

Question 10

A patient is exhibiting several signs of acid- base imbalance. Blood tests reveal that blood pH is 7.5, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?

A)metabolic acidosis with respiratory compensation
B)respiratory acidosis with renal compensation
C)respiratory alkalosis with renal compensation
D)metabolic alkalosis with respiratory compensation
E)Blood pH is normal.

Question 11

Which statement best describes why estrogen may contribute to osteoporosis?

A)Estrogen is a steroid hormone that interferes with calcium resorption.
B)A decrease in estrogen stimulates an increase in osteoblast activity due to the activation of 1,25- (OH2)D3.
C)A decrease in estrogen causes a corresponding decrease in interleukin- 6 that then lowers calcium levels.
D)A decrease in estrogen stimulates the production of interleukin- 6 that then stimulates osteoclast activity.
E)A decrease in estrogen stimulates calcitonin secretion from the pituitary gland.

Question 12

Angiotensin II acts directly in the hypothalamus to stimulate what?

A)a systemic increase in blood pressure
B)an increase in body temperature
C)an increase in thirst
D)the release of aldosterone
E)the release of oxytocin

Question 13

ADH increases the insertion of aquaporin- 2 where?

A)principal cells basolateral membrane
B)principal cells apical membrane
C)intercalated cells basolateral membrane
D)proximal tubule basolateral membrane
E)proximal tubule apical membrane

Question 14

The last step to synthesis of 1,25- dihydroxy vitamin D3 occurs in what organ?

A)skin
B)brain
C)kidney
D)liver
E)gastrointestinal tract

Question 15

Carbonic anhydrase is located where?

A)proximal tubule apical membrane
B)intercalated cells basolateral membrane
C)principal cells basolateral membrane
D)proximal tubule basolateral membrane
E)principal cells apical membrane

Question 16

How might a high- fat diet cause metabolic acidosis?

A)loss of hydrogen ions
B)direct production of hydrogen ions
C)loss of phosphate
D)breakdown of fat into fatty acids
E)loss of bicarbonate

Question 17

Which of the following accurately describes the thick ascending limb of the loop of Henle?

A)permeable to water and does NOT contain Na+/K+/Cl- cotransporters
B)permeable to water and contains Na+/K+/Cl- cotransporters
C)permeable to water in the presence of specific hormones
D)impermeable to water and does NOT contain Na+/K+/Cl- cotransporters
E)impermeable to water and contains Na+/K+/Cl- cotransporters

Question 18

What form of osteoporosis would be localized to a specific bone?

A)disuse osteoporosis
B)primary osteoporosis
C)secondary osteoporosis
D)tertiary osteoporosis
E)hyperosteoporosis

Question 19

What regulates the rate of water loss?

A)lungs
B)kidney
C)skin
D)digestive tract
E)cardiovascular system

Question 20

Which of the following ions acts as a buffer to minimize changes in intracellular pH?

A)phosphate
B)potassium
C)bicarbonate
D)sodium
E)chloride

Question 21

Plasma can gain solutes and/or water from which of the following?

A)gastrointestinal tract only
B)renal tubules only
C)bone only
D)both the gastrointestinal tract and bone
E)both the gastrointestinal tract and renal tubules

Question 22

What hormone increases calcium resorption from bone?

A)ADH
B)aldosterone
C)angiotensin II
D)atrial natriuretic peptide
E)parathyroid hormone

Question 23

If hydrogen ions are added to a solution, the pH will

A)increase.
B)decrease.
C)remain the same.

Question 24

Under which of the following conditions do cell volumes not change and the osmolarity in both extracellular and intracellular fluids remain the same?

A)hypotonicity
B)hypertonicity
C)hypovolemia
D)osmotic equilibrium
E)hypervolemia

Question 25

In diabetes insipidus, blood levels of are decreased causing an increase in _ .

A)ADH : plasma volume
B)aldosterone : sodium in the urine
C)insulin : glucose in the urine
D)aldosterone : potassium in the urine
E)ADH : urine volume

Question 26

Renin is released by cells of the .

A)granular : afferent arteriole
B)granular : distal tubule
C)intercalated : afferent arteriole
D)principal : afferent arteriole
E)principal : distal tubule

Question 27

Exposure of the skin to sunlight converts _ _ to vitamin D3.

A)cholesterol
B)7- dehydrocholesterol
C)calcium
D)25- OH D3
E)calcitriol

Question 28

In the proximal tubule, hydrogen ions are transported into the filtrate by

A)Na+/H+countertransporters only.
B)H+ primary active transporters only.
C)H+/Cl- cotransporters only.
D)both Na+/H+ countertransporters and H+ primary active transporters.
E)both Na+/H+ countertransporters and H+/Cl- cotransporters.

Question 29

The primary function of atrial natriuretic peptide (ANP)is to

A)increase the stretching capacity of the atria.
B)decrease potassium secretion thereby increasing potassium reabsorption.
C)increase potassium secretion thereby decreasing potassium reabsorption.
D)increase sodium secretion thereby decreasing sodium reabsorption.
E)decrease sodium secretion thereby increasing sodium reabsorption.

Question 30

What would the following blood values indicate? Blood pH = 7.3, [HCO3- ] is low, PCO2 is low.

A)respiratory acidosis with renal compensation
B)metabolic alkalosis with respiratory compensation
C)respiratory alkalosis with renal compensation
D)metabolic acidosis with respiratory compensation
E)metabolic acidosis only

Question 31

Which of the following diseases is associated with decreased responsiveness of the renal tubules to ADH?

A)diabetes mellitus type 1
B)diabetes mellitus type 2
C)central diabetes insipidus
D)diabetic nephropathy
E)nephrogenic diabetes insipidus

Question 32

During hyperventilation, why do some people detect a tingling sensation in their hands and feet?

A)an increase in carbon dioxide in blood
B)a decrease in carbon dioxide in blood
C)a decrease in blood flow to the distal extremities
D)hyperexcitability of afferent neurons
E)widespread release of catecholamines

Question 33

Respiratory compensation for changes in pH is originated by

A)proprioceptors.
B)central chemoreceptors.
C)baroreceptors.
D)peripheral chemoreceptors.
E)directly affecting the activity of the diaphragm.

Question 34

What stimulates atrial natriuretic peptide release?

A)distension of the atrial wall due to an increase in plasma volume
B)changes in the concentration of sodium in the blood of the atrium
C)distension of the atrial wall due to an increase in blood pressure
D)changes in the concentration of potassium in the blood of the atrium
E)renin

Question 35

Which type of cell carries out bone formation?

A)osteoblasts
B)osteons
C)ossicles
D)osteoclasts
E)osteocytes

Question 36

Receptors for ADH are located where?

A)intercalated cells basolateral membrane
B)proximal tubule apical membrane
C)proximal tubule basolateral membrane
D)principal cells apical membrane
E)principal cells basolateral membrane

Question 37

Potassium secretion is regulated by

A)parathyroid hormone (PTH).
B)renin.
C)aldosterone.
D)angiotensin I.
E)atrial natriuretic peptide (ANP).

Question 38

Which of the following statements on sodium movement in the renal tubules is TRUE?

A)Sodium is actively secreted from the collecting duct.
B)Sodium is actively transported across the basolateral membrane of both the proximal and distal tubule.
C)Sodium channels are located on the basolateral membrane of principal cells.
D)Sodium reabsorption follows water reabsorption in all segments of the renal tubules.
E)Sodium is actively secreted from the proximal tubule.

Question 39

What would the following blood values indicate? Blood pH = 7.5, [HCO3- ] is high, PCO2 is high.

A)metabolic acidosis with respiratory compensation
B)respiratory acidosis with renal compensation
C)metabolic acidosis only
D)respiratory alkalosis with renal compensation
E)metabolic alkalosis with respiratory compensation

Question 40

Aquaporin- 3 is located on what membrane in the absence of ADH?

A)proximal tubule basolateral membrane
B)principal cells apical membrane
C)intercalated cells basolateral membrane
D)proximal tubule apical membrane
E)principal cells basolateral membrane

Question 41

What hormone decreases plasma calcium levels?

A)calcitonin only
B)1,25- dihydroxy vitamin D3 only
C)parathyroid hormone only
D)both calcitonin and 1,25- dihydroxy vitamin D3
E)both calcitonin and parathyroid hormone

Question 42

The effects of antidiuretic hormone (ADH)are not restricted to regulating water movement; it also affects sodium reabsorption by

A)increasing the synthesis of sodium channels in principal cells.
B)increasing the synthesis of Na+/K+ pumps in principal cells.
C)increasing the synthesis of sodium channels in intercalated cells.
D)decreasing the synthesis of sodium channels in intercalated cells.
E)decreasing the synthesis of sodium channels in principal cells.

Question 43

In diabetes insipidus, why does polyuria occur?

A)A lack of ADH decreases water reabsorption.
B)Glucose transporters in the renal tubules become saturated.
C)An increase in aldosterone increases water reabsorption.
D)A lack of insulin decreases water permeability of the renal tubules.
E)A lack of angiotensin II decreases thirst.

Question 44

Fluid and electrolyte balance occur when

A)the amount of solute in the plasma is the same as the amount in the interstitial fluid.
B)the charges are neutral and happen to be in an aqueous solution.
C)solutes and water enter the plasma at a greater rate than it exits.
D)solutes and water enter and exit the plasma at the same rate.
E)solutes and water exit the plasma at a greater rate than it enters.

Question 45

What enzyme converts angiotensinogen into angiotensin I?

A)renin
B)angiotensin converting enzyme (ACE)
C)carbonic anhydrase
D)mucin
E)atrial natriuretic peptide

Question 46

The hemorrhage- induced decrease in blood flow to the kidneys will

A)increase glomerular filtration rate.
B)increase the production of leukocytes.
C)increase the production of erythrocytes.
D)decrease the release of renin.
E)increase the release of atrial natriuretic peptide.

Question 47

If a person is normovolemic and consumes a large quantity of a hyperosmotic solution, it will

A)cause cells to swell due to an increase in the osmolarity of extracellular fluid.
B)have no effect on cell osmolarity and thereby cell size.
C)cause cells to shrink due to a decrease in the osmolarity of extracellular fluid .
D)cause cells to shrink due to an increase in the osmolarity of extracellular fluid.
E)cause cells to swell due to a decrease in the osmolarity of extracellular fluid.

Question 48

When an increase in hydrogen ions remains after one hour, this will lead to a(n)

A)increased hydrogen reabsorption in the kidneys.
B)increase in hydrogen ion secretion from the kidneys.
C)decrease in bicarbonate reabsorption in the kidneys.
D)failure of the kidneys to filter any more hydrogen ions.
E)increase in bicarbonate secretion in the kidneys.

Question 49

Which of the following best describes sodium movement in the distal tubule?

A)Sodium is transported across the apical membrane by the Na+/K+ pump and across the basolateral membrane by diffusion through sodium channels.
B)Sodium is transported across the basolateral membrane by the Na+/K+ pump and across the apical membrane by facilitated diffusion.
C)Sodium is transported across the apical membrane by the Na+/K+ pump and across the basolateral membrane by facilitated diffusion.
D)Sodium is transported across the apical membrane by the Na+/K+ pump and across the basolateral membrane by secondary active transport.
E)Sodium is transported across the basolateral membrane by the Na+/K+ pump and across the apical membrane by diffusion through sodium channels.

Question 50

A person must void what volume of urine per day?

A)0 mL
B)15 mL
C)120 mL
D)440 mL
E)1200 mL

Question 51

If nothing else is removed from the filtrate once it reaches the late distal tubules, the urine excreted would have which of the following properties?

A)low osmolarity and low volume
B)devoid of ions and large volume
C)high osmolarity and large volume
D)high osmolarity and low volume
E)low osmolarity and large volume

Question 52

Potassium channels located where are necessary for its secretion?

A)intercalated cells basolateral membrane
B)principal cells basolateral membrane
C)proximal tubule apical membrane
D)principal cells apical membrane
E)proximal tubule basolateral membrane

Question 53

What enzyme converts angiotensin I into angiotensin II?

A)carbonic anhydrase
B)mucin
C)atrial natriuretic peptide
D)angiotensin converting enzyme (ACE)
E)renin

Question 54

The regulation of acid- base balance in the kidneys occurs primarily through the unique action of which cells in the distal tubules and collecting ducts?

A)intercalated cells
B)granular cells
C)principal cells
D)podocytes
E)mesangial cells

Question 55

From where is ADH released?

A)pancreas
B)anterior pituitary
C)collecting duct
D)posterior pituitary
E)distal tubule

Question 56

Which statement BEST distinguishes metabolic acidosis from respiratory acidosis?

A)Metabolic acidosis is a disturbance in blood pH caused by something other than an abnormal P_CO2.
B)Metabolic acidosis is a disturbance in blood pH caused by exercise as opposed to hyper- or hypoventilation.
C)Metabolic acidosis occurs due to changes in PO2 as opposed to PCO2.
D)Metabolic acidosis occurs due to changes in blood glucose as opposed to changes in PO2 and P_CO2.
E)Metabolic acidosis occurs due to changes in bicarbonate as opposed to PCO2.

Question 57

Which of the following structures is NOT involved in the regulation of plasma calcium?

A)bone
B)gastrointestinal tract
C)skin
D)kidneys
E)skeletal muscle

Question 58

The most important buffer system in the extracellular fluid is

A)carboxyl groups.
B)bicarbonate.
C)monoprotonated phosphates.
D)chloride.
E)amino acids.

Question 59

Kidneys compensate for changes in plasma volume and osmolarity by adjusting the rate of water

A)reabsorption only.
B)secretion only.
C)resorption only.
D)reabsorption and secretion.
E)secretion and resorption.

Question 60

The extent of potassium excretion is regulated primarily by the

A)amount secreted into the distal tubule.
B)amount filtered by the basement membrane of the glomerular capillaries.
C)amount reabsorbed in the distal tubule.
D)amount secreted into the proximal tubule.
E)amount reabsorbed into the proximal tubule.

Question 61

Which of the following conditions would be associated with hypernatremia?

A)decreased plasma volume
B)increased plasma sodium
C)hypotension
D)decreased plasma osmolarity
E)increased plasma potassium

Question 62

What hormone activates the cAMP second messenger system in principal cells of the distal tubules and collecting ducts?

A)ADH
B)aldosterone
C)angiotensin II
D)atrial natriuretic peptide
E)parathyroid hormone

Question 63

A greater plasma volume than normal is called

A)hypovolemia.
B)normovolemia.
C)hypervolemia.
D)equilibrium.
E)fluid balance.

Question 64

Sodium- glucose cotransporters are located where?

A)proximal tubule apical membrane
B)proximal tubule basolateral membrane
C)principal cells basolateral membrane
D)intercalated cells basolateral membrane
E)principal cells apical membrane

Question 65

Which of the following is associated with actions of aldosterone on principal cells?

A)increased potassium secretion
B)increased calcium reabsorption
C)increased sodium secretion
D)decreased blood pressure
E)decreased plasma osmolarity

Question 66

The bone can supply calcium to the plasma by what process?

A)ossification
B)filtration
C)resorption
D)reabsorption
E)calcification

Question 67

A substance is in positive balance when

A)it exits plasma at a greater rate than it enters plasma.
B)it enters plasma at the same rate it exits plasma.
C)its production by cells is decreased.
D)its usage by cells is increased.
E)it enters plasma at a greater rate than it exits plasma.

Question 68

The osmotic gradient in the medullary region of the kidneys is established and maintained by which of the following?

A)Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle
B)Na+/K+/Cl- cotransporters in the descending limb of the loop of Henle
C)efflux of Na+ from the descending limb of the loop of Henle
D)efflux of water from the descending limb of the loop of Henle
E)efflux of water from the ascending limb of the loop of Henle

Question 69

In the renal tubules, where is the Na+/K+ pump located?

A)in both the apical and basolateral membranes of intercalated cells
B)in the basolateral membrane of the proximal tubules
C)in the apical membrane of the collecting ducts
D)in both the apical and basolateral membranes of principal cells
E)in the apical membrane of the descending limb of the loop of Henle

Question 70

The regulation of sodium and water balance in the kidneys occurs primarily through the unique action of which cells in the distal tubules and collecting ducts?

A)podocytes
B)mesangial cells
C)principal cells
D)intercalated cells
E)granular cells

Question 71

Seawater has an osmolarity of around 1000 mOsm, mostly from dissolved sodium. Given what you know about the osmolarity in most of the cells in the body, why is it dangerous to drink seawater?

A)In the nervous system, the additional extracellular sodium concentration would slow down the normal flow of sodium ions used to generate action potentials.
B)In the digestive system, the seawater would draw more water out of the bloodstream than would be absorbed, leading to severe dehydration.
C)In the cardiovascular system, the higher sodium levels would decrease the pressure in the arteries making it more difficult to get blood to the systemic capillaries.
D)In membrane transport, the increased sodium concentration would slow down secondary active transport of glucose into cells.
E)In the renal system, the osmolarity of the medulla of the kidney would become even more concentrated.

Question 72

Which of the following is NOT a response to hemorrhage?

A)increased epinephrine secretion
B)decreased renin secretion
C)increased ADH release
D)increased angiotensin II production
E)increased sympathetic activity

Question 73

Which type of cell carries out bone resorption?

A)osteoclasts
B)osteoblasts
C)ossicles
D)osteons
E)osteocytes

Question 74

What hormone increases excretion of sodium?

A)ADH
B)aldosterone
C)angiotensin II
D)atrial natriuretic peptide
E)parathyroid hormone

Question 75

How might a high- protein diet cause metabolic acidosis?

A)loss of hydrogen ions
B)production of phosphoric acid and sulfuric acid
C)loss of phosphate
D)loss of bicarbonate
E)direct production of hydrogen ions

Question 76

What hormone stimulates the release of aldosterone?

A)ADH
B)aldosterone
C)angiotensin II
D)atrial natriuretic peptide
E)parathyroid hormone

Question 77

Atrial natriuretic peptide causes which of the following effects in principal cells?

A)afferent arteriole constriction
B)increase in glomerular filtration rate
C)decreased activity of the Na+/K+ pump in the basolateral membrane
D)decreased number of open sodium channels in the apical membrane
E)efferent arteriole dilation

Question 78

A patient is exhibiting several signs of acid- base imbalance. Blood tests reveal that blood pH is 7.3, and bicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?

A)metabolic alkalosis with respiratory compensation
B)metabolic acidosis with respiratory compensation
C)respiratory acidosis with renal compensation
D)respiratory alkalosis with renal compensation
E)Blood pH is normal.

Question 79

Aldosterone is released from the in response to _ .

A)adrenal cortex : increases in plasma potassium
B)posterior pituitary : increases in plasma osmolarity
C)macula densa : increased flow of tubular fluid in the distal tubule
D)adrenal medulla : decreases in plasma sodium
E)pancreas : increases in plasma glucose

Question 80

A substance is in negative balance when

A)its usage by cells is decreased.
B)it enters plasma at a greater rate than it exits plasma.
C)its production by cells is increased.
D)it exits plasma at a greater rate than it enters plasma.
E)it enters plasma at the same rate it exits plasma.