Deck 19: The Urinary System

Question 1

Blood in the renal arcuate arteries flows next into which vessels?

A) Afferent arterioles
B) Efferent arterioles
C) Glomerular capillaries
D) Interlobar arteries
E) Interlobular arteries

Answer 1

Interlobular arteries

Question 2

Which cell type comprises the visceral layer of Bowman capsule?

A) Endothelial cells
B) Juxtaglomerular cells
C) Mesangial cells
D) Podocytes
E) Extraglomerular mesangial (or Lacis) cells

Answer 2

Podocytes

Question 3

Which type of epithelium lines the thick ascending limb of the loop of Henle?

A) Pseudostratified columnar
B) Simple columnar
C) Simple cuboidal
D) Simple squamous
E) Transitional (urothelium)

Answer 3

Simple cuboidal

Question 4

Which cell is a modified smooth muscle cell that secretes renin?

A) Macula densa cells
B) Mesangial cells
C) Podocytes
D) Juxtaglomerular cells
E) Endothelial cells

Question 5

Epithelial cell membrane domains containing many stiffened plaques of protein are an important feature in which part of the urinary system?

A) Juxtaglomerular apparatus
B) Bladder mucosa
C) Collecting ducts
D) Renal pyramids
E) Membranous urethra

Question 6

An immunohistochemical technique using antibodies against aquaporins to stain a section of kidney would be expected to stain cells in which structures most intensely?

A) Collecting ducts
B) Lining of the major and minor calyces
C) Proximal convoluted tubules
D) Distal convoluted tubules
E) Glomeruli

Question 7

What type of epithelium lines the prostatic urethra?

A) Simple columnar
B) Pseudostratified columnar
C) Stratified squamous
D) Simple squamous
E) Transitional (urothelium)

Question 8

A 14-year-old patient presents in the nephrology clinic with fatigue, malaise, anorexia, abdominal pain, and fever. She reports a loss of $6 \mathrm{lb}$ in the past 2 months. Serum gamma globulin and the immunoglobulins $\operatorname{IgG}$ , $\operatorname{Ig} A$ , and $\operatorname{IgM}$ are all elevated. Her serum creatine is $1.4 \mathrm{mg} / \mathrm{dL}$ (normal $0.6-1.2 \mathrm{mg} / \mathrm{dL}$ ) and urinalysis of glucose and protein are $2+$ on a dipstick test, confirmed by laboratory at $8.0 \mathrm{~g} /$ $\mathrm{dL}$ and $0.95 \mathrm{~g} / \mathrm{dL}$ , respectively. A renal biopsy is prepared for light microscopy, and an infiltrate containing lymphocytes, plasma cells, and eosinophils is found among tubules having cells with prominent brush borders. Which one of the following statements correctly pertains to these epithelial cells?

A) Impermeable to water despite presence of $\mathrm{ADH}$
B) The primary site for the reduction of the tubular fluid volume
C) The site of the countercurrent multiplier
D) The site of action of aldosterone
E) Indirectly involved in the release of renin

Question 9

A 45-year-old man presents with nephrolithiasis or kidney stones. The process of calcium oxalate stone formation as seen in this patient begins with Randall plaques found in the basement membranes of which one of the following structures found only in the renal medulla?

A) Proximal convoluted tubules
B) Distal convoluted tubules
C) Thin loops of Henle
D) Afferent arterioles
E) Collecting ducts

Question 10

A 15-year-old male presents with hematuria, hearing loss, lens dislocation, and the onset of cataracts. Genetic analysis reveals a mutation in the COL4A5 gene. Transmission EM examination of a renal biopsy confirms that the disorder has affected a component of the renal corpuscles in which damage disrupts normal glomerular filtration. Which one of the following structures would most likely be abnormal in the TEM of this patient's biopsy?

A) Pedicels
B) Filtration slits
C) Slit diaphragms
D) Glomerular basement membranes
E) Fenestrated endothelium of glomerular capillaries