Deck 20: Integrative Physiology II: Fluid and Electrolyte Balance

Question 1

When venous return is increased,stretch receptors in the atria of the heart are activated. This results in

A) secretion of ADH.
B) inhibition of ADH secretion.
C) increased glomerular filtration.
D) decreased urine production.
E) increased thirst.

Answer 1

B

Question 2

The hormone that regulates water excretion by the kidneys

A) decreases water permeability throughout the kidney tubules.
B) increases water permeability throughout the kidney tubules.
C) only decreases water permeability in certain portions of the kidney tubules.
D) only increases water permeability in certain portions of the kidney tubules.

Answer 2

D

Question 3

When baroreceptors in the carotid and aortic bodies register increased blood pressure,this results in

A) secretion of ADH.
B) inhibition of ADH secretion.
C) increased glomerular filtration.
D) decreased urine production.
E) increased thirst.

Answer 3

B

Question 4

The hormone ADH

A) is secreted by the anterior pituitary gland in response to changes in blood osmolarity.
B) stimulates the kidneys to retain sodium ion.
C) stimulates water conservation at the kidneys.
D) causes the kidneys to produce a large volume of urine.
E) All of the answers are correct.

Question 5

Most body water is located

A) in plasma.
B) in interstitial fluid.
C) inside cells.
D) in lumens of organs open to the outside.

Question 6

Why do patients taking loop diuretics need to take supplemental potassium?

A) They cause active secretion of potassium in the loop of Henle.
B) They inhibit the reabsorption of potassium as well as sodium in the loop of Henle.
C) They inhibit intestinal absorption of potassium.
D) They cause active reabsorption of potassium in the distal convoluted tubule.

Question 7

Kidneys respond relatively ________ to changes in blood volume.

A) slowly
B) quickly

Question 8

Why is sodium actively reabsorbed in the nephron?

A) to decrease osmolarity inside the nephron
B) to make urine less concentrated
C) to increase passive reabsorption of water
D) to decrease blood pressure

Question 9

Cell volume (and therefore cell function)in most cells is dependent upon careful regulation of

A) volume of extracellular fluid.
B) blood pressure.
C) osmolarity of extracellular fluid.
D) permeability of cell membranes.
E) resting membrane potential.

Question 10

Kidneys regulate

A) water loss only.
B) water gain only.
C) both water loss and gain.

Question 11

Water reabsorption by the kidneys is a result of

A) both passive and active transport processes.
B) cotransport with ions.
C) exchange with ions.
D) osmosis.

Question 12

Osmoreceptors depolarize after they ________ in response to ________ plasma osmolarity.

A) shrink, decreased
B) shrink, increased
C) swell, decreased
D) swell, increased

Question 13

When a body is dehydrated,water in the urinary bladder

A) can be returned to the circulation directly.
B) can be returned to the circulation after moving back into the kidneys.
C) will still be expelled from the body in the urine.

Question 14

The primary route for ion loss from the body is the ________ system.

A) respiratory
B) urinary
C) digestive
D) integumentary
E) cardiovascular

Question 15

The primary route for water loss from the body is the ________ system.

A) respiratory
B) urinary
C) digestive
D) integumentary
E) cardiovascular

Question 16

The hormone that directly controls water excretion by the kidneys is

A) ADH.
B) aldosterone.
C) epinephrine.
D) ANP.
E) angiotensin.

Question 17

Juxtaglomerular cells in the nephron secrete

A) angiotensinogen.
B) angiotensin I.
C) aldosterone.
D) renin.
E) angiotensin converting enzyme.

Question 18

The two organ systems that work together to regulate most aspects of the body's water balance are

A) digestive and respiratory.
B) urinary and respiratory.
C) cardiovascular and respiratory.
D) urinary and cardiovascular.
E) digestive and cardiovascular.

Question 19

The primary osmoreceptors are located in the

A) pons.
B) kidney.
C) stomach.
D) hypothalamus.
E) medulla.

Question 20

Shrinkage of hepatocytes in the liver causes them to cause which of the following?

A) glycogen production only
B) glycogen breakdown only
C) protein synthesis only
D) both glycogen production and protein synthesis
E) both glycogen breakdown and protein synthesis

Question 21

ACE converts

A) renin to angiotensinogen.
B) angiotensinogen to angiotensin I.
C) angiotensin I to angiotensin II.
D) angiotensin II to aldosterone.
E) renin to aldosterone.

Question 22

Which of the following is NOT true about angiotensin II?

A) increases cardiac output
B) activates parasympathetic output
C) is a potent vasoconstrictor
D) elevates blood pressure
E) stimulates thirst

Question 23

Angiotensin II

A) stimulates thirst only.
B) causes widespread vasoconstriction throughout the body only.
C) causes the synthesis and release of aldosterone from the adrenal cortex.
D) stimulates thirst and causes widespread vasoconstriction throughout the body.
E) stimulates thirst, causes widespread vasoconstriction throughout the body, and causes the synthesis and release of aldosterone from the adrenal cortex.

Question 24

Stimuli for the activation of the RAAS pathway include

A) low blood pressure in arterioles in the nephron only.
B) a decrease in fluid flow through the distal tubule only.
C) high blood pressure in the renal artery only.
D) low blood pressure in arterioles in the nephron and a decrease in fluid flow through the distal tubule.
E) low blood pressure in arterioles in the nephron, a decrease in fluid flow through the distal tubule, and high blood pressure in the renal artery.

Question 25

Aldosterone

A) is secreted in response to elevated levels of sodium in the blood.
B) promotes sodium retention in the kidneys.
C) helps decrease blood volume.
D) increases the concentration of sodium in urine.
E) functions in pH regulation.

Question 26

Atrial natriuretic peptide

A) increases the GFR.
B) inhibits the release of renin.
C) stimulates the release of renin.
D) increases the GFR and inhibits the release of renin.
E) increases the GFR and stimulates the release of renin.

Question 27

The primary role of the carbonic acid-bicarbonate buffer system is

A) to buffer stomach acid.
B) to buffer carbonic acid formed by carbon dioxide.
C) the prevention of pH changes caused by organic and fixed acids.
D) to buffer the urine.
E) to increase the amount of carbonic acid during ventilation.

Question 28

Which of the following statements concerning the hormone atrial natriuretic peptide is FALSE?

A) Atrial natriuretic peptide is produced by cells in the heart.
B) Atrial natriuretic peptide promotes sodium loss at the kidneys.
C) Atrial natriuretic peptide reduces the sensation of thirst.
D) Atrial natriuretic peptide suppresses ADH secretion.
E) Atrial natriuretic peptide increases aldosterone secretion.

Question 29

Excess potassium ions are eliminated from the body by the

A) sweat glands.
B) kidneys.
C) liver.
D) digestive system.
E) spleen.

Question 30

The osmolarity in the deepest part of the loop of Henle is ________ mOsM.

A) 1200
B) 100
C) 300
D) 900
E) None of these answers are correct.

Question 31

Thirst is

A) controlled by centers in the hypothalamus.
B) triggered by increased osmolarity.
C) relieved only when plasma osmolarity is decreased.
D) controlled by centers in the hypothalamus and triggered by increased osmolarity.
E) controlled by centers in the hypothalamus, triggered by increased osmolarity, and relieved only when plasma osmolarity is decreased.

Question 32

Angiotensin I is converted to angiotensin II by enzymes primarily located in the

A) kidneys.
B) liver.
C) heart.
D) lungs.
E) blood vessels.

Question 33

The most important factor affecting the pH of plasma is the concentration of

A) lactic acid.
B) ketone bodies.
C) organic acids.
D) carbon dioxide.
E) hydrochloric acid.

Question 34

Symptoms of low plasma pH may include

A) CNS depression.
B) confusion and disorientation.
C) numbness, tingling, or muscle twitches.
D) CNS depression and confusion and disorientation.
E) CNS depression; confusion and disorientation; and numbness, tingling, or muscle twitches.

Question 35

The enzyme renin is responsible for the activation of

A) angiotensin.
B) cortisol.
C) erythropoietin.
D) atrial natriuretic peptide.
E) adrenaline.

Question 36

An increase in plasma potassium levels is properly called

A) hypernatremia.
B) hyperpotassemia.
C) hyperpotasseplasmia.
D) hyperkalemia.
E) hypercalcemia.

Question 37

A hormone that helps to regulate the sodium ion concentration of the blood is

A) cortisol.
B) parathormone.
C) thymosin.
D) somatotropin.
E) aldosterone.

Question 38

Decreased ECF volume causes

A) sympathetic output from the cardiovascular control center to increase.
B) parasympathetic output from the cardiovascular control center to increase.
C) the force of ventricular contraction to decrease.
D) arteriolar vasodilation.
E) sympathetic output from the cardiovascular control center to increase and arteriolar vasodilation.

Question 39

As a result of respiratory alkalosis,

A) the respiratory rate increases.
B) the tidal volume increases.
C) the kidneys conserve bicarbonate.
D) the kidneys secrete fewer hydrogen ions.
E) the body retains less carbon dioxide.

Question 40

Drugs that treat hypertension by preventing Angiotensin I from becoming Angiotensin II are called

A) ACE inhibitors.
B) beta blockers.
C) calcium channel blockers.
D) diuretics.

Question 41

Prolonged vomiting of the stomach's contents can result in

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 42

Renal tubule cells in the kidney medulla are constantly exposed to high extracellular osmolarity.How do they maintain normal cell volume?

A) They synthesize organic solutes as needed to match the osmolarity.
B) They synthesize water molecules through increased metabolism to offset volume loss.
C) They maintain a water-impermeable membrane.
D) They add or remove aquaporins as needed.

Question 43

The principal ions in the ECF are ________.

Question 44

The anatomical arrangement of the kidney that allows transfer of solutes from one blood vessel to another is called the ________.

Question 45

The ________ cells of the distal nephron are interspersed among the principal cells and contribute to acid-base regulation.

Question 46

How do kidneys alter urine concentration?

Question 47

The enzyme that catalyzes the conversion of H₂O and CO₂ to H₂CO₃ is called ________.

Question 48

Removal of excess water in urine is known as ________.

Question 49

The normal pH range for most body fluids is ________.

Question 50

A person who suffers from emphysema will exhibit signs of

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 51

Abnormal fat and amino acid metabolism may lead to the condition called ________.

Question 52

A person who suffers from hyperventilation will exhibit signs of

A) respiratory acidosis.
B) respiratory alkalosis.
C) metabolic acidosis.
D) metabolic alkalosis.
E) None of the answers are correct.

Question 53

When the pH rises above 7.45,a state of ________ exists.

Question 54

AQP2 water pores are added to the cell membrane by ________ and withdrawn by ________ in a process known as ________.

Question 55

The high ________ osmolarity allows urine to be concentrated.

Question 56

The RAAS pathway begins with

A) secretion of angiotensin converting enzyme.
B) secretion of the enzyme renin.
C) secretion of angiotensinogen.
D) secretion of aldosterone.
E) secretion of antidiuretic hormone.

Question 57

A(n)________ consists of a combination of a weak acid and its dissociation products.

Question 58

A rise in angiotensin II levels would result in

A) elevated blood pressure.
B) increased retention of sodium ions at the kidney.
C) increased water retention.
D) increased blood volume.
E) all of these effects.

Question 59

When the pH of body fluids begins to fall,proteins will

A) release a hydrogen from the carboxyl group.
B) release a hydrogen from the amino group.
C) bind a hydrogen at the carboxyl group.
D) bind a hydrogen at the amino group.
E) cause none of these actions.

Question 60

Paracrine feedback from the ________ in the distal tubule to the granular cells stimulates release of ________.

Question 61

Dan has been lost in the desert for two days with very little water.As a result,you would expect to observe

A) elevated ADH levels.
B) decreased blood osmolarity.
C) normal urine production.
D) increased blood volume.
E) cells enlarged with fluid.

Question 62

What are oropharynx receptors,which hormone do they suppress,and how is it known that they exist? If a person stranded on a desert island drank seawater to try to quench his thirst,how would this affect the oropharynx receptors?

Question 63

Fred suffers from chronic emphysema.Blood tests show that his pH is normal but his bicarbonate levels are elevated significantly.How can this be?

Question 64

In response to a rapid increase of organic acid in the body,you would expect to observe

A) increased alveolar ventilation only.
B) decreased blood pressure only.
C) decreased heart rate only.
D) decreased blood pH only.
E) increased alveolar ventilation and decreased blood pH.

Question 65

When the pH of the extracellular fluid declines,

A) the kidneys excrete more sodium ions.
B) the kidneys excrete more bicarbonate ions.
C) the kidneys reabsorb more potassium ions.
D) the pH of the urine increases.
E) the kidneys reabsorb less water.

Question 66

Mary,a nursing student,has been caring for burn patients.She notices that they consistently show elevated levels of potassium in their urine and wonders why.What would you tell her?

Question 67

Dehydration may cause some ions to become concentrated.If a person was suffering from severe hyperkalemia,you would expect

A) the potassium ion concentration of the interstitial fluid to be less than normal.
B) the membrane potential of nerves and muscles to be more negative.
C) the skeletal muscles to be unresponsive and cardiac arrest could occur.
D) muscle weakness and increased strength of twitch contractions.
E) All of the answers are correct.

Question 68

Diabetes mellitus produces many homeostatic imbalances,including acidosis.The pH imbalance is due to ketoacidosis,which results from excessive accumulation of by-products of fat metabolism,as the body cannot meet energy needs from carbohydrate metabolism.Sally is a teenaged diabetic who sometimes rebels by not taking her insulin.Her mother takes her to the hospital because her breathing has become deep and gasping.Explain Sally's breathing pattern.What other compensatory responses may occur,and would they occur earlier or later than the respiratory response?

Question 69

What three stimuli control vasopressin secretion? The most potent stimulus for vasopressin release is ________.

Question 70

Mr.Gregory comes to the doctor with high blood pressure.Tests show that he also has elevated levels of renin in his blood and atherosclerotic plaques that have nearly blocked blood flow through his renal arteries.Mr.Gregory is puzzled.Explain to him how decreased blood flow in his renal arteries could cause renin secretion to increase.Map the pathways through which elevated renin causes high blood pressure for Mr.Gregory.

Question 71

"Water,water,every where,nor any drop to drink" is a phrase from the Rime of the Ancient Mariner by Samuel Taylor Coleridge.This poem describes an ocean ship unable to sail to land and running out of its supply of fresh water; sailors have long known that drinking seawater cannot prevent death from dehydration.What would result if the sailors attempted to alleviate their dehydration by drinking seawater? Justify your answer by describing kidney physiology.Why wouldn't reflexes,in response to dehydration,fully compensate? What does this illustrate about the force allowing kidneys to retain water under more normal conditions?

Question 72

Water gain during a day comes from either ________ or ________.How is water lost during a day?

Question 73

Gossip,an undergraduate,has normal P_CO2 levels,high H⁺ levels,low pH and bicarbonate levels.What type of disturbance is Gossip suffering from and what might cause this? If his P_CO2 were elevated,would your answer change? Explain.

Question 74

What are the two ways of bicarbonate reabsorption in the proximal tubule?

Question 75

Two hours before major surgery is to begin,the patient experiences "jitters," an elevated heart rate and blood pressure,increased rate of breathing,cold sweats,and an urge to urinate.These symptoms are the result of

A) sympathetic activation.
B) decreased levels of epinephrine in the blood.
C) decreased activity of sympathetic centers in the hypothalamus.
D) increased parasympathetic activity.
E) all of these mechanisms.

Question 76

Devising new food recipes is more successful when the chefs understand basic food chemistry.For example,to create a new cake recipe,one must understand the role of both acids and bases in leavening (rising,or trapping of tiny gas bubbles as dough is baking,to provide the characteristic texture).The principle is to incorporate baking soda (NaHCO₃)into an acidic batter,causing a chemical reaction resulting in gas production.Looking at the chemical formula,what gas do you think is formed? Summarize the chemical reaction that occurs in a cake batter that contains NaHCO₃ and vinegar or acetic acid (produces acetate when ionized: CH₃COO^- + H⁺).What would happen to your cake if you didn't use enough baking soda? What would happen if you forgot to acidify your batter with vinegar or a similar food acid?

Question 77

Diabetes mellitus produces many homeostatic imbalances,including acidosis.The pH imbalance is due to ketoacidosis,which results from excessive accumulation of by-products of fat metabolism,as the body cannot meet energy needs from carbohydrate metabolism.Sally is a teenaged diabetic who sometimes rebels by not taking her insulin.Her body is beginning to develop ketoacidosis as a result.Create a chart to indicate and explain how her blood pH,HCO₃^-,and P_CO2 react,by indicating "increase," "decrease," or "no change."
1.ketoacidosis has just developed
2.respiratory compensation occurs
3.renal compensation occurs

Question 78

What effect would a decrease in pH have on the amount of potassium ion in the urine?

A) an increase in the amount of potassium in the urine
B) a decrease in the amount of potassium in the urine
C) no effect on the amount of potassium in the urine

Question 79

"Glucose,glucose,every where,nor any speck to utilize" is a phrase made up by one of the authors working on this test question.Similar to the irony of not being able to prevent dehydration by drinking seawater,people with untreated diabetes mellitus are unable to prevent starvation despite the large amount of glucose surrounding their cells; as if that isn't bad enough,dehydration is also a problem.Explain why there is glucose in the urine of such people,why glucose is not present in the urine of normal people,and why diabetics become dehydrated.

Question 80

The cellular mechanisms for renal handling of H⁺ and HCO₃^- involve several membrane transporters; name three.