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1) The mechanism that establishes the medullary osmotic gradient depends most on the permeability properties of the ________.
A) loop of Henle
B) glomerular filtration membrane
C) collecting duct
D) distal convoluted tubule
Answer: A

2) Urine passes through the ________.
A) renal hilum to the bladder to the ureter
B) pelvis of the kidney to ureter to bladder to urethra
C) glomerulus to ureter to renal tubule
D) hilum to urethra to bladder
Answer: B

3) Which of the following is not associated with the renal corpuscle?
A) a podocyte
B) a vasa recta
C) a fenestrated capillary
D) an efferent arteriole
Answer: B

4) An increase in the permeability of the cells of the collecting tubule to water is due to a(n) ________.
A) decrease in the production of ADH
B) increase in the production of ADH
C) increase in the production of aldosterone
D) decrease in the concentration of the blood plasma
Answer: B

5) The urinary bladder is composed of ________ epithelium.
A) transitional
B) simple squamous
C) stratified squamous
D) pseudostratified columnar
Answer: A

6) The kidneys are stimulated to produce renin ________.
A) when the peritubular capillaries are dilated
B) when the pH of the urine decreases
C) by a decrease in the blood pressure
D) when the specific gravity of urine rises above 1.10
Answer: C

7) Which of the choices below is not a function of the urinary system?
A) helps maintain homeostasis by controlling the composition, volume, and pressure of blood
B) regulates blood glucose levels and produces hormones
C) maintains blood osmolarity
D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat
Answer: D

8) Which gland sits atop each kidney?
A) adrenal
B) thymus
C) pituitary
D) pancreas
Answer: A

9) The ________ artery lies on the boundary between the cortex and medulla of the kidney.
A) lobar
B) arcuate
C) interlobar
D) cortical radiate
Answer: B

10) The glomerulus differs from other capillaries in the body in that it ________.
A) has a basement membrane
B) is impermeable to most substances
C) is drained by an efferent arteriole
D) has a blood pressure much lower than other organ systems
Answer: C

11) The descending limb of the loop of Henle ________.
A) is not permeable to water
B) is freely permeable to sodium and urea
C) pulls water by osmosis into the lumen of the tubule
D) contains fluid that becomes more concentrated as it moves down into the medulla
Answer: D

12) Select the correct statement about the ureters.
A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine.
B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch.
C) The ureters are capable of peristalsis like that of the gastrointestinal tract.
D) The ureter is innervated by parasympathetic nerve endings only.
Answer: C

13) The fatty tissue surrounding the kidneys is important because it ________.
A) ensures adequate energy for the adrenal glands to operate efficiently
B) stabilizes the position of the kidneys by holding them in their normal position
C) is necessary as a barrier between the adrenal glands and kidneys
D) produces vitamin D
Answer: B

14) The renal corpuscle is made up of ________.
A) Bowman's capsule and glomerulus
B) the descending loop of Henle
C) the renal pyramid
D) the renal papilla
Answer: A

15) The functional and structural unit of the kidneys is the ________.
A) nephron
B) loop of Henle
C) glomerular capsule
D) basement membrane of the capillaries
Answer: A

16) The juxtaglomerular apparatus is responsible for ________.
A) the secretion of drugs
B) the secretion of acids and ammonia
C) reabsorption of organic molecules, vitamins, and water
D) regulating the rate of filtrate formation and controlling systemic blood pressure
Answer: D

17) The chief force pushing water and solutes out of the blood across the filtration membrane is ________.
A) the design and size of the podocytes
B) the thickness of the capillary endothelium
C) glomerular hydrostatic pressure (glomerular blood pressure)
D) the size of the pores in the basement membrane of the capillaries
Answer: C

18) Which of the following statements describes the histology of the ureters?
A) They are trilayered (mucosa, muscularis, and adventitia).
B) They are actually an extension of the visceral peritoneum.
C) They are made up of several layers of endothelium.
D) They are made up entirely of muscle tissue because they need to contract in order to transport urine efficiently.
Answer: A

19) Which of the following statements is a false or incorrect statement?
A) The male urethra serves both the urinary and reproductive systems at the same time.
B) The male urethra serves both the urinary and reproductive systems but at different times.
C) The male urethra is longer than the female urethra.
D) The male urethra is a passageway for both urine and semen.
Answer: A

20) Which of the following acts as the trigger for the initiation of micturition (voiding)?
A) the stretching of the bladder wall
B) motor neurons
C) the pressure of the fluid in the bladder
D) the sympathetic efferents
Answer: A

21) The filtration membrane includes all except ________.
A) glomerular endothelium
B) podocytes
C) renal fascia
D) basement membrane
Answer: C

22) The mechanism of water reabsorption by the renal tubules is ________.
A) active transport
B) osmosis
C) solvent drag
D) cotransport with sodium ions
Answer: B

23) Most electrolyte reabsorption by the renal tubules is ________.
A) not Tm limited
B) in the distal convoluted tubule
C) hormonally controlled in distal tubule segments
D) completed by the time the loop of Henle is reached
Answer: C

24) The macula densa cells respond to ________.
A) aldosterone
B) antidiuretic hormone
C) changes in pressure in the tubule
D) changes in solute content of the filtrate
Answer: D

25) Which of the following is not reabsorbed by the proximal convoluted tubule?
A) Na+
B) K+
C) glucose
D) creatinine
Answer: D

26) The fluid in the glomerular (Bowman's) capsule is similar to plasma except that it does not contain a significant amount of ________.
A) glucose
B) hormones
C) electrolytes
D) plasma protein
Answer: D

27) Alcohol acts as a diuretic because it ________.
A) is not reabsorbed by the tubule cells
B) increases the rate of glomerular filtration
C) increases secretion of ADH
D) inhibits the release of ADH
Answer: D

28) The function of angiotensin II is to ________.
A) constrict arterioles and increase blood pressure
B) decrease the production of aldosterone
C) decrease arterial blood pressure
D) decrease water absorption
Answer: A

29) A disease caused by inadequate secretion of antidiuretic hormone (ADH) by the pituitary gland with symptoms of polyuria is ________.
A) diabetes mellitus
B) diabetes insipidus
C) diabetic acidosis
D) coma
Answer: B

30) An important characteristic of urine is its specific gravity or density, which is ________.
A) 1.041-1.073
B) 1.001-1.035
C) 1.030-1.040
D) 1.000-1.015
Answer: B

31) Place the following in correct sequence from the formation of a drop of urine to its elimination from the body.

1. major calyx
2. minor calyx
3. nephron
4. urethra
5. ureter
6. collecting duct

A) 3, 1, 2, 6, 5, 4
B) 6, 3, 2, 1, 5, 4
C) 2, 1, 3, 6, 5, 4
D) 3, 6, 2, 1, 5, 4
Answer: D

32) Select the correct statement about the nephrons.
A) The parietal layer of the glomerular capsule is simple squamous epithelium.
B) The glomerulus is correctly described as the proximal end of the proximal convoluted tubule.
C) Podocytes are the branching epithelial cells that line the tubules of the nephron.
D) Filtration slits are the pores that give fenestrated capillaries their name.
Answer: A

33) What would happen if the capsular hydrostatic pressure were increased above normal?
A) Net filtration would increase above normal.
B) Net filtration would decrease.
C) Filtration would increase in proportion to the increase in capsular pressure.
D) Capsular osmotic pressure would compensate so that filtration would not change.
Answer: B

34) Which of the following is not a part of the juxtaglomerular apparatus?
A) granular cells
B) macula densa
C) podocyte cells
D) mesangial cells
Answer: C

35) Tubular reabsorption ________.
A) includes substances such as creatinine
B) by active mechanisms usually involves movement against an electrical and/or chemical gradient
C) by passive processes requires ATP to move solutes from the interior of the tubule to the blood
D) is a way for the body to get rid of unwanted waste
Answer: B

36) Which of the following is not a reason why substances are either not reabsorbed or are incompletely reabsorbed from the nephron?
A) They lack carriers.
B) They are not lipid soluble.
C) They are too large to pass through the fenestrations.
D) They are extremely complex molecules.
Answer: D

37) Reabsorption of high levels of glucose and amino acids in the filtrate is accomplished by ________.
A) facilitated diffusion
B) passive transport
C) countertransport
D) secondary active transport
Answer: D

38) Which of the choices below is a function of the loop of Henle?
A) form a large volume of very concentrated urine or a small volume of very dilute urine
B) form a large volume of very dilute urine or a small volume of very concentrated urine
C) absorb electrolytes actively with an automatic absorption of water by osmosis
D) none of these
Answer: B

39) Fetal kidneys do not have to work very hard because ________.
A) fetuses do not have any waste to excrete
B) there are no functional nephrons until after birth
C) the placenta allows the mother's urinary system to clear the waste from fetal blood
D) there is no way a fetus could excrete urine until the seventh month of development
Answer: C

40) Which of the following best describes kidney function in older adults (70 years or older)?
A) Kidney function remains the same throughout life, regardless of age.
B) Only about 3% of older adults have any loss of kidney function.
C) Only obese and diabetic older adults have any kidney dysfunction.
D) Kidney function decreases due to kidney atrophy.
Answer: D

41) The factor favoring filtrate formation at the glomerulus is the ________.
A) colloid osmotic pressure of the blood
B) glomerular hydrostatic pressure
C) capsular hydrostatic pressure
D) myogenic mechanism
Answer: B

42) If the Tm for a particular amino acid is 120 mg/100 ml and the concentration of that amino acid in the blood is 230 mg/100 ml, the amino acid will ________.
A) be actively secreted into the filtrate
B) be completely reabsorbed by the tubule cells
C) appear in the urine
D) be reabsorbed by secondary active transport
Answer: C

43) If one says that the clearance value of glucose is zero, what does this mean?
A) The glucose molecule is too large to be filtered out of the blood.
B) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules.
C) Normally all the glucose is reabsorbed.
D) The clearance value of glucose is relatively high in a healthy adult.
Answer: C

44) Excretion of dilute urine requires ________.
A) relative permeability of the distal tubule to water
B) impermeability of the collecting tubule to water
C) transport of sodium and chloride ions out of the descending loop of Henle
D) the presence of ADH
Answer: B

45) Which of the choices below is not a method by which the cells of the renal tubules can raise blood pH?
A) by secreting hydrogen ions into the filtrate
B) by reabsorbing filtered bicarbonate ions
C) by producing new bicarbonate ions
D) by secreting sodium ions
Answer: D

46) In the ascending limb of the loop of Henle the ________.
A) thin segment is freely permeable to water
B) thick segment is permeable to water
C) thin segment is not permeable to sodium and chloride
D) thick segment moves ions out into interstitial spaces for reabsorption
Answer: D

47) Select the correct statement about urinary system development.
A) Kidneys develop from urogenital ridges.
B) The metanephric ducts will become the urethras.
C) The pronephros (first tubule system) develops during the tenth week of gestation.
D) The mesonephros will develop into the kidneys.
Answer: A

48) Which of the choices below does not describe the importance of tubular secretion?
A) disposing of substances not already in the filtrate, such as certain drugs
B) eliminating undesirable substances such as urea and uric acid that have been reabsorbed by passive processes
C) ridding the body of bicarbonate ions
D) ridding the body of excessive potassium ions
Answer: C

49) Which statement is correct?
A) Reabsorption of water is hormonally controlled.
B) Normal filtrate contains a large amount of protein.
C) Most of the water passing through the kidney is eliminated as urine.
D) The excretion of sodium ions is one of the mechanisms that maintains the pH balance of the blood.
Answer: A

50) What is the function of the juxtaglomerular apparatus?
A) help regulate blood pressure and the rate of blood filtration by the kidneys
B) help regulate blood pressure and the rate of excretion by the kidneys
C) help regulate urea absorption by the kidneys
D) help regulate water and electrolyte excretion by the kidneys
Answer: A

51) Which of the choices below is the salt level-monitoring part of the nephron?
A) macula densa
B) principal cell
C) vasa recta
D) loop of Henle
Answer: A

52) Which of the hormones below is responsible for facultative water reabsorption?
B) thyroxine
C) aldosterone
D) atrial natriuretic peptide
Answer: A

53) Which of the choices below is not a glomerular filtration rate control method?
A) renal autoregulation
B) neural regulation
C) electrolyte levels
D) hormonal regulation
Answer: C

54) Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion?
A) angiotensin II and ADH
B) angiotensin II and aldosterone
C) angiotensin I and epinephrine
D) angiotensin I and atrial natriuretic peptide
Answer: B

55) Which cells of the kidney are chemoreceptors that respond to changes in solute content of the filtrate?
A) juxtaglomerular cells
B) mesangial cells
C) macula densa cells
D) podocytes
Answer: C 

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