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Excretory Products and Elimination

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Which of the following does NOT cause vasoconstriction in the kidney?

  1. Angiotensin II

  2. Vasopressin

  3. Epinephrine

  4. Prostaglandins

  5. Non-steroidal anti-inflammatory drugs


Correct Option: D
Explanation:

Prostaglandins are powerful vasodilators and there is a normal tonic level of vasodilation in the renal blood vessels, which is caused by the prostaglandins.

Which among the following statements does not characterises the renal development in humans?

  1. There are three kidney structures which are formed at different times during development.

  2. The final adult kidney forms from the pronephros.

  3. The ureteric bud forms the draining system.

  4. Capillaries invaginate the tubules to form glomeruli.

  5. The final adult kidney rises up the body during development.


Correct Option: B
Explanation:

It is the metanephros which goes on to become the adult kidney.

Which of the following statements concerning renal blood flow are true?

  1. The efferent arterioles deliver blood to the glomerulus.

  2. Vasa recta receive their blood supply from the efferent arterioles.

  3. Vasoconstriction of the afferent arterioles increases glomerular filtration.

  4. Vasoconstriction of the efferent arterioles decreases glomerular filtration.

  5. Vasoconstriction reduces the resistance to flow in a blood vessel.


Correct Option: B
Explanation:

For nephrons which are in the outer cortex and do not have vasa recta or long loops of Henle, the efferent arterioles supply the peritubular capillaries. Flow occurs when the pressure at one end of a tube is made greater than that at the other end.

Which among the following statements concerning transport processes in the tubules is correct?

  1. Water molecules can be pumped directly by active transport.

  2. Active transport delays concentration gradient.

  3. Counter-transport of oppositely charged molecules can maintain electroneutrality.

  4. Water moves by osmosis from a region of high osmolality to a region of low osmolality.

  5. Active transport can establish an electrical gradient.


Correct Option: E
Explanation:

Active transport can move charged or uncharged molecules across a membrane and so can establish concentration gradients and if the molecules are charged, electrical gradients. However, if the charges are of opposite sign, then one side of the membrane will become more positive and the other side will become more negative.

Which of the following statements are true concerning developmental anomalies of the renal system?

  1. Failure of the ureteric bud to develop causes hypospadias.

  2. Horseshoe kidneys occur when the pronephros fails to regress.

  3. Adult kidneys can only have one renal artery each.

  4. Early splitting of the ureteric bud can result in one kidney having two ureters.

  5. The ureteric bud forms the glans penis.


Correct Option: D
Explanation:

The ureteric bud forms the collecting system and if it splits before it enters the kidney, the result, which is not uncommon, is that the kidney will have two ureters.

Which of the following statements concerning erythropoietin is true?

  1. Erythropoietin is a protein.

  2. Hypoxia (a low level of oxygen) inhibits erythropoietin production.

  3. Most erythropoietin is made in the pancreas in adults.

  4. Erythropoietin stimulates white blood cell production.

  5. Erythropoietin detects hypoxia easily.


Correct Option: A
Explanation:

Erythropoietin is a glycoprotein hormone that controls erythropoiesis, or red blood cell production.

Paracetamol causes acute and chronic renal tubules failure in humans. From the following statements, select the false statement concerning the renal tubules in kidneys.

  1. The major changes in tubular fluid composition are made in the proximal tubules.

  2. The proximal tubules substantially increases the concentration of urine.

  3. Part of the loop of henle is permeable to water.

  4. The vasa recta are blood vessels.

  5. The walls of the tubules are made up of epithelial cells.


Correct Option: B
Explanation:

The osmolality of filtered fluid entering the proximal tubule from the glomerulus is essentially that of plasma from which it is produced. Reabsorption in the proximal tubule is iso-osmotic, which means that the osmolality of the tubular fluid does not change because solutes and water are removed together in the same ratio at which they are present in the tubules. For this reason, the concentration of urine (i.e. its osmolality) in the proximal tubule is not altered.

After medical examination doctor confirmed that Mr. Bansal is suffering from chronic renal disease. In patients with chronic renal disease, which of the following statements does not take place?

  1. Erythropoietin levels are usually lowered.

  2. Anemia is a common problem.

  3. Erythropoietin can be given to treat the anemia.

  4. Erythropoietin is usually given as oral tablets.

  5. Iron deficiency can occur.


Correct Option: D
Explanation:

As erythropoietin is a protein, it cannot be given orally as it would be digested in the gut. It is usually given subcutaneously or less commonly, intravenously.

Which of the following statements concerning the water balance function of kidney is true?

  1. The key hormone regulating water reabsorption is secreted from the posterior pituitary gland.

  2. Aquaporin is the main hormone regulating water reabsorption.

  3. The vasa recta is the same structure as the loop of Henle.

  4. There are osmoreceptors in the pituitary gland.

  5. There is no limit to how much the body can concentrate urine.


Correct Option: A
Explanation:

The main hormone regulating water reabsorption is anti-diuretic hormone (ADH or vasopressin). There are indeed osmoreceptors in the hypothalamus, which detect an increase in plasma osmolality. In response to input from these receptors and other stimuli, cells in the posterior pituitary gland release ADH.

The kidneys excrete about 15% of the filtered potassium load of 10 mEq/kg per day. Which among the following statements concerning potassium is true?

  1. Potassium is the major extracellular ion.

  2. Within cells, the concentration of potassium is lower than that of sodium.

  3. Potassium excretion is regulated by altering potassium secretion.

  4. The 3Na+/2K+ ATPase pumps potassium out of the cells.

  5. Selected cells have potassium channels.


Correct Option: C
Explanation:

Potassium is freely filtered and then most of the filtered potassium is reabsorbed. Potassium excretion is then controlled by the secretion of potassium by the principal cells in the collecting ducts.

Which of the following statements concerning sodium ions in the nephron is correct?

  1. The concentration of sodium ions is generally higher inside the cells than outside the cells.

  2. Sodium is not filtered in the glomerulus.

  3. Most sodium is reabsorbed in the distal tubule.

  4. There is no active transport of sodium.

  5. The diuretic drug furosemide blocks the NaK2Cl channel in the loop of henle.


Correct Option: E
Explanation:

If drugs are given which inhibit sodium reabsorption, then there is more sodium in the tubules and this means that more water stays in the tubules with it because of the osmotic effect of the sodium. Such drugs are known as diuretics because they increase the amount of water excretion. Diuretics such as furosemide (frusemide) inhibit sodium reabsorption in the loop of henle, drugs such as the thiazides oppose sodium reabsorption in the distal tubule and drugs such as amiloride oppose sodium reabsorption in the collecting ducts.

Considering acid-base regulation in the body, which of the following statements are true?

  1. Overall human metabolism results in acid production.

  2. Buffers must be strong acids or bases.

  3. Carbon dioxide directly raises the pH of body fluids.

  4. The pH of a buffer solution is always 7.0.

  5. A decrease in the plasma level of bicarbonate ions (HCO3-) will directly raise the pH of plasma.


Correct Option: A
Explanation:

Overall, the body is a net producer of acid and a major function of the kidney is to excrete this acid load. A large change in body pH cannot be tolerated as it will have adverse effects on cellular function.

Mrs. Verma is seven months pregnant and is suffering from urinary tract infection. Which of the following options is false regarding urinary tract infection?

  1. Staphylococcus aureus is a common cause.

  2. Lower urinary tract infection is a superficial infection.

  3. Can cause renal damage if it involves the kidney.

  4. Upper urinary tract infection are minimised during pregnancy.

  5. Causes white cells to occur in the urine.


Correct Option: A
Explanation:

The common causes of urinary tract infection are Escherichia coli, Klebsiella and Proteus species. Staphylococci are not common causes of urinary tract infection.

Which of the following statements is/are incorrect regarding the excretory function of the body?

  1. Carbon dioxide can pass across cell membranes.

  2. Proteins can act as buffers.

  3. The lungs excrete carbon dioxide.

  4. The kidney absorbs all the bicarbonate ions.

  5. There are no buffers in urine.


Correct Option: E
Explanation:

There are buffers in the urine, including sodium phosphate. In addition, hydrogen ions can be excreted in the form of ammonium ions (NH4+) in the urine. The buffers are necessary because urine cannot be made very acidic because below a certain pH, the hydrogen ion gradient across the tubule wall cannot be maintained.

Which of the following statements concerning the excretion of acid by the nephrons are true?

  1. Acid can be excreted as NH3 ions.

  2. Acid excretion mainly occurs in the early nephron.

  3. In the distal nephron, secreted hydrogen ions mainly contribute to bicarbonate reabsorption.

  4. Sodium phosphate is a urinary buffer.

  5. Urine is usually alkaline.


Correct Option: D
Explanation:

Sodium phosphate can exist as Na2HPO4 or NaH2PO4 and the two form a buffer pair. The form NaHPO4 is a weak base which can accept a hydrogen ion to become NaH2PO4. Similarly NaH2PO4 is a weak acid which can donate a hydrogen ion to become Na2HPO4.

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