Renal Regulation: Master Kidney Function and Fluid Balance

Question 1

Which of the following mechanisms is responsible for promoting sodium reabsorption in the distal convoluted tubule (DCT)?

Accepted Answer

Increased activity of the Na+/K+/ATPase pump

Answer

Increased production of atrial natriuretic peptide (ANP)

Answer

Decreased activity of the renin-angiotensin-aldosterone system (RAAS)

Question 2

Which hormone is primarily responsible for stimulating water reabsorption in the collecting ducts?

Accepted Answer

Antidiuretic hormone (ADH)

Answer

Aldosterone

Answer

Epinephrine

Answer

Parathyroid hormone (PTH)

Question 3

What is the main mechanism by which the kidneys regulate sodium excretion?

Accepted Answer

Renin-angiotensin-aldosterone system (RAAS)

Answer

Glomerular filtration rate (GFR)

Answer

Atrial natriuretic peptide (ANP)

Answer

Sympathetic nervous system

Question 4

What is the primary function of the macula densa in the regulation of kidney function?

Accepted Answer

Detects changes in tubular fluid composition

Answer

Secretes hormones that regulate GFR

Answer

Controls the release of renin from the juxtaglomerular apparatus

Answer

Produces prostaglandins that influence renal blood flow

Question 5

What is the most important role of the proximal tubule in kidney function?

Accepted Answer

Reabsorption of glucose and other essential nutrients

Answer

Secretion of waste products

Answer

Regulation of the body's pH balance

Answer

Production of hormones

Question 6

How does aldosterone promote sodium reabsorption in the collecting ducts?

Accepted Answer

Increases the number of sodium-potassium pumps

Answer

Decreases the number of sodium-potassium pumps

Answer

Increases the permeability of the collecting ducts to sodium

Answer

Decreases the permeability of the collecting ducts to sodium

Question 7

What is the effect of sympathetic nervous system activation on renal blood flow?

Accepted Answer

Decreases renal blood flow

Answer

Increases renal blood flow

Answer

Increases GFR

Answer

Decreases GFR

Question 8

Which hormone is NOT directly involved in regulating renal function?

Accepted Answer

Insulin-like growth factor-1 (IGF-1)

Answer

Antidiuretic hormone (ADH)

Answer

Renin

Answer

Erythropoietin (EPO)

Question 9

Which hormone primarily regulates sodium reabsorption in the distal convoluted tubule, maintaining fluid balance?

Accepted Answer

Aldosterone

Answer

Antidiuretic hormone (ADH)

Answer

Atrial natriuretic peptide (ANP)

Answer

Parathyroid hormone (PTH)

Question 10

Which factor leads to a decreased glomerular filtration rate (GFR)?

Accepted Answer

Increased resistance in the afferent arteriole

Answer

Increased resistance in the efferent arteriole

Answer

Increased plasma oncotic pressure

Answer

Increased renal blood flow

Question 11

Which drug inhibits the sodium-potassium-2-chloride (NKCC2) cotransporter in the thick ascending limb of Henle, acting as a potent diuretic?

Accepted Answer

Furosemide

Answer

Hydrochlorothiazide

Answer

Spironolactone

Answer

Vasopressin

Question 12

Which disorder is characterized by an inability to concentrate urine, leading to excessive urination both during the day (polyuria) and night (nocturia)?

Accepted Answer

Diabetes insipidus

Answer

Fanconi syndrome

Answer

Hyperaldosteronism

Answer

Lupus nephritis

Question 13

What is the primary afferent signal that activates the juxtaglomerular apparatus (JGA), a key regulator of blood pressure?

Accepted Answer

Decreased glomerular filtration rate (GFR)

Answer

Increased arterial pressure

Answer

Increased sympathetic stimulation

Answer

Stimulation of β1-adrenergic receptors

Question 14

Which clinical finding is characteristic of nephrotic syndrome, a disorder involving damage to the glomerular filtration barrier?

Accepted Answer

Edema due to protein loss in the urine

Answer

Hematuria due to red blood cell leakage

Answer

Hypertension due to fluid retention

Answer

Oliguria due to decreased urine output

Question 15

In the hormonal regulation of renal function, which hormone is not directly involved?

Accepted Answer

Growth hormone

Answer

Antidiuretic hormone (ADH)

Answer

Renin

Question 16

Which hormone stimulates water reabsorption in the collecting duct?

Accepted Answer

Antidiuretic hormone

Answer

Aldosterone

Answer

Angiotensin II

Answer

Atrial natriuretic peptide

Question 17

Which mechanism filters blood in the kidney?

Accepted Answer

Glomerular filtration

Answer

Tubular secretion

Answer

Tubular reabsorption

Answer

Countercurrent mechanism

Question 18

What is a major function of the loop of Henle?

Accepted Answer

Establishing a concentration gradient in the medulla

Answer

Reabsorbing sodium and chloride ions

Answer

Secreting hydrogen ions

Answer

Producing urine

Question 19

Which disorder involves excessive urine production?

Accepted Answer

Polyuria

Answer

Oliguria

Answer

Anuria

Answer

Dysuria

Question 20

Which ion is actively transported out of the renal tubules by the Na+/K+/2Cl- cotransporter?

Accepted Answer

Chloride

Answer

Sodium

Answer

Potassium

Answer

Bicarbonate

Question 21

What is a major function of the juxtaglomerular apparatus?

Accepted Answer

Secreting renin

Answer

Regulating blood pressure

Answer

Producing erythropoietin

Answer

Reabsorbing glucose

Question 22

Which is a primary function of the proximal convoluted tubule?

Accepted Answer

Reabsorbing glucose and amino acids

Answer

Secreting hydrogen ions

Answer

Producing urine

Answer

Regulating blood pressure

Question 23

How does measuring serum creatinine levels contribute to the clinical evaluation of renal function?

Accepted Answer

Serum creatinine levels directly reflect the glomerular filtration rate.

Answer

Elevated serum creatinine levels are solely indicative of acute renal failure.

Answer

Serum creatinine measurements are not valuable in assessing renal function in children.

Question 24

Which hormone is primarily responsible for regulating the reabsorption of water in the collecting ducts?

Accepted Answer

Antidiuretic hormone (ADH [Vasopressin])

Answer

Aldosterone

Answer

Atrial natriuretic peptide (ANP)

Answer

Epinephrine

Question 25

When renal blood flow decreases, the juxtaglomerular apparatus (JGA) releases which hormone?

Accepted Answer

Renin

Answer

Aldosterone

Answer

Antidiuretic hormone (ADH)

Answer

Erythropoietin

Question 26

Which part of the nephron is responsible for the majority of potassium secretion?

Accepted Answer

Distal convoluted tubule and collecting ducts

Answer

Bowman's capsule

Answer

Proximal tubule

Answer

Loop of Henle

Question 27

Which disorder is characterized by excessive thirst and urine production due to impaired antidiuretic hormone secretion?

Accepted Answer

Diabetes insipidus

Answer

Nephrotic syndrome

Answer

Renal failure

Answer

Hypertension

Question 28

Which component is a part of the renin-angiotensin-aldosterone system (RAAS)?

Accepted Answer

Renin

Answer

Atrial natriuretic peptide (ANP)

Answer

Antidiuretic hormone (ADH [Vasopressin])

Answer

Erythropoietin

Question 29

The primary site of bicarbonate reabsorption in the nephron is the:

Accepted Answer

Proximal tubule

Answer

Loop of Henle

Answer

Distal convoluted tubule

Answer

Collecting ducts

Question 30

Which is a function of the renal pelvis?

Accepted Answer

Collecting urine from the nephrons

Answer

Regulating urine pH

Answer

Concentrating urine

Answer

Reabsorbing sodium

Question 31

In the juxtaglomerular apparatus (JGA), which cells release renin?

Accepted Answer

Juxtaglomerular cells

Answer

Macula densa cells

Answer

Mesangial cells

Answer

Podocytes

Question 32

Which hormone primarily increases glomerular filtration rate (GFR)?

Accepted Answer

Atrial natriuretic peptide (ANP)

Answer

Antidiuretic hormone (ADH)

Answer

Aldosterone

Answer

Angiotensin II

Question 33

Which condition arises from excessive production of ADH?

Accepted Answer

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Answer

Diabetes insipidus

Answer

Nephrogenic diabetes insipidus

Answer

Renal failure

Question 34

Which hormone plays a pivotal role in regulating blood volume and osmolality by promoting sodium and water reabsorption in the kidneys?

Accepted Answer

Antidiuretic hormone (ADH)

Answer

Renin

Answer

Aldosterone

Answer

Atrial natriuretic peptide (ANP)

Question 35

When blood pressure drops, which mechanism triggers increased renin secretion from the kidneys?

Accepted Answer

Juxtaglomerular apparatus (JGA)

Answer

Baroreceptor reflex

Answer

Renin-angiotensin-aldosterone system (RAAS)

Answer

Tubular glomerular feedback

Question 36

Which of the following is NOT a renal function related to maintaining acid-base balance?

Accepted Answer

Sodium absorption

Answer

Bicarbonate reabsorption

Answer

Ammonia production

Answer

Hydrogen ion (H+) secretion

Question 37

In diabetes insipidus, which factor is commonly impaired, leading to excessive thirst and increased urine output?

Accepted Answer

ADH secretion

Answer

Renin production

Answer

Aldosterone release

Answer

ANP synthesis

Question 38

Which type of kidney failure is characterized by a sudden and severe decline in kidney function, potentially requiring dialysis or transplantation?

Accepted Answer

Acute kidney failure

Answer

Chronic kidney failure

Answer

End-stage renal disease (ESRD)

Answer

Nephrotic syndrome

Question 39

Hematuria, or the presence of blood in the urine, is a characteristic finding in which kidney disease?

Accepted Answer

Glomerulonephritis

Answer

Pyelonephritis

Answer

Interstitial nephritis

Answer

Renal calculi

Question 40

Which class of medications targets the renin-angiotensin-aldosterone system and is commonly used to treat hypertension?

Accepted Answer

ACE inhibitors

Answer

Diuretics

Answer

Beta-blockers

Answer

Calcium channel blockers

Question 41

Which hormonal mechanism is primarily responsible for the kidneys' response to reduced blood volume?

Accepted Answer

Activation of the renin-angiotensin-aldosterone system (RAAS)

Answer

Increased secretion of antidiuretic hormone (ADH)

Answer

Secretion of atrial natriuretic peptide (ANP)

Answer

Inhibition of the sympathetic nervous system

Question 42

Which of the following hormones inhibits sodium reabsorption in the collecting ducts?

Accepted Answer

Atrial Natriuretic Peptide (ANP)

Answer

Parathyroid Hormone (PTH)

Answer

Antidiuretic Hormone (ADH)

Answer

Renin

Question 43

Which of the following is the primary mechanism by which the kidneys maintain acid-base balance?

Accepted Answer

Bicarbonate reabsorption and excretion

Answer

Urea reabsorption

Answer

Potassium secretion

Answer

Phosphate excretion

Question 44

Which component of the juxtaglomerular apparatus is responsible for renin release?

Accepted Answer

Juxtaglomerular cells (JG cells)

Answer

Glomerular endothelial cells

Answer

Mesangial cells

Answer

Macula densa cells

Question 45

Which characteristic feature of urine is observed in osmotic diuresis?

Accepted Answer

High urine volume with low urine osmolality

Answer

Low urine pH

Answer

High urine specific gravity

Answer

Low urine volume with high urine osmolality

Question 46

Which of the following factors can increase the glomerular filtration rate (GFR)?

Accepted Answer

Increased afferent arteriolar vasodilation and decreased efferent arteriolar vasoconstriction

Answer

Increased afferent arteriolar vasoconstriction and increased efferent arteriolar vasodilation

Answer

Increased afferent and efferent arteriolar vasoconstriction

Question 47

Which modifiable factor increases the risk of developing kidney stones?

Accepted Answer

Dehydration

Answer

High dietary intake of fiber

Answer

Regular physical activity

Answer

Low urine pH

Question 48

Which of the following is a primary function of the proximal tubule in maintaining homeostasis?

Accepted Answer

Reabsorption of glucose and amino acids

Answer

Production of renin

Answer

Concentration of urine

Answer

Secretion of hydrogen ions

Question 49

Which hormone is responsible for regulating water reabsorption in the collecting ducts?

Accepted Answer

Antidiuretic Hormone (ADH)

Answer

Aldosterone

Answer

Parathyroid Hormone (PTH)

Answer

Atrial Natriuretic Peptide (ANP)

Question 50

A patient presents with excessive thirst and frequent urination. Lab tests reveal high serum osmolality and high urine volume. Which hormone is most likely deficient in this patient?

Accepted Answer

Antidiuretic hormone (ADH)

Answer

Atrial natriuretic peptide (ANP)

Answer

Parathyroid hormone (PTH)

Answer

Aldosterone

Question 51

Which of the following is a direct effect of aldosterone on the kidneys?

Accepted Answer

Increased sodium reabsorption in the distal tubules and collecting ducts

Answer

Increased potassium reabsorption in the proximal tubules

Answer

Increased calcium reabsorption in the distal tubules

Answer

Increased water reabsorption in the descending limb of the loop of Henle

Question 52

A patient with chronic kidney disease presents with hyperkalemia. Which hormonal mechanism is most likely impaired in this condition?

Accepted Answer

Aldosterone-mediated potassium secretion

Answer

PTH-mediated calcium reabsorption

Answer

ADH-mediated water reabsorption

Answer

ANP-mediated sodium excretion

Question 53

What is the primary stimulus for the release of renin from the juxtaglomerular cells?

Accepted Answer

Decreased renal perfusion pressure

Answer

Increased serum potassium concentration

Answer

Decreased sympathetic nervous system activity

Answer

Increased serum sodium concentration

Question 54

Which of the following changes would occur in response to a decrease in blood volume?

Accepted Answer

Increased renin secretion

Answer

Decreased ADH secretion

Answer

Decreased aldosterone secretion

Answer

Increased ANP secretion

Question 55

Which part of the nephron is primarily responsible for the reabsorption of glucose?

Accepted Answer

Proximal convoluted tubule

Answer

Descending limb of the loop of Henle

Answer

Collecting duct

Answer

Distal convoluted tubule

Question 56

In which segment of the nephron is the majority of filtered water reabsorbed?

Accepted Answer

Proximal convoluted tubule

Answer

Collecting duct

Answer

Ascending limb of the loop of Henle

Answer

Descending limb of the loop of Henle

Question 57

What is the primary mechanism by which the kidneys regulate acid-base balance?

Accepted Answer

Secretion of hydrogen ions and reabsorption of bicarbonate ions

Answer

Excretion of urea and reabsorption of creatinine

Answer

Excretion of sodium ions and reabsorption of potassium ions

Answer

Filtration of plasma proteins and reabsorption of amino acids

Question 58

A patient with acute kidney injury presents with metabolic acidosis. Which of the following is a likely contributing factor to this acid-base disturbance?

Accepted Answer

Impaired excretion of hydrogen ions

Answer

Enhanced buffering capacity of the blood

Answer

Excessive reabsorption of bicarbonate ions

Answer

Increased production of ammonia in the renal tubules

Question 59

What is the physiological effect of atrial natriuretic peptide (ANP) on renal function?

Accepted Answer

Increased sodium and water excretion

Answer

Stimulation of renin release

Answer

Increased sodium and water reabsorption

Answer

Decreased potassium excretion