(MCQ) Sample 2017 Dr. Ahmad .S.

Alarabi

Renal Physiology

Q1: The cells of the proximal convoluted tubules:

a) Have very few mitochondria. b) Have many brush border.

c) Responding mainly to ADH. d) Responding mainly to aldosterone.
e) Are for reabsorption only.

Q2: The cortical nephrons when compared to the juxtamedullary nephrons cortical
nephrons have:

a) Longer loops of Henle. b) Greater numbers. c) Vasa recta.

d) Major role in urine concentration. e) Lower blood supply.

Q3: In humans, what percentage of nephrons has long loop of Henle:

a) 5. b) 15. c) 35. d) 85.

Q4: The juxtamedullary nephrons are characterized by:

a) They have 15% of total number. b) They have long loop of Henle.
c) They are involved in urine concentration. d) All of the above are correct.

Q5: Renal blood flow:

a) Is about 80% of the cardiac output.

b) Is more in the medulla than in the cortex.
c) Can be calculated if renal plasma flow and GFR are known.
d) Is more in the cortex than in the medulla.
e) Is usually calculated by inulin clearance.

Q6: The renal capillaries are characterized by all the following EXCEPT:

a) Glomerular capillaries have the highest capillary pressure.

b) Glomerular capillaries lies in-between narrow afferent and wide efferent arterioles.
c) Peritubular capillaries have pressure of 13 mmHg.
d) Peritubular capillaries show continuous reabsorption of tubular fluid.

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Q7: Which of the following statement is correct about renal blood flow:

a) Blood flow to medulla is more than cortex.

b) The vasa recta present only in the juxtamedullary nephron.
c) There is about 1200 plasma /min.
d) All of the above are correct.

Q8: Stimulation of sympathetic nerves causes:

a) Low diuresis. b) Increased glucose urine level.

c) Decreased glucose urine level. d) Increased glomerular hydrostatic pressure.

Q9: The juxtaglomerular apparatus:

a) Is present in the distal convoluted tubules.

b) Contains the macula densa as NaCl receptors.
c) Is stimulated by decreased blood flow through the afferent arteriole.
d) All of the above are correct.

Q10: The juxtaglomerular cells of the JGA secrete:

a) Aldosterone. b) ADH. c) Angiotensin II. d) Rennin. e) Adrenaline.

Q11: Concerning juxtaglomerular (JGA) apparatus which of the following is correct:

a) It is located in the area of contact between afferent & efferent arteriole, and DCT.
b) JG cells act as receptors for NaCl concentration.
c) Macula densa cells secrete rennin.
d) Its main function is to regulate glucose concentration in the plasma.
e) It is present in the juxtamedullary nephrons only.

Q12: Macula densa cells:

a) Secrete renin. b) Function as baroreceptors.

c) Functions as chemoreceptors. d) Are present in PCT.

Q13: Macula densa is responsible for:

a) Renin secretion. b) Urea secretion.

c) Detecting the change in glucose concentration. d) None of the above is correct.

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Q14: Macula densa:

a) Is present in the collecting ducts. b) Secretes rennin.

c) Responding to an increase in glucose conc. d) Detects NaCl load.
e) Is present in media of afferent arteriole.

Q15: Renin is secreted from the:

a) Juxtaglomerular cells. b) Macula densa cells.

c) Vasa recta. d) Principal cells.

Q16: Rennin hormone is secreted:

a) From juxtaglomerular cells. b) From macula densa cells.

c) From epithelial cells. d) In response to increased NaCl.
e) In response to increased blood flow to the kidney.

Q17: Which of the following statements about renin is correct:

a) It is secrete by cells of PCT.

b) Its secretion leads to loss of Na+ & water from plasma.
c) Its secretion is stimulated by increase in mean renal arterial pressure.
d) It converts angiotensinogen to angiotensin I.
e) It converts angiotensin I to angiotensin II.

Q18: The function of the kidney includes:

a) Regulation of blood pressure.

b) Regulation of the volume, composition, and PH of body fluids.
c) Control of the rate of RBCs production.
d) All of the above are correct.
e) Only b & c are correct.

Q19: Which of the following is NOT a function of the kidney:

a) Regulation of solutes concentration. b) Production of rennin.

c) Production of angiotensin. d) Activation of vitamin D.
e) Urine formation.

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Q20: All of the following are functions of the kidney EXCEPT:

a) Regulation of acid base balance.

b) Production and release of rennin.
c) Conversion of angiotensin I into angiotensin II.
d) Activation of vitamin D.
e) Regulation of the volume and ionic composition of body fluids.

Q21: The glomerular filtration barrier is composed of all the following EXCEPT:

a) Fenestrated capillary endothelium. b) Macula densa.

c) Basement membrane. d) Podocytes.

Q22: The term filtration fraction is used to refer to:

a) RPF / GFR. b) GFR / RPF. c) RPF / RBF. d) RPF X GFR.

Q23: It's correct to say:

a) The kidneys are richly innervated by parasympathetic nerves.

b) The blood supply to the medulla is derived from macula densa cells.
c) Molecules with M.W more than 80,000 can pass through membrane.
d) Osmotic pressure of proteins in Bowman's capsule = zero.

Q24: Which of the following is correct about glomerular capillary hydrostatic pressure:

a) Is increased with vasoconstriction of the afferent arteriole.

b) Is on the average 60 mmHg.
c) Is the force with opposes filtration.
d) Is increased with sympathetic stimulation.

Q25: Which of the following is correct about glomerular capillary hydrostatic pressure:

a) Is increased with vasoconstriction of the afferent arteriole.

b) Is on the average 25 mmHg.
c) Is the force which opposes filtration.
d) Rises with mild constriction of the efferent arteriole.

Q26: GFR is increased by:

a) Constriction of afferent arteriole. b) Sever constriction of efferent arteriole.

c) Sympathetic stimulation. d) Increased glomerular capillary pressure.

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Q27: If the glomerular capillary hydrostatic pressure, osmotic pressure of plasma

proteins, hydrostatic pressure and osmotic pressure in Bowman's capsule space
are 40,25,5 and 0 respectively, what is the net pressure driving filtration of fluid
into the Bowman's space:

a) 10 mmHg. b) 15 mmHg. c) 20 mmHg. d) 25 mmHg.

Q28: Which of the following factors decreases GFR:

a) Increased blood flow. b) Increased plasma osmotic pressure.

c) Mild constriction of the efferent arteriole. d) Dilatation of the afferent arteriole.

Q29: GFR decreases by:

a) Dilatation of afferent arteriole. b) Mild constriction of efferent arteriole.

c) Severe constriction of efferent arteriole. d) Increased K f.

Q30: Which of the following decreases filtration from the glomeruli:

a) An increase in the diameter of afferent arteriole.

b) A mild constriction of the efferent arteriole.
c) An increase in bowman’s capsule pressure.
d) An increase in renal blood flow.
e) An increase in filtration coefficient (K f).

Q31: When the ABP changes within physiological range 80–180 mmHg may cause:

a) Marked increase in GFR due to glomerulo-tubular balance.

b) Little effect in GFR due to autoregulation mechanism.
c) No change in GFR.
d) Slightly decrease in GFR.

Q32: Glomerulo-tubular balance for control of Na+ excretion means that:

a) When GFR rises, Na+ reabsorption rises.

b) When GFR rises, the peritubular capillary pressure decreased.
c) When GFR rises, the osmotic pressure in the peritubular capillaries rises.
d) All of the above are correct.

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Q33: Concerning glomerular filtration:

a) Filtration coefficient = GFR / RPF. b) Is about 125 ml /hour.

c) Filtration fraction = GFR / net filtration pressure. d) None of the above is correct.

Q34: GFR is increased when:

a) Afferent arteriole is constricted. b) Efferent arteriole is severely constricted.

c) Efferent arteriole is mildly constricted. d) Efferent arteriole is dilated.
e) Pressure in bowman’s capsule is increased.

Q35: GFR increases by:

a) Decreased filtration coefficient.

b) Increased osmotic pressure of proteins in Bowman's capsule.
c) Stone in ureter.
d) Sympathetic stimulation.

Q36: Which of the following causes an increase in GFR:

a) Sever constriction of the efferent arterioles.

b) Constriction of the afferent arterioles.
c) Increased plasma osmotic pressure.
d) Increased Bowman’s capsule osmotic pressure.
e) Decreased glomerular hydrostatic capillary pressure.

Q37: It's correct to say:

a) Filtration fraction = RPF / GFR. b) Macula densa cells secrete H+.

c) Vasa recta produced concentrated urine. d) Net filtration pressure = 12.5 mmHg.

Q38: Clearance of a substance is:

a) The amount of the substance cleared by the kidney per minute.

b) The amount of the substance excreted in urine per minute.
c) The volume of plasma cleared from the substance per minute.
d) The volume of plasma filtered per minute.
e) The amount of substance filtered.

Q39: Which of the following substances has the lowest clearance:

a) Inulin. b) Urea. c) Glucose. d) Creatinine.

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Q40: The renal clearance of a substance is:

a) Is inversely related to its urinary concentration.

b) Is directly related to the rate of urine formation.
c) Is directly related to its plasma concentration.
d) Is expressed in units of volume per units of concentration.

Q41: Which of the following is used for the measurement of GFR for substance (x):

a) Ux . Px / V b) Vx . Px / Ux c) Ux / Vx d) Ux . V / Px
e) None of the above.

Q42: Which of the following substances is filtered by the glomerular capillary but not
reabsorbed by the renal tubules:

a) Inulin. b) Glucose. c) Sodium chloride. d) Urea. e) None of the above.

Q43: It is correct to say that:

a) PAH clearance is 250 ml/min.

b) Inulin clearance is 80 ml/min.
c) Glucose clearance is zero.
d) The maximal urine osmolarity reaches 70 m.osm/L.
e) None of the above is correct.

Q44: If creatinine concentration in the plasma = 150 mg%, creatinine concentration

in urine = 125 mg /ml, urine flow rate = 180 ml /h, GFR would be:

a) 100 ml /min. b) 250 ml /min. c) 75 ml /min. d) 125 ml /min.

Q45: If creatinine concentration in plasma is 1 mg /ml, creatinine concentration in

urine is 125 mg /ml, and urine flow rate is 1 ml /min, GFR is:

a) 100 ml /min. b) 150 ml /min. c) 75 ml /min. d) 125 ml /min.

Q46: If inulin concentration in plasma is 100 mg%, inulin concentration in urine is

60 mg/ml, and urine flow rate is 2 ml /min, GFR is:

a) 100 ml /min. b) 150 ml /min. c) 75 ml /min. d) 120 ml /min.

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Q47: If the plasma inulin = 2 mg%, the urine inulin = 2 mg/ml, and the volume of
urine = 1ml/min, the GFR will be:

a) 1 ml/min. b) 125 ml/min. c) 200 ml/min. d) 100 ml/min. e) 100 mg/min.

Q48: The renal blood flow:

a) Is 40% of the cardiac output.

b) Can be measured by inulin clearance.
c) Reflects the high oxygen consumption by the kidney.
d) Is more to the cortex than to the medulla.

Q49: The glomerular filtrate:

a) Is different from plasma in its ionic composition.

b) Production rate is about 1 ml/min.
c) Is hypotonic compared to plasma.
d) Contains a small amount of albumin.
e) None of the above.

Q50: Glucose is reabsorbed at luminal border:

a) By passive transport. b) By Na+ co-transport.

c) By H+ counter transport. d) By diffusion.

Q51: Glucose:

a) Is partially reabsorbed in the PCT. b) Is partially reabsorbed in the DCT.

c) Is completely reabsorbed in the DCT. d) Has a clearance value of zero ml/min.
e) Is completely reabsorbed by all segments of renal tubules.

Q52: Glucose is:

a) Reabsorbed actively at the DCT. b) Reabsorbed passively at the PCT.

c) Reabsorbed actively at the PCT. d) Reabsorbed actively at the DCT & PCT.
e) Filtered but neither reabsorbed nor secreted by the nephron.

Q53: Glucose reabsorption occurs in the:

a) Loop of Henle. b) Proximal convoluted tubules.

c) Collecting ducts. d) Distal convoluted tubules.

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Q54: Glucose reabsorption in renal tubules:

a) Occurs in every segment of the renal tubules.

b) Is passive and results from potassium reabsorption.
c) Is coupled to sodium reabsorption in the PCT.
d) Is complete when the plasma glucose level is 280 mg%.

Q55: As plasma glucose concentration rises above the normal level:

a) The tubular transport maximum for glucose rises linearly.

b) The amount of glucose filtered increases linearly.
c) The renal clearance of glucose rises above zero.
d) All the above are correct.
e) Both b & c are correct.

Q56: It's correct to say:

a) Normal tubular load of glucose = 225 mg /min.

b) Normal Tm for glucose 125 mg%.
c) Normal renal threshold for glucose 180 mg /min.
d) Glucose reabsorption is coupled by Na+ reabsorption.

Q57: If blood glucose concentration is 180 mg%, and GFR is 100 ml /min, the tubular
load for glucose is:

a) 125 mg /min. b) 100 ml /min. c) 130 mg %. d) 180 mg /min.

Q58: If glucose concentration 200 mg%, and GFR is 120 ml/min, the tubular load for
glucose is:

a) 125 mg /min. b) 100 ml /min. c) 240 mg /min. d) None of the above.

Q59: If the plasma glucose level is 150 mg/dl and GFR = 100 ml/min, the tubular load
for glucose would be:

a) 125 mg/min. b) 1500 mg/min. c) 150 mg/min. d) 90 mg/ml. e) 190 mg/ml.

Q60: Sodium reabsorption in PCT is:

a) Passive at basal border. b) By secondary active transport at basal border.

c) By co-transport at luminal border. d) About 90% of the filtered amount.
e) About 65% of the filtered amount.

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Q61: The following data were collected from an adult male:

o Plasma glucose level = 135 mg / dL.

o Concentration of inulin in plasma = 50 mg / dL.
o Concentration of inulin in urine = 6000 mg / dL.
o Volume of urine collected in 40 minute = 60 ml.
o The subject’s GFR was:

a) 7200 ml/min. b) 180 ml/min. c) 0.5 ml/min. d) 0.5 L/min. e) 7.2 L/min.

Q62: Based on the above data, his glucose tubular load was:

a) 243 ml/min. b) 675 mg/min. c) 243 mg/dl. d) 243 mg/min. e) 243 mg/ml.

Q63: Active reabsorption of sodium occurs at:

a) Thick part of ascending limb of L.H. b) Descending limb of L.H.

c) Thin part of ascending limb of L.H. d) None of the above is correct.

Q64: Sodium reabsorbed passively in:

a) PCT. b) DCT. c) CD. d) Descending limb of loop of Henle.

e) Thin part of the ascending limb of loop of Henle.

Q65: Which of the following increases N+ reabsorption:

a) Erythropoietin. b) Renin. c) Aldosterone. d) ADH.

Q66: Aldosterone hormone increases Na+ reabsorption from which of the following
parts of nephron:

a) DCT and collecting ducts. b) PCT. c) Glomerulus.

d) Ascending limb of loop of Henle. e) Descending limb of loop of Henle.

Q67: Na+ reabsorption occurs in all the following sites EXCEPT:

a) DCT. b) Descending limb of loop of Henle.

c) PCT. d) Ascending limb of loop of Henle.

Q68: Which ion is both secreted and reabsorbed by the nephron:

a) Na+. b) K+. c) Cl-. d) Ca++.

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Q69: Potassium:

a) Deficiency favors hydrogen secretion.

b) Is reabsorbed in PCT.
c) Is secreted in DCT.
d) All of the above are correct.

Q70: Potassium secretion occurs in:

a) PCT. b) Late DCT. c) Cortical collecting ducts. d) Both b and c.

Q71: Potassium in the kidney is:

a) Freely filtered, neither reabsorbed nor secreted.

b) Freely filtered, secreted but not reabsorbed.
c) Freely filtered, reabsorbed and secreted.
d) Freely filtered, reabsorbed and not secreted.

Q72: Potassium ions:

a) Reabsorbed in the descending limb of loop of Henle.

b) Reabsorption in tubules is insulin dependent.
c) Reabsorbed and secreted in the descending limb of loop of Henle.
d) None of the above is correct.

Q73: Chloride is reabsorbed actively from:

a) Thin part of the ascending limb of loop of Henle. b) PCT.

c) Thick part of the ascending limb of loop of Henle. d) DCT.
e) Collecting ducts.

Q74: Normally, most of the filtered HCO3- is reabsorbed from:

a) PCT. b) DCT. c) Cortical collecting ducts. d) Loop of Henle.

Q75: Concerning bicarbonate reabsorption:

a) It increases if carbonic anhydrase decreases.

b) It occurs mainly in CD.
c) It decreases if chloride reabsorption increases.
d) It occurs mainly in DCT.

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Q76: Concerning bicarbonate reabsorption:

a) It occurs mainly in the DCT.

b) It increases if carbonic anhydrase decrease.
c) It increases if chloride reabsorption decreases.
d) It is not related to hydrogen ions secretion.

Q77: It is correct to say:

a) The majority of water reabsorption occurs in the DCT.

b) 99% of the filtered water is reabsorbed by osmosis.
c) ADH increases water reabsorption from the PCT.
d) Water reabsorption from PCT increases osmolarity of medullary interstitial fluid.
e) Counter current exchanger is the function of loop of Henle.

Q78: Concerning water reabsorption by the nephrons:

a) ADH increases water reabsorption from the PCT.

b) The thick part of the ascending limb of loop of Henle is impermeable to water.
c) The collecting ducts are the main sites for water reabsorption.
d) Counter current mechanism increases water reabsorption from the DCT.
e) Reabsorption of water decreases the osmolarity of urine.

Q79: Secretion of:

a) Aldosterone tends to rises urine volume.

b) Renin takes place from cells in juxtamedullary apparatus.
c) ADH tends to rises Na+ reabsorption.
d) Parathormone tends to decrease Ca++ reabsorption.

Q80: Which of the following substances will be more concentrated at end of PCT if
compared at the beginning of PCT:

a) Glucose. b) Creatinine. c) Sodium. d) Phosphate. e) None of the above.

Q81: Which of the following is reabsorbed passively in the PCT:

a) Na+. b) K+. c) Glucose. d) Urea. e) Amino acids.

Q82: Which of the following substances is reabsorbed actively by the renal tubules:

a) Urea. b) Glucose. c) Bicarbonate. d) Water. e) Creatinine.

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Q83: It is correct to say:

a) Inulin clearance equals zero in normal subjects.

b) Sodium is reabsorbed actively in the thin part of ascending limb of loop of Henle.
c) Creatinine is used for the measurement of RPF.
d) Loop diuretics are operating through inhibition of ADH action in DCT and CD.
e) Glucose is actively reabsorbed in the luminal border of the renal tubules.

Q84: Under normal conditions, all of the following substances could be detected in
urine EXCEPT:

a) Na+. b) HCO3-. c) Amino acids. d) Urea.

Q85: Under normal conditions, which of the following substances could be detected in
urine:

a) Glucose. b) Urea. c) Amino acids. d) Proteins.

Q86: Which of the following substances has the lowest clearance:

a) Proteins. b) creatinine. c) Phosphate. d) Urea.

Q87: In the PCT:

a) The luminal fluid is hypotonic to plasma.

b) 40 % of the filtered Na+ is reabsorbed.
c) 100 % of the amino acids are reabsorbed.
d) H+ is passively reabsorbed.

Q88: The counter current mechanism of the nephron:

a) Is dependent on GFR. b) Is necessary for producing concentrated urine.

c) Can be inhibited by ADH. d) Is a function of the cortical nephrons only.
e) Both b & d are correct.

Q89: Counter-current multiplier is a function of:

a) Loop of Henle of juxtamedullary nephron.

b) Loop of Henle of cortical nephron.
c) Vasa recta of juxtamedullary nephrons.
d) Medullary collecting ducts.

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Q90: Which of the following is a part of the counter current exchanger mechanism:

a) Active transport of NaCl in proximal convoluted tubules.

b) Active transport of NaCl in collecting tubules.
c) In ascending limb of vasa recta NaCl passes from medullary interstitium into blood.
d) In descending limb of vasa recta H2O passes from blood to medullary interstitium.

Q91: Medullary hyperosmolarity causes:

a) Increased Na+ reabsorption from the DCT.

b) Increased H+ secretion from the PCT.
c) Increased H2O reabsorption from the collecting ducts.
d) Release of angiotensinogen.
e) Dilution of urine.

Q92: Which of the following parts of the nephron shows the highest osmolarity:

a) PCT. b) Thick part of the ascending limb of loop of henle.

c) DCT. d) Cortical collecting ducts. e) Medullary collecting ducts.

Q93: The tubular fluid is iso-osmotic at the end of:

a) Proximal tubules. b) Distal tubules. c) Medullary collecting tubules.

d) Descending limb of loop of Henle. e) Ascending limb of loop of Henle.

Q94: It's correct to say:

a) Filtered HCO3- is reabsorbed in CO form.

b) There is inverse relation between glucose and HCO3- reabsorption.
c) H2O reabsorption in PCT is ADH dependent.
d) Cl- is passively reabsorbed in PCT.

Q95: The system for formation of concentrated or diluted urine doesn't include the:

a) PCT. b) Loop of Henle. c) Vasa recta. d) Medullary hyperosmolarity.

Q96: Tubular fluid is most concentrated in the:

a) Early part of the ascending limb of loop of Henle.

b) Early part of DCT.
c) Early part of descending limb of loop of Henle.
d) Late part of DCT.

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Q97: The urine flow becomes hyper-osmotic under:

a) High aldosterone level. b) High ADH level.

c) Normal aldosterone level. d) Very low ADH.

Q98: The tubular reabsorption becomes hypo-osmotic at:

a) Early part of proximal convoluted tubules.

b) Late part of proximal convoluted tubules.
c) The end of descending limb of loop of Henle.
d) The end of ascending limb of loop of Henle.

Q99: In dehydrated subject, osmolarity of tubular filtrate drops as it goes through:

a) Descending limb of loop of Henle. b) PCT. c) DCT.

d) Ascending limb of loop of Henle. e) Cortical collecting ducts.

Q100: Under normal plasma ADH level:

a) Urine osmolarity can be reached is 1/3 that of plasma.

b) Urine osmolarity can be reached is 3 times that of plasma.
c) Urine osmolarity can be reached is 5 times that of plasma.
d) Urine osmolarity can be reached is 1/10 that of plasma.

Q101: Abnormal high levels of ADH may result in:

a) Decrease in Na+ concentration in plasma. b) Secretion of concentrated urine.

c) Increase in urine flow rate. d) Diuresis. e) Both a & b are correct.

Q102: Low levels of ADH:

a) Are reached at end of a fasting day.

b) Are accompanied by increased plasma Na+ concentration.
c) Leads to formation of hyper-osmotic urine.
d) Can be a result of supra-optic nucleus damage.
e) Both b & d are correct.

Q103: Which of the following is correct:

a) Osmolar clearance = Urine osmolarity X Urine flow rate / Blood osmolarity.

b) Free water clearance = Osmolar clearance – Urine volume per minute.
c) Negative free water clearance means urine is concentrated more than the plasma.
d) Zero free water clearance means urine is concentrated.

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Q104: Free water clearance is positive:

a) If solute removal equal to water removal.

b) If solute removal less than water removal.
c) If solute removal more than water removal.
d) None of the above is correct.

Q105: If the plasma osmolarity is 300 mOsm/ L, urine osmolarity is 200 mOsm/ L,
and volume of urine collected in 20 min. is 60 ml, free water clearance would be:

a) 4 ml /min. b) 1 ml /min. c) 2 ml /min. d) 10 ml /min.

Q106: The free water clearance of a subject whose urine flow rate is 2 ml/min, plasma
osmolarity is 300 m.osmol/l, and urine osmolarity is 300 m.osmol/l is:

a) 4500 ml/min. b) 2 ml/min. c) 600 m osmol/L. d) 1 ml/min. e) Zero ml/min.

Q107: In nephron, the highest amount of H+ ions is secreted into tubular lumen in the:

a) PCT. b) DCT. c) Collecting ducts. d) Loop of Henle.

Q108: Hydrogen ion secretion decrease in case of:

a) Increased plasma concentration of CO2.

b) Increased Na+ reabsorption.
c) Increased Cl- reabsorption.
d) Inhibition of carbonic anhydrase.
e) Decreased K+ secretion.

Q109: Primary active secretion of H+ occurs at:

a) The PCT. b) Late DCT. d) Early DCT.

c) Thick part of the ascending limb of loop of Henle.
e) The descending limb of loop of Henle.

Q110: Tubular secretion of hydrogen ions is:

a) Increased in renal failure.

b) Increased by lowering plasma PCO2.
c) Increased by hyperventilation.
d) Increased by marked increase in Na+ reabsorption.
e) Increased by inhibiting Carbonic Anhydrase (C.A) activity in the cell.

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Q111: Hydrogen ions:

a) Secretion increases if K+ secretion decreases.

b) Secretion decreases if potassium secretion decreases.
c) Secretion increases if Na+ reabsorption decreases.
d) Secretion increases if carbonic anhydrase enzyme decreases.

Q112: The greatest amount of hydrogen ion secreted by PCT is associated with:

a) Excretion of potassium ion. b) Excretion of hydrogen ion.

c) Reabsorption of calcium ion. d) Reabsorption of bicarbonate ion.

Q113: Reaction of secreted hydrogen ion by the nephron with filtered phosphate:

a) Occurs mainly in PCT.

b) Is the source of titrable acids in urine.
c) Occurs in both PCT & DCT.
d) Is the source of ammonia in urine.
e) Normally consumes most of the secreted H+.

Q114: Osmotic diuresis is associated with:

a) Low urine flow rate. b) Presence of excess unreabsorbed solutes.

c) Increased response to ADH. d) Production of hypo-osmotic urine.

Q115: Osmotic diuresis is associated with:

a) Low urine flow rate. b) Increased response to ADH.

c) Excess reabsorbed solutes. d) Production of hyper-osmotic urine.

Q116: It's correct to say that:

a) Water diuresis can excrete iso-osmotic urine.

b) Water diuresis can excrete hypo-osmotic urine.
c) Water diuresis can excrete hyper-osmotic urine.
d) Osmotic diuresis can excrete very low urine volume.

Q117: Which of the following diuretics is K+ sparing:

a) Carbonic anhydrase inhibitors (acetazolamide). b) Loop diuretics (frucemide).

c) Chlorothiazides. d) Spironolactone. e) ADH antagonist.

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Q118: Loop diuretics:

a) Increase Na+ and K+ reabsorption.

b) Decrease Na+ and K+ reabsorption in the ascending limb of loop of Henle.
c) Increase Na+ reabsorption and decrease K+ secretion.
d) Inhibit Na+, K+ and Cl- reabsorption in the thick ascending limb of loop of Henle.

Q119: Frusemide diuretics:

a) Increases Na+ and K+ reabsorption.

b) Causes as much as 8% of GFR to pass into urine.
c) Decreases medullary hyperosmolarity.
d) Inhibits Na+, K+, and Cl- transport in DCT.

Q120: Administration of Furosemide leads to:

a) Excretion of hypo-osmotic fluid. b) Increase in urine flow rate.

c) Decrease solute delivery to DCT. d) Hypervolemia. e) None of the above.

Q121: Normal urine contains:

a) Large number of RBCs. b) Large amount of glucose.

c) Large amount of globulin. d) 99% of the filtered urea.
e) None of the above is correct.

Q122: Normally, urine analysis is characterized by:

a) Its PH is about 3.5. b) Its volume is about 3 L /day.

c) Its specific gravity ranges from 1010 to 1025. d) All of the above.

Q123: If the clearance of substance X is zero ml/min, it indicates that the substance X
undergoes:

a) Partial secretion. b) Complete secretion.

c) Partial reabsorption. d) Complete reabsorption.

Q124: If the clearance of the substance is:

a) Between 125 – 260 ml/min that means the substance is partially reabsorbed.
b) Between 0 – 125 ml/min that means the substance is partially secreted.
c) Equals 125 ml/min that means the substance neither reabsorbed nor secreted.
d) Equals 0 ml/min that means the substance is completely secreted.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

Q125: If the clearance of a substance which is freely filtered is less than that of inulin:

a) There is a net reabsorption of the substance in the tubules.

b) There is a net secretion of the substance in the tubules.
c) The substance becomes bound to protein in the tubules.
d) The substance is neither secreted nor reabsorbed.
e) The substance is secreted in the PCT to a greater degree than in the DCT.

Q126: A substance with a clearance value 95 ml /min is:

a) Freely filtered and totally reabsorbed.

b) Freely filtered and partial tubular reabsorbed.
c) Freely filtered and tubular secretion.
d) Is a good substance to measure GFR.

Q127: A substance with a clearance value 650 ml /min is:

a) Freely filtered and totally reabsorbed.

b) Freely filtered and partial tubular reabsorbed.
c) Freely filtered and tubular secretion.
d) A good substance to measure GFR.

Q128: Chronic renal failure is associated with:

a) Alkalosis due to a decrease in H+ secretion.

b) Polycythemia due to over secretion of erythropoietin.
c) Hypokalemia.
d) Edema due to an increase in filtration and urinary output.
e) Hypertension due to an increase in rennin production and Na+ & water retention.

Q129: Which of the following is a result of chronic renal failure:

a) Alkalosis. b) Hypotension. c) Anemia.

d) High fixed specific gravity of urine. e) Hypokalemia.

Q130: Chronic renal failure is associated with:

a) Metabolic alkalosis. b) Dehydration. c) Hypokalemia. d) Metabolic acidosis.

Q131: Chronic renal failure is associated with:

a) Alkalosis. b) Hypotension. c) Hypokalemia. d) Anemia.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

Q132: Chronic renal failure is associated with:

a) Metabolic alkalosis. b) Hypertension. c) Hypokalemia. d) Polycythemia.

Q133: Which of the following is NOT seen in CRF patient:

a) Acidosis. b) Hyperkalemia. c) Uremia.

d) Hypervolemia. e) None of the above.

Q134: It is correct to say:

a) Diabetes insipidus causes high urine osmolarity.

b) Chronic renal failure would causes azotemia.
c) In chronic renal failure, anemia is mainly due to iron deficiency.
d) Aldosterone secretion tends to raise the urinary fluid volume.
e) Both a & b are correct.

Q135: Micturition reflex involves:

a) A center in the 4th and 5th thoracic segment of the spinal cord.
b) Efferent sympathetic fibers in the pelvic nerve.
c) Stimulus due to increased pressure in the urinary bladder.
d) A receptor located in the urethral sphincter.
e) None of the above.

Q136: Micturition reflex:

a) Its afferent fibers are in the vagus.

b) Its efferent fibers are in the vagus.
c) Its receptors are chemoreceptors.
d) Its afferent fibers are in the pelvic.
e) Its response includes relaxation of the wall of the bladder.

Q137: In a healthy adult, the urge to void urine is first felt at bladder volume of about:

a) 50 ml. b) 150 ml. c) 250 ml. d) 350 ml.

Q138: The permeability of the cell membrane in the PCT:

a) Is much less for water than urea.

b) Allows water to diffuse rapidly following actively reabsorbed solutes.
c) Is high for inulin. d) Both a & c are correct. e) Both b & c are correct.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

Q139: It is correct to say:

a) There is a direct relation between H+ secretion and Na+ reabsorption.

b) Urea reabsorption increases water reabsorption from PCT.
c) Potassium secretion is a function of intercalated cells of the DCT.
d) Formation of titratable acid is the most important mechanism by which free H+ is
removed from the renal tubules.
e) Juxtamedullary nephrons have short loops of Henle.

Q140: It is correct to say:

a) K+ reabsorption occurs in all segments of nephron except descending limb of L.H.

b) An increase in intracellular K+ causes its secretion in the PCT.
c) An increase in H+ secretion causes an increase in K+ secretion.
d) There is an inverse relation between Cl- reabsorption and HCO3- reabsorption.
e) Counter current exchanger is a function of loop of Henle.

Q141: Concerning Henle’s loop which of the following is correct:

a) The descending limb is impermeable to water.

b) The cortical type acts as a counter current multiplier.
c) The juxtamedullary type is shorter than the cortical type.
d) The descending limb is impermeable to sodium.
e) The thick part of the ascending limb is impermeable to sodium.

Q142: It is correct to say:

a) Secretion of renin is inversely proportional to the concentration of sodium in DCT.

b) Insulin is used to measure GFR.
c) Sodium has renal tubular transport maximum.
d) Filtration coefficient has no effect on GFR.
e) None of the above is correct.

Q143: It is correct to say:

a) Renin is used to estimate GFR.

b) Inulin has tubular transport maximum.
c) Juxtaglomerular nephrons are important for the counter current system.
d) Inulin clearance is 80 ml/min.
e) Both c & d are correct.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

Q144: It is correct to say:

a) The PCT contains JG cells which secretes renin.

b) The descending limb of loop of Henle is freely permeable to electrolytes.
c) Renal tubular secretion occurs in the glomeruli.
d) The renal clearance of urea is lower than that of inulin.
e) Both a & d are correct.

Q145: It is correct to say that:

a) The cells of DCT determine the final composition of urine.

b) In descending limb of vasa recta, NaCl passes from blood to medullary interstitium.
c) Emptying of the urinary bladder can't occur after sensory denervation of the bladder
d) All of the above are correct.
e) Both b & c are correct.

Q146: Concerning the proximal convoluted tubules (PCT):

a) The fluid in the PCT is isotonic with plasma.

b) H+ are actively reabsorbed in the PCT.
c) About 99 % of the filtered fluid is reabsorbed.
d) All of the above are correct.
e) Only a & c are correct.

Q147: In the proximal convoluted tubules (PCT) all of the following occur EXCEPT:

a) Active absorption of 65% of sodium.

b) Absorption of 65% of water under the control of ADH.
c) Complete active absorption of amino acids.
d) Complete active absorption of glucose.
e) Secondary active H+ secretion.

Q148: Metabolic alkalosis will be observed in a patient with:

a) Hyperventilation. b) Hyperaldosteronism. c) Renal failure.

d) Persistent vomiting. e) Diabetes.

Q149: Renal correction of acute hyperkalemia will result in:

a) Alkalosis. b) Acidosis.
c) Increased secretion of HCO3. d) Increased secretion of Na+.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

Q150: It's correct to say that:

a) H+ secreted passively by PCT.

b) Normally most of secreted H+ react with filtered HCO3-.
c) Micturation reflex is not self regenerative.
d) All of the above are correct.
!!
Q151: Carbonic anhydrase plays an important role in all the following EXCEPT: **

a) The renal handling of HCO3- within the cells of proximal tubules.

b) The renal handling of HCO3- within the lumen of proximal tubules.
c) The renal handling of HCO3- within the cells of the tubules of the distal nephron.
d) The renal handling of HCO3- within the lumen of distal tubules.

Q152: Hyperkalemia can result from:

a) Administration of spironolactone. b) Administration of CA inhibitors.

c) Alkalosis. d) Drinking a large amount of water. e) Both a & b are correct.

Q153: It is correct to say:

a) The fluid in the PCT is generally hypertonic to plasma.

b) The pressure in the Bowman’s capsule is normally about 28 mmHg.
c) Below the renal threshold level none of the substance should appear in the urine.
d) Contraction of the mesangial cells increases GFR.
e) Inulin clearance is zero.

Use the following laboratory values to answer the next two questions (Q 154 & 155):
- PAH clearance = 750 ml/min.
- Urinary flow rate = 2 ml/min.
- Plasma creatinine concentration = 0.8 mg/dL.
-Plasma glucose concentration = 120 mg/dL.
- Urinary creatinine concentration = 66 mg/dL.

Q154: What is the patient's filtration fraction?

a) 0.18. b) 0.20. c) 0.22. d) 0.24. e) 0.26.

Q155: Approximately how much glucose is reabsorbed by this patient's kidneys?

a) 0 mg/min. b) 120 mg/min. c) 165 mg/min. d) 200 mg/min. e) 320 mg/min.

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(MCQ) Sample 2017 Dr. Ahmad .S. Alarabi

The Answers key

Q Ans Q Ans Q Ans Q Ans Q Ans

1 b 32 a 63 a 94 d 125 a
2 b 33 d 64 e 95 a 126 b
3 b 34 c 65 c 96 c 127 c
4 d 35 b 66 a 97 b 128 e
5 d 36 d 67 b 98 d 129 c
6 b 37 c 68 b 99 d 130 d
7 b 38 c 69 d 100 b 131 d
8 a 39 c 70 d 101 e 132 b
9 b 40 b 71 c 102 e 133 e
10 d 41 d 72 d 103 c 134 b
11 a 42 a 73 c 104 b 135 c
12 c 43 c 74 a 105 b 136 d
13 d 44 b 75 c 106 e 137 b
14 d 45 d 76 c 107 a 138 b
15 a 46 d 77 b 108 d 139 a
16 a 47 a 78 b 109 b 140 d
17 d 48 d 79 b 110 d 141 d
18 d 49 d 80 b 111 a 142 a
19 c 50 b 81 d 112 d 143 c
20 c 51 d 82 b 113 b 144 d
21 b 52 c 83 e 114 b 145 c
22 b 53 b 84 c 115 d 146 a
23 d 54 c 85 b 116 b 147 b
24 b 55 e 86 a 117 d 148 b
25 d 56 d 87 c 118 d 149 b
26 d 57 d 88 b 119 c 150 b
27 a 58 c 89 a 120 b 151 d
28 b 59 c 90 d 121 e 152 a
29 c 60 e 91 c 122 c 153 c
30 c 61 b 92 e 123 d 154 c
31 b 62 d 93 a 124 c 155 d

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