2.

1 After how many weeks of development, the tubules of the human fetus start functioning :

(a) 7

(b) 9

(c) 11

(d) 13

2.2 By which week of gestation, the loop of henle is functional :

(a) 14

(b) 16

(c) 18

(d) 20

2.3 Which of the following is responsible low glomerular filtration rate (GFR) during fetal life :

(a) Smaller percent of cardiac output

(b) High renal vascular resistance

(c) Low filtration fraction

(d) All of the above

2.4 Around which week of gestation urine production in human kidney is known to begin :

(a) 8-10 weeks

(b) 10-12 weeks

(c) 12-14 weeks

(d) 14-16 weeks

2.5 The daily lymph volume produced by the normal human kidneys in comparision to the daily
 urine output is :

(a) 1/5 th

(b) half

(c) equal

(d) double

2.6 During fetal life, how many percent of the cardiac output is received by the kidney in utero :

(a) 1

(b) 2

(c) 3

(d) 4

2.7 How many percent of cardiac output is recieved by the kidney in newborns ?

(a) 13

(b) 15

(c) 17

(d) 19

2.8 The kidneys recieves how many percent of cardiac output in adult :

(a) 10

(b) 20

(c) 30

(d) 40

2.9 What percentage of body’s oxygen kidneys consume ?

(a) 2-4%

(b) 4-6%

(c) 6-8%

(d) 8-19%

2.10 How many ml of oxygen from 100ml of arterial blood do the kidney extract ?

(a) 0.5 ml

(b) 1.0 ml

(c) 1.5 ml

(d) 2.0 ml

2.11 What percentage of the renal blood flow does the renal cortex :

(a) 60%

(b) 70%

(c) 80%

(d) 90%

2.12 The elevation of blood pressure along with hydronephrosis maybe :

(a) Coincidental

(b) From uremia

(c) From retained sodium and water

(d) All of the a bove

2.13 How many tubules are present in the pronephros :

(a) 3

(b) 5

(c) 7

(d) 9

2.14 At about which week of fetal development, the mesonephros develops :

(a) 2

(b) 4

(c) 6

(d) 8

2.15 At which week of fetal life, the metanephros originates :

(a) 2

(b) 4

(c) 6

(d) 8

2.16 As early as in which week of fetal life, the nephrone in the metanephros appear to function :

(a) 8-9 th

(b) 9-10 th

(c) 10-11 th

(d) 11-12 th

2.17 The loop of henle is present in the :

(a) Cortex
(b) Medulla

(c) Both

2.18 The brush border mucose is present in the :

(a) Proximal convulated tubules

(b) Loop of henic

(c) Distal convoluted tubule

(d) Collecting ducts

2.19 The glomerular capillaries allow filtration of molecule of which diameter :

(a) 5.0 nm

(b) 6.0 nm

(c) 7.0 nm

(d) 8.0 nm

2.20 Which of the following determine the degree of glomerular filtration of a molecule ?

(a) Size

(b) Shape

(c) Charge

(d) All of the a bove

2.21 The following are the principal determinants of extracellular fluid osmolality except :

(a) Sodium

(b) Chloride

(c) Potasium
(d) Bicarbonate

2.22 Filtration through the glomerulus is governed by :

(a) Hydrostatic pressure in bowman’s capsule

(b) The diference between the intracapillary pressure and the peritubular oncotic pressure

(c) Constriction of dilatation of afferent and efferent arterioles

(d) All of the a bove

2.23 How much glomerular filtrate is formed each minute in normal adult men ?

(a) 100-120 ml

(b) 120-140 ml

(c) 140-160 ml

(d) 160-180 ml

2.24 Approximately, how much glomerular filtrate is formed in 24 hours in normal adult men :

(a) 120 liters

(b) 140 liters

(c) 160 liters

(d) 180 liters

2.25 Approximately, how much glomerular filtrate is reabsorbed in the proximal convulted tubules :

(a) 50%
(b) 60%

(c) 70%

(d) 80%

2.26 In comparison to bowman’s capsule, the filtrate reaching the loop of henle is :

(a) Hypertonic

(b) Isotonic

(c) Hypotonic

2.27 In comparision to bowman’s capsule, the filtrate reaching the distal tubule is :

(a) Hypertonic

(b) Isotonic

(c) Hypotonic

2.28 Which of the following subtance is niether reabsorbed nor secreted into the renal tubule

(a) Saline

(b) Inulin

(c) Glucose

(d) Para amino hippurate (PAH)

2.29 The clearence of creatinine, in comparision to the rate of glomerular filtration is :

(a) More

(b) Same

(c) Less
2.30 What is the normal glomerular filtration rate (GFR) in adults?

(a) 80 ml/mnt

(b) 100 ml/mnt

(c) 120 ml/mnt

(d) 140 ml/mnt

2.31 The following subtance are passivley reabsorbed from the reneal tubules EXCEPT:

(a) Water

(b) Sodium

(c) Urea

(d) Calcium

2.32 The following subtance are secreted by renal tubules EXCEPT :

(a) Penicillins

(b) Salicylates

(c) Inulin

(d) Radiopaque constrat media

2.33 Potassium clearance can exceed inulin clearance because :

(a) More potassium is flitered through the glomerulus

(b) Less potassium is reabsorbed

(c) More inulin is reabsorbed

(d) Potassium is resecreted in the distal tubule

2.34 With the high rate of sodium excretion that follows high instage of sodium, the potassium excretion
will be :
(a) Low

(b) High

(c) Same

2.35 Aldosterone, which increases reabsorption of sodium and increases potassium excretion, mainly
acts on the :

(a) Proximal convoluted tubule

(b) Distal convoluted tubule

(c) Loop of henle

(d) Collecting ducts

2.36 When the hydrogen ion content of the tubular cell is high, as in acidosis, potassium secretion in to
the tubular fluid, will be?

(a) Same

(b) High

(c) Low

2.37 In acid-base regulation, the hydrogen sodium exchange plays a large role in the reabsorption of :

(a) Chloride

(b) Bicarbonate

(c) Potassium

(d) Calcium
2.38 Hydrogen ion secreted into the proximal tubular lumen combines with the bicarbonate ion in the
filtrate to form :

(a) Citric acid

(b) Hydrochloric acid

(c) Carbonic acid

2.39 Ammonia is generated in the cells of the renal tubules by the demination of :

(a) Glutamine

(b) Glycine

(c) Alanine

(d) All of the above

2.40 What is the PH of the plasma :

(a) 5.4

(b) 6.4

(c) 7.4

(d) 8.4

2.41 What is the minimum PH of the urine ?

(a) 3.4

(b) 4.4

(c) 5.4

(d) 6.4

2.42 Antidiuretic hormone (ADH) is produced in the :

(a) Thalamus

(b) Hypothalamus

(c) Pituitary

(d) Kidney

2.43 The antidiuretic hormone (ADH) acts on :

(a) Proximal convoluted tubule

(b) Loop of henele

(c) Distal convulated tubule and collecting ducts

(d) All of the above

2.44 How many percent of weight loss occurs to the kidneys between 4th and 8th decade of life ?

(a) 5

(b) 10

(c) 15

(d) Over 20

2.45 By which age, GFR reach adult level :

(a) 6 months

(b) 12 months

(c) 18 months

(d) 24 months

2.46 What is the value of the fractional excretion of sodium FENA% in acute renal failure of a prerenal
etiology ?
(a) Less than 1 percent

(b) 2 percent

(c) 3 percent

(d) 4 percent

2.47 Which segment of nephron is impermeable to water ?

(a) Proximal convoluted tubule

(b) Descending limb of loop henle

(c) Ascending limb of loop of henle

(d) Distal convoluted tubule

2.48 Approximately, what is the normal filtered load of HCO3 in meg/day :

(a) 3500

(b) 4000

(c) 4500

(d) 5000

2.49 How many percent of filtered HCO, appear in the final urine ?

(a) Less than 0,1 percent

(b) 0,5 percent

(c) 0,8 percent

(d) 1,0 percent

2.50 Approximately how many percent of filtered HCO3, is reabsorped by the proximal tubule :
(a) 75

(b) 80

(c) 85

(d) 90

2.51 In which part of the nephron, most of the NET acid excretion occurs :

(a) Proximal convoluted tubule

(b) Loop of henle

(c) Distal convoluted tubule

(d) Collecting ducts

2.52 How many percent of plasma potassium undergo glomerular filtration ?

(a) 75

(b) 80

(c) 85

(d) More than 90

2.53 Ultrafiltrate calcium represents how many percent of total calcium :

(a) 50

(b) 60

(c) 70

(d) 80

2.54 How many percent of filtered calcium is subsequently reabsorbed by tubules ?

(a) 92-94
(b) 94-96

(c) 96-98

(d) 98-100

2.55 Calcium absorption is stimulated by PTH in the following parts of the nephron EXCEPT :

(a) Proximal convoluted tubule

(b) Loop of henle

(c) Distal convoluted tubule

(d) Collecting ducts

2.56 In which part of the nephron furosemide inhibits calcium reabsoption :

(a) Proximal convoluted tubule

(b) Loop of henle

(c) Distal convoluted tubule

(d) Colleting ducts

2.57 In which part of the nephron, chorthiazide stimulates calcium reabsoption :

(a) Proximal convoluted tubule

(b) Loop of henle

(c) Distal convoluted tubule

(d) Collecting ducts

2.58 The following factors stimulates calcium reabsorption between the late proximal tubule and early
distal convoluted tubules EXCEPTS :

(a) Hypocalcemia

(b) Metabolic alkalosis

(c) Vitamin d

(d) Phosphate loading

(e) Hypermagnesemia

2.59 How many percent of filtered phosphate is reabsorbed?

(a) 50-67

(b) 60-77

(c) 70-87

(d) 80-97

2.60 With low purine diet, approximately what is the daily uric acid production from the endogenous
source ?

(a) 400 mgs

(b) 500 mgs

(c) 600 mgs

(d) 700 mgs

2.61 What percent of the filtered citrate load is excreated in men ?

(a) 10-35

(b) 20-45

(c) 30-55
(d) 40-65

2.62 The following decreases citrate excretion EXCEPT :

(a) Metabolic alkalosis

(b) Metabolic acidosis

(c) Distal renal tubular acidosis

(d) Administration of acetazolamide

2.63 Which of the following hormone is not with cell membrane receptor ?

(a) Catecholamines

(b) Aldosterone

(c) Antidiuretic

(d) Parathyroid

2.64 Which of the following statement is WRONG about Prostaglandins ?

(a) It is a lipid which arises from the renal medulla

(b) It causes peripheral vasodilatation

(c) It decreases sodium excretion

(d) It plays a role in both regulation of blood pressure and sodium excretion

2.65 Furosemide acts directly on the :

(a) Proximal convoluted tubule

(b) Ascending limb of the loop of henle

(c) Descending limb of the loop of henle

(d) Distal convoluted tubule

2.66 Which is the source of erythropoietin production in the body ?

(a) Kidney

(b) Ulterine myomas

(c) Cerebellar hemangioblastomas

(d) All of the above

2.67 Kidney is the site of synthesis of the following hormones EXCEPT :

(a) Erythropoietin

(b) 1.25 dihydroxyvitamin D

(c) Renin

(d) Insulin

2.68 During fetal life, which is the site of production of erythropoietin:

(a) Kidney

(b) Liver

(c) Spleen

(d) Lungs

2.69 Which is the primary mechanism of anaemia in patients with chronic renal disease ?

(a) Erythropoietin deficiency

(b) Bone marrow depression

(c) Chronic blood loss

(d) Lungs
2.70 When should erythropoietin be given to patient on dialysis and treatment with erythropoientin?

(a) One day before dialysis

(b) Immediately before dialysis

(c) During the dialysis

(d) At the end of dialysis

2.71 Which is the major adverse event in patients with chronic renal failure receiving recombinant
human erythropoietin ?

(a) Allergic reactions

(b) Changes in WBC or platelet count

(c) Elevated blood pressure

(d) Electrocardiographic abnormalities

2.72 In which of the following ,increases renal production of erythropoietin can occur :

(a) Renal artery stenosis

(b) Hydronephrosis

(c) Renal cysts

(d) All of the above

2.73 Which of the following factors influence the biosynthesis and secretion of renin from kidney ?

(a) Renal perfusion pressure (intrarenal beroreceptor)

(b) Adrenergic nervous system

(c) Delivery of sodium to the macula densa (distal tubule)

(d) Atrial natriuretic factor

(e) All of the above

2.74 How many percent of renal kallikrein is found in the contex ?

(a) 60

(b) 70

(c) 80

(d) More than 90

2.75 The renal kalikrein kinin system can stimulate which of the following :

(a) Renal angiotensin system

(b) Prostaglandin system

(c) Both of them

(d) None of them

2.76 Approximately, what is the resting or baseline ureteral pressure:

(a) 0-5 cm H2 O

(b) 5-10 cm H2 O

(c) 10-15 cm H2 O

(d) 15-20 cm H2 O

2.77 Megaureter can be produced by :

(a) Normal ureteral pressure

(b) Sudden elevation of ureteral pressure

(c) Sustained elevation of ureteral pressure

(d) Sustained low ureteral pressure

2.78 Which of the following drugs have no effect on ureteral pressure complexes ?

(a) Epinephrine. Ephedrine

(b) Atropine

(c) Neostigmine

(d) Urecholine

(e) All of the above

2.79 Which of the following can cause impediment of efficient bolus transfer across the UVJ into the
bladder ?

(a) When there is an obstruction at the UVJ

(b) When intravesical pressure is excessive

(c) When flow rates are so high to exceed the transport capacity of the normal UVJ

(d) All of the above

2.80 On which of the following, effect of obstruction on the ureteral function is dependent

(a) Degree and duration of obstruction

(b) On the rate of urine flow

(c) On the presence or absence of infection

(d) All of the above

2.81 What are the factors which have been implicated in the development of vesicoureteral reflux?

(a) Anatomic and functional abnormalities at the UVJ

(b) Inordinately high intravesical pressures

(c) Impaired ureteral function

(d) All of the above

2.82 At what time first pathologic change are noted in the glomerulus after complete ureteral
obstruction :

(a) 7 days

(b) 14 days

(c) 21 days

(d) 28 days

2.83 At what time proliferation of the medullary interstitial cells is noted after complete ureteral
obstruction :

(a) 5 th day

(b) 7 th day

(c) 9 th day

(d) 11 th day

2.84 By which route, most of the fluid exits from the renal pelvis in hydronephrosis with low pressure :

(a) Extravasation in to the perirenal space

(b) Pyelovenous backflow

(c) Pyelolymphatic backflow

(d) Pyelotubular backflow

2.85 Which of the following changes occur by the continous high protein intake ?
(a) Nephron hyperperfusion

(b) Hyperfiltration

(c) Both of them

(d) None of them

2.86 Which is the most accurate method of predicting the recovery potential of a hydronephrotic kidney
?

(a) Intravenous urogram

(b) 99 Tc-DMSA scan

(c) 99 Tc DPTA scan

(d) Temporary relief of the obstruction by nephrostomy followed by test measuring renal function

2.87 Which of the following is not affected in the obstructed kidney ?

(a) Glomerular filtration

(b) Renal blood flow

(c) Hydrogen ion clearance

(d) Urinary dilution

2.88 Following are the changes in the obstructed kidney EXCEPT :

(a) Reduction in glomerular filtration

(b) Reduction in renal blood flow

(c) Impairement of acidification

(d) Reduction in urinary dilution

2.89 Which of the following is damaged last in a completely obstructed kidney ?

(a) Distal convoluted tubule

(b) Loop of henle

(c) Proximal convoluted tubule

(d) Glomerulus

2.90 Which of the following has slightly higher pressure ?

(a) Renal pelvis

(b) Intraperitoneal

(c) Bladder

(d) Extraperitoneal

2.91 What is the renal pressure measured with percutaneous puncture in a normal antidiuretic patient ?

(a) 5.5 mm Hg

(b) 6.5 mm Hg

(c) 7.5 mm Hg

(d) 8.5 mm Hg

2.92 Which of the following determine effects of ureteral obstruction on renal function ?

(a) Severity

(b) Duration

(c) Totality

(d) Infection

(e) All of the above

2.93 The post obstructive diuresis is due to :

(a) Impaired sodium reabsorption

(b) Impaired urine concentrating ability

(c) Solute diuresis due to retained urea or administered glucose

(d) All of the above

2.94 How many percent of the output should be replaced in post obstructive diuresis ?

(a) 50-60 percent

(b) 60-70 percent

(c) 70-80 percent

(d) 80-90 percent

2.95 Which fluid is preferred for replacement in post obstructive diuresis ?

(a) 5% dextrose

(b) 0.5% normal saline

(c) Ringer’s Lactate

(d) B&C

2.96 Which is the site of leakage in spontaneus extravasation following ureteral obstruction ?

(a) Ureter

(b) Pelvis

(c) Calyx

(d) Fernix

2.97 The osmolality of the stored urine remains :

(a) Same

(b) Low

(c) High

2.98 Which of the following stimulates renal growh ?

(a) Partial nephrectomy

(b) Protein ingestion. High sodium intake or low potassium

(c) Ingestion of folic acid. Thyroxin testosterone growth hormone. Corticoids.

(d) All of the above

2.99 With the loss of renal tissue. The compensating growth of the remaining tissue is mostly by ?

(a) Hypertrophy

(b) Hyperplasia

(c) None of the above

(d) Both of the above

2.100 The following occur in compensatory renal growth by hypertrophy EXCEPT :

(a) Cytoplasmic enlargement

(b) Increase in the ratio of RNA and protein to DNA

(c) Glomeruli increase in number

(d) Glomeruli increase insize

(e) Blood vessels increase in calibre

2.101 In which of the following a greater degree of hydronephrotic parenchymal atrophy will occur :
(a) If renal blood flow is decreased

(b) If renal venous outflow is restricted

(c) If posteropr branch of the renal artery is ligated

(d) All of the above

2.102 In a patient with one normal functioning hypertrophied kidney and other obstructed poorly
functioning kidney, after release of obstruction. Function in the obstructed kidney will be :

(a) Increased

(b) Decreased

(c) Unchanged