Renal Physiology MCQ by DR Of2027-28

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6/5/22, 8:02 AM 300+ TOP Renal Physiology MCQs and Answers Pdf Quiz Exam
1. Concerning renal ontogeny:

A. the pronephros is a transitory kidney present during the embryonic
life of all vertebrates
B. the mesonephros is a functional yet transitory kidney during
intrauterine life of mammals
C. a main morphological difference between the metanephros
(permanent kidney) and the mesonephros, is the development of the
loop of Henle
D. A and C are correct
E. all are correct
Answer: E
2. The main barrier precluding the free passage of albumin

across the glomerular capillary walls is formed by:
A. the fenestrated glomerular endothelium
B. anionic proteoglycan clusters within the glomerular basement
membrane
C. the filtration slits in between visceral epithelial cells (podocytes)
D. none are correct
E. all are correct
Answer: B
3. Concerning the measurement of renal plasma flow (RPF)

and glomerular filtration rate(GFR):
A. inulin is a good GFR marker because it is freely filtered in the
glomeruli and it is not reabsorbed, or secreted, by the renal tubules
B. inulin concentration in the proximal tubule’s lumen increases
progressively as water is reabsorbed in the segment of the nephron
C. PAH (para-amino-hippuric acid)is a good marker of renal plasma
flow because it is freely filtered and is rapidly secreted by the proximal
tubule; as a result very little PAH reaches the renal vein
E. all are correct
Answer: E
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4. Concerning the functional histology of the kidney:

A. the superficial nephrons have short loops of Henle; thus, they have
a low capacity to reabsorb salt (salt losing nephrons)
B. the deep nephrons have long loops of Henle; thus they have a high
capacity to reabsorb salt and water
C. in dehydration, the blood flow to deep nephrons tends to increase
E. all are correct
Answer: E
5. The following factor(s) tend(s) to INCREASE the rate of

glomerular filtration (GFR):
A. decreased albumin concentration in plasma
B. vasodilation of the afferent (pre-glomerular) arteriole
C. vasoconstriction of the efferent (post-glomerular) arteriole
E. all are correct
Answer: E
6. The following factor(s) tend(s) to INCREASE the rate of

glomerular filtration (GFR):
A. sympathetic stimulation (norepinephrine) of the afferent arteriole
B. obstruction of the renal tubules, ureter or urethra
C. vasodilation of the efferent arteriole
D. none are correct
E. all are correct
Answer: D
7. Concerning the function of the glomerular mesangial

cells:
A. mesangial cells can contract and cause some decrease in total
glomerular filtration area
B. mesangial cells play a major role in systemic angiotensin II
production
C. mesangial cells are phagocytic and play a role in the clearing of
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proteins and immune-deposits entrapped in the mesangium

E. all are correct
Answer: D
8. Concerning the function of the proximal tubule:

A. most of the glomerular ultrafiltrate is reabsorbed in the proximal
tubule in an iso-osmotic fashion.
B. the concentration of PAH doesn’t change much along the length of
the proximal tubule
C. under normal conditions, most of the filtered glucose and
bicarbonate are reabsorbed in the proximal tubule
E. all are correct
Answer: D
9. Concerning metabolic energy (at production) for renal

transport:
A. the main substrate for proximal tubule is glucose
B. the cortical PO2 is about 10 mmHg
C. the papillary tissues normally generate ATP via oxidative
metabolism
E. all are correct
Answer: B
10. Concerning water reabsorption by the proximal tubule:

A. main driving forces for water reabsorption in the proximal tubule
are solute uptake and oncotic pressure in peritubular capillaries
B. a significant amount of water uptake in the proximal tubule is
dependent on sodium uptake by the Na/H antiports present in their
luminal membrane
C. aquaporine-I (water channels) are abundantly present in the
cellular membranes of proximal tubule cells
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E. all are correct
Answer: E
Renal Physiology MCQs
11. Concerning the THICK loop of Henle:

A. the thick segment of the loop has a very powerful Na/K/2Cl pump
that moves salt from the tubular lumen into the peritubular space
B. water and urea move freely across the epithelium of the thick
ascending segment of the loop
C. following the administration of furosemide (lasix) large volumes of
diluted urine are produced
E. all are correct
Answer: D
12. Concerning urinary concentration:

A. the thick loop of Henle generates most of the osmotic gradient
needed for reabsorption of water in the collecting duct
B. the tubular urine that reaches the collecting duct is generally
hypotonic with respect to plasma
C. in the absence of ADH, urine is not concentrated along the length of
the collecting duct
E. all are correct
Answer: E
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13. Concerning the transport of urea in the different

segments of the nephron:
A. main tubular urea sound is the plasma via the glomerular
ultrafiltrate
B. the urea concentration in the lumen of the cortical collecting ducts
increases as water is reabsorbed
C. the thin loop of Henle and the medullary collecting duct are
permeable to urea
E. all are correct
Answer: E
14. Concerning the macula densa:

A. the macula densa senses the total amount of sodium chloride
(sodium chloride concentration times volume) of tubular urine being
delivered by the loop of Henle into the distal convoluted tubule
B. if the delivery of sodium chloride is lower than normal the macula
densa signals the afferent arteriole (pre-glomerular) to release renin
C. renin release causes intravascular angiotensin formation and
indirectly aldosterone release
E. all are correct
Answer: E
15. Concerning angiotensin II:

A. the exocrine renin-angiotensin-aldosterone system includes
angiotensinogen production by the liver, renin secretion by the
juxtaglomerular apparatus and angiotensin-converting enzyme
present at the luminal surface of endothelial cells
B. aldosterone, but not AII, stimulate thirst and salt appetite
C. angiotensin II induces marked increases in sodium reabsorption by
the loop of Henle and the collecting duct
E. all are correct
Answer: A
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16. Within an hour following intravenous angiotensin II

infusion, the following is(are) clinically evident:
A. increased sodium uptake in the proximal tubular epithelium
B. systemic vasoconstriction
C. increased plasma aldosterone
E. all are correct
Answer: E
17. Within eight hours following large intravenous

aldosterone infusion the following is(are)clinically evident:
A. unchanged sodium reabsorption by the collecting duct
B. decreased potassium and hydrogen excretion in urine
C. hypernatremia (high sodium in plasma), hypokalemia (low
potassium in plasma) and alkalosis (low hydrogen ion activity in
plasma)
E. all are correct
Answer: C
18. Concerning arterial blood pressure regulation:

A. prostaglandins and dopamine and bradykinin are vasodilators
B. ADH, angiotensin II and epinephrine are vasoconstrictors
C. the vasodilator/vasoconstrictor ratio that regulates total peripheral
resistance plus cardiac stroke volume and heart rate are determinants
of blood pressure
D. all are correct
E. none are correct
Answer: E
19. Concerning cell volume regulation:

A. the Na/H and Cl/HCO3 antiports are involved in hypertonic cell
volume regulation
B. rapid efflux of cytoplasmic water is followed by volume regulatory
KCL efflux
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C. KCL efflux is involved in hypotonic cell volume regulation

E. all are correct
Answer: D
20. Intravenous administration of 1.5 liters of isotonic

Ringer’s solution to a healthy adult could cause:
A. increased cardiac output and renal blood flow
B. increased GFR
C. increased atrial natriuretic peptide and decreased renin in plasma
E. all are correct
Answer: E
21. Renin
A. Increased H2O reabsorption
B. Decreased sodium reabsorption
C. AII formation
D. Increased sodium reabsorption
E. Decreased phosphate reabsorption
Answer: C
22. Atrial natriuretic peptide

C. AII formation
Answer: B
23. ADH
C. AII formation
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Answer: A
24. AII
C. AII formation
Answer: D
25. PTH
C. AII formation
Answer: E
26. Which one of the following is correct about nonvolatile

acids.
A. they are not essential to eliminate from the body
B. we generate much greater amounts of nonvolatile than volatile
acids
C. they are fully buffered by bone
D. they are products of intermediary metabolism and protein
degradation
E. they are eliminated by the lungs
Answer: D
27. All of the following occur within one hour of eating a

large acid load EXCEPT:
A. the acid load is immediately buffered by intracellular proteins and
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phosphates as well as extracellular bicarbonate

B. the lungs will begin eliminating CO2 generated as a result of the
acid load
C. the kidney will eliminate all the nonvolatile acids and regenerate
bicarbonate to replace all the bicarbonate used in buffering
D. hemoglobin will buffer some of the protons
Answer: C
28. If the pH is 7.60 (H+ concentration = 25 nEq/L) and the

pCO2 is 40 mmHg, what is the HCO3- concentration (in
mEq/liter).
A. 10
B. 20
C. 30
D. 40
Answer: D
29. A patient takes a drug overdose and becomes comatose.

His blood pCO2 was 40 mmHg ten minutes ago, but you
discover it is now 80 mmHg. Which one of the following
statements about this patient is correct.
A. the pH of his CSF is likely to fall more slowly than the pH of his
blood
B. the pH of his blood is likely to fall more slowly than the pH of his
CSF
C. the pH of the blood and CSF will not change because he will rapidly
eliminate bicarbonate in the urine in response to the rise in pCO2
D. the pH of the blood and CSF will change to a similar degree in this
time period
Answer: B
30. Which one of the following statements is true about the

proximal tubule.
A. the Na+/K+ ATPase drives sodium into the cell from the urine side
of the tubule
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B. Na+/H+ exchange is largely the mechanism by which hydrogen ion

secretion occurs
C. bicarbonate reabsorption is independent of carbonic anhydrase
activity
D. the pH in the lumen of the proximal tubule can reach as low as
about 5.0
Answer: B
31. A patient ingests antifreeze and needs to eliminate the

ingested acid. Renal elimination of the protons in this
excess acid is primarily accomplished by which of the
following mechanisms.
A. increased urinary ammonium excretion
B. increased urinary excretion of phosphates
C. hyperventilation
D. increased urinary free hydrogen ion concentration
E. increased urinary sulfate excretion
Answer: A
32. Renal ammonium ion excretion is increased by

aldosterone, elevated blood pCO2 and acidemia
A. true
B. false
Answer: A
33. Which one of the following statements is correct with

regard to net collecting duct hydrogen ion secretion.
A. it is decreased by increased renal production of ammonia
B. it is increased by increased reabsorption of sodium through the
apical sodium channel
C. it is not affected by the presence or absence of titratable acids
D. aldosterone does not modify collecting duct hydrogen ion secretion
Answer: B
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RENAL
1. The reabsorption of Na in the proximal tubules

a. Reabsorbs 80% of the filtered sodium load
b. Causes increased hypertonicity
c. Is powered by N/H ATPase
d. Shares a common carrier with glucose
e. All of the above
2. In chronic acidosis the major adaptive buffering system in the urine is

a. Carbamino compounds
b. HCO3
c. Ammonia
d. Histidine residues
e. Phosphate
3. These gases – pH 7.32, pCO2 31, HCO3 20mmol/L represent

a. Primary metabolic acidosis
b. Primary respiratory alkalosis
c. A picture consistent with diuretic abuse
d. Mixed respiratory acidosis, metabolic acidosis
e. Partly compensated metabolic acidosis
4. with regard to osmotic diuresis

a. urine flows are much less than in water diuresis
b. ADH secretion is almost zero
c. The concentration of the urine is less than plasma
d. Increased urine flow is due to decreased water resorption in the proximal
tubule and loop of Henle
e. Osmotic diuresis can only be produced by sugars such as mannitol
5. Which of the following is most permeable to water

a. Thin ascending limb of the loop of Henle
b. Distal convoluted tubule
c. Thin descending limb of the loop of Henle
d. Cortical portion of the collecting tubule
e. Thick ascending loop of Henle
6. Renal acid secretion is affected by all of the following except

a. pCO2
b. K
c. Carbonic anhydrase
d. Aldosterone
e. Ca

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7. Glucose reabsorption in the kidney is

a. A passive process
b. Closely regulated with K
c. Resembles glucose transport in the intestine
d. Occurs predominantly in the distal tubule
e. Is the same in all nephrons
8. with regard to urea

a. it moves actively out of the proximal tubule
b. it plays no part in the establishment of an osmotic gradient in the
medullary pyramids
c. all of the tubular epithelium is impermeable to urea except for the inner
medullary portion of the collecting duct
d. a high protein diet reduces the ability of the kidneys to concentrate urine
e. ADH has no effect on the movement of urea across tubular epithelium
9. Which of the following best describes the changes in uncompensated respiratory

alkalosis
a. Low pH, HCO3 and PaCO2
b. High pH, low HCO3 and PaCO2
c. Low pH and HCO3 and normal PaCO2
d. High pH, low HCO3 and normal PaCO2
e. Low pH, high HCO3 and normal PaCO2
10. Which of the following regarding the nephron is true

a. The capillary endothelium has 4nm pores
b. Filtration slits are approximately 8nm wide
c. Filtration slits formed by podocytes are closed by a thin membrane
d. Mesangial cells are located between the basal lamina and the podocytes
e. Mesangial cells function only as flow refulation
11. regarding the tubules of the nephron which is false

a. the DCT has a thick brush border
b. the PCT is approximately 15mm long
c. the collecting duct epithelium contains intercalated cells
d. the longest loops of henle are in juxtamedullary nephrons
e. the juxtaglomerular apparatus contains 3 types of cells
12. Which of the following is false regarding the renal circulation

a. The lymph drainage is into the superior mesenteric vein
b. The descending vasa recta is non-fenestrated
c. The pressure drop across the glomerulus is in the order of 1-3mmHg
d. The kidneys receive approximately 25% of CO
e. Renal blood flow exhibit autoregulation across a perfusion pressure range
of approximately 90-220mmHg

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13. Which of the following effects on the renal blood flow is true
a. Increased by NA
b. Increased by high protein diet
c. Increased by angiotensin II
d. Decreased by ACh
e. Decreased by DA
14. Regarding filtration in the nephron which is false

a. Contraction of mesangial cells decreases GFR
b. Particles less than approx 4nm are freely filtered
c. Angiotensin II and vasopressin causes mesangial cell contraction
d. Exchange across the glomerular capillaries is diffusion not flow limited
e. Albuminuria in nephritis occurs without an increase in filtration size
15. regarding tubuloglomerular feedback, which is true

a. tends to maintain renal blood flow
b. the sensor is JG cell
c. operates via contraction of the mesangial cells
d. acts to reduce GFR if the flow rate in the ascending loop of Henle falls
e. GFR is modulated via contraction or dilation of the afferent arteriole
16. regarding water excretion in the kidney, which one is false

a. a minimum of 87% of filtered water is reabsorbed
b. aquaporin 2 is inserted into the luminal membrane of the collecting duct
under the control of vasopressin
c. the DCT removes approximately 5% total filtered fluid
d. the thin part of the ascending loop of Henle is permeable to water
e. the PCT removes 60 – 70% of te filtered load
17. During an osmotic diuresis, which is true

a. The concentration of sodium delivered to the loop of Henle falls
b. The sodium concentration in the interstitium of the PCT falls
c. Increased fluid load but decreased sodium load to the DCT
d. The concentration gradient in the medullary pyramid rises
e. Volumes of urine are less in a pure water diuresis
18. calculate the free water clearance based on the following values. Urine flow
200mL/h, plasma osmolality 300mOsm/kg and urine osmolality 450 mOsm/kg
a. 100 mL/h
b. 77 mL/h
c. 300mL/h
d. -77 mL/h
e. -100mL/h

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19. Regarding H+ excretion

a. H+ is secreted in the PCT via an ATPase
b. P cells in the collecting duct actively excrete acid
c. The limiting urine pH is approximately 5.5
d. For each H+ secreted in the PCT, one Na and one HCO3 enters the
interstitium
e. Carbonic anhydrase in the DCT luminal membrane facilitates H+ buffering
and the formation of H2CO3
20. Acid secretion is not increased in the following

a. Aldosterone
b. Hypokalaemia
c. Carbonic anhydrase inhibitors
d. High arterial pCO2
e. Chronic acidosis
21. regarding Na handling by the kidney, which is false

a. aldosterone acts via synthesis of new sodium channels
b. ANP produces a diuresis through the inhibition of Na/K ATPase
c. Angiotensin II acts to increase Na absorption in the PCT
d. PGE2 causes a natriuresis
e. Daily output can range from 1 – 400mEq/d
22. Regarding the regulation of K excretion, which of the following is true

a. The rate of K excretion is inversely proportional to the rate of flow of
tubular fluid
b. K secretion is increased in conditions of alkalosis
c. Hypoaldosteronism produces elevated urinary K levels
d. Carbonic anhydrase inhibitors decrease the excretion of K
e. Increased Na delivery to the collecting ducts leads to increased K
reabsorption
23. regarding the bladder, which is false

a. when out carousing and ale drink, once the seal is broken its broken
b. there is no somatic innervation to the detrusor muscle
c. the reflex contraction of the detrusor usually begins at approximately 300-
400mL
d. long term lesions of the cauda equine produce a dilated thin walled
bladder
e. micturition is fundamentally spinal cord reflex

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24. In the kidney

a. K is actively reabsorbed in the DCT
b. K excretion is decreased when H secretion is decreased
c. K does not compete with H in tubular fluid
d. The rate of K secretion is proportionate to the rate of flow of tubular fluid
in the distal nephron
e. K is reabsorbed and Na secreted in DCT
25. In regards to the renal handling of Na

a. Na is actively transported out of all parts of the renal tubule
b. Na is pumped out of the thin portion of the loop of Henle by Na/K ATPase
c. The N/K ATPase extrudes 1 Na in for 1 K out of the tubular cell
d. Most of the Na is actively transported out of the tubular cell into the lateral
intercellular spaces
e. Around 60% of Na is reabsorbed back into the circulation
26. In the kidney

a. K secretion in DCT and collecting ducts mainly occur through Na
dependent transport mechanism
b. pH of 4.5 in the urine is the limiting pH for H secretion
c. for each H secreted, 2 Na ions are reabsorbed
d. the H secretion in the PCT is mainly dependent on ATP driven proton
pump
e. the carbonic anhydrase inhibitors increase H secretion
27. In the kidney

a. Glucose is secreted by the collecting duct
b. The renal threshold refers to glucose resorption from the urine
c. Glucose is reabsorbed by 2ndary active transport
d. Glucose is reabsorbed in the loop of Henle
e. There is no glucose carrier in the kidney
28. In the loop of Henle

a. Descending limb is impermeable to water
b. Thin ascending limb is permeable to water
c. Thick ascending limb is permeable to water
d. Fluid in the descending limb becomes hypotonic
e. Fluid at the top of the ascending limb is hypotonic cf plasma
29. With respect to filtered water by the nephron

a. At the end of the PCT 15% of filtered water is resorbed
b. 5% of filtered water is removed by the DCT
c. <87% of filtered water is reabsorbed when the urine volume is 23L in
24hours
d. 30% of filtered water is removed by the loop of Henle
e. total solute excretion over 24 hours depends on the urine volume

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30. Renal acid secretion is independent of

a. K
b. Intracellular CO2
c. Carbonic anhydrase level
d. Aldosterone
e. ADH
31. With respect to buffers in the blood

a. Plasma is rich in carbonic anhydrase
b. Oxyhaemoglobin is better buffer than deoxyhaemoglobin
c. Phosphate is an important buffer in plasma
d. 80% of the acid load in metabolic acidosis is buffered in plasma
e. the most effective buffers have pK values close to the pH of the
environment they operate in
32. With regards to the regulation of K excretion, K is

a. Passively reabsorbed in the DCT
b. secretion does no undergo adaptation
c. excretion is increased when H ion secretion is increased
d. is actively reabsorbed in the PCT
e. excretion is independent of Na concentration in the distal tubular fluid
33. Osmotic diuresis

a. Increased urine flow is due to decreased water reabsorption in the PCT
and loops
b. In osmotic diuresis the amount of water reabsorbed in PCT is normal
c. Na reabsorption from the proximal tubules is unaffected by osmotic load
d. Medullary hypertonicity is increased
e. ADH prevents the concentration of urine approaching that of plasma
34. The greatest permeability to urea is found in

a. Inner medullary portion of the collecting tubule
b. DCT
c. Thin descending limb of loop of Henle
d. Thick ascending limb of loop of Henle
e. Thin ascending limb of loop of Henle
35. With respect to tubular function

a. Creatinine resorption is dependent on tubular flow rates
b. Creatinine is secreted by the tubules
c. Sodium is actively transported out of the thin portion of the loop of Henle
d. glucose resorption occurs by passive diffusion mainly in proximal tubules
e. urine acidification does not occur in the collecting tubules

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36. In the kidney

a. Glucose is removed from the urine by secondary active transport
b. 100% glucose is absorbed in the DCT
c. the calculated renal threshold for glucose is lower than its actual value
d. phlorizin enhances glucose binding to the sodium – glucose symport
e. levo isoform of glucose is more efficiently transported by the sodium –
glucose smport
37. Regarding renal tubular function

a. The clearance is less than the GFR if there is tubular secretion
b. The active transport of Na occurs in all portion of the tubule
c. Proximal tubular reabsorptate is slightly hypotonic
d. Water can leak across tight junctions back into the tubule lumen
e. 30% of the filtered water enters the DCT
38. Regarding the renal handling of sodium

a. 80% of the total filtered sodium load is reabsorbed
b. Na is actively transported out of all parts of the renal tubule except for the
thin portion of the loop of Henle
c. Only a minority of Na is actively transported via the lateral intercellular
spaces
d. Na transport is coupled to the movement of H and glucose but not to
amino acids and phosphates
e. The Na/H exchanges in the proximal tubule extrudes one Na for ever H
reabsorbed
39. The juxtaglomacular apparatus

a. Contains macular densa cells in afferent and efferent arterioles
b. Containes juxtamglomerular cells in the afferent arterioles only
c. Responds to a fall in arterial pressure by increasing renin secretion
d. Responds to an increase in Na concentration by increasing GFR
e. Releases renin which is activated by angiotensin I
40. In metabolic alkalosis

a. A common cause is the ingestion of aspirin
b. Respiratory compensation can fully restore pH to normal
c. Base excess is positive
d. Treatment with NaHCO3 restores pH to normal
e. There is more renal excretion of H ions
41. Compensatory mechanisms in metabolic acidosis include

a. A fall in pH
b. Decreased CO2 formation
c. Decreased minute volume
d. An alkaline urine
e. Reduction in the pCO2 of alveolar gas

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42. In the normal structure of the kidney

a. Mesangial cells can assists in the regulation of glomerular function
b. Basal lamina has filtration slits of 25nm
c. DCT has a less obvious brush border than the PCT
d. The macula densa is located in walls of the afferent arteriole near the
termination of the thick ascending loop of Henle
e. The collecting ducts commence at the corticomedullary junction
43. Which is false about the loop of Henle

a. Descending loop is permeable to water
b. Ascending loop is impermeable to water
c. Chloride is transported out of the thick part of the ascending limb
d. At the top of the ascending loop the tubular fluid is hypotonic
e. Tubular fluid is hypertonic as it enters the descending limb
44. Renal blood flow

a. Glomerular capillaries drain into peritubular veins
b. Renal autoregulation is prevented by denervation
c. Oxygen extraction is higher in the cortex than the medulla
d. Kidney’s receive approximately 15% CO
e. Angiotensin II causes greater constriction of the efferent than the afferent
arteriole
45. What is the GFR (ml/min) if the urinary concentration of inulin is 40mg/mL, the
urinary flow rate is 60mL/h and the plasma concentration is 0.4mg/ml
a. 0.6
b. 2.6
c. 100
d. 160
e. 1000
46. with respect to how sodium is handled by the kidney

a. is actively transported out of all parts of the renal tubule except the thick
portion of the loop of Henle
b. changes in aldosterone concentration takes ~ 6 hours before an appreciable
change to sodium reabsorption is noted
c. increasing intracellular Ca concentration inhibits sodium reabsorption
d. most of the Na/H exchange by active transport is performed in the DCT
e. tubuloglomerular feedback ensures a constant proportion of Na is
reabsorbed for any change in the GFR

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47. Water excretion

a. At least 95% is reabsorbed
b. 50% of the filtered water is reabsorbed by the end of the PCT
c. the first part of the DCT is impermeable to water
d. water tends to recirculate in the medullary pyramids
e. decreasing the tonicity in the medulla has no effect on water excretion
48. Urinary buffers

a. Carbonic anydrase in the DCT increases the buffering capacity
b. Dibasic phosphate sytme plays a role in buffering in the distal tubule and
the collecting ducts
c. The conversion of glutamate to glutamine in the renal tubular cells provide
NH3 for buffering
d. The largest pH difference between the tubular cells and the lumen occurs
across the PCT
e. The NH4+ content of the urine increases with serum HCO3 concentrations
above 28mmol
49. With respect to the following ABG taken on 24% O2 – pH - 7.56, pO2 – 135,
pCO2 – 28, HCO3 – 26
a. The person would b expected to have a lower pO2
b. The person has an acute metabolic alkalosis
c. The person is demonstrating respiratory compensation
d. The person has a chronic respiratory alkalosis
e. In a few days time they would compensate by lowering HCO3
concentrations
50. The most important buffer in intracellular fluid is

a. Bicarbonate
b. Ammonia
c. Dipphosphate
d. Albumin
e. Myoglobin
51. In micturition
a. Contraction of the trigone is mainly responsible for emptying of the
bladder
b. The relationship between bladder volume and intravesical pressure has a
linear relationship
c. The first urge to urinate is produced at 250mL
d. Urine in the female urethra empties by contraction of the periurethral
smooth muscle
e. Sympathetic nerves play no role in micturition

lOMoARcPSD|23392613
52. With regard to tubuloglomerular feedback

a. The GFR increases when flow through the distal tubule increases
b. The macula densa on the affertent arteriole is the sensor
c. The afferent arteriole is constricted by TXA2
d. It is designed to maintain Na re-absorption
e. It does not operate in individual nephrons
53. With respect to the counter current system

a. The loops of Henle act as counter current exchangers
b. Solute diffuse out of vessels conducting blood towards the cortex
c. Water diffuses out of the ascending vessels
d. Water diffuses into the collecting ducts
e. Counter current exchange is passive and can operate even if counter
current multiplication ceases
54. regarding the osmolality of renal tubular fluid it is

a. hypotonic in the loop of Henle
b. isotonic in the PCT
c. hypertonic in the DCT
d. hypotonic in the collecting duct
e. hypotonic in the PCT
55. renal autoregulation

a. the macula densa cells sense change in afferent arteriolar pressure
b. falling GFR results in feedback to decrease efferent arteriolar pressure
c. falling GFR results in an increase in renin secetion from the macula densa
cells
d. decreased macula densa concentration of NaCl results in dilation of the
afferent arteriole
e. decreased GFR decreases NaCl reabsorption in the ascending loop of
Henle
56. What is the clearance of a substance when its concentration in plasma is 1mg/mL,
its concentration in urine is 10mg/mL and urine flow is 2mL/min
a. 2mL/min
b. 10mL/min
c. 20mL/min
d. 200mL/min
e. clearance cannot be determined from the information given

lOMoARcPSD|23392613
57. regarding the PCT which is false

a. Na is co-transported out with glucose
b. Na is actively transported into the intracellular spaces by Na/K ATPase
c. The cells are characterized by a brush border and tight junctions
d. ADH increases the permeability of water by causing the rapid insertion of
water channels into the luminal membrane
e. Water moves out passively along osmotic gradients
58. With regard to the effects of hormones on the renal tubules, which is correct
a. Aldosterone increases K reabsorption from the distal tubule
b. Angiotensin II increases H secretion from the proximal tubule
c. ADH increases water reabsorption in the PCT
d. ANP decreases Na reabsorption from the PCT
e. PTH increases PO4 reabsorption
59. the thin ascending loop of Henle is

a. relatively permeable to water
b. relatively impermeable to Na
c. permeable to both Na and water
d. relatively impermeable to water
e. relatively impermeable to both Na and water
60. In relation to acid base balance in the body

a. Respiratory compensation in metabolic alkalosis is limited by carotid and
aortic chemoreceptor response
b. HCO3 concentration will decrease in compensated respiratory acidosis
c. The rate of renal H secretion is not affected by pCO2 in respiratory
acidosis
d. Cl excretion is decreased in respiratory acidosis
e. Hepatic glutamine synthesis is decreased in chronic metabolic acidosis
61. Regarding renal compensation in respiratory acidosis and alkalosis

a. The rate of HCO3 reabsorption is inversely proportional to the arterial
pCO2
b. In respiratory acidosis, HCO3 reabsorption is reduced
c. Changes in plasma Cl concentration are proportional to HCO3
concentrations
d. In respiratory alkalosis, renal H secretion is increased
e. HCO3 reabsorption depends upon the rate of H secretion by the renal
tubular cells

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62. All of the following effect GFR except

a. Changes in renal blood flow
b. Urethral obstruction
c. Dehydration
d. Oedema outside of the renal capsule
e. Glomerular capillary pressure
63. The thick ascending loop of Henle

a. Is impermeable to water
b. Has maximal permeability to NaCl
c. Is relatively permeable to water
d. Is impermeable to NaCl
e. Is a site where there is no active transport of Na
64. In the normal bladder, micturition is

a. Initiated by the pelvic nerves
b. Co-ordinated in the lumbar portion of the spinal cord
c. Initiated at a volume of 600mL
d. Significantly affected by sympathetic nerves
e. not facilitated at the level of the brain stem
65. In the kidney Na is mostly absorbed with

a. HCO3
b. Glucose
c. K
d. Ca
e. Cl
66. The filtration fraction of the kidney is

a. 0.1
b. 0.2
c. 0.3
d. 0.4
e. 0.5
67. the main buffer in the interstitium is

a. protein
b. Hb
c. Phosphate
d. Ammonia
e. HCO3

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68. Regarding the anion gap

a. It is the difference between cations including Na and anions including CL
and HCO3
b. It is increased in hyperchloraemic acidosis secondary to ingestion of
NH4Cl
c. It is decreased when Ca/Mg is decreased
d. It consists mostly of HPO42-, SO42- and organic acids
e. It is decreased when the albumin is increased
69. What factor decreases renin secretion

a. Hypovolaemia
b. Supine position
c. Cardiac failure
d. Na depletion
70. With regard to the kidney

a. Has optimum autoregulation over a range of 60-100mmHg
b. Medullary blood flow is greater than cortical blood flow
c. PGs decrease medullary blood flow
d. PGs increase cortical blood flow
71. The ratio of HCO3 ions to carbonic acid at pH of 7.1 is

a. 1
b. 10
c. 0.1
d. 100
e. 0.01
72. hypokalaemic metabolic acidosis may be associated with

a. carbonic anhydrase inhibitors
b. diuretic use
c. chronic diarrhea
73. All of the following represents an acid load to the body except
a. DKA
b. CRF
c. Fruit
d. Ingestion of acid salts
74. What is the osmolality of the interstitium of the tip of the papilla
a. 200
b. 800
c. 1200
d. 2000
e. 3000

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75. What is the H ion concentration at a pH of 7.4

a. 0.0001meq/L
b. 0.00004meq/L
c. 0.0004meq/L
d. 0.0002meq/L
e. 0.00002meq/L
76. Hypokalaemic metabolic alkalosis is associated with

a. Carbonic anhydrase inhibition
b. Diuretic use
c. Chronic diarrhea
77. Which of the following would be best used for measuring GFR
a. Radiolabelled albumin
b. Inulin
c. Deuterium oxide
d. Tritium oxide
e. Mannitol
78. given the following values, calculate the GFR: urine PAH 90, plasma PAH 0.3,
urine inulin 35, plasma inulin 0.25, urine flow 1mL/min, Hct 40%
a. 120
b. 150
c. 180
d. 240
e. 400

lOMoARcPSD|23392613
ANSWERS
1. D 28. E 55. D
2. C 29. B 56. C
3. E 30. E 57. D
4. D 31. E 58. D
5. C 32. D 59. D
6. E 33. A 60. A
7. C 34. A 61. E
8. ?C 35. B 62. D
9. B 36. A 63. A
10. C 37. D 64. A
11. A 38. B 65. E
12. A 39. C 66. B
13. B 40. C 67. E
14. D 41. E 68. D
15. E 42. A 69. B
16. D 43. E 70. ?
17. A 44. E 71. B
18. E 45. C 72. A
19. D 46. C 73. C
20. C 47. C 74. C
21. B 48. B 75. B
22. B 49. E 76. B
23. D 50. C 77. B
24. D 51. E 78. B
25. D 52. C
26. B 53. B
27. ?C 54. B

lOMoARcPSD|23392613
Question & Answers
1. Which of the following is not one of the four fundamental pathways of drug movement
and modification in the body?
A. Distribution
B. Metabolism
C. Absorption
D. Dissolution
E. Elimination
2. Which is correct regarding the process of passive diffusion?

A. It requires a carrier protein molecule.
B. It occurs when a concentration gradient exists from one side of a membrane to the
other.
C. It is a saturable process.
D. The only drugs that can enter cells via passive diffusion are antibiotics.
E. None of the above are correct.
3. Which of the following factors has the potential to affect absorption of an orally
administered drug?
A. Reduction in blood flow to the intestines

B. Increased GI transit time
C. Extremely low levels of stomach acid
D. Eating a large meal just prior to taking an oral medication
E. All of the above
4. Choose the incorrect statement.
A. Most drugs reversibly bind to plasma proteins.

B. Albumin is the most important drug binding plasma protein.
C. Low albumin levels can lead to drug toxicity in the case of drugs that are highly
protein bound.
D. Only a drug that is protein bound can penetrate tissues.
E. None of the above is incorrect.
5. Elimination of drugs from the body is dependent on which of the following?

A. Biotransformation in the liver
B. Filtration or secretion in the kidney
C. Sufficient blood flow to the liver and kidneys
D. Only a and b
E. a, b, and c

lOMoARcPSD|23392613
6. Which of the following are important for the auto regulation of glomerular pressure?
A. Erythropeitin
B. Mecula Densa
C. ADH
D. Renal artery diameter
E. None of the above
7. Which of the following white blood cells is capable of phagocytosis?

A. Basophil
B. Lymphocytes
C. Neutrophil
D. Eosinophil
E. None of the above
8. The hormone erythropoietin stimulates red blood cell production in the bone marrow.
Where in the body is erythropoietin produced?
A. Spleen
B. Kidney
C. Liver
D. Thyroid
E. Bone marrow
9. Which of the following factors act as a vasodilator?

A. parathyroid hormone
B. angiotensin II
C. ADH
D. endothelin
E. nitric oxide
10. For those substances that are actively reabsorbed, the maximal amount that can be
transported per unit time by the kidney tubules:
A. depends on the maximum rate at which the transport mechanism itself operates
B. is directly related to the plasma concentration of the substance
C. is termed the tubular transport maximum
D. is dependent upon tubular load
E. A and C are correct.

lOMoARcPSD|23392613
11. The plasma concentration at which a particular substance begins to appear in the urine
is the:
A. transport maximum (Tm)
B. fractional excretion
C. filtered load
D. renal threshold
E. titration point
12. The plasma concentration at which a particular substance begins to appear in the urine
is the:
A. transport maximum (Tm)
B. fractional excretion
C. filtered load
D. renal threshold
E. titration point
13. Renin is produced and secreted from granules located in the:

A. macula densa
B. mesangial cells
C. intercalated cells
D. afferent arteriole
E. interstitial cells
14. Ammonia produced by the kidneys comes mainly from:

A. glutamine
B. glycine
C. leucine
D. alanine
E. B and D are correct.
15. Glomerular filtration produces an ultrafiltrate of plasma:

A. in which the concentration of electrolytes is equal to plasma
B. in which the concentration of protein is equal to plasma
C. containing only those substances which must be eliminated in the urine
D. A and B are correct.
E. B and C are correct.
16. Which of the following might you expect to find associated with chronic renal failure?
A. elevated packed cell volume (hematocrit)
B. abnormally low plasma creatinine concentration
C. decreased bone density
D. lower than normal PTH (parathyroid hormone) concentration
E. None of the above is correct.

lOMoARcPSD|23392613
17. The vasa recta:

A. are the straight portions of the proximal tubules, found just proximal to the loops of
Henle
B. extend from the efferent arterioles of the superficial cortical nephrons
C. are the microvilli found on the cells of the macula densa
D. comprise the capillary network found in the medulla of the kidney
E. are the small straight segments of afferent arterioles found directly next to the
mecula densa
18. An increase in the osmolality of the extracellular fluid will:

A. stimulate the volume and osmoreceptors, and stimulate ADH secretion
B. stimulate the volume and osmoreceptors, and inhibit ADH secretion
C. inhibit the volume and osmoreceptors, and stimulate ADH secretion
D. inhibit the volume and osmoreceptors, and inhibit ADH secretion
E. cause no change in ADH secretion
19. Which of the following statements is/are correct?

A. Filtration fraction equals glomerular filtration rate divided by renal plasma flow.
B. Tubular maximum secretion has a finite upper limit, though it exhibits a
phenomenon analogous to the threshold phenomenon for reabsorption.
C. Clearance ratio equals renal clearance of one substance divided by the clearance of
another substance.
D. Effective renal plasma flow is the volume of plasma flow supplied to juxtamedullary
nephrons.
E. A, B, and C are correct.
20. The renal "countercurrent" mechanism is dependent upon the anatomic relationship
between:
A. the distal tubule and the macula denza
B. the loop of Henle and the macula denza
C. the loop of Henle and the vasa recta
D. the glomerulus and the afferent and efferent arterioles
E. the glomerulus and the proximal tubule
21. Enzymes facilitate chemical transformation reactions in drug metabolism.

A. True
B. False
22. After oral administration, drugs pass through the liver before they ever reach the
circulation, with the potential for significantly reducing the amount of drug to reach the
site of action.
A. True
B. False

lOMoARcPSD|23392613
23. Body weight is more important than age when determining the appropriate dose of a
drug because a 6-month-old is just a smaller version of a 16-year-old child.
C. True
D. False
24. Before a tablet can be absorbed through the GI tract it must dissolve.
A. True
B. False
25. Half-life is defined as the time it takes for the serum concentration of a drug to drop to
0.
E. True
F. False

lOMoARcPSD|23392613
ANSWERS
1. D
2. B
3. E
4. D
5. D
6. B
7. C
8. B
9. B
10. E
11. D
12. B
13. D
14. A
15. A
16. C
17. D
18. A
19. E
20. C
21. T
22. T
23. F
24. T
25. F

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1. Concerning renal ontogeny:

2. The main barrier precluding the free passage of albumin

3. Concerning the measurement of renal plasma flow (RPF)

4. Concerning the functional histology of the kidney:

5. The following factor(s) tend(s) to INCREASE the rate of

6. The following factor(s) tend(s) to INCREASE the rate of

7. Concerning the function of the glomerular mesangial

proteins and immune-deposits entrapped in the mesangium

8. Concerning the function of the proximal tubule:

9. Concerning metabolic energy (at production) for renal

10. Concerning water reabsorption by the proximal tubule:

D. A and C are correct

Renal Physiology MCQs

11. Concerning the THICK loop of Henle:

12. Concerning urinary concentration:

13. Concerning the transport of urea in the different

14. Concerning the macula densa:

15. Concerning angiotensin II:

16. Within an hour following intravenous angiotensin II

17. Within eight hours following large intravenous

18. Concerning arterial blood pressure regulation:

19. Concerning cell volume regulation:

C. KCL efflux is involved in hypotonic cell volume regulation

20. Intravenous administration of 1.5 liters of isotonic

22. Atrial natriuretic peptide

D. Increased sodium reabsorption

26. Which one of the following is correct about nonvolatile

27. All of the following occur within one hour of eating a

phosphates as well as extracellular bicarbonate

28. If the pH is 7.60 (H+ concentration = 25 nEq/L) and the

29. A patient takes a drug overdose and becomes comatose.

30. Which one of the following statements is true about the

B. Na+/H+ exchange is largely the mechanism by which hydrogen ion

31. A patient ingests antifreeze and needs to eliminate the

32. Renal ammonium ion excretion is increased by

33. Which one of the following statements is correct with

Renal Physiology Objective Questions with Answers Pdf Download

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3. These gases – pH 7.32, pCO2 31, HCO3 20mmol/L represent

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14. Regarding filtration in the nephron which is false

15. regarding tubuloglomerular feedback, which is true

16. regarding water excretion in the kidney, which one is false