Which of the following is a function of kidney?
A. Regulate body fluid 
B. Regulate BP
C. Balance electrolytes and pH
D. Secrete hormones
E. Produce urine
F. Eliminate metabolite wastes
G. Eliminate drugs and/or drug metabolites
*H. All of the above

Which of the following hormone is produced by kidney?
*A. Renin
*B. Erythropoietin
*C. Active vitamin D
D. Angiotensin II
E. Aldosterone

Which of the following is a capillary of kidney?
*A. Glomerulus
*B. Peritubular capillary
*C. Vasa recta
D. Bowman’s capsule

Which of the following is a less abundant type of nephron with a long LOH (dipping deep into medulla)?
A. Cortical nephron
*B. Juxtamedullary nephron
C. None of the above

Which of the following serves as a filter of nephron?
*A. Glomerulus
B. PCT
C. DCT
D. LOH
E. Collecting duct

Which of the following is a reabsorption site of nephron?
A. Glomerulus
*B. PCT
*C. DCT
*D. LOH
*E. Collecting duct

 
Which of the  following is matched correctly?
*A. PCT / ~60-63% Na-H2O reabsorption and major secretion site
*B. LOH /  ~25% Na-H2O reabsorption and critical for formation of osmolality gradient
*C. DCT / ~10% Na-H2O reabsorption 
*D. Collecting Duct / ~2-5%  Na-H2O reabsorption and urine acidification/condensation

Which of the following is a correct blood flow direction?
*A. Renal artery, interlobar artery, arcuate artery, interlobular artery, afferent arteriole
*B. Afferent arteriole, glomerular capillaries, efferent arteriole, peritubular capillaries, venule 
C. Afferent arteriole, glomerular capillaries, peritubular capillaries, venule 
D. Efferent arteriole, glomerular capillaries, afferent arteriole, peritubular capillaries, venule 

Which of the following is a part of GFB?
*A. Capillary endothelial cell membrane
*B. Basement membrane
*C. Podocyte membrane processes
D. Bowman’s capsular membrane

Which of the following statement is correct?
*A. Glomerular filtration rate (GFR) is the primary indicator of overall kidney function
*B. GFR represents the total amount of filtration occurring in the kidneys each minute
*C. GFR is directly proportional to the number of functioning nephrons, and it declines as nephrons die due to kidney disease
D. GFR is consistent and irrelevant to renal blood flow and BP

Which of the following chemical’s clearance can be used to estimate GFR?
A. Glucose
B. Urea
*C. Creatinine
D. Albumin

Protein loss in glomerular filtration is minimized by
*A. Negative charge of basement membrane
B. Large number of endothelial fenestrae
C. Actions of intercalated cells
D. Increased reabsorption of albumin into peritubular capillaries
E. The positive charge on the podocytes that form filtration slits

Which of the following represents a property of the glomerular filtration barrier? 
a. Basement membrane proteins have positive charges to repel protein movements 
b. Glomerular capillary hydrostatic pressure remains low to limit filtration 
*c. Narrow pores between podocytes restrict movements of large particles 
d. Tight junctions link glomerular capillary endothelial cells 
 
Which of the renal capillary Starling forces exhibits the largest change when blood flows from glomerular capillaries to peritubular capillaries and capillary filtration changes to capillary reabsorption? 
*a. Capillary hydrostatic pressure 
b. Capillary oncotic pressure 
c. Tissue hydrostatic pressure 
d. Tissue oncotic pressure 

Which of the following would be expected to produce increases in serum creatinine?
A. An increased amount of protein in the diet
B. Decreased aldosterone secretion
*C. Decreased glomerular filtration rate
D. Hypernatremia
E. Increased urine output

Which of the following is not likely to have immune complex deposition in a person with autoimmune disease? 
a. Basement membrane below glomerular capillary endothelial cells 
b. Mesangial cells and matrix 
c. Podocyte membranes 
*d. Proximal tubule cell brush border 

What is the cause of increased urinary albumin to creatinine ratio in a patient with diabetic nephropathy? 
a. Decreased creatinine production due to muscle wasting 
*b. Destruction of the glomerular filtration barrier due to advanced glycation products 
c. Failure of proximal tubule albumin reabsorption 
d. Increased hepatic albumin synthesis due to metabolic dysregulation 

How does chronic hypertension cause kidney damage? 
a. In hypertension, sodium fails to be excreted normally, damaging the kidneys 
*b. In hypertension, elevated perfusion pressures cause nephron hyperfiltration and afferent arteriole wall thickening 
c. In hypertension, fluid and electrolyte homeostasis is lost, leading to volume overload 
d. In hypertension, elevated sympathetic nervous system activity causes renal vasoconstriction 
 
Which of the following are the diagnostic hallmarks of early kidney damage due to coexisting hypertension and diabetes? 
a. Increased BUN and hyperkalemia 
b. Decreased hemoglobin and hematocrit 
*c. Increased urine albumin/creatinine ratio and decreased estimated glomerular filtration rate 
d. Decreased bone density and increased parathyroid hormone 

Which aspect of renal blood flow autoregulation involves the macula densa? 
a. Autonomic autoregulation 
b. Myogenic autoregulation 
c. Renal baroreceptors 
*d. Tubuloglomerular feedback 

 
Which of the following is true regarding the regulation of RBF and GFR?
a. Sympathetic stimulation elevated blood pressure that favors the increase in RBF and GFR. But it causes vasoconstriction of renal arteries and afferent arterioles that may lead to decrease RBF and GFR 
b. Activation of RAAS system can increase GFR
c. Tubuloglomerular Feedback autoregulation helps to keep GFR stable  
d. Dilation of afferent arterioles or constriction of efferent arterioles leads to increase GFR
*e. All of the above

Which membrane transport protein drives secretion and reabsorption of most reabsorbed and secreted ions throughout the nephron? 
a. Apical membrane aquaporin 
b. Apical membrane sodium-chloride cotransporter 
c. Basolateral membrane sodium-calcium countertransporter 
*d. Basolateral membrane sodium-potassium active transporter 

Which of the following statement is true regarding the tubules of nephron?
a. Descending limb of LOH is permeable to H2O but not Na 
b. Thick ascending limb of LOH is permeable to salts but not H2O
c. PCT and DCT segments reabsorb both salts and H2O
d. Collecting duct segments are the major site for water-channel mediated H2O reabsorption 
e. Reabsorption of tubules are mediated by transporters and channels
*f. All of the above 

What type of proximal tubule transporter is most likely to conduct secretion of diverse endogenous and exogenous waste products and metabolites? 
a. Apical membrane proton active transporter 
*b. Apical membrane organic anion transporter 
c. Basolateral membrane sodium-bicarbonate cotransporter 
d. Basolateral membrane sodium-potassium active transporter 

Which of the following is true for PCT?
a. It reabsorbs up to 65% of Na and H2O in the ultrafiltrate
b. It is the major site for HCO3- reabsorption
c. It has Na-glucose cotransporter (SGLT2) that mediates the reabsorption of glucose
d. It is the major secretion site for drugs and metabolites
*e. All of the above

What type of proximal tubule transporter is most likely to conduct secretion of diverse endogenous and exogenous waste products and metabolites? 
a. Apical membrane proton active transporter 
*b. Apical membrane organic anion transporter 
c. Basolateral membrane sodium-bicarbonate cotransporter 
d. Basolateral membrane sodium-potassium active transporter 

Which of the following is true for PCT?
a. It reabsorbs up to 65% of Na and H2O in the ultrafiltrate
b. It is the major site for HCO3- reabsorption
c. It has Na-glucose cotransporter (SGLT2) that mediates the reabsorption of glucose
d. It is the major secretion site for drugs and metabolites
*e. All of the above

Which of the following is the major transporter in the apical membrane of DCT?
a. SGLT2
b. AQP2
c. NK2C
d. Na-H cotransporter
*e. Na-Cl cotransporter

Vitamin D and PTH regulate Ca reabsorption at
a. PCT
b. LOH
*c. DCT
d. Collecting duct

Which of the following is the major transporter in the apical membrane of CD?
*a. Na Channels and AQP2
b. NK2C
c. Na-H cotransporter
d. Na-Cl cotransporter

Aldosterone and ADH regulate Na-H2O reabsorption at
a. PCT
b. LOH
c. DCT
*d. Collecting duct

What is the renal response to increased circulating levels of arginine vasopressin? 
a. Glomerular filtration decreases, conserving blood volume 
b. Sodium reabsorption at the distal tubule and collecting duct increases, conserving extracellular fluid volume 
c. Thirst increases, promoting drinking and expansion of total body water 
*d. Water and urea permeability of the collecting duct increase, promoting water reabsorption 

What is the renal response to increased circulating levels of arginine vasopressin?
A. Glomerular filtration decreases, conserving blood volume
B. Sodium reabsorption at the distal tubule and collecting duct increases, conserving extracellular fluid volume
C. Thirst increases, promoting drinking and expansion of total body water
*D. Water permeability of the collecting duct increase, promoting water reabsorption

Which of the following would be expected to cause acute renal failure secondary to intrinsic kidney damage?
A. Nephrolithiasis
B. Decreased cardiac output
C. Ureteral obstruction
*D. Acute tubular necrosis
E. Benign prostate hyperplasia

Which process is shown in the picture below?
A. Filtration and partial reabsorption
B. Secretion only
C. Filtration and secretion
*D. Filtration and complete reabsorption
E. Filtration only

Which of the following structure plays a key role in the formation of renal osmotic gradient?
A. LOH of cortical nephrons
*B. LOH of juxtamedullary nephrons
C. Collecting duct of juxtamedullary nephrons
D. Vasa recta of cortical nephrons
E. PCT and DCT of nephrons

Inside the ascending Loop of Henle, assume that the osmolarity is approximately 800 mOsm/L. What would be the expected osmolarity in the interstitial fluid immediately adjacent to that section of the Loop?
A. 600 mOsm/L
B. 800 mOsm/L
*C. 1000 mOsm/L
D. 1200 mOsm/L

Which of the following buffer pairs is considered the major plasma buffering system?
A. Protein/fat
*B. Carbonic acid/bicarbonate
C. Sodium/potassium
D. Amylase/albumin
E. Phosphoric acid/Phosphate

Which kidney-regulating substance increases to compensate for states of hypervolemia and hypertension? 
a. Aldosterone 
b. Angiotensin II 
c. Arginine vasopressin 
*d. B-type natriuretic peptide 

The renin-angiotensin system will be activated by:
A. increased blood volume
B. elevated sodium concentrations
*C. decreased blood pressure in the afferent arterioles
D. renal hypertension

What structure does urine pass through prior to entering the ureters?
A. Collecting duct
*B. Renal pelvis
C. Urethra
D. Urinary bladder
E. Loop of Henle

Which type of patient is at the greatest risk for prerenal kidney injury?
*A. An ICU patient with trauma and severe blood loss
B. A patient with kidney stones
C. An older adult being treated with an aminoglycoside antibiotic
D. A child with acute poststreptococcal glomerulonephritis

What is the final step in the progression of chronic kidney disease causing loss of nephron function? 
a. Effacement of podocyte foot processes 
*b. Filtration surface area of the capillary bed is lost 
c. Foam cells and hyaline fluid fill glomerular capillaries 
d. Glomerular capillary adhesions form with lining of Bowman’s capsule 

A patient diagnosed with a bone fracture also has some abnormal lab findings. The serum phosphate level is high and the estimated glomerular filtration rate (eGFR) is 18 mL/min. 
Which of the following is most likely?
*A. Chronic kidney disease
B. Nephrolithiasis
C. IgA nephropathy
D. Acute kidney injury
E. Diabetes insipidus

A patient in the intensive care unit (ICU) is diagnosed with hypovolemic shock based on blood pressure of 88/53 mm Hg, heart rate of 122 beats/min, respiratory rate of 26 breaths/min. Given these vital signs, what urine output is expected?
A. Maintained between 30 to 50 mL/hour with no sediment in the bag
B. Increased to 60 mL/hr with dilute urine
*C. Decreased below 30 mL/hr with decrease glomerular filtration rate (GFR)
D. Patient's normal amount with dark, concentrated urine

Which of the following is an abnormal finding in a standard urinalysis?
A. Negative for erythrocytes
B. Negative for casts
C. Specific gravity 1.015
*D. pH = 8.40
E. Negative for proteins or ketones

The following test results were obtained: urine flow rate 1.0 ml/min; urine inulin concentration 50 mg/ml; plasma inulin concentration 0.5 mg/ml; What is the glomerular filtration rate?
A. 1.0 ml/min
B. 25 ml/min
C. 50 ml/min
*D. 100ml/min
E. 120 ml/min