Chapter 24: Urinary System PDF

Chapter 24: Urinary System Herlihy: The Human Body in Health and Illness, 7th Edition MULTIPLE CHOICE 1. What vascular structure is found between the afferent and efferent arterioles? a. Peritubular capillaries b. Renal artery c. Glomerulus d. Renal veins ANS: C 2. W...

Chapter 24: Urinary System Herlihy: The Human Body in Health and Illness, 7th Edition MULTIPLE CHOICE 1. What vascular structure is found between the afferent and efferent arterioles? a. Peritubular capillaries b. Renal artery c. Glomerulus d. Renal veins ANS: C 2. What is the major artery that supplies the kidneys? a. Carotid b. Portal c. Celiac axis d. Renal ANS: D 3. Which of the following is correct? a. One kidney b. One ureter c. Two urinary bladders d. One urethra ANS: D 4. The urinary tract is lined with a. serous membrane. b. the renal capsule. c. mucous membrane. d. tubular epithelium. ANS: C 5. The renal cortex descends between the pyramids as the a. pelvis. b. collecting ducts. c. calyces. d. renal columns. ANS: D 6. The renal capsule a. lines the tubules. b. lines the urinary bladder. c. surrounds the kidneys. d. outlines the trigone. ANS: C  7. Which blood vessel(s) is (are) primarily concerned with reabsorption? a. Renal artery b. Glomeruli c. Renal vein d. Peritubular capillaries ANS: D 8. What is the urine-making structure of the kidney? a. Trigone b. Renal pyramid c. Renal capsule d. Nephron unit ANS: D 9. Where does aldosterone exert its effects? a. Glomeruli b. Efferent arteriole c. Distal convoluted tubule d. Ascending limb (loop of Henle) ANS: C 10. The efferent arterioles extend to become the a. peritubular capillaries. b. afferent arterioles. c. glomeruli. d. renal artery. ANS: A 11. The proximal convoluted tubules extend to become the a. peritubular capillaries. b. collecting duct. c. descending limb (loop of Henle). d. glomeruli. ANS: C 12. Urine flows from the ascending limb (loop of Henle) into the a. glomeruli. b. proximal convoluted tubule. c. distal convoluted tubule. d. ureter. ANS: C 13. The calyces receive urine from the a. proximal convoluted tubule. b. collecting ducts. c. glomeruli.  d. peritubular capillaries. ANS: B 14. ADH exerts its effects primarily on the a. proximal convoluted tubule. b. afferent arteriole. c. collecting duct. d. renal pelvis. ANS: C 15. Which of the following is not “plumbing”? a. Glomeruli b. Ureters c. Urinary bladder d. Urethra ANS: A 16. The detrusor muscle is located in the a. urethra. b. renal pelvis. c. urinary bladder. d. glomeruli. ANS: C 17. The word voiding refers to a. urine formation. b. catheterization. c. micturition. d. cystitis. ANS: C 18. Which of the following words best describes the function of the urinary bladder? a. Filtration b. Storage c. Reabsorption d. Buffering of H+ ANS: B 19. Which structure is located between the renal pelvis and the urinary bladder? a. Urethra b. Trigone c. Urinary meatus d. Ureter ANS: D 20. The urinary meatus is a part of the  a. ureter. b. urinary bladder. c. urethra. d. collecting duct. ANS: C 21. The detrusor muscle is concerned with a. urine formation. b. micturition. c. sodium reabsorption. d. potassium excretion. ANS: B 22. Kaliuresis refers to the renal excretion of a. sodium. b. bicarbonate. c. water. d. potassium. ANS: D 23. Natriuresis refers to the renal excretion of a. K+. b. Na+. c. water. d. bicarbonate. ANS: B 24. The renal excretion of Na+ is generally accompanied by the excretion of a. bicarbonate. b. water. c. albumin. d. renin. ANS: B 25. The juxtaglomerular apparatus (JGA) secretes a. aldosterone. b. ADH. c. angiotensin. d. renin. ANS: D 26. Renin activates a. aldosterone. b. converting enzyme. c. angiotensinogen. d. angiotensin II.  ANS: C 27. Activation of the renin-angiotensin-aldosterone system a. reabsorbs K+ and eliminates Na+ in the urine. b. causes albuminuria. c. expands blood volume. d. causes hematuria. ANS: C 28. Aldosterone a. depletes blood volume. b. causes potassium reabsorption. c. causes sodium excretion. d. causes Na+ and water reabsorption. ANS: D 29. The juxtaglomerular apparatus (JGA) is located near the a. collecting duct. b. afferent arteriole. c. ureter. d. renal pelvis. ANS: B 30. The internal and external sphincters are associated with (the) a. renal pelvis. b. Bowman’s capsule. c. juxtaglomerular apparatus. d. urinary bladder. ANS: D 31. Which of the following is not located within the urinary bladder? a. Trigone b. Detrusor muscle c. Internal sphincter d. Calyces ANS: D 32. Which of the following should not be found in the glomerular filtrate? a. Albumin b. Sodium c. Potassium d. Water ANS: A 33. Which of the following is most likely to cause polyuria? a. Oversecretion of aldosterone b. Decreased glomerular filtration rate (GFR)  c. Deficiency of ADH d. Activation of angiotensinogen ANS: C 34. Which of the following is not true of ADH? a. Secreted by the posterior pituitary gland b. Secreted in response to low blood volume and concentrated plasma (as in dehydration) c. Causes the renal excretion of sodium, potassium, and water d. Deficiency causes diabetes insipidus ANS: C 35. Which of the following is absorbed across the walls of the collecting duct under the influence of ADH? a. Potassium b. Urea c. Water d. Albumin ANS: C 36. Pyuria is indicative of a. infection. b. glomerular damage. c. deficiency of ADH. d. excess secretion of aldosterone ANS: A 37. Which substance is filtered by the glomerulus and is excreted in the urine (there is minimal reabsorption)? a. Albumin b. Glucose c. Sodium d. Creatinine ANS: D 38. Cystitis refers to inflammation of the a. kidneys. b. meatus. c. urinary bladder. d. renal pelvis. ANS: C 39. Which of the following is found in the kidney? a. Detrusor muscle b. Trigone c. Nephron units d. Urethra  ANS: C 40. Bowman’s capsule is part of the a. nephron unit. b. renal pelvis. c. collecting duct. d. urinary bladder. ANS: A 41. What part of the nephron unit filters 180 L of water per day? a. Peritubular capillaries b. Glomeruli c. Calyces d. Trigone ANS: B 42. Creatinine is a. completely reabsorbed by the peritubular capillaries. b. a waste product that is filtered and not reabsorbed. c. a renal enzyme that activates angiotensinogen. d. a renal hormone that stimulates red blood cell production by the bone marrow. ANS: B 43. A diuretic a. causes the excretion of sodium and water in the urine b. causes hyperglycemia. c. blocks the effects of PTH. d. stimulates the reabsorption of sodium by the peritubular capillaries. ANS: A 44. Which of the following occurs at the distal convoluted tubule? a. 180 L of water is filtered into the tubules. b. Renin is secreted. c. Urine flows from the distal convoluted tubule into the ascending loop of Henle. d. Sodium and water are reabsorbed. ANS: D 45. Which of the following terms refers to the voluntary expulsion of urine? a. Polyuria b. Diuresis c. Micturition d. Dialysis ANS: C 46. With regard to reabsorption, which structure plays the most important role? a. Glomeruli  b. Renal pelvis c. Urinary bladder d. Peritubular capillaries ANS: D 47. ADH a. is secreted by the anterior pituitary gland. b. is a mineralocorticoid that is secreted by the adrenal cortex. c. stimulates the collecting duct to reabsorb water. d. increases the GFR. ANS: C 48. Low levels of oxygen stimulate the kidneys to secrete which hormone? a. Renin b. Aldosterone c. Erythropoietin d. Converting enzyme ANS: C 49. In the process of secretion, a substance moves from the peritubular capillaries into what structure? a. Glomeruli b. Calyces c. Renal pelvis d. Renal tubules ANS: D 50. Under normal conditions, which substance is present in the urine? a. Creatinine b. Fibrinogen c. Myosin d. Albumin ANS: A 51. Which condition is associated with proteinuria? a. Bladder infection b. Urethritis c. Glomerular damage d. Deficiency of ADH ANS: C 52. Which hormone affects blood volume? a. PTH b. Erythropoietin c. Insulin d. Aldosterone  ANS: D 53. Aldosterone a. is secreted by the posterior pituitary gland. b. acts on the collecting duct blocking the reabsorption of water. c. stimulates the reabsorption of water but has no effect on potassium. d. is a mineralocorticoid that stimulates the reabsorption of sodium. ANS: D 54. Which of the following is caused by a deficiency of erythropoietin? a. Oliguria b. Anemia c. Albuminuria d. Cystitis ANS: B 55. Which of the following is caused by prolonged hypotension? a. Oliguria b. Albuminuria c. Cystitis d. Glomerulonephritis ANS: A 56. What is the meaning of an elevated serum creatinine? a. The kidneys are making too much creatinine. b. Too much creatinine is being reabsorbed by the pertibular capillaries. c. The kidneys are not filtering creatinine; this is a sign of kidney failure. d. The kidneys are excreting too much urine. ANS: C 57. A drug is classified as a diuretic. Most likely, the drug a. decreases the GFR. b. blocks the tubular reabsorption of Na+. c. activates the renin-angiotensin-aldosterone system. d. causes the release of ADH. ANS: B 58. Which condition is characterized by hematuria and pyuria? a. Renal failure b. Diuresis c. Urinary retention d. Cystitis ANS: D 59. Renal failure causes anemia because of a. a lack of erythropoietin. b. gross hematuria.  c. uremia-induced hemolysis. d. uremia-induced hypokalemia. ANS: A 60. The urinary bladder a. contains only skeletal muscle. b. receives urine from two urethras. c. causes diuresis in response to ADH deficiency. d. causes micturition when the detrusor muscle contracts and the internal sphincter relaxes. ANS: D 61. When the arterial blood pressure declines to 70/40 mm Hg, a. GFR decreases. b. diuresis occurs. c. aldosterone secretion decreases. d. ADH secretion diminishes. ANS: A 62. What happens at the glomerular membrane? a. Water and dissolved solute are filtered into Bowman’s capsule. b. The JGA cells release ADH. c. The JGA cells release aldosterone. d. Na+ is reabsorbed. ANS: A 63. The distal convoluted tubule a. receives urine from the collecting duct. b. reabsorbs Na+ and water in response to aldosterone. c. is the nephron structure that is primarily associated with filtration. d. empties its urine into Bowman’s capsule. ANS: B 64. A patient with stenosis (narrowing) of the renal artery is most likely to present with a. uremia. b. hypertension. c. albuminuria, hypoalbuminemia, and edema. d. glucosuria. ANS: B 65. Micturition a. is another term for urination. b. occurs across the glomerular membrane. c. is the opposite of voiding. d. All of the above are true. ANS: A 66. Which of the following is true of glomerular function? a. It is unaffected by blood pressure. b. It is concerned with the filtration of 1.5 L/24 hr (of water). c. A decline in GFR (glomerular filtration rate) causes polyuria. d. An increase in GFR increases urine formation. ANS: D 67. A deficiency of aldosterone causes a decrease in the tubular reabsorption of sodium and water, causing a significant decrease in blood volume and a. azotemia and uremia. b. generalized edema. c. hypotension. d. anemia. ANS: C 68. Which of the following is true of aldosterone? a. It is an androgen. b. It is the “salt-retaining” hormone. c. It causes the tubular reabsorption of sodium, potassium, and water. d. All of the above are true. ANS: B 69. Which of the following urine-making processes occurs first? a. Urine concentration by by the collecting ducts b. Glomerular filtration c. Reabsorption of Na+ d. Secretion of K+ ANS: B 70. Which of the following is false with regard to normal urine? a. Normal urine has E. coli as part of its normal flora. b. Urinary tract infections are more common in alkaline urine than in acid urine. c. Urine does not contain glucose. d. Urine does not contain significant amounts of albumin. ANS: A 71. Glucosuria is most likely to cause a. hyperglycemia. b. uremia and azotemia. c. polyuria and dehydration. d. hematuria and anemia. ANS: C 72. Renin a. is a hormone secreted by the posterior pituitary gland. b. is called converting enzyme.  c. activates angiotensinogen. d. Two of the above are true. ANS: C 73. Angiotensin II a. is secreted by the JGA cells in the kidney. b. is converted to angiotensin I by renin. c. is a potent vasoconstrictor. d. inhibits the release of aldosterone from the adrenal cortex. ANS: C 74. Most tubular reabsorption takes place a.across the glomerular membrane. b.in response to aldosterone. c.in response to ADH. d.across the proximal tubule. ANS: D 75. A drug that blocks the effects of aldosterone a. decreases the reabsorption of Na+ and water. b. is kaliuretic. c. causes oliguria. d. Two of the above are true. ANS: A 76. Glucose is not normally excreted in the urine because a. glucose cannot be filtered. b. all filtered glucose is reabsorbed. c. glucose is used up by the metabolizing nephron units. d. glucose is converted to ammonia in the distal tubule and excreted as urea. ANS: B 77. Albuminuria is most indicative of a. an enlarged pore size of the collecting duct membrane. b. urinary incontinence. c. increased pore size of the glomeruli d. a deficiency of ADH and/or aldosterone. ANS: C 78. Albuminuria and generalized edema (anasarca) are usually accompanied by a. cystitis. b. hypoalbuminemia. c. glucosuria. d. pyuria. ANS: B 79. What is the earliest consequence of a decreased GFR, as in shock? a. Urinary retention b. Glucosuria c. Albuminuria d. Oliguria ANS: D 80. An anticholinergic (muscarinic antagonist) drug, such as atropine, prevents both the relaxation of the urinary sphincter and the contraction of the detrusor muscle. You would therefore observe the patient for signs of a. uremia. b. urinary suppression. c. urinary retention. d. nephrotic syndrome. ANS: C 81. Which of the following structures is considered “plumbing”? a. Collecting duct b. Ureter c. Glomerulus d. Two of the above are true. ANS: B 82. Urea is a. transported from theliver to the kidneys by the blood b. made in the liver. c. excreted by the kidneys. d. All of the above are true. ANS: D 83. An elevated serum creatinine level is most indicative of a. urinary retention. b. declining renal function. c. urinary bladder infection. d. renal calculi. ANS: B 84. The “urine-making” structure of the kidney is the a. urinary bladder. b. nephron unit. c. trigone. d. renal pelvis. ANS: B 85. Glomerular filtration pressure is caused by a. intrathoracic pressure. b. pressure within the renal tubules.  c. blood pressure. d. intraabdominal pressure. ANS: C 86. A sudden decline in blood pressure to 80/45 mm Hg is most apt to a. increase GFR. b. increase glomerular filtration. c. cause oliguria. d. cause hematuria. ANS: C 87. When does renal reabsorption occur? a. When water and dissolved solute move from the tubules into the peritubular capillaries b. When water and dissolved solute move from the tubules into the glomerular capillaries c. When water moves from the collecting duct into the renal pelvis d. When water and dissolved solute move from the peritubular capillaries into the renal tubules ANS: A 88. The collecting duct a. is primarily concerned with the concentration of urine. b. collects urine from the renal pelvis and pumps it into the ureters. c. collects urine from Bowman's capsule and pumps it into the peritubular capillaries. d. is primarily concerned with micturition. ANS: A 89. Which of the following is handled by the kidneys as either urea or ammonia? a. Carbon dioxide b. Creatinine c. Nitrogen d. Glucose ANS: C 90. Most diuretics work by a. increasing blood flow to the kidneys. b. increasing the urge to urinate. c. stimulating the contraction of the detrusor muscle. d. blocking the tubular reabsorption of Na+. ANS: D 91. Severe hyperglycemia is most apt to induce a. glucosuria. b. osmotic diuresis. c. increased tubular solute load. d. All of the above are true.  ANS: D 92. The juxtaglomerular apparatus a. secretes angiotensin in response to a decline in blood pressure. b. is located within the walls of the collecting ducts. c. secretes aldosterone. d. is a blood pressure regulating structure. ANS: D 93. Angiotensin II a. causes vasodilation. b. is secreted by the JGA. c. elevates blood pressure. d. activates angiotensinogen. ANS: C 94. Most angiotensin I is converted to angiotensin II primarily in the a. kidneys. b. JGA. c. lungs. d. liver. ANS: C 95. The trigone, detrusor, and rugae are all related to the a. nephron unit. b. renal pelvis. c. Bowman’s capsule. d. urinary bladder. ANS: D 96. Which of the following is true of aldosterone? a. Is secreted by the adrenal medulla b. Stimulates the distal tubule to reabsorb Na+ c. Stimulates the proximal tubule to reabsorb K+ d. Works on the collecting duct membrane to determine membrane permeability to water ANS: B 97. A severe decline in blood pressure is most apt to induce a. respiratory acidosis. b. osmotic diuresis. c. oliguria. d. hematuria. ANS: C 98. This hormone increases systemic vascular resistance and causes the release of aldosterone.  a. Renin b. Erythropoietin c. Brain natriuretic hormone d. Angiotensin II ANS: D 99. Which of the following is true of dehydration? a. Is characterized by an increase in urine specific gravity b. Is accompanied by a decrease in sodium retention c. Causes a shift of water from the vasculature into the interstitium d. Is generally treated with a diuretic ANS: A 100. Which of the following is true of urea? a. Is an excretable form of nitrogen b. Is synthesized by the kidneys c. Is converted to ammonia by converting enzyme in the lungs d. Is a pancreatic proteolytic enzyme ANS: A 101. Hyperkalemia a. causes blood volume expansion and hypertension. b. refers to an elevation in serum potassium. c. is uncomfortable but never serious. d. is due to an accumulation of the urea in the blood ANS: B