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Lymphatic and Urinary System

Total questions: 115

Worksheet time: 58mins

Name
Class
Date
1.

Match the Lymphatic Structure with its description: largest lymph organ; removes aged, defective RBCs and contains red and white pulp

a)

spleen

b)

lymph nodes

c)

thymus

d)

peyer's patch

e)

tonsils

2.

Match the Lymphatic Structure with its description: filters lymph

a)

spleen

b)

lymph nodes

c)

thymus

d)

Peyer's patches

e)

tonsils

3.

Match the Lymphatic Structure with its description: particularly large and important during youth; helps to program T cells of the immune system

a)

spleen

b)

lymph nodes

c)

thymus

d)

Peyer's patches

e)

tonsils

4.

Match the Lymphatic Structure with its description: acts against bacteria breaching the intestinal wall

a)

spleen

b)

lymph nodes

c)

thymus

d)

Peyer's patches

e)

tonsils

5.

Match the Lymphatic Structure with its description: includes the adnoids; lacks a complete capsule and has crypts in which bacteria may become trapped

a)

spleen

b)

lymph nodes

c)

thymus

d)

Peyer's patches

e)

tonsils

6.

Lymphatic vessels help to keep the cardiovascular system functional by:

a)

pushing veins to facilitate the return of blood to the heart

b)

removing wastes from the blood vessels

c)

supplying nutrients to the blood vessels

d)

maintaining blood volume

7.

Lacteals are found in the GI tract and carry absorbed ________________. 

a)

proteins

b)

bacteria

c)

fats

d)

viruses and bacteria

8.

Primary lymphoid organs generate lymphocytes.  The two primary lymphoid organs are the:

a)

thymus and bone marrow

b)

thymus and spleen

c)

bone marrow and spleen

d)

thymus and spleen

9.

Select all that apply:

The main function(s) of the spleen include

a)

production of blood cells during fetal life

b)

remove particulate matter and aged blood cells, mainly red blood cells

c)

production of immune cells to fight antigens

d)

production of lymphocytes

e)

enhance the activity of neutrophils

10.

In general, there are more afferent than efferent lymph vessels in a lymph node.

a)

True

b)

False

11.

Lymphatic capillaries differ from vascular capillaries in that:

a)

  vascular capillaries are blind-ended and lymphatics are not

b)

  lymphatics are less permeable than vascular capillaries

c)

  lymphatics are more permeable than vascular capillaries

d)

  vascular capillaries allow for the spread of cancer cells and pathogens

12.

Lymphatic vessels present in the intestinal mucosa which absorb digested fat and carry chyle are known as:

a)

lacteals

b)

  lactiferous ducts

c)

  mucosal lymphatics

d)

chylomicrons

13.

Larger lymphatic vessels resemble:

a)

  arteries except they have thinner walls, valves and less anastomoses

b)

  capillaries except they have thicker walls, valves and less anastomoses

c)

  veins except they have thinner walls, more valves and more anastomoses

d)

  muscular arterioles except they have thinner walls, more valves and less anastomoses

14.

Excessive interstitial tissue from the right and left ankles would ultimately drain into the: 

a)

  subclavian artery

b)

  thoracic duct

c)

  right subclavian vein

d)

  right lymphatic duct

15.

Asking a patient to rest his ankle following injury is good advice because:

a)

  immobilization increases blood flow and lymphatic drainage from the area

b)

  immobilization keeps inflammatory materials in the injured area to accelerate healing

c)

  immobilization reduces the likelihood that injury will be repeated

d)

  immobilization will reduce pain in the ankle by reducing the amount of inflammatory chemicals

16.

A woman who has recently undergone a double mastectomy following a breast cancer scare presents with a swollen left arm.  Why?

a)

  During surgery the patient's arm was injured and now it is swelling because of the injury.

b)

  Following surgery, the patient was bed-ridden for several days. She developed a blood clot which has resulted in excessive swelling.

c)

  Allergic reaction? Who knows?

d)

  During surgery some of the lymphatics draining the left upper extremity were removed due to concern for cancer metastasis. Now normal removal of lymph is blocked.

17.

My body makes __________________________ in response to ___________________.

a)

  antigens; antibody

b)

  antibody; antigens

c)

  plasma cells; antibodies

d)

  antigens; plasma cells

18.

While both B and T cells originate in the ______________, only B cells mature there.  T cells, on the other hand, mature in the ________________.

a)

  thyroid; bone marrow

b)

  bone marrow; thyroid

c)

  thymus; bone marrow

d)

  bone marrow; thymus

19.

Lymph arrives at the lymph node at the _______________________ lymphatic vessels and exits the lymph node through the _______________________ lymphatic vessels.

a)

  efferent; afferent

b)

  posterior; anterior

c)

  afferent; efferent

d)

  anterior; posterior

20.

Lymphocyte proliferation, immune surveillance and response, cleansing the blood of aged red blood cells and platelets and debris removal from macrophages all occurs in the ____________________________.

a)

  lymph nodes

b)

thymus

c)

  thoracic duct

d)

spleen

21.

Differentiated T and B cells that target the same antigen are:

a)

clones

b)

naive

c)

Helper cells

d)

macrophages

22.

Which T cell that is activated by the macrophages will active B cells to respond to an invader?

a)

T helper

b)

T cytotoxic

c)

T regulator

d)

T memory

23.

Cells that kill other cells that lack MHC I

a)

Natural killer T cell

b)

T cytotoxic cell

c)

Natural killer cell

d)

T regulator

24.

B cells must be activated by T helper cells before phagocytosing a foreign cell

a)

True

b)

False

25.

The ability of an antibody to attach to a cell and flag it for phagosomal uptake is called:

a)

neutralization

b)

Opsonization

c)

Induction of complement

d)

agglutination

26.

Vaccines are given to build what immunological property in the body?

a)

Memory

b)

Natural killer cells

c)

Antibodies

d)

T helper cells

27.

Vaccines composed of live viruses that have lost their virulence factors are called:

a)

Heat-killed vaccines

b)

Subunit vaccine

c)

Live-attenuated vaccines

d)

conjugated vaccines

28.

Lymph nodes:

a)

  are located along lymphatic vessels.

b)

  are scattered throughout the body.

c)

  are bean-shaped organs.

d)

  All of the above.

29.

Worn-out and damaged red blood cells are destroyed in the

a)

  lymph nodes.

b)

  thymus gland.

c)

tonsils

d)

spleen

30.

Lymphatic fluid in lacteals:

a)

  is dumped directly into the liver

b)

  is also known as chyle

c)

  contains proteins from digestion

d)

  is clear and contains carbohydrates

31.

There are more afferent lymph vessels than efferent lymph vessels.

a)

True

b)

False

32.

Select all that apply.

Regarding the spleen:

a)

  it removes old red blood cells

b)

  it lacks a capsule

c)

  it synthesizes antibodies in its white pulp

d)

  It is found in the upper left quadrant of the abdominal cavity, just posterior to the stomach

e)

  it is found in the upper right quadrant of the abdomen

33.

At the arteriole end of the capillary bed, water is pushed outward by:

a)

  osmotic pressure

b)

  This question is too much pressure

c)

  hydrostatic pressure

d)

  oncotic pressure

34.

return to systemic circulation

a)

reabsorption

b)

filter

c)

excretion

d)

secretion

35.

separate substances based on size

a)

reabsorption

b)

filter

c)

excretion

d)

secretion

36.

remove from the body

a)

reabsorption

b)

filter

c)

excretion

d)

secretion

37.

move from one part of the body to another

a)

reabosrption

b)

filter

c)

excretion

d)

secretion

38.

____________________ nephrons produce concentrated urine. 

a)

large

b)

juxtamedullary

c)

cortical

d)

  primary active

39.

Glucose and amino acids are filtered from the blood and later reabsorbed.

a)

True

b)

False

40.

Carbonic anahydrase inhibitors primarily act at the:

a)

  distal convoluted tubule

b)

  ascending limb of the nephron loop

c)

  proximal convoluted tubule

d)

  collecting tubules

41.

Alcohol inhibits:

a)

  angiotensinogen converting enzyme (ACE)

b)

aldosterone

c)

  anti-diuretic hormone (ADH)

d)

renin

42.

Micturition is the clinical term for urination.

a)

True

b)

False

43.

A kidney infection/inflammation is known as:

a)

  nephrotic syndrome

b)

pyelonephritis

c)

glomerulonephritis

d)

  renal calculi

44.

A condition in which there is blood in the urine is known as:

a)

pyuria

b)

glucosuria

c)

ketonuria

d)

hematuria

45.

The proximal convoluted tubule and distal convoluted tubule differ in that:

a)

the proximal convoluted tubule consists of columnar cells while the distal convoluted tubule has cuboidal cells

b)

the proximal convoluted tubule has cuboidal cells while the distal convoluted tubule has columnar cells

c)

the proximal convoluted tubule has a brush border while the distal convoluted tubule does not

d)

the proximal convoluted tubule does not have a brush border while the distal convoluted tubule does have a brush border

46.

Long, thin-walled blood vessels running parallel to juxtamedullary nephron loops and function in the concentration of urine are known as:

a)

efferent arterioles

b)

peritubular capillaries

c)

afferent arterioles

d)

vasa recta

47.

The rate of filtrate formation and blood pressure are regulated in the nephron by the:

a)

mesangial cells

b)

macula densa

c)

granular or JG cells

d)

juxtaglomerular complex

48.

Cells that sense the NaCl concentration of filtrate are known as __________________________, while cells involved in pressure regulation are ____________________________ .

a)

mesangial cells; macula densa cells

b)

JG or granular cells; macula densa cells

c)

macula densa cells; JG or granular cells

d)

JG or granular cells; mesangial cells

49.

__________________________________ forces fluids and solutes through the filtration membrane of the renal corpuscle.  It is essentially ______________________________.  

a)

Hydrostatic pressure in the glomerular capillaries; blood pressure of the glomerulus

b)

Hydrostatic pressure in the capsule; systemic blood pressure

c)

Colloid osmotic pressure in the glomerulus; systemic blood pressure

d)

Hydrostatic pressure in the capsular space; blood pressure in the glomerulus

50.

High NaCl concentration of the filtrate due to reduced reabsorption time is the result of:

a)

a decrease in NFP

b)

a decrease in glomerular blood pressure

c)

a decreased GFR

d)

an increased GFR

51.

_____________ transport by primary active transport, provides the energy and the means for reabsorbing almost every other substance in the kidney.

a)

water

b)

sodium

c)

potassium

d)

chloride

52.

In _______________ water reabsorption, water is reabsorbed through aquaporins inserted in collecting ducts if ADH is present, while in ______________ water reabsorption, water is reabsorbed through osmosis through aquaporins that are always present in the proximal convoluted tubule.

a)

  facultative; obligatory

b)

  primary; secondary

c)

  active; passive

d)

  obligatory; facultative

53.

A patient who is hyperglycemic may have glucose spill into his/her urine because there is a (n)_______________ for glucose which reflects the number of carriers in the renal tubule available for glucose.

a)

  transport maximum

b)

  principle of limitation

c)

  concentration channel

d)

  voltage-gated receptor

54.

Which hormone targets principal cells of the collecting ducts and the distal convoluted tubule leading to the synthesis of apical sodium and potassium ad chloride channels and a basolateral ATPase for sodium reabsorption?

a)

aldosterone

b)

angiotensin 1

c)

atrial naturietic peptide

d)

anti-diuretic hormone

55.

In the countercurrent multiplier, the ascending limb is impermeable to ____________, while the descending limb is freely permeable to it.

a)

water

b)

potassium

c)

sodium

d)

bicarbonate

56.

True or False:  The volume of blood at the end of the vasa recta is greater than the volume of blood at the beginning of it.

a)

True

b)

False

57.

The phrase, "You only rent beer!" is true because alcohol inhibits _____________.

a)

aldosterone

b)

antidiuretic hormone (ADH)

c)

ANP

d)

renin

58.

Renal Clearance tests are performed to determine ________________________.

a)

the amount of ADH in one's system

b)

Net Filtration Pressure (NFP)

c)

Diabetic osmolarity

d)

Glomerular Filtration Rate (GFR)

59.

True or False:  Specific Gravity of Urine can sometimes be less than 1.  

a)

True

b)

False

60.

A 48 year old multi-parous (means she's had multiple pregnancies) mother of 5 complains of involuntary urination when she coughs, laughs or sneezes.  What would you guess is her diagnosis?

a)

multiple sclerosis

b)

diabetes

c)

overflow incontinence

d)

stress incontinence

61.

Which type of nephron makes up the bulk of nephrons and in almost entirely in the cortex?

a)

Juxtamedulary nephrons

b)

Cortex nephrons

c)

Cortical nephrons

d)

Medullary nephrons

62.

Which countercurrent mechanism involves the vasa recta?

a)

Countercurrent exchanger

b)

Counter current divider

c)

Countercurrent multiplier

d)

None of the Above

63.

Where does the T cell originate?

a)

Thymus

b)

Nodes

c)

Thyroid

d)

Bone marrow

64.

The lymphatic system circulates ______ of interstitial fluid a day.

a)

3L

b)

4L

c)

1L

d)

13L

65.

_____________ is a condition in which lymphatic vessels appear as painful red lines under the skin.

a)

lymphangitis

b)

lymphoma

c)

lymphedema

d)

lymphangiomatosis

66.

What is the major function of the lymphatic system?

a)

help filter blood

b)

return fluids leaked from blood vessels back to blood

c)

return the pH balance of blood in the body

d)

send blood to fight cuts or scrapes

67.

The lymphatic system is a two-way system like the cardiovascular system.

a)

True

b)

False

68.

The process which results in filtrate production is known as __________.

a)

filtration

b)

reabsorption

c)

secretion

d)

excretion

69.

When something is removed from the filtrate and returned to systemic circulation, ____________ has occurred.

a)

filtration

b)

resorption

c)

secretion

d)

excretion

70.

The removal of waste from the body is known as:

a)

filtration

b)

resorption

c)

secretion

d)

excretion

71.

Removing a substance from systemic circulation to the filtrate is known as:

a)

filtration

b)

resorption

c)

secretion

d)

excretion

72.

Blood pressure is high in the glomerulus because:

a)

Afferent arterioles are larger in diameter than efferent arterioles

b)

Arterioles are high resistance vessels

c)

Afferent arterioles are smaller than efferent

d)

Red & Yellow Answer Choices

73.

Lymph Nodes:

a)

Clean Lymph & Activate the immune system

b)

Clean lymph and produce macrophages

c)

activate the immune system & play a role in reabsorption

d)

None of the above

74.

Renin-angiotensin-aldosterone mechanism is the Main mechanism for increasing blood pressure

a)

True

b)

False

75.

Lacteals____________________.

a)

help process lactose by producing lactase.

b)

absorb digested fat and deliver chyle to the blood.

c)

are inflamed lymph nodes.

d)

remove Na+ from the blood

76.

Interconnecting cells of the JGC (Juxtaglomerular Complex) that have gap junctions are:

a)

macula densa

b)

granular cells

c)

extraglomerular mesangial cells

d)

none of the above

77.

The hormone that increases blood pressure and decreases K+ levels in the renal tubules and collecting ducts is:

a)

Aldosterone

b)

Antidiuretic hormone (ADH)

c)

Atrial natriuretic peptide

d)

parathyroid hormone

78.

Inflammation of the bladder is known as:

a)

Urethritis

b)

Cystitis

c)

Pyelitis

d)

Pyelonephritis

79.

You note in your patient's chart a urine output of 1.5 L a day. Is this alarming to you?

a)

YES! Why is it so high?

b)

No, this is normal.

c)

Yes, it should be twice that amount!

d)

None of the above

80.

Filtration occurs:

a)

at the level of the renal corpuscle

b)

in the distal convoluted tubule

c)

in the proximal convoluted tubule

d)

within the ascending limb of the nephron

81.

Concentrating urine is the job of the:

a)

renal corpuscle

b)

distal convoluted tubule

c)

proximal convoluted tubule

d)

collecting duct

82.

65% of water and solutes are reabsorbed within the:

a)

distal convoluted tubule

b)

nephron loop

c)

proximal convoluted tubule

d)

collecting duct

83.

Aldosterone works at the:

a)

proximal convoluted tubule

b)

nephron loop

c)

distal convoluted tubule

d)

collecting duct

84.

_____________ drains right upper arm and right side of head and thorax while ______________ drains the rest of the body.

a)

Lymphatic Capillaries/ Lymphatic Vessels

b)

Right Lymphatic Duct/Thoracic Duct

c)

Lymphatic Vessels/Lymphatic Capillaries

d)

Thoracic Duct/ Right Lymphatic Duct

85.

Internal Urethral Sphincter is under involuntarily control, while the external urethral sphincter is voluntary.

a)

True

b)

False

86.

What lymphoid organ has no follicles, lacks B cells & does not directly fight antigens?

a)

Spleen

b)

Lymph Nodes

c)

Appendix

d)

Thymus

87.

A muscular tube that drains the urinary bladder is a(n):

a)

sphincter

b)

ureter

c)

urethra

d)

descending loop of nephron

88.

Neurogenic incontinence is due to increased intra-abdominal pressure.

a)

True

b)

False

89.

Renal failure is defined as a GFR < 60ml/min for 3 months.

a)

True

b)

False

90.

Patients with high blood sugar "spill" sugar into their urine because:

a)

their kidneys are not functioning properly

b)

the sugar is secreted by the blood at the distal convoluted tubule

c)

the amount of sugar in the filtrate exceeds the transport maximum

d)

the sugar is filtered due to many damaged glomeruli

91.

What does the Central Nervous System use for drainage?

a)

Lymphatic capillaries

b)

Cerebral spinal fluid

c)

Lacteals

d)

Cisterna chyli

92.

On the microscopic view of a nephron, the lumen of which tubule appears fuzzy due to microvilli?

a)

proximal convoluted tubule

b)

ascending limb of the nephron loop

c)

distal convoluted tubule

d)

descending limb of the nephron loop

93.

All of the following are functions of the spleen EXCEPT:

a)

Stores breakdown products of RBCs (e.g., iron) for later reuse

b)

Metabolizes fats, proteins, and carbohydrates

c)

Stores blood platelets and monocytes for release into blood when needed

d)

May be site of fetal erythrocyte production

94.

What is the correct order of urine flow?

a)

Minor calyx->Major calyx ->Renal pyramid->Renal pelvis->Ureter

b)

Renal pyramid->Major calyx->Minor calyx-> Renal pelvis->Ureter

c)

Renal pyramid ->Minor calyx -> Major calyx-> Renal pelvis -> Ureter

d)

Renal pyramid -> Minor calyx -> Major calyx -> Urethra -> Ureter

95.

A decrease in movement of a region of the body decreases the flow of lymph and may help promote faster healing.

a)

True

b)

False

96.

B cells produce plasma cells that secrete antibodies.

a)

True

b)

False

97.

The arterial blood flow through kidneys is:

a)

Renal=>segmental=> interlobar=> cortical radiate(interlobular)=> arcuate

b)

Renal= segmental= interlobar= arcuate= corticalradiate(interlobular)

c)

Renal=>interlobar=> segmental=>arcuate=> cortical radiate(interlobular)

d)

Renal=>segmental=> arcuate=> interlobar=>cortical radiate(interlobular)

98.

The renal arterial and venous system are the same except there are no arcuate veins.

a)

True

b)

False

99.

Which cells are responsible for secreting antibodies?

a)

T cells

b)

Plasma Cells

c)

B cells

d)

Dendritic Cells

100.

A swollen, but not painful lymph node can be a sign of ______________.

a)

The beginning of an infection

b)

Cancer-infiltrated lymph node

c)

The end of an infection

d)

Lymph node that is over-filled with lymph

101.

A vegetarian diet, prolonged vomiting and Urinary Tract Infections all:

a)

can increase the acidity of urine

b)

lead to an increase in urine output

c)

lead to a reduction in urine output

d)

can increase the alkalinity of urine

102.

The Glomerulus capillaries are fed by _____________ and drained by ________________.

a)

Afferent arteriole; Efferent vein

b)

Afferent arteriole; Efferent arteriole

c)

Efferent arteriole; Afferent vein

d)

Efferent arteriole; Afferent arteriole

103.

The nephron structure NOT restricted to the cortex of the kidney is the:

a)

glomerulus

b)

distal convoluted tubule

c)

proximal convoluted tubule

d)

nephron loop/loop of Henle

104.

Sodium enters the tubule cell of the PCT at the basal surface through:

a)

passive transport

b)

secondary active transport

c)

osmosis

d)

active transport

105.

Sodium enters the tubule cell of the PCT at the apical surface through:

a)

diffusion

b)

secondary active transport

c)

osmosis

d)

active transport

106.

The PCT is where _________ water reabsorption occurs.

a)

no

b)

facultative

c)

obligate

d)

scant

107.

What is renal clearance?

a)

Volume of urine kidneys can clear of a substance in a given time period

b)

Volume of filtrate kidneys can clear of a substance in a given time period

c)

Volume of plasma kidneys can clear of a substance in a given time period

d)

None of the above

108.

A patient with a UTI may have:

a)

glycosuria

b)

pyuria

c)

proteinuria

d)

none of the above

109.

In the tubuloglomerular feedback mechanism:

a)

Salty urine leads to an increased GFR

b)

Salty urine leads to a decreased GFR

c)

High blood pressure leads to constriction of the afferent arterioles

d)

Low blood pressure leads to constriction of the afferent arterioles

110.

The cells responsible for sensing the amount of salt in the urine are the:

a)

macula densa cells

b)

granular cells

c)

mesangial cells

d)

tubule cells

111.

The myogenic mechanism of feedback:

a)

involes smooth muscle of the peritubular capillary

b)

occurs when the afferent arteriole contracts due to stretching of its walls

c)

occurs when the afferent arteriole relaxes due to stretching of its walls

d)

occurs when the filtrate is too salty

112.

ADH works by:

a)

decreasing the number of aquaporins in the PCT

b)

decreasing the number of aquaporins in the collecting duct

c)

increasing the number of aquaporins in the PCT

d)

increasing the number of aquaporins in the collecting duct

113.

Drugs are never fully excreted from the body.

a)

True

b)

False

114.

The interstitial fluid of the medulla becomes more concentrated as you move down, away from the cortex.

a)

True

b)

False

115.

_____ can diffuse across the descending limb of Henle, but not the ascending limb.

a)

Salt

b)

Urea

c)

Water

d)

Potassium

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