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WorksheetsGlomerular Filtration and Renal Function
Total questions: 74
Worksheet time: 58mins
Renal fraction can be described as the percentage of cardiac output that is received by the kidneys.
true
false
filtration fraction is the percentage of plasma that will become filtrate. what percentage of plasma is generally pushed out to enter bowman's capsule?
about 50%
about 10%
about 20%
about 30%
What is the difference across the glomerular capillary wall?
net filtration pressure
glomerular filtration rate
intrinsic control
extrinsic control
two of these are correct
match the following.
the pressure of the glomerular capillary pushing a percentage of the blood outward to bowman’s capsule
glomerular hydrostatic pressure
the pressure of the proteins that pulls inward to the capillary
glomerular osmotic pressure
the pressure of the capsular space resulting from the “traffic jam” from the accumulation of filtrate
capsular hydrostatic pressure
match the following
glomerular hydrostatic pressure
about 55 mmHg
glomerular osmotic pressure
about 30 mmHg
capsular hydrostatic pressure
about 15 mmHg
net filtration pressure
about 7-10 mmHg
the glomerular capillary and blood capillaries found throughout the body function similarly in that they both deliver and pick up wastes and nutrients.
true
false
filtrate is essentially the same composition as which of the following, minus the larger molecules found in this fluid-
intracellular fluid
intracellular fluid
plasma and intracellular fluid
extracellular fluid and intracellular fluid
plasma
through which vessel does blood arrive to the glomerular capillary?
the glomerular capillary itself
the afferent arteriole
the efferent arteriole
both the afferent and efferent arteriole
it depends
which of the following is too large to pass through the capillary wall to become part of the filtrate?
proteins
blood cells
both of these are correct
neither of these is correct
which of the following structures serves to "catch" filtrate pushed out of the blood and guide it to the nephron loops?
the glomerular capillary
loop of henle
efferent arteriole
bowman's capsule
GFR determines NFP.
true
false
what is the average GFR rate of a healthy adult?
125mL/min
125L/day
180mL/min
180mL/day
two of these are true
the velocity of flow of filtrate through the nephron is determined by-
NFP
GFR
intrinsic controls
extrinsic controls
none of these are correct
match the following.
desirable contents of filtrate will not be able to be reabsorbed as needed
if GFR is fast-
desirable contents of filtrate will be reabsorbed but also undesirables
if GFR is slow-
the kidneys may still function well even if flow through the nephron loop is increased or decreased by-
30%
this answer choice does not match with anything
60%
where will intrinsic controls of regulation of glomerular filtration rate occur?
in the kidneys
in the plasma
in the glomerulus
in the renal pelvis
none of these are correct
extrinsic controls of glomerular filtration rate will take action when the body must override intrinsic controls.
true
false
which of the following is not an example of extrinsic control of regulation of glomerular filtration rate?
sympathetic nervous system activation
renin-angiotensin mechanism
hemorrhagic shock
parasympathetic nervous system activation
during the fight or flight response, which of the following is not a common location for arteriole vasoconstriction?
skin
digestive organs
brain
kidneys
select the following hormone(s) that specifically constrict the afferent arterioles during fight or flight.
epinephrine
norepinephrine
cortisol
parathyroid hormone
antrial natriuretic peptide
during hemorrhagic shock, which of the following events will cause the glomeruli to initiate the renin-angiotensin mechanism?
high blood pressure
low blood pressure
decreased ADH production
increased aldosterone release
all of these are correct
which of the following is not an effect of the renin-angiotensin mechanism?
increased vasodilation
increased aldosterone release
increased ADH
increase in water reabsorption back into the blood
these are all correct
which of the following fluids are assumed when talking about the extracellular fluids? select more than one if applicable.
plasma
interstitial fluid
cerebrospinal fluid
intracellular fluid
none of these are correct
urine production is usually adjusted via changed in NFP and GFR.
true
false
which of the following is what causes most adjustments to urine production? select multiple if applicable.
ADH
aldosterone
atrial natriuretic peptide
NFP
G
The most abundant intracellular cation is-
sodium
potassium
chloride
magnesium
all of these are correct
what is the normal range of potassium ions in the extracellular fluid?
3.5-4.5 mEq/L
1.2-2.4 mEq/L
2.5-5.5 mEq/L
6.8-9.9 mEq/L
the normal pH of blood is (a)
Reorder the following based on their frequency of occurence.
respiratory acidosis
metabolic acidosis
respiratory alkalosis
metabolic alkalosis
which type of feedback mechanisms adjust and affect input (thirst) and output (urine)?
negative feedback mechanisms
positive feedback mechanisms
countercurrent multiplier feedback mechanisms
countercurrent exchanger feedback mechanisms
two of these are correct
where may you find osmoreceptors in the brain?
thalamus
medulla oblongata
pons
hypothalamus
you reabsorb about (a) % of filtrate back into the blood.
all nephrons must go through the medullary layer of the kidney. which of the following is reabsorbed at this layer? how?
potassium; the isotonic environment of the medulla causes diffusion
sodium; the hypotonic environment of the medulla causes diffusion
water; the hypertonic environment of the medulla causes osmosis
water; the hypotonic environment of the medulla causes diffusion
sodium; he hypertonic environment of the medulla causes diffusion
which of the following descriptions best describes how the countercurrent multiplier and exchangers work?
they filter blood plasma directly into the renal pelvis for urine formation
they occur in the kidneys and keep the medullary layer of kidney tissue concentrated and hypertonic so water can be reabsorbed by osmosis
they actively pump water out of the collecting ducts to form concentrated urine
they increase the blood pressure inside the glomerulus to enhance filtration
all of these are true
osmoreceptors will crenate when their environment becomes hypertonic.
true
false; osmoreceptors will swell
false; osmoreceptors crenate when in isotonic environments due to their high solvent nature
false; osmoreceptors creante due to hypertonic AND isotonic environments
Reorder the following.
you eat a salty meal causing osmoreceptors to shrink
nerve impulses are sent to the posterior pituitary gland
posterior pituitary gland releases ADH and simultaneously saliva production is slowed
ADH circulates throughout the body and will eventually have its effects at the kidneys
water is put back into the blood and osmoreceptor environment returns to normal
excess urine production can be described using the term-
diuretics
hyperuresis
diarrhea
diuresis
atriuresis
categorize the following depending on which category of diuretics they belong to.
will inhibit water reabsorption
caffiene
Lasix
HCTZ
glucose in DM
mannitol
which of the following statements is the most correct of how diabetes mellitus acts as an osmotic?
if blood glucose levels are high, the kidneys become overwhelmed and cannot reabsorb it all, resulting in glucose leaving via urine and water following it
diabetes mellitus causes the kidneys to directly increase sodium excretion, which forces water to leave the body through urine
high insulin levels in diabetes mellitus stimulate the kidneys to remove excess water through active transport mechanisms
diabetes mellitus increases aldosterone secretion, which reduces water reabsorption and leads to water loss in urine
mannitol can be reabsorbed at the kidneys, hence its use for treating cerebral edema.
true
false; mannitol is not used to treat cerebral edema
false; mannitol is not reabsorbed at the kidneys
false; mannitol is used to treat severe cases of high glucose levels in DM patients
where may you find proteins at in the fluid compartments? select multiple if applicable
extracellular fluid
plasma
interstitial fluid
intracellular fluid
none of these are correct
which of the following structures separates ISF and plasma?
capillaries
cell membranes
protein chains
two of these are correct
none of these are correct
cell membranes are more selective than capillary walls.
true
false
categorize the following depending on where they are most abundant.
potassium
chloride
sodium
hydrogen phosphate
calcium
bicarbonate ions
what is the tendency of a solution to attract water?
osmosis
net filtration pressure
diffusion
two of these are correct
in which of the following scenarios are rapid alterations of plasma protein concentrations most likely to change?
kidney failure
urinary tract infections
severe third degree burns
kidney inhibition
you may estimate osmolarity based on-
sodium concentrations
potassium concentrations
chloride concentrations
sodium and potassium inverse concentrations
what is the normal osmolality of the blood?
280-350
250-280
280-320
120-220
none of these are correct
determine if the following patients blood osmolality is normal, hypotonic or hypertonic based on their sodium concentration lab results.
145mEq/L
160mEq/L
140mEq/L
150mEq/L
180mEq/L
130mEq/L
120mEq/L
135mEq/L
which of the following substances can move freely between the membranes?
sodium
water
bicarb
anion proteins
plasma
which of the following scenarios is likely to cause fluid shifts between the membranes?
none of these are correct
isotonic osmoreceptor environment
alteration in water volume
alterations in electrolytes and their concentrations
if pamela is a 32 year old woman, what should you expect her calcium ion concentration to be in her extracellular fluid?
20-32 mEq/L
2.5-5.5 mEq/L
9-10 mg/dl
2.5-5.5 mg/dl
categorize the following information about calcium.
reservoir for 99% of calcium
most of remaining 1% is stored here
a small fraction of the remaining 1%
alterations may cause heart arrythmias may occur
is the most important location of calcium
which of the following is not a target tissue of PTH?
bones
small intestine
kidneys
stomach
about what percentage of calcium is absorbed in the small intestine?
10%
20%
30%
40%
if henry's sodium levels are 152mEq/L, is this normal?
yes
no, his levels should be between 125-135mEq/L
no, his levels should be between 135-145mEq/L
none of these are are correct
what is the number one most influential cation on osmotic pressure?
sodium
chlorine
potassium
bicarb
Which of the following hormones regulate ECF concentrations of sodium?
ANP
ADH
PTH
aldosterone
Sodium levels can be measured in the body at the kidneys.
true
false
the extreme low and high of for pH is ___-___. (format as #.#-#.#; no spaces)
(a)
a patient is receiving an intravenous infusion of 0.9% normal saline (NS). which of the following best describes the effect this solution will have on the patient’s red blood cells?
the cells will swell and burst because the solution is hypotonic
the cells will shrink because the solution is hypertonic
the cells will maintain their normal size because the solution is isotonic
the cells will lyse immediately because of the high osmolarity of sodium in the solution
a trauma patient presents with severe blood loss and needs rapid fluid replacement. which IV solution is most appropriate to administer initially to maintain plasma volume and minimize fluid shifts between compartments?
0.45% sodium chloride (half-normal saline)
dextrose 5% in water (D5W)
mannitol
0.9% sodium chloride (normal saline)
a physician orders mannitol for a patient with cerebral edema following a traumatic brain injury. how does mannitol help reduce the swelling?
it dilutes the plasma, causing water to move into brain tissue
it acts as a hypertonic solution, drawing water out of brain cells into the bloodstream to be excreted by the kidneys
it increases plasma sodium levels, forcing water to remain inside the vasculature
it directly shrinks neurons by disrupting their plasma membranes
a nurse is administering 0.45% sodium chloride (half-normal saline) to a severely dehydrated patient. why is this hypotonic solution infused slowly and carefully?
to allow gradual fluid movement from plasma into interstitial and intracellular spaces without causing cells to burst
because hypotonic solutions are hyperosmolar and can shrink cells rapidly if infused too fast
to prevent water from being trapped in the vasculature, leading to hypertension
to avoid diluting plasma sodium too quickly, which could cause cellular dehydration
which of the following IV solution substances is most similar in composition to plasma?
0.9% sodium chloride (normal saline)
dextrose 5% in water (D5W)
lactated Ringer's solution (LR)
0.45% sodium chloride (half-normal saline)
a patient’s arterial blood gas reveals a pH of 7.28. which of the following best describes this condition?
the patient is in alkalosis due to excessive bicarbonate
the patient is hyperkalemic but pH is within normal limits
the patient is in acidosis due to excess hydrogen ions or insufficient bicarbonate
the patient's pH is too high, indicating respiratory alkalosis
which of the following is a primary effect of acidosis on the central nervous system (CNS)?
depression of neuronal activity, resulting in lethargy, confusion, and possible coma
overexcitation of neurons, leading to seizures
increased sympathetic nervous system activity, causing severe anxiety
irregular electrical conduction, leading to ventricular fibrillation
a patient is experiencing metabolic acidosis. which of the following respiratory patterns would you expect as a compensatory mechanism?
slow, shallow breathing (hypoventilation) to retain CO2
rapid, deep breathing (hyperventilation) to blow off excess CO2.
periodic breath-holding to prevent CO2 loss.
breathing patterns would not change as compensation is renal-only.
if hypoventilation is the primary cause of acidosis, which organ system must compensate to help restore acid-base balance?
cardiovascular system through increased heart rate
liver through increased ammonia production
kidneys through increased bicarbonate reabsorption and hydrogen ion excretion
muscular system through lactic acid buffering
a patient's arterial blood gas reveals a pH of 7.52. which of the following best describes this condition?
the patient is in alkalosis due to excessive bicarbonate or loss of hydrogen ions
the patient is in acidosis due to hydrogen ion retention
the patient is hyperkalemic, which causes alkalosis
the patient's pH is normal, but shows signs of metabolic acidosis compensation
Which of the following best explains why a patient in alkalosis might experience muscle spasms and tetany?
high pH causes sodium to bind plasma proteins, reducing action potentials
excess bicarbonate blocks acetylcholine receptors at neuromuscular junctions
alkalosis shifts calcium to intracellular stores, causing hypocalcemia and making neurons and muscles more excitable
the central nervous system is depressed, causing irregular muscle activity
a patient has numbness and tingling in their fingers and lips, appears nervous and jittery, and is hyperventilating. Which of the following is the most likely acid-base disturbance?
respiratory acidosis
metabolic alkalosis without respiratory involvement
respiratory alkalosis
metabolic acidosis
if a patient is hyperventilating, how does this influence arterial blood pH?
CO2 levels decrease, raising blood pH and causing alkalosis
CO2 levels increase, lowering blood pH and causing acidosis
increased CO2 binding to hemoglobin raises blood pH
bicarbonate is retained, resulting in metabolic acidosis
which of the following statements explains why resting membrane potentials (RMPs) in skeletal muscle are closer to threshold in alkalosis?
low extracellular calcium fails to stabilize voltage-gated sodium channels, making them open prematurely
excess bicarbonate blocks potassium channels, depolarizing the membrane
high extracellular calcium blocks voltage-gated calcium channels, preventing repolarization
hydrogen ions buffer sodium channels, preventing their activation
categorize the following scenarios
hyperventilation due to emotions
excessive vomiting or suction of stomach chemicals
excessive ingestion of sodium bicarbonate antacids
hypovolemic shock or hemorrhagic shock
aspirin overdose (acetylsalicylic acid)
COPD late stages, or cystic fibrosis
uncontrolled diabetes mellitus
partial heart failure: cardiac output and tissue perfusion is reduced
diuretics that deplete K+ (also tend to deplete H+)
severe diarrhea
starvation
Severe obesity hypoventilation syndrome
neuromuscular disorders (e.g., myasthenia gravis, guillain-barré)
Severe asthma attack
pain-induced hyperventilation
heat-stroke
