WorksheetsRenal Physiology Worksheet – Grade 13
Total questions: 47
Worksheet time: 24mins
A 45-year-old man has a glomerular filtration rate of 120 mL/min and a plasma glucose of 400 mg/dL. If the transport maximum for glucose is 375 mg/min, what is the glucose excretion rate?
0 mg/min
25 mg/min
105 mg/min
480 mg/min
Which part of the nephron is known as the diluting segment because it reabsorbs solutes but is impermeable to water?
Proximal convoluted tubule
Descending limb of the loop of Henle
Thick ascending limb of the loop of Henle
Medullary collecting duct
A patient presents with severe edema. Which of the following changes would increase the glomerular filtration rate?
Constriction of the afferent arteriole
Constriction of the efferent arteriole
Increased plasma colloid osmotic pressure
Increased hydrostatic pressure in Bowman’s capsule
In the presence of maximum antidiuretic hormone, the highest osmolality of tubular fluid is found in which part?
Bowman’s capsule
End of the proximal tubule
Tip of the loop of Henle
Early distal tubule
A patient with uncontrolled diabetes mellitus develops ketoacidosis. Which renal mechanism is most important for excreting the excess H+ ?
Increased reabsorption of glucose
Increased secretion of NH4+
Decreased filtration of bicarbonate
Inhibition of the Na+/H+ exchanger
Which substance is used to measure effective renal plasma flow because it is both filtered and highly secreted?
Inulin
Creatinine
Para-aminohippuric acid (PAH)
Glucose
An increase in the concentration of which of the following tends to decrease the glomerular filtration rate?
Atrial natriuretic peptide
Glucocorticoids
Plasma proteins
Prostaglandins
In a patient with primary aldosteronism (Conn’s syndrome), which of the following is expected?
Hypotension and hyperkalemia
Hypertension and hypokalemia
Hypotension and hyponatremia
Metabolic acidosis
The myogenic mechanism of renal autoregulation involves the response of which vessel to increased blood pressure?
Efferent arteriole
Afferent arteriole
Peritubular capillaries
Vasa recta
Which part of the nephron reabsorbs the majority (approximately 85%) of filtered bicarbonate?
Proximal tubule
Loop of Henle
Distal tubule
Collecting duct
A 60-year-old woman is treated with furosemide (a loop diuretic). Which transport system is inhibited?
Na+-glucose cotransporter
Na+-K+-2Cl- cotransporter
Na+-Cl- cotransporter
H+-ATPase
What is the effect of moderate levels of Angiotensin II on renal hemodynamics?
Preferential constriction of afferent arterioles
Preferential constriction of efferent arterioles
Dilation of both arterioles
Decrease in Filtration Fraction
Which of the following is the primary stimulus for the secretion of Renin?
Increased NaCl delivery to the macula densa
Decreased NaCl delivery to the macula densa
Increased stretch of the afferent arteriole
Parasympathetic stimulation
A patient has a plasma creatinine of 2.0 mg/dL (Baseline = 1.0 ). What is the estimated change in GFR?
GFR has doubled
GFR has decreased by 25%
GFR has decreased by 50%
GFR remains unchanged
Which segment of the loop of Henle is highly permeable to water but almost impermeable to solutes?
Thin descending limb
Thin ascending limb
Thick ascending limb
Cortical collecting duct
Central Diabetes Insipidus is characterized by a lack of ADH. What is the expected urine profile?
Low volume, high osmolality
High volume, high osmolality
High volume, low osmolality
Low volume, low osmolality
What happens to the filtration fraction (FF = GFR/RPF) if the afferent arteriole is constricted?
Increases
Decreases
Remains constant
Becomes zero
Which cell type in the late distal tubule is responsible for K + secretion?
Intercalated Type A cells
Intercalated Type B cells
Principal cells
Macula densa cells
A patient consumes a high-protein diet. What is the expected effect on GFR?
Decreases GFR due to afferent constriction
Increases GFR due to increased amino acid–sodium reabsorption
No effect on GFR
Decreases GFR to conserve urea
The macula densa cells are located in which part of the nephron?
End of the proximal tubule
Beginning of the thin descending limb
Initial portion of the distal tubule
Medullary collecting duct
Which hormone decreases the reabsorption of phosphate in the proximal tubule?
Insulin
Parathyroid Hormone (PTH)
Aldosterone
Vasopressin
Calculate the Renal Blood Flow (RBF) if Renal Plasma Flow is 600 mL/min and Hematocrit is 40% .
360 mL/min
1000 mL/min
1200 mL/min
1500 mL/min
What is the effect of strong sympathetic stimulation on Renal Blood Flow?
Marked increase in renal blood flow due to vasodilation
Marked decrease in renal blood flow due to intense vasoconstriction
No significant change in renal blood flow
Transient increase followed by normalization
Which buffer system is the most important for "titratable acid" excretion in the urine?
Bicarbonate buffer
Phosphate buffer
Ammonium buffer
Protein buffer
A patient with Addison’s disease (adrenal insufficiency) will likely show:
Hypernatremia and hypokalemia
Hyponatremia and hyperkalemia
Hypertension and alkalosis
Normal electrolyte levels
Excessive consumption of natural licorice can lead to hypertension because it inhibits 11β-HSD2, allowing which hormone to activate mineralocorticoid receptors?
Estrogen
Cortisol
Thyroxine
Glucagon
The kidney’s ability to concentrate urine depends on the high osmolarity of the renal medullary interstitium. Which molecule contributes roughly 50% of this osmolarity?
Sodium
Glucose
Urea
Potassium
Which of the following is NOT normally filtered through the glomerular capillaries?
Glucose
Amino acids
Myoglobin
Plasma albumin
Thiazide diuretics act primarily on which segment?
Proximal tubule
Thick ascending limb
Early distal tubule
Collecting duct
What is the renal response to metabolic alkalosis?
Increased secretion of H+
Increased excretion of HCO3−
Increased production of NH4+
Decreased urine pH
An increase in plasma colloid osmotic pressure has what effect on GFR?
Increases GFR
Decreases GFR
No effect
Increases filtration fraction
The stimulation of Atrial Natriuretic Peptide (ANP) leads to:
Afferent constriction and efferent dilation
Afferent dilation and efferent constriction
Increased sodium reabsorption
Increased renin secretion
Which substance has a renal clearance of zero under normal physiological conditions?
Urea
Sodium
Glucose
Inulin
Bartter’s Syndrome (a genetic defect in the NKCC2 transporter) mimics the effect of which diuretic?
Thiazides
Acetazolamide
Furosemide
Spironolactone
The vasa recta play a crucial role in:
Generating the medullary osmotic gradient
Maintaining the medullary osmotic gradient via countercurrent exchange
Active transport of sodium into the medulla
Reabsorbing 100% of filtered glucose
The clearance of Inulin is the gold standard for measuring:
Renal Plasma Flow
Renal Blood Flow
Glomerular Filtration Rate
Tubular Secretion Rate
A rise in peritubular capillary hydrostatic pressure will:
Increase net reabsorption of fluid
Decrease net reabsorption of fluid
Have no effect on reabsorption
Increase GFR
Carbonic anhydrase inhibitors (Acetazolamide) act primarily on which segment?
Proximal Tubule
Loop of Henle
Distal Tubule
Collecting duct
"Renal Glycosuria" (glucose in urine with normal blood sugar) is usually caused by:
Diabetes Mellitus
Genetic defect in SGLT2 transporters
High protein intake
Excess Aldosterone
What happens to the anion gap in metabolic acidosis caused by diarrhea?
It increases
It remains normal (Hyperchloremic acidosis)
It decreases
It becomes negative
Urea reabsorption in the medullary collecting ducts is significantly increased by:
Aldosterone
ADH (Vasopressin)
PTH
ANP
The majority of filtered Magnesium (65%) is reabsorbed in which segment?
Proximal Tubule
Thick Ascending Limb of Henle
Distal Tubule
Collecting Duct
Parathyroid hormone (PTH) increases calcium reabsorption in the:
Proximal Tubule
Descending limb
Distal Tubule
Bowman's capsule
The descending limb of the loop of Henle is:
Impermeable to water
Highly permeable to water
Actively transports Sodium
Reabsorbs Bicarbonate
Liddle’s Syndrome (hypertension and hypokalemia) is caused by:
Overactivity of ENaC channels
Lack of Aldosterone
Failure of the Na–K pump
Defect in the Loop of Henle
Which of the following increases K+ secretion by the principal cells?
Low sodium diet
High tubular fluid flow rate
Metabolic acidosis
Epinephrine
Renal clearance of PAH is a marker for:
GFR
Renal Plasma Flow
Filtration Fraction
