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2nd year

Total questions: 80

Worksheet time: 40mins

Name
Class
Date
1.

Which part of the nephron is the primary site of obligatory water reabsorption?

a)

Proximal convoluted tubule

b)

Distal convoluted tubule

c)

Collecting duct

d)

Loop of Henle

2.

The glomerular filtration barrier prevents passage of proteins based on what property?

a)

Size and positive charge

b)

Size and negative charge

c)

Length and width

d)

Only molecular weight

3.

Which nerve provides parasympathetic innervation for bladder contraction?

a)

Hypogastric nerve

b)

Pelvic nerve

c)

Pudendal nerve

d)

Phrenic nerve

4.

What is the primary function of the countercurrent multiplier?

a)

Excrete glucose

b)

Create medullary hyperosmolarity

c)

Reabsorb all potassium

d)

Secrete renin

5.

Atonic bladder is typically caused by damage to which structure?

a)

Sensory nerve fibers

b)

Brainstem

c)

Cerebral cortex

d)

Urethra

6.

Which substance is used clinically to estimate GFR?

a)

Inulin

b)

Creatinine

c)

Para-aminohippurate (PAH)

d)

Urea

7.

Net filtration pressure is determined by which combination of Starling forces?

a)

PG−PB−πGP_G - P_B - \pi_G

b)

PG+PB+πGP_G + P_B + \pi_G

c)

PB−PGP_B - P_G

d)

πG−PG\pi_G - P_G

8.

Aldosterone primarily acts on which renal cells?

a)

Principal cells of the collecting duct

b)

Macula densa

c)

Podocytes

d)

Thin limb of the loop of Henle

9.

Hypernatremia is most likely caused by:

a)

Excess water intake

b)

Diabetes Insipidus

c)

SIADH

d)

Excessive beer drinking

10.

The thick ascending limb is often called the "diluting segment" because it is:

a)

Permeable to water

b)

Impermeable to water but reabsorbs solutes

c)

Permeable to urea

d)

Secretes Na

11.

Which diuretic class causes hypokalemia and metabolic alkalosis?

a)

Carbonic anhydrase inhibitors

b)

Loop diuretics

c)

Spironolactone

d)

Amiloride

12.

Mechanism of action of Acetazolamide:

a)

Inhibits Na/K pump

b)

Inhibits Carbonic Anhydrase

c)

Blocks ADH

d)

Blocks Aldosterone

13.

Primary intracellular cation is:

a)

Sodium

b)

Potassium

c)

Calcium

d)

Magnesium

14.

Normal GFR in a healthy adult is approximately:

a)

50 mL/min

b)

125 mL/min

c)

180 mL/min

d)

600 mL/min

15.

Which factor increases GFR?

a)

Constriction of afferent arteriole

b)

Dilation of afferent arteriole

c)

Constriction of efferent arteriole

d)

Both B and C

16.

"Facultative" water reabsorption is controlled by:

a)

Insulin

b)

ADH

c)

Glucagon

d)

Renin

17.

Acute Kidney Injury (AKI) caused by kidney stones is classified as:

a)

Prerenal

b)

Intrinsic

c)

Postrenal

d)

Functional

18.

Nephrotic syndrome is characterized by:

a)

Hematuria

b)

Heavy proteinuria >3.5g/day

c)

Hypotension

d)

Low cholesterol

19.

Which bacteria is the most common cause of UTI?

a)

Proteus

b)

E. coli

c)

Staphylococcus

d)

Klebsiella

20.

Hydronephrosis is defined as:

a)

Inflammation of the glomerulus

b)

Dilation of renal pelvis due to obstruction

c)

Infection of the bladder

d)

Kidney cyst

21.

Thirst is stimulated by:

a)

Decreased plasma osmolarity

b)

Increased plasma osmolarity

c)

Increased blood volume

d)

Low Angiotensin II

22.

The Anion Gap is useful in diagnosing:

a)

Metabolic Acidosis

b)

Respiratory Alkalosis

c)

Hypercalcemia

d)

Diabetes Insipidus

23.

Compensation for Respiratory Acidosis involves:

a)

Renal HCO3- retention

b)

Hyperventilation

c)

Renal HCO3- excretion

d)

Vomiting

24.

Which drug is an Osmotic Diuretic?

a)

Furosemide

b)

Mannitol

c)

Hydrochlorothiazide

d)

Spironolactone

25.

"Automatic Bladder" occurs after spinal cord injury:

a)

Below sacral segments

b)

Above sacral segments

c)

In the brain

d)

In the peripheral nerves

26.

Obligatory urine volume for a 70kg man is approximately:

a)

100 mL

b)

500 mL

c)

2000 mL

d)

5000 mL

27.

Specific gravity of 1.001 indicates:

a)

Concentrated urine

b)

Dilute urine

c)

Normal urine

d)

Presence of protein

28.

Renal threshold for glucose is:

a)

100 mg/dL

b)

180 mg/dL

c)

300 mg/dL

d)

375 mg/dL

29.

Type A Intercalated cells secrete:

a)

HCO3-

b)

H+ ions

c)

K+ ions

d)

Sodium

30.

Principal cells secrete:

a)

H+

b)

K+

c)

Glucose

d)

Amino acids

31.

Vasa Recta preserve medullary gradient via:

a)

Active transport

b)

Countercurrent exchange

c)

Osmosis

d)

Filtration

32.

Angiotensin II blockers (ARBs) can cause:

a)

Hypokalemia

b)

Hyperkalemia

c)

Hypernatremia

d)

Hypertension

33.

Central Diabetes Insipidus is treated with:

a)

Desmopressin

b)

Insulin

c)

Furosemide

d)

Thiazides

34.

WBC casts in urine are indicative of:

a)

Cystitis

b)

Pyelonephritis

c)

Glomerulonephritis

d)

Bladder stone

35.

Most common cause of chronic pyelonephritis:

a)

High protein diet

b)

Vesicoureteral reflux

c)

Low water intake

d)

Hypertension

36.

Histology: The bladder is lined by:

a)

Columnar epithelium

b)

Transitional epithelium

c)

Squamous epithelium

d)

Cuboidal epithelium

37.

Anti-diuretic hormone (ADH) acts on which receptor in the kidney?

a)

V1

b)

V2

c)

Alpha-1

d)

Beta-2

38.

Which condition causes Hyperosmotic Volume Expansion?

a)

Diarrhea

b)

Excessive NaCl intake

c)

Infusion of Isotonic Saline

d)

Adrenal insufficiency

39.

Acute Glomerulonephritis typically presents with:

a)

Hematuria and hypertension

b)

Polyuria

c)

Hypotension

d)

Weight loss

40.

Myogenic mechanism responds to:

a)

Low salt

b)

Increase in arterial pressure (stretch)

c)

High pH

d)

ADH

41.

Primary stimulus for Renin release:

a)

High blood pressure

b)

Low Sodium at Macula Densa

c)

High blood volume

d)

Low K+

42.

Urea recycling occurs between the collecting duct and:

a)

PCT

b)

Loop of Henle

c)

DCT

d)

Bowman's capsule

43.

A pH of 7.2 with high pCO2 is:

a)

Metabolic Acidosis

b)

Respiratory Acidosis

c)

Metabolic Alkalosis

d)

Respiratory Alkalosis

44.

A patient with COPD usually has:

a)

Respiratory Alkalosis

b)

Respiratory Acidosis

c)

Metabolic Acidosis

d)

Normal pH

45.

In histology, Umbrella cells are found in:

a)

Stomach

b)

Bladder

c)

Liver

d)

Lung

46.

Gastritis is defined as:

a)

Inflammation of the gastric mucosa

b)

Ulcer in the duodenum

c)

Infection of the colon

d)

High acid secretion

47.

Most common cause of chronic gastritis:

a)

Alcohol

b)

H. pylori

c)

NSAIDs

d)

Smoking

48.

Peptic Ulcer Disease (PUD) most commonly occurs in:

a)

Esophagus

b)

Stomach and Duodenum

c)

Jejunum

d)

Ileum

49.

A punched-out mucosal defect with straight margins is:

a)

Gastric Cancer

b)

Peptic Ulcer

c)

Gastritis

d)

Polyp

50.

Drug of choice for H. pylori eradication:

a)

Loperamide

b)

PPI + Antibiotics

c)

Antacids

d)

Magnesium sulfate

51.

Loperamide is used as an:

a)

Antacid

b)

Anti-diarrheal

c)

Antibiotic

d)

Laxative

52.

Mechanism of Loperamide:

a)

Blocks H2 receptors

b)

Stimulates Mu-opioid receptors in gut

c)

Neutralizes acid

d)

Increases motility

53.

Bismuth subsalicylate is used for:

a)

Constipation

b)

Traveler’s Diarrhea

c)

Diabetes

d)

Hypertension

54.

Common side effect of Aluminum-containing antacids:

a)

Diarrhea

b)

Constipation

c)

Flatulence

d)

Cough

55.

Mechanism of Proton Pump Inhibitors (PPIs):

a)

Blocks H2 receptors

b)

Irreversibly inhibits H+/K+ ATPase

c)

Blocks M3 receptors

d)

Blocks Gastrin

56.

Acute Hemorrhagic Gastritis is frequently caused by:

a)

NSAIDs/Aspirin

b)

Yogurt

c)

Exercise

d)

High fiber

57.

Which anti-diarrheal is an adsorbent?

a)

Loperamide

b)

Kaolin-Pectin

c)

Diphenoxylate

d)

Codeine

58.

Chronic atrophic gastritis can lead to:

a)

Iron deficiency

b)

Pernicious anemia (Vit B12 deficiency)

c)

Weight gain

d)

Low pH

59.

"Curling Ulcer" is associated with:

a)

Brain injury

b)

Severe burns

c)

Smoking

d)

Alcohol

60.

"Cushing Ulcer" is associated with:

a)

Burns

b)

Increased intracranial pressure

c)

Sepsis

d)

Aspirin

61.

ORS (Oral Rehydration Salts) contains:

a)

Only water

b)

Na, K, chloride, and glucose

c)

Only sugar

d)

Protein

62.

Which nerve increases gastric acid secretion?

a)

Sympathetic

b)

Vagus

c)

Phrenic

d)

Sciatic

63.

The primary risk factor for bladder cancer is:

a)

Alcohol

b)

Smoking

c)

High salt

d)

Obesity

64.

"Free Water Clearance" is zero when:

a)

Urine is concentrated

b)

Urine is isosmotic with plasma

c)

Urine is dilute

d)

ADH is high

65.

Potassium-sparing diuretics act on:

a)

Loop of Henle

b)

Late distal tubule/collecting duct

c)

Proximal convoluted tubule

d)

Glomerulus

66.

Major symptom of acute pyelonephritis:

a)

Flank pain and fever

b)

Painless hematuria

c)

Diarrhea

d)

Weight gain

67.

Filtration fraction normally is:

a)

10%

b)

20%

c)

50%

d)

100%

68.

Renal blood flow is about what percent of cardiac output?

a)

5%

b)

10%

c)

20–25%

d)

50%

69.

Hypokalemia can cause which ECG change?

a)

Tall T waves

b)

U waves

c)

Short PR interval

d)

Wide QRS

70.

Primary hormone regulating plasma calcium is:

a)

Aldosterone

b)

Parathyroid hormone (PTH)

c)

ADH

d)

Thyroxine

71.

Metabolic acidosis with a normal anion gap is seen in:

a)

Diabetic ketoacidosis

b)

Diarrhea

c)

Lactic acidosis

d)

Starvation

72.

"Umbrella cells" are characteristic of:

a)

Endothelium

b)

Urothelium

c)

Mesothelium

d)

Myocardium

73.

The detrusor muscle is:

a)

Skeletal muscle

b)

Smooth muscle

c)

Cardiac muscle

d)

Voluntary

74.

ADH secretion is inhibited by:

a)

Pain

b)

Alcohol

c)

Nicotine

d)

Morphine

75.

Most common pathogen for traveler's diarrhea:

a)

Shigella

b)

Enterotoxigenic Escherichia coli (ETEC)

c)

Salmonella

d)

Giardia

76.

Which diuretic is used to treat glaucoma?

a)

Furosemide

b)

Acetazolamide

c)

Mannitol

d)

Spironolactone

77.

Intracellular fluid makes up what fraction of total body water?

a)

1/3

b)

2/3

c)

1/4

d)

1/2

78.

Isosmotic volume contraction occurs in:

a)

Hemorrhage

b)

Sweating

c)

Diabetes insipidus

d)

Water deprivation

79.

Which cells secrete pepsinogen in the stomach?

a)

Parietal cells

b)

Chief cells

c)

G-cells

d)

Mucous cells

80.

Parietal cells secrete:

a)

Pepsin

b)

HCl and intrinsic factor

c)

Gastrin

d)

Somatostatin

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