MCQs on Physiology for Staff Nurse and Medical Exams

1)The GFR is increased by:
A. Vasoconstriction in the afferet arteriole.
B. An increase in capsular hydrostatic pressure.
C. An increase in the surface area of glomerular capillaries
D. A decrease in the capillary filteration coefficient.
E. An increase in the plasma colloid osmotic pressure.


(2) In the collecting ducts:
A. 65% of the water in the glomerular filterate is reabsorbed.
B. Urea is completely reabsorbed.
C. 80% of sodium cloride in the glomerular filterate is reabsorbed.
D. Urine osmolarity reaches 4 times as much as plasma
E. A DH decreases permeability to water.


(3) In the proximal convoluted tubule:
A. 30% of water from the glomular filterate is reabsorbed.
B. Glomular filtrate is hypertonic with plasma .
C. Sodium is actively secreted .
D. Glomular filtrate is isotonic with plasma .
E. Potassium ions are passively secreted .


(4) Renin-angiotensin system is stimulated by :
A. Increased renal blood flow.
B. Low serum K+ levels.
C. Increased arterial blood pressure.
D. Low serum sodium levels.
E. Increased glomerular filteration rate.


(5) Any substance filtered by the glomeruli, reabsorbed but not secreted will have renal clearance :
A. Equal to GFR.
B. Less than the clearance of glucose.
C. Equal to clearance of amino acids.
D. Less than the clearance of inulin.
E. Equal to clearance of PAH.


(6) Micturition:
A. A feeling of urgency arises when bladder contains 80 ml of urine.
B. Is influenced by ihibitory & facilitory centres in brain stem & cerebral cortex.
C. Is initiated if intravesicular pressure reaches 1.0 cm of water.
D. Involves contraction of external sphincter of bladder.
E. Is stimulated by motor sympathetic impulses.


(7) An enzyme that causes renal formation of ammonia is:
A. Adenylate cyclase.
B. Glutaminase.
C. Renin.
D. Carbonic anhydrase.
E. An ATPase.


(8) Renal tubules normally reabsorb the following Except:
A. 90% of glucose.
B. All filtered bicarbonates in respiratory acidosis.
C. All filtered amino acids.
D. More potassium than chloride.
E. Part of the filtered urea.


(9) Glucose:
A. Is only absorbed in proximal convoluted tubule.
B. Is completely reabsorbed in the distal tubule.
C. Has a plasma clearance equal to GFR.
D. Is filtered by the glomeruli & passively reabsorbed.
E. Has a Tm equal to 180-200 mg/min.


(10) Normal aldosterone secretion tends to raise the volume of:
A. Urine.
B. Interstitial fluid.
C. Cerebrospinal fluid.
D. Intracellular fluid.
E. Transcellular fluid.

11. The kidneys contribute to calcium homeostasis by secreting:
a. Renin
b. Angiotensin II
c. Erythropoitein
d. 1,25 dihydroxycholecalciferol


12. Which of the following leads to a decrease in the GFR?
a. Increase in blood pressure.
b. Blockage of the ureter by a stone.
c. Increase in filtration coefficient (Kf).
d. Vasodilation of the afferent arteriole.


13. Which one of the following parts of a nephron reabsorbs potassium maximally?
a. Proximal tubule.
b. Loop of Henle.
c. Distal tubule.
d. Collecting duct.


14. The reabsorption of amino acids from the renal tubular lumen into the cells:
a. Is a passive process.
b. Is a primary active process.
c. Occurs mainly in the distal tubule.
d. Depends on the presence of sodium in the filtrate.


15. When the dietary intake of K+ increases, body K+ balance is maintained by an increase in K+ excretion primarily by which of the following?
a. Decreased glomerular filtration of K+.
b. Decreased K+ reabsorption by the proximal tubule.
c. Decreased K+ reabsorption by the loop of Henle.
d. Increased K+ secretion by the late distal and collecting tubules.


16. Aldosterone acts on principal cells in cortical collecting ducts to:
a. Increase calcium secretion
b. Increase potassium secretion
c. Decrease sodium reabsorption
d. Decrease water permeability


17. Which of the following is the effect of antidiuretic hormone (ADH) on the kidney?
a. Increased permeability of the distal nephron to water.
b. Decreased excretion of sodium.
c. Increased excretion of water.
d. Increased diameter of the renal artery.


18. Hyponatremia (deceased plasma sodium concentration) will result from excess secretion of which of the following?
a. Vasopressin (ADH)
b. Atrial natriuretic hormone (ANP)
c. Norepinephrine
d. Angiotensin II


19. The effect of PTH on the kidney is to:
a. Increase Ca excretion and increase phosphate excretion
b. Increase Ca excretion and decrease phosphate excretion
c. Decrease Ca excretion and increase phosphate excretion
d. Decrease Ca excretion and decrease phosphate excretion


20. Which one of the following takes place when the plasma osmolarity increases?
a. Decrease in water intake
b. Decreased ADH secretion
c. Retention of water
d. Increase aldosterone secretion

22. In which of the following situations is urinary volume less than normal?
a. Diabetes mellitus
b. Diabetes insipidus
c. Sympathetic stimulation
d. Increased renal arterial pressure


23. Poor kidney function can be confirmed by an elevated blood level of?
a. Glucose
b. Protein
c. Creatinine
d. Bilirubin


24. Concerning renal function tests:
a. PAH clearance is used to measure GFR.
b. Inulin clearance is used to estimate renal plasma flow.
c. Creatinine clearance can be clinically used to estimate GFR.
d. Blood urea concentration is an accurate index of renal function.


25. The kidneys contribute to homeostasis by regulating:
a. Body temperature
b. Blood glucose level
c. Extracellular fluid pH
d. Plasma aldosterone level


26. GFR would be increased by which of the following?
a. A decrease in renal blood flow.
b. Constriction of the afferent arteriole.
c. A decrease in the plasma protein concentration.
d. A decrease in glomerular capillary hydrostatic pressure.


27. Hydrostatic pressure in renal glomerular capillaries:
a. Is lower than pressure in efferent arterioles.
b. Rises when efferent arterioles constrict.
c. Is lower than in most capillaries.
d. Equals to 18 mm Hg.


28. What percentage of the filtered load of water is reabsorbed by the proximal tubule?
a. 15%
b. 25%
c. 65%
d. 95%


29. As the tubular fluid flows through the proximal tubule:
a. The urea concentration falls.
b. There is a decrease in the volume of the fluid.
c. The concentration of glucose increase.
d. The osmolality of the fluid increases.


30. Which of the following nephron segments is the primary site for potassium secretion?
a. Proximal tubule.
b. Descending limb of the loop of Henle.
c. Ascending limb of the loop of Henle.
d. Late distal and collecting tubules.

31. Renal nerve sympathetic stimulation causes:
a. Increased sodium excretion
b. Stimulation of renin release
c. Increased GFR
d. Increased ANP release.


32. Aldosterone secretion is increased when there is an increase in the plasma concentration of which of the following?
a. Chloride
b. Sodium
c. Hydrogen
d. Potassium


33. The actions of angiotensin II include:
a. Inhibition of thirst.
b. Inhibition of aldosterone secretion.
c. Stimulation of ADH secretion.
d. Stimulation of renin secretion.


34. Which of the following changes would you expect to find in a patient consuming a high sodium diet?
a. Increased plasma aldosterone concentration.
b. Increased urinary potassium excretion.
c. Decreased plasma renin concentration.
d. Decreased plasma atrial natriuretic peptide.


35. Which one of the following hormones is not secreted in a state of dehydration?
a. Vasopressin (ADH)
b. Atrial natriuretic hormone (ANP)
c. Aldosterone
d. Angiotensin II


36. PAH clearance is a measure of:
a. Filtration fraction.
b. Renal plasma flow.
c. Tubular maximum.
d. Glomerular filtration rate (GFR).


37. Concerning renal function tests:
a. PAH clearance is used to measure GFR.
b. Inulin clearance is used to estimate renal plasma flow.
c. Creatinine clearance can be clinically used to estimate GFR.
d. Blood urea concentration is an accurate index of renal function.


38. In the proximal convoluted tubule:
A. Glomerular filterate is isotonic with plasma.
B. 50% of water from the glomerular filterate is reabsorbed.
C. Glomerular filterate is hypertonic with plasma.
D. H+ is actively secreted.


40. Renin angiotensin system is stimulated by:
A. An increased in renal blood flow.
B. Decreased serum K+ levels.
C. An increased glomerular filtration rate.
D. Decreased serum Na+ levels.

41. The clearance of PAH is equal to:
A. Glomerular filtration rate.
B. Renal blood flow.
C. Filtration fraction.
D. Renal plasma flow.


42. All the following are true about the kidney Except:
A. It secretes 25-hydroxycholecaciferol.
B. It secretes prostaglandins.
C. It secretes erythropoietin.
D. It participates in blood pressure regulation.


43. To calculate urea clearance, the following data should be available:
A. Concentration of urea in the blood.
B. Concentration of urea in urine.
C. Volume of urine.
D. All of the above.


44. Glucose:
A. Has a plasma clearance equal to GFR.
B. Has a normal Tm of 180 mg%.
C. Has a clearance value equal to zero ml/min.
D. Is filtered by the glomeruli & passively reabsorbed in PCT.


46. The clearance of inulin is equal to:
A. GFR.
B. Filtration fraction.
C. Filtration coefficient.
D. Renal plasma flow.


47. All the following are true about the kidney Except:
A. About 85% of the nephrons are cortical.
B. About 15% of the nephrons have long loop of Henle.
C. The afferent arteriolar pressure is 60 mmHg.
D. The peritubular capillary pressure is about 12 mm of Hg.


48. One of the following about the kidney is NOT true:
A. Rate of renal blood flow is less than GFR.
B. GFR is normally 125 ml/min.
C. Most of the glomerular filtrate is reabsorbed.
D. GFR is normally equal to inulin clearance.


49. In the loop of Henle:
A. Urea is actively secreted.
B. Na+ is actively reabsorbed in descending limb of loop of Henle.
C. Water passes out of the descending limb of loop of Henle.
D. ADH absorbs water from ascending limb of loop of Henle.


50. The measured urea clearance shows that, it is:
A. Equal to that of inulin.
B. Completely reabsorbed in the DCT.
C. Faltered & partially reabsorbed.
D. Faltered & secreted.

51. Osmolarity of tubular fluid is 4 times with respect to plasma in:
A. Ascending limb of the loop of Henle.
B. Distal convoluted tubule (DCT).
C. DCT & ascending limb of loop of Henle.
D. Collecting ducts.


52. In the PCT:
A. 90% OF glucose is absorbed.
B. Water is actively reabsorbed.
C. Na+ is actively reabsorbed.
D. Urea is secreted.


53. Micturition:
A. Is initiated if the intravesicular pressure reaches 1.0 cm water.
B. A feeling of urgency arises when bladder contains 60 ml of urine
C. Is stimulated by motor parasympathetic impulses.
D. Is not influenced by the brain in any way.


54. Any substance faltered by the glomeruli & secreted but not absorbed will have renal clearance :
A. Equal to GFR.
B. Less than the clearance of inulin.
C. Equal to clearance of urea.
D. Greater than the clearance of inulin.


55. To compensate for acidosis the kidney:
A. Alkalizes urine.
B. Increases Na+ excretion.
C. Secrete 50% of filtered bicarbonate.
D. Excrete titrable acid & ammonium salts.


57. The GFR:
A. Increases when pressure in Bowman’s capsule increases.
B. Decreases when afferent arteriole constricts.
C. Decreases when efferent arteriole constricts.
D. Increases when glomerular O.P. increases.


58. Regarding glomerular filtrate, all the following are true Except:
A. It is a selective process.
B. It is devoid of blood cells & plasma proteins.
C. Glycoproteins in the filtration barrier are –vely charged.
D. The size & the charge of solute determine filterability.


59. An enzyme that causes renal formation of ammonia is:
A. Renin.
B. Adenyl cyclase.
C. Glutaminase.
D. Carbonic anhydrase.


60.The volume of plasma needed each minute to supply a substance at the rate at which it is excreted in urine is known as:
A. Filtration rate of the substance.
B. Excretion ratio of the substance.
C. Clearance of the substance.
D. Diffusion constant of the substance.

61. The transport of materials across tubular epithelium is dependent upon:
A. The size and charge of molecules.
B. Lipid solubility.
C. Concentration gradient.
D. All are correct.


62. Clearance ratio greater than one is most likely seen with substance, which is:
A. Reabsorbed.
B. Secreted.
C. Neither neither secreted nor absorbed.
D. None are correct.


63. Solute particles move from plasma of the renal glamorous to the fluid in Bowman’s capsule by:
A. Diffusion.
B. Active transport.
C. Bulk flow.
D. A and C are correct.


64. The tonicity of urine as it enters the renal collecting duct may be:
A. Isotonic.
B. Hypotonic.
C. Hypotonic or isotonic but never hypertonic.
D. Hypertonic.


65. The renal “countercurrent” mechanism is dependent upon the anatomic arrangement of the:
A. Loop of Henle.
B. Proximal tubule.
C. Vasa recta.
D. A and C are correct.


66. Extracellular dehydration results in:
A. Inhibition of volume & osmoreceptors & increase ADH secretion.
B. Stimulate of volume & osmoreceptors & increase ADH secretion.
C. Inhibition of volume &osmoreceptors &decrease ADH secretion.
D. Decrease extracellular osmolality.


The following are obtained from a volunteer who participated in
renal clearance study :
Plasma inulin = 20 mg/ml.
Plasma glucose = 150 mg/ml.
Urine flow = 2 ml/min.
Urine inulin = 500 mg/dl.
Urine glucose = 30 mg/dl.

67. What was the clearance of glucose:
A. 60 ml/min.
B. 6.0 ml/min.
C. 0.6 ml/min.
D. 0.4 ml/min.


68. Find the reabsorption of glucose by this volunteer:
A. Approximately 75 mg/min.
B. Approximately 20 mg/min.
C. Approximately 150 mg/min.
D. Glucose reabsorption must be at its maximum level.


69. A new drug, which causes GFR to increase but RBF to decrease.
It does not affect arterial blood flow. The drug causes:
A. Constriction of the afferent arteriole.
B. Dilation of the afferent arteriole.
C. Constriction of the efferent arteriole.
D. Dilation of the efferent arteriole.


70. A patient with a hyper secretion of aldosterone. Which of the following parameters is elevated above normal:
A. Plasma renin concentration.
B. Plasma angiotensin concentration.
C. Plasma potassium concentration.
D. Plasma ANP concentration.

71. As tubular fluid passes along the ascended limb of loop of Henle:
A. Osmolarity increases.
B. Water is always reabsorbed.
C. Urea concentration increase more than 3-fold.
D. Chloride is reabsorbed.


72. A drug that blocks angiotensin converting enzyme ( ACE ) is given to a patient. All the following are likely to decrease except:
A. Plasma aldosterone secretion.
B. Arterial blood pressure.
C. Plasma renal secretion.
D. Plasma angiotensin II content.


73. If you place a patient on a low sodium diet you would expect a decrease in:
A. Glucose and amino acid reabsorption.
B. Hydrogen ion secretion by the PCT.
C. Bicarbonate reabsorption.
D. None of the above is correct.


74. Sodium is reabsorbed from basolateral surface of renal epithelial cells by:
A. Na/H exchange
B. Na- glucose cotransport.
C. Na-K pump.
D. Facilitated diffusion.


75. The absorption of H+ in the PCT is primarily associated with:
A. Excretion of potassium.
B. Excretion of hydroxyl.
C. Reabsorption of calcium.
D. Reabsorption of bicarbonate.


76. After a large haemorrhage you would expect all the following Except:
A. Increased ADH secretion.
B. Increased aldosterone secretion.
C. Increased osmolar excretion.
D. Decreased urine flow


77. Depletion of K+ concentration would most likely result from an increase in the circulating levels of:
A. Parathyroid hormone.
B. Atrial natriuretic peptide.
C. Antidiuretic hormone.
D. Aldosterone hormone.


78. GFR is increased by:
A. Constriction of the afferent arteriole
B. Constriction of the efferent arteriole
C. An increase in the concentration of plasma protein
D. Decreased glomerular capillary pressure.
E. Decreased glomerular filtration area.


79. The clearance of PAH is equal to:-
A. Glomerular filtration rate.
B. Filteration fraction.
C. Renal blood flow.
D. Capillary filteration coefficient.
E. Renal plasma flow


80. The greatest fraction of filtered water is reabsorbed in:-
A. Proximal tubule.
B. Loop of Henle.
C. Distal tubule.
D. Cortical collecting duct.
E. Medullary collecting duct.

81. Renin release is stimulated by: -
A. An increase in renal arterial pressure.
B. An increase in circulating ADH.
C. A decrease in renal sympathetic discharge.
D. A decrease in the delivery of NaCl to the macula densa.
E. An increase in circulating angiotensin II.


82. Glucose:-
A. Is completely reabsorbed in the collecting tubule.
B. Is filtered by the glomeruli & passively reabsorbed.
C. Is completely reabsorbed in the distal tubule.
D. Is filtered by the glomeruli & actively reabsorbed in the proximtubule.
E. Has a plasma clearance equal to GFR.


83. In the loop of Henle:-
A. Na+ is reabsorbed in the descending limb of the loop of Henle.
B. Descending limb is freely permeable to water.
C. Urea is actively secreted.
D. The fluid becomes hypotonic as it goes towards the tip of the loop.
E. ADH has its major function.

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