Physiology 001 - Introduction to Human Physiology » Summer 2021 » Exam 4 Chapter 13 and 14 (2)

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Question #1
Which of the following organs is the main site of aldosterone secretion?
A.   Liver
B.   Kidneys
C.   The atria of the heart
D.   Systemic and pulmonary blood vessels
E.   Adrenal glands
Question #2
In the condition diabetes mellitus, why does glucose appear in the urine?
A.   Without the hormone insulin, glucose cannot enter proximal tubule epithelial cells.
B.   The plasma concentration of glucose becomes so high that it diffuses from peritubular capillaries into the proximal tubule, down its concentration gradient.
C.   The rate of tubular secretion of glucose becomes greater than the sum of glucose filtration and reabsorption.
D.   The filtered load of glucose becomes greater than the tubular maximum for its reabsorption.
E.   Without insulin, the glomerular filtration barrier becomes extremely leaky to glucose, which is not normally filterable.
Question #3
You are the CEO of a drug company where you've asked five teams of scientists to generate new drugs to decrease blood pressure. You can only send four of the drugs to market. Which of these drugs is least likely to decrease blood pressure and can be eliminated from potential development?
A.   A drug that decreases liver production of angiotensinogen
B.   A drug that interferes with aldosterone synthesis
C.   A drug that decreases sympathetic stimulation of renal arterioles
D.   A drug that enhances the activity of angiotensin-converting enzyme
E.   A drug that is an agonist of atrial natriuretic factor
Question #4
Which of the following statements about renal control of blood acid-base balance is TRUE?
A.   Increased metabolism of glutamine by renal tubular cells increases the plasma bicarbonate concentration.
B.   The kidneys compensate for a metabolic alkalosis by increasing CO2 production.
C.   When hypoventilation occurs at the lungs, the kidneys compensate by reducing glutamine metabolism.
D.   Excretion in the urine of hydrogen bound to phosphate buffers decreases plasma bicarbonate concentration.
E.   H+ that binds to filtered bicarbonate in the tubular fluid is excreted in the urine.
Question #5
Which of the following statements concerning the process of glomerular filtration is correct?
A.   The glomerular filtration rate is limited by a transport maximum.
B.   The hydrostatic pressure in glomerular capillaries opposes filtration.
C.   All of the plasma that enters the glomerular capillaries is filtered.
D.   The osmotic force due to plasma proteins favors filtration.
E.   The hydrostatic pressure in Bowman's space opposes filtration.
Question #6
Constriction of the ________ decreases hydrostatic pressure in ________.
A.   renal vein; peritubular capillaries
B.   efferent arterioles; proximal convoluted tubules
C.   afferent arterioles; glomerular capillaries
D.   efferent arterioles; glomerular capillaries
E.   efferent arterioles; Bowman's capsule
Question #7
Compared to the normal plasma osmolarity, the tubular fluid is ________ as it enters Bowman's space, ________ at the beginning of the loop of Henle, ________ at the tip of the loop, and ________ at the beginning of the distal convoluted tubule.
A.   isosmotic; hyperosmotic; hyperosmotic; isosmotic
B.   isosmotic; isosmotic; hyperosmotic; hypoosmotic
C.   isosmotic; isosmotic; hyperosmotic; isosmotic
D.   isosmotic; isosmotic; hypoosmotic; hypoosmotic
E.   isosmotic; isosmotic; hypoosmotic; hyperosmotic
Question #8
Carbonic anhydrase catalyzes a reaction that combines which of the following?
A.   H2O and CO2
B.   H2O and O2
C.   H2O and CO
D.   CO2 and O2
E.   H+ and HCO3-
Question #9
After prolonged exertion in a hot climate, baroreceptors would ________ firing, leading to ________ secretion of ________ and thus ________ renal reabsorption of ________.
A.   increase; increased; renin; increased; Na+
B.   decrease; decreased; vasopressin; increased; water
C.   decrease; increased; renin; decreased; Na+
D.   decrease; increased; vasopressin; increased; water
E.   increase; decreased; vasopressin; decreased; water
Question #10
Which is normally TRUE about the intrapleural pressure?
A.   It is between +5 and +10 mmHg above atmospheric pressure at functional residual capacity.
B.   It alternates between being less than, and greater than, atmospheric pressure.
C.   During a passive exhale, it increases to a value above atmospheric pressure.
D.   It is lower than alveolar pressure.
E.   It is always the same as atmospheric pressure during a passive exhale.
Question #11
In which region of the nephron does the fractional reabsorption of water vary the most in response to variation in the state of hydration?
A.   The loop of Henle
B.   The collecting duct
C.   The proximal convoluted tubule
D.   The distal convoluted tubule
E.   The glomerulus
Question #12
How would the kidneys respond to hypoventilation?
A.   Increasing secretion of H+ and increasing production of new HCO3-
B.   Increasing excretion of CO2
C.   Decreasing secretion of H+ and increasing production of new HCO3-
D.   Increasing secretion of H+ and decreasing reabsorption of HCO3-
E.   Decreasing secretion of H+ and decreasing reabsorption of HCO3-
Question #13
All of the following substances are present in proximal tubular fluid in the kidney, but which one is NOT normally present in urine?
A.   H+
B.   HPO42-
C.   Glucose
D.   Ca2+
E.   K+
Question #14
What is the rate-limiting (regulated) step for stimulating the secretion of aldosterone?
A.   Secretion of angiotensin II by the kidney
B.   Conversion of angiotensin I to angiotensin II in the blood
C.   Secretion of angiotensinogen by the liver
D.   Conversion of angiotensinogen to angiotensin I in the blood
E.   Secretion of ACTH by the anterior pituitary
Question #15
Which is TRUE regarding renal tubular reabsorption?
A.   Reabsorption of Na+ only occurs from nephron regions that come after the descending limb of the loop of Henle.
B.   Urea reabsorption cannot occur at any point along the nephron.
C.   Reabsorption of glucose saturates at a maximum transport rate.
D.   Reabsorption of Na+ from the proximal tubule occurs as a result of water reabsorption.
E.   Toxic substances are removed from the body by reabsorption from peritubular capillaries into the proximal tubule.
Question #16
If a patient with pulmonary disease began to hypoventilate, how would plasma levels of [H+], HCO3-, and PCO2 be changed, compared to normal?
A.   Decreased [H+], decreased PCO2, and decreased [HCO3-]
B.   Increased [H+], increased PCO2, and increased [HCO3-]
C.   Increased [H+], increased PCO2, and decreased [HCO3-]
D.   Decreased [H+], increased PCO2, and decreased [HCO3-]
E.   Increased [H+], decreased PCO2, and decreased [HCO3-]
Question #17
  
A.   Phagocytizing bacteria and other foreign particles
B.   Secretion of mucus
C.   Production of surfactant
D.   Lining the pleural space
E.   Make up the majority of the epithelial wall of the alveoli
Question #18
Which of the following is TRUE about how water is handled by the nephron?
A.   Vasopressin inserts pumps in the collecting duct membrane that move water against its concentration gradient.
B.   Water is filtered out of glomerular capillaries by bulk flow.
C.   The permeability of the ascending limb of the loop of Henle is modified by vasopressin.
D.   Water is actively secreted into the descending loop of Henle.
E.   Water is actively reabsorbed from the proximal tubule, and Na+ follows down its diffusion gradient.
Question #19
Which one of the following substances is LEAST dependent on the kidney for regulation of its plasma concentration?
A.   Water
B.   HPO42-
C.   Glucose
D.   K+
E.   Na+
Question #20
Water and NaCl reabsorbed from the loop of Henle directly reenter which blood vessels?
A.   Vasa recta
B.   Efferent arterioles
C.   Cortical peritubular capillaries
D.     
E.   Collecting ducts
F.   Afferent arterioles
Question #21
In the presence of aldosterone, which nephron region reabsorbs the greatest fraction of the filtered Na+?
A.   Distal convoluted tubule
B.   Descending limb of the loop of Henle
C.   Macula densa
D.   Proximal tubule
E.   Cortical collecting duct
F.     
Question #22
Which of the following is least likely to be filtered into Bowman's capsule in a normal, healthy person?
A.   Glucose
B.   Sodium
C.   Bicarbonate ion
D.   Urea
E.   Plasma protein
Question #23
A decrease in metabolism without a similar, compensatory decrease in alveolar ventilation will have what effect on the systemic pH?
A.   pH will increase.
B.   No change to pH is expected in this circumstance.
C.   It is impossible to predict the effect on pH without first understanding why metabolism decreased.
D.   pH will decrease.
Question #24
You embark on a hiking trip on Mt. Kilimanjaro (altitude = 19,000 ft; Atmospheric air pressure = 379 mmHg). As you ascend, what happens to the PO2 in the alveoli?
A.   No change from sea level, as long as we breathe in the same volume of air.
B.   Alveolar PO2 decreases.
C.   Alveolar PO2 increases.
Question #25
In which form is most of the oxygen carried in arterial blood?
A.   Bound to hemoglobin
B.   Dissolved in the plasma
C.   Dissolved in the cytosol of erythrocytes
D.   Converted to HCO3-
E.   Bound to myoglobin
Question #26
Which of the following most accurately describes the renal transport of Na+?
A.   Na+ is actively transported in all segments of the tubule.
B.   Na+ is actively secreted into the nephron lumen by cells in the cortical collecting ducts.
C.   Na+ is actively transported across the luminal membrane of proximal tubule cells in exchange for K+, by Na+/K+ ATPase pumps.
D.   Most of the Na+ transport occurs in the distal convoluted tubule and collecting ducts.
E.   Primary active transport of Na+ allows for secondary active transport of glucose and H+ in the proximal tubule.
Question #27
The amount of a substance that is excreted in the urine is equal to the amount that is ________ plus the amount that is ________ minus the amount that is ________.
A.   reabsorbed; secreted; filtered
B.   filtered; reabsorbed; secreted
C.   secreted; reabsorbed; filtered
D.   filtered; secreted; reabsorbed
E.   reabsorbed; filtered; secreted
Question #28
Which of the following would cause a decrease in the binding affinity of hemoglobin for oxygen?
A.   The presence of carbon monoxide
B.   Decreased DPG levels in erythrocytes
C.   Increased temperature of the blood
D.   Decreased concentration of H+ in the blood
E.   Increased pH of the blood
Question #29
Which of the following drugs, administered as an aerosol spray, would be most likely to help a patient during an asthmatic attack?
A.   Pulmonary surfactant
B.   A β2-adrenergic agonist
C.   A muscarinic agonist
D.   Histamine
E.   A β2-adrenergic antagonist
Question #30
When blood Ca2+ levels fall below normal, in what ways do the kidneys help restore them toward normal?
A.   By increasing 1,25-dihydroxyvitamin D3 formation, decreasing tubular phosphate reabsorption, and increasing tubular Ca2+ reabsorption
B.   By decreasing 1,25-dihydroxyvitamin D3 formation, increasing tubular phosphate reabsorption, and increasing tubular Ca2+ reabsorption
C.   Increasing 1,25-dihydroxyvitamin D3 formation and increasing secretion of parathyroid hormone
D.   By increasing renal secretion of parathyroid hormone and increasing bone resorption
E.   By increasing 1,25-dihydroxyvitamin D3 formation, increasing tubular phosphate reabsorption, and increasing tubular Ca2+ reabsorption
Question #31
In what segment of the nephron is the greatest fraction of filtered water reabsorbed?
A.   The collecting ducts
B.   The proximal tubule
C.   The ascending limb of the loop of Henle
D.   The distal convoluted tubule
E.   The descending limb of the loop of Henle
Question #32
Which of these is demonstrated by the oxygen-hemoglobin dissociation curve?
A.   At normal resting systemic arterial PO2, hemoglobin is almost 100% saturated with oxygen.
B.   The greater the PO2 of the blood, the greater the dissociation of O2 from hemoglobin.
C.   As PO2 increases, the saturation of hemoglobin with oxygen increases linearly.
D.   More additional oxygen binds to hemoglobin when going from a PO2 of 60 to 100 mmHg, than is added when going from a PO2 of 40 to 60 mmHg.
E.   At normal resting systemic venous PO2, only about 75% of the hemoglobin is in the form of deoxyhemoglobin.
Question #33
Which of the following is a cause of asthma?
A.   Elevation of intrapleural pressure to equal atmospheric pressure
B.   Inflammation of the bronchioles
C.   Loss of alveoli
D.   Lack of pulmonary surfactant
E.   Environmental chemicals that stimulate β2-adrenergic receptors
Question #34
Under normal circumstances, which of the following would result from an increase in transpulmonary pressure?
A.   Pneumothorax
B.   A collapsed lung
C.   Exhalation/expiration
D.   Emphysema
E.   Inhalation/inspiration
Question #35
Jerome has had too many alcoholic drinks at a party. One of the effects of alcohol is that it inhibits the release of vasopressin. Which of the following is Jerome likely to notice?
A.   An increase in blood pressure
B.   The excretion of glucose in the urine increased
C.   High volume of dilute urine
D.   A reduction in urine volume
E.   Very concentrated urine
Question #36
You have a patient with extensive birth defects that affect the kidney anatomy. Nevertheless, she does have some kidney function. One thing you've noticed in her labs is extremely low renin secretion. Which of the following anatomical locations is likely to exhibit abnormal development?
A.   The efferent arteriole
B.   The juxtaglomerular apparatus
C.   The glomerular capillaries
D.   The proximal tubule
E.   The ascending limb of the loop of Henle
Question #37
You (a healthy individual) are swimming underwater when you can no longer resist the urge to breathe. This overwhelming urge is probably due to
A.   the increase in pH has made your blood dangerously alkaline.
B.   the autorhymthic cells in your diaphragm contracting.
C.   the decrease in O2 available to the cells of the body.
D.   the increase in plasma H+.
Question #38
After CO2 is produced by tissues, in what form is most of that carbon transported to the lungs for removal from the body?
A.   As carbonic anhydrase
B.   As H2CO3
C.   As dissolved CO2
D.   Bound to hemoglobin
E.   As dissolved HCO3-
Question #39
You are an EMT and arrive at the scene of an opioid overdose. The overdose victim is breathing extremely slowly and shallowly. When you arrive at the ER, you report that the medical team should watch out for signs of
A.   respiratory acidosis.
B.   metabolic alkalosis.
C.   metabolic acidosis.
D.   respiratory alkalosis.
Question #40
What is the primary regulator of the magnitude of alveolar ventilation under normal circumstances?
A.   Stretch receptors in the lung
B.   The PO2 of the arterial blood, which is monitored by peripheral chemoreceptors
C.   The H+ concentration in the brain extracellular fluid, which is monitored by central chemoreceptors
D.   The H+ concentration in the arterial blood, which is monitored by central chemoreceptors
E.   The PO2 of the arterial blood, which is monitored by central chemoreceptors
Question #41
Which of these correctly describes the chloride shift?
A.   In the tissues, chloride enters red blood cells in exchange for bicarbonate ions.
B.   In the lungs, chloride enters red blood cells in exchange for bicarbonate ions.
C.   In the lungs, chloride enters red blood cells in exchange for CO2.
D.   In the tissues, chloride exits red blood cells in exchange for carbonic acid.
E.   In the tissues, chloride enters red blood cells in exchange for CO2.
Question #42
Which of the following statements about the response of arteriolar smooth muscle to changing oxygen partial pressures is TRUE?
A.   Both systemic and pulmonary arterioles respond to a decrease in PO2 by constricting.
B.   Systemic arterioles respond to a decrease in PO2 by constricting, but pulmonary arterioles dilate in response to decreased PO2.
C.   Both systemic and pulmonary arterioles respond to a decrease in PO2 by dilating.
D.   Systemic arterioles respond to a decrease in PO2 by dilating, but pulmonary arterioles constrict in response to decreased PO2.
E.   Changes in PO2 do not affect arteriolar smooth muscle in the pulmonary system.
Question #43
Which is TRUE about the hormone vasopressin (also known as antidiuretic hormone, ADH)?
A.   It triggers insertion of aquaporins into the apical membranes of collecting duct cells.
B.   It stimulates the excretion of K+ in the urine.
C.   It promotes the excretion of more water in the urine.
D.   Its main function is to trigger the secretion of aldosterone.
E.   It is a peptide hormone released from the adrenal gland.
Question #44
During a run, your gastrocnemius (calf) muscle has a temperature of 38.5° C, while your biceps brachii (upper arm) muscle has a temperature of 37.5° C. Which of the following is TRUE of the red blood cells as they pass by these muscles?
A.   The hemoglobin molecules will have the same affinity for oxygen at both locations.
B.   The hemoglobin molecules may denature as they pass by the gastrocnemius.
C.   The hemoglobin molecules will have a higher affinity for oxygen as they pass by the gastrocnemius compared to the biceps brachii.
D.   The hemoglobin molecules will have a higher affinity for oxygen as they pass by the biceps brachii compared to the gastrocnemius.
Question #45
How does the renal countercurrent multiplier mechanism allow the creation of a concentrated urine?
A.   When anti-diuretic hormone is present, it stimulates the pumping of NaCl from the medullary interstitial fluid and water follows, concentrating the urine.
B.   By pumping NaCl and urea into the ascending limb of the loop of Henle, it raises the solute load, which turns into a concentrated urine once water is extracted from the collecting duct.
C.   It transports urea from the medullary interstitial fluid into the collecting duct, which directly increases the osmolarity of the urine.
D.   By concentrating NaCl in the renal medullary interstitial fluid, it allows water to be reabsorbed from the collecting ducts when vasopressin is present.
E.   It transports NaCl from the medullary interstitial fluid into the collecting duct, which directly increases the osmolarity of the urine.
Question #46
During a yoga class you take a deep breath, then relax and let the breath out slowly. During that exhalation, which would NOT be true?
A.   Alveolar pressure is greater than atmospheric pressure.
B.   Lung volume decreases.
C.   The diaphragm relaxes.
D.   Intrapleural pressure becomes less negative.
E.   Intrapleural pressure is greater than alveolar pressure.
Question #47
Which of the following statements regarding hypoxia is correct?
A.   Cyanide poisoning is an example of hypoxic hypoxia.
B.   Exposure to high altitude is a form of hypoxic hypoxia.
C.   "Anemic hypoxia" refers to the condition of lower than normal arterial PO2.
D.   Carbon monoxide poisoning is an example of hypoxic hypoxia.
E.   Carbon monoxide poisoning is an example of ischemic hypoxia.
Question #48
What region of the nephron reabsorbs about two-thirds of filtered Na+ and Cl-?
A.   Glomerulus
B.   Ascending loop of Henle
C.   Collecting duct
D.   Distal convoluted tubule
E.   Proximal convoluted tubule
Question #49
Type II alveolar cells are among the last cells to mature during fetal development. In babies born prematurely, type II alveolar cells are often not ready to perform their function. Which of the following would be TRUE of these babies?
A.   They would be at risk of bacterial infections in the lungs.
B.   They would be at risk of alveolar collapse due to too much surface tension in the alveoli.
C.   They would be at risk of autoimmune diseases with lung complications.
D.   None of these would occur.
E.   They would be more likely to have coughing fits.
Question #50
Which of the following statements regarding Ca2+ homeostasis is TRUE?
A.   In the absence of parathyroid hormone, plasma Ca2+ levels would be abnormally low, resulting in the hyperpolarization of nerve and muscle membranes.
B.   When plasma Ca2+ increases above normal, the secretion of parathyroid hormone increases.
C.   Vitamin D decreases the renal tubular reabsorption of Ca2+.
D.   Parathyroid hormone directly stimulates Ca2+ reabsorption by the kidneys.
E.   Parathyroid hormone directly stimulates Ca2+ absorption from the GI tract.

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