Urinary System Review Questions

5) The presence of protein in the urine indicates which of the following? A) too much protein in the diet B) high levels of transcription and translation by the bodies tissues C) damage to the filtration membrane D) damage to the renal tubules Answer: C 7) Cells and transport proteins are physically prevented from passing through the filtration membrane. This has the following effect on filtration. A) increased osmotic pressure in the filtrate that draws plasma through the membrane B) decreased osmotic pressure in the filtrate that increases the amount of filtration C) increasing osmotic pressure in the glomerular capillaries that reduces the amount of filtration D) neutral change in osmotic pressure with no effect on filtration Answer: C 22) Which of the choices below is NOT a function of the urinary system? A) helps maintain homeostasis by controlling the composition, volume, and pressure of blood B) regulates blood glucose levels and produces hormones C) maintains blood osmolarity D) eliminates solid, undigested wastes and excretes carbon dioxide, water, salts, and heat Answer: D 26) Select the correct statement about the ureters. A) Ureters contain sphincters at the entrance to the bladder to prevent the backflow of urine. B) The epithelium is stratified squamous like the skin, which allows a great deal of stretch. C) The ureters are capable of peristalsis like that of the gastrointestinal tract. D) The ureter is innervated by parasympathetic nerve endings only. Answer: C 27) The fatty tissue surrounding the kidneys is important because it ________. A) ensures adequate energy for the adrenal glands to operate efficiently B) stabilizes the position of the kidneys by holding them in their normal position C) is necessary as a barrier between the adrenal glands and kidneys D) produces vitamin D and other chemicals needed by the kidney Answer: B 28) The renal corpuscle is made up of ________. A) Bowman's capsule and glomerulus B) the descending nephron loop C) the renal pyramid D) the renal papilla Answer: A 29) The functional and structural unit of the kidneys is the ________. A) nephron B) nephron loop C) glomerular capsule 1 D) capsular space Answer: A 35) The glomerular capsular space contains ________. A) urine B) blood C) filtrate D) plasma Answer: C 48) Which of the choices below is a function of the nephron loop? A) form a large volume of very concentrated urine or a small volume of very dilute urine B) form a large volume of very dilute urine or a small volume of very concentrated urine C) absorb electrolytes actively and water by osmosis in the same segments D) absorb water and electrolytes into the tubular network Answer: B 53) If one says that the clearance value of glucose is zero, what does this mean? A) The glucose molecule is too large to be filtered out of the blood. B) Most of the glucose is filtered out of the blood and is not reabsorbed in the convoluted tubules. C) 100% of glucose is reabsorbed. D) The clearance value of glucose is relatively high in a healthy adult. Answer: C 14) Freshly voided urine has very little smell, but shortly after voiding it can give off a very strong smell. Why? Answer: Freshly voided urine is relatively sterile but if it is allowed to stand, bacteria begin to metabolize the urea solutes to release ammonia and other smells depending on the person's diet. A fruity smell generally means there is a diabetes problem. Clinical Questions 1) An older man sees his doctor for severe pain in his lower abdominal or flank area, elevated temperature, and nausea. Exhaustive tests rule out abdominal obstructions and infections. Plain X-rays indicate a radiopaque (whitish) spot in the area of his right ureter. Diagnose his problem. Give suggested treatment and prognosis. Answer: The symptoms indicate a kidney stone that has been passed into the ureter. Recommended treatments include IV therapy to flush the stone out, surgery, or ultrasound waves to shatter the calculi. The usual prognosis is for complete recovery. There is a possibility of kidney stones forming again. 2 2) What clinical effects would low blood pressure have on the kidneys of a burn patient? Answer: This patient would have a much lower glomerular hydrostatic pressure due to water losses through burned skin and would have a low GFR. This is highly dangerous, leading to failure of the nephron loop to maintain countercurrent flow, flowed by anuria. It is made worse if any muscle is burned and myoglobin in the blood exceeds its transport maximum, resulting in plugging of the tubules and death of the nephron. Often massive fluid transfusions are required to maintain blood volume, high GFR, and dilution of myoglobinuria to avoid catastrophe. 3) Eleven-year-old Harry is complaining of a severe sore throat and gets to stay home from school. His pediatrician prescribes a course of broad-spectrum antibiotics, and Harry feels much better within a few days. However, some two weeks later, Harry has a dull, bilateral pain in his lower back and his urine is a smoky brown color. On the basis of Harry's signs and symptoms, diagnose his condition and indicate the relationship (if any) between his present condition and his earlier sore throat. Answer: Harry is showing the symptoms of kidney inflammation. Kidney inflammations usually result from infections either of the lower urinary tract or, in Harry's case, from his earlier infection of a sore throat. Streptococcal infection of the throat can induce anti-streptococcal antibodies that bind to them, depositing immune complexes in the glomerular membranes. The kidney inflammation that primarily involves glomeruli is called glomerulonephritis, and if severe enough can cause permanent renal failure. In post-streptococcal glomerulonephritis, the smoky brown color of urine most commonly represents the leakage of blood cells through the damaged glomerular membrane. 4) Ellen, a 47-year-old woman who has suffered kidney disease for several years, has been diagnosed with proteinuria. Her legs and feet are so swollen that she has difficulty walking. Her hands and her left arm are also swollen. What is proteinuria, and could this condition be playing a role in her swollen limbs? Answer: Proteinuria is a condition in which the permeability of the glomerular capillaries is increased to such an extent that large amounts of plasma proteins (mostly albumin) pass into the glomerular filtrate and are excreted in the urine. If the condition is severe, the loss of plasma proteins may decrease osmotic pressure substantially. When this happens there is a tendency for fluid to leave the systemic blood vessels and enter the tissue space. This is the reason for Ellen's swollen limbs. 5) Rachael has been complaining of frequent and burning urination. She also reported seeing some blood in her urine. Her physician suspects cystitis. What is cystitis, and how can it cause these symptoms? Answer: It is possible that Rachael has cystitis, a condition in which the mucous membrane lining the bladder becomes swollen and bleeding occurs. This condition is caused by bacterial invasion of the bladder or by chemical or mechanical irritation. Burning on urination alone implies urethritis – inflammation of the urethra alone, but urinary frequency suggests the bladder itself is also involved, with the inflammation causing smooth muscle irritability lowering the stretch trigger point for micturition. 3