QMU Section 6

7/29/2019 QMU Section 6

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QMU

29/12/12

1. Which of the following is true about urinary bladdera. Hollow muscular organ acting as reservoir for urineb. It has one ligament, median umbilical ligamentc. In adults it is a pelvic organd. All of the above

2. Which of the following is true about urinary bladder trigonea. Contains smooth muscle called superficial trigonal muscleb. It has smooth surfacec. It is more vascular, sensitive and elastic than other mucosad. All of the above

3. Which of the following statements is true about interureteric bara. Small rounded elevation that lies immediately behind internal uretheral openingb. It is caused by protrusion of underlying middle lobe of the prostatec. It is raised transversed ridge between the two uretheric orificesd. All the above

4. Male urethera is S shaped duct about 20 cm ( or 8 inches ) in length. T/F5. Which of the following statements is not true about female urethera

a. It is about 4 cm longb. Less dilatable than male uretherac. Its upper part is surrounded by spinchter urethraed. All of the above

Answer: d,d,c,t,b

TUBULAR MAXIMA

The glucose tubular maximum is

A. The maximum amount of glucose in mg which can be reabsorbed per hour

B. The maximum amount of glucose in mg which can be secreted per minute

C. The maximum amount of glucose in mg which can be reabsorbed per minute


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D. The maximum amount of glucose in mg which can be secreted per hour

The Paraaminohippuric acid (PAH) tubular maximum is

A. The maximum amount of PAH in mg which can be reabsorbed per hour

B. The maximum amount of PAH in mg which can be secreted per minute

C. The maximum amount of PAH in mg which can be reabsorbed per minute

D. The maximum amount of PAH in mg which can be secreted per hour

At glucose critical or threshold level (about 180 mg%), maximum absorbing capacity of

tubules on glucose is reached.

A. True

B. False

At glucose level 100mg/100ml, no glucose is excreted in urine. What happen to the

excretion of glucose if the glucose level is 120 mg/100 ml?

A. No glucose is excreted

B. 20 mg of glucose will be excreted

C. 20% of glucose from filtration will be excreted

D. All glucose will be excreted

Tubular maxima of Paraaminohippuric acid (PAH) is equal to

A. 7.5 mg/min

B. 75 mg/min

C. 75 ml/min

D. 75 mg/ml

Protein carriers for glucose reabsorption is limited and equally distributed between

nephrons in both kidneys.

A. True

B. False


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Answers:

C, B, B, A, B, B

30/12/12

1.in the ureter, what is the cause of folding mucosa in the empty state?(m/s 43)

A.it has the lining epithelium, called urothelium

B.the epithelium rest on an indistinct corrugated basement membrane

C.it is supported by loose areolar lamina propria rich in elastic fibers

D.the ureter has stellate shaped,narrow lumen

2.what is the main function of musculosa of ureter?(m/s 43)

A.slow peristaltic contractions forcing urine in unidirectional pulses down into bladder.

B.it cause folding of mucosa in the empty state

C.contain blood vessels,lymphatics and nerves

D. reservoir for urine before being discharged through terminal urinary passage

3. arrange the correct order of urinary passage below(m/s 43)

A. renal pelvis - major calyces - minor calyces ureters

B. renal pelvis - major calyces ureters - minor calyces

C.minor calyces major calyces renal pelvis ureters

D. major calyces - minor calyces - renal pelvis ureters.


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4.what is osmotic barrier(urinary bladder barrier)?(m/s 46)

A.barrier between diluted hypertonic urine in the lumen of the bladder and the

interstitial tissue of the bladder

B. barrier between concentrated hypotonic urine in the lumen of the bladder and the


C. barrier between concentrated hypertonic urine in the lumen of the ureter and the


D. barrier between concentrated hypertonic urine in the lumen of the bladder and the


5.which of the following epithelium lining female urethra is true?(m/s 47)

A. transitional epithelium at the end

B.pseudostratified columnar at the beginnig

C.stratified squamos epithelium at the end

D.pyramidal epithelium in the middle

Answers: C,A,C,D,C

PHYSIOLOGY 30 DECEMBER 2012

Questions:

1. All are true regarding osmolality EXCEPT:

A. Normal osmolality is about 300 osmoles per kilogram water.

B. Posm = osmolality of electrocytes + osmolality of glucose + osmolality of urea.


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C. Osmolality of the filtrate is isotonic and similar to plasma.

D. A measure of the total concentration of discrete solute particles in solution.

2. All are true about diluting mechanism EXCEPT:

A. Osmolality of fluid in ascending limb of LH decrease progressively to about 100

milliosmoles per Kg water.

B. Active absorption of Na+ and 2ndry active absorption of Cl- and K+ at thick

portion of LH and 1st segment of DCT.

C. Late DCT and CD are impermeable to H2O when ADH is present.

D. Absorption of solutes at distal segment of tubules and failure of reabsorption ofH2O.

3. Concentrating mechanism is as the following EXCEPT:

A. Also called counter-current multiplier mechanism.

B. A system which inflow runs parallel, counter to, and adjacent to the outflow.

C. Depends on special anatomical arrangement of LH and VR.

D. 1st step in concentration urine is to create hyperosmolarity of medullary tubular

fluid.

4. Regarding solute-concentrating mechanism, all are true EXCEPT:

A. At thick portion of ascending limb of LH, active transport of Na+ and 2ndry active

transport of Cl- and K+ into medullary interstitial fluid are occur.

B. Active reabsorption of Na+ and Cl- at thin ascending limb of LH according to

medullary gradient cause reabsorption of H2O.

C. Reabsorption of urea from the inner medullary part of the CD helped by ADH.

D. Active reabsorption of Na+ from the CD into medullary interstitial fluid

associated with electrogenic passive absorption of Cl-.


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5. True statement is:

A. In late DCT and CD, passive absorption of Na+ and Cl- occur.

B. In late DCT and CD, osmolality of interstitial fluid decreases as 65-70 milliosmoles

per Kg H2O by the time it enters the CD and leaves as urine.

C. Hemodilution cause dilution of urine due to increase H2O and increase ADH.

D. Counter-current multiplier mechanism cause multiplies or increases the

osmolarity of the renal cortical interstitial fluid.

E. When ADH is high, epithelium of the late part of DCT and CD becomes highly

permeable to H2O.

Answers:

1. A

2. C

3. D

4. B

5. E

31/12/12

QMU

1)Q: carbonic anyhydrase inhibitor cause increase ph in PCT ? true or false

A:true

2)loop diuretics are naturitic ? true or false

A:True

3)thiazide act on PCT and colecting tubule only .true or false ?


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A:false

4)acetazolamide decrease secretion of HCO3 in CSF? true or false ?

A:true

5)decrease ph of urine due to drugs intake can cause formation of renal stone?

true or false ?

A:false

Concentrating mechanism for kidney

The medullary blood flow characteristic for maintaining high solute concentration in

medulla interstitium constant is :

A. It is permeable to solute not to water

B. Have higher osmolality than medullary interstitial at the descending limb in vasa

recta

C. Medullary blood flow is very small in quantity

D. Also known as counter current multiplier mechanism

The most important cause to retain high solute in medullary interstitial occurring in

thick ascending limb loop of henle is :

A. Active transport Na and passive transport chloride and K into medullary

interstitial

B. Passive transport Na and chloride into medullary interstitial

C. Active transport of Na and secondary active transport chloride and K into

medullary interstitial

D. Its anatomical position between loop of henle and vasa recta

Which of the following is true:

A. The purpose of counter current mechanism is to create hyperosmolality of

medullary interstitial fluid

B. To maintain diluting mechanism of kidney for its equilibrium


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C. Concentrating urine mechanism also known as counter current multiplier

D. The epithelium of late part of distal convoluted and collecting ducts is not

permeable to water even in the present of vasopressin

Which of the following is true :

A. Active reabsorption of Na only occur at thick ascending limb Loop of Henle and

collecting duct for counter current multiplier mechanism

B. All transporting mechanism required carrier protein

C. Counter current mechanism will be activated if we drink lots of water in normal

people

D. Nothing interesting down here

A counter current mechanism is :

A. Used for defense mechanism against antigen

B. Depends on special anatomical arrangement of Loop of Henle and peritubular

capillaries

C. A system which the inflow runs parallel , counter to, and adjacent to the outflow

D. Passive reabsorption of Na occur at thin descending loop of henle

Answers: 1C, 2A, 3A, 4A, 5C

1/1/13

1)Which drugs can be used for glaucoma?

a)chlorothiazide and torsemide

b)eplerenone and acetazolamide

c)furosemide and mannitol

d)acetazolamide and mannitol

2)which drug may cause hypersensitivity?


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a)mannitol

b)spironolactone

c)hydrochlorothiazide

d) triamferene

3)whats the different mechanisms in potassium sparing agents?

a)inhibit atpase and k channel absorption

b)inhibit na channel and aldosterone antagonist

c)inhibit na/cl transporter and inhibit na/K/2Cl cotransporter

d)decrease intraocular and intracranial pressure

4)which drug can be used for treatment of nephrogenic diabetes insipidus?

a)hydrochlorothiazide

b)eplerenone

c)mannitol

d)furosemide

5)what is the main side effect of hydrochlorothiazide?

a)hypoglycaemia

b)hypocalcemia

c) hyperuricaemia

d)hyperkalemia

FROM PAGE 27 TO PAGE 29

1. The phosphate buffer system is more effective in ECF than in ICF


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Answer : False

2. The kidney though the most powerful requires several hours to several days to readjust the

hydrogen ion concentration.

Answer : True

3. Acidosis is present when arterial pH falls below .. and alkalosis when the arterial pH rises

above ..

a) 7.40 . 7.42

b) 7.38 . 7.40

c) 7.38 . 7.42

d) 7.36 . 7.38

Answer : C

4. The phosphate buffer system is effective in buffering the tubular fluid in the kidney because :

a) The pH of the ECF is more acidic than the pH of the tubular fluid.

b) Phosphate become greatly concentrated in the tubular fluid due to the reabsorption of water in

excess of phosphate.

c) A & B

Answer : B

5. The defense mechanisms against changes in hydrogen ion concentration are included :

a) Acid-base buffer system in body fluids

b) The respiratory system

c) The kidney

d) A & C

e) All of the above

Answer : E


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2/1/13

GLOMERULAR NEPHRITIS

Functions of mesangial cell are:

I. phagocytosing foreign antigen

II. supporting endothelial cells

III. antigen presenting cell

IV. contractility

A. I only

B. I and II only

C. I, II and III only

D. Not all of the above

E. All of the above

The type of cells(antigen) which causing antigen-antibody complexes for in situ

complexes is/are?

A. Glomerular cells

B. Both glomerular and non-glomerular cells

C. Non-glomerular cells

D. Foreign antigens


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The waste products passing from the blood into the Bowmans space in sequence :

I. basement membrane

II. fenestrae

III. slit-like space

A. III-II-I

B. I-II-III

C. II-I-III

D. III-I-II

The pathological Glomerulonephritis can be diagnosed most accurately by several

method except :

A. Fluorescene microscopy

B. Direct observation on kidneys

C. Electron microscopy

D. Light microscopy


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The fate of immune deposits if there are repeated exposure of antigen :

A. progressive glomerulosclerosis

B. acute glomerulonephritis

C. progressive glomerulonephritis

D. amyloidosis

Answers:

E, B, C, B, C

ACID BASE BALANCE 2

What is the mechanisms that is used by the kidney to regulate the P (HCO-3 ) in the

blood?

A. Reabsorption of filtered bicarbonate

B. Secretion of hydrogen ion

C. Generation of new bicarbonate

D. Both A and C

All of the following statement is true about the respiratory regulation of acid basebalance except?

A. The lungs regulate the pH by regulating the partial pressure of CO2 in the venous

blood

B. Respiratory regulation of the pH is effective but almost never completed


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C. Respiratory control returns the hydrogen ion concentration to 50-70% to normal

D. The increase in hydrogen ion concentration inside the CSF will stimulate the

chemoreceptor in medulla oblongata which will then stimulate ventilation

Choose the correct answer about renal regulation of pH?

A. The most effective buffer system

B. Regulate the pH by regulating the concentration of CO2 in plasma and secretion

of hydrogen ion

C. The slowest buffer system

D. All of the above

Which of the following statement is true about ammonia as a buffer?

A. Ammonia is a highly effective buffer

B. Synthesized in the epithelial cells of the proximal tubule and distal nephron and

is secreted into the tubular fluid

C. Highly lipid soluble and can passively diffuse across the cellular membrane

D. All of the above

Which of the following answer is not true about the process of reabsorption of filtered

bicarbonate?

A. The limiting pH for reabsorption of filtered bicarbonate to occur is 6.9

B. Occurs in distal convoluted tubules and collecting duct

C. Occurs in the presence of carbonic anhydrase enzyme

D. Occurs in proximal convoluted tubule only

Answer: D A B D B


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3/3/13

PATHOLOGY.(3/1)

1. Azotemia is elevation of:

a. Serum creatinine level

b. Blood urea nitrogen

c. Blood pressure

d. a and b

2. Acute nephritic syndrome is characterized by the following except:

a. Oligouria

b. Hypertension

c. Mild edema

d. Hypercholesterolemia and lipiduria

3. Which one of these is the LM picture of the acute nephritic syndrome?

a. Large epithelial deposits(humps)

b. Granular deposits of IgG and c3 along capillary wall

c. Increase in mesengial cells & infiltration by neutrophils

4. Hypertension in acute nephritic syndrome is caused by?

a. Fluid retention

b. Inflammatory reaction


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c. Renin released

d. a and c

5. Clinical picture of acute nephritic syndrome except?

a. Gross hematuria

b. Proteinuria

c. low serum complement level

d. Low titer of ASO in serum

physiology

1. All the following are the causes of metabolic alkalosis excepta. Excessive vomiting of gastric contentb. Excessive intake of alkaline drugc. Hypoaldosteronismd. Hyperaldosteronism

2. What is the total water output per daya. 2000-3000 ml/dayb. 2050-3050 ml/dayc. 2100-2300 ml/dayd. 2100-3400 ml/day

3. All the following controlled the secretion of adh excepta. AV3V regionb. Supraoptic nucleic. Preoptic hypothalamusd. Paraventricular nuclei

4. Which one of the following is not the characteristic of acute nephrotic syndromea. Hematuriab. Mild edemac. Oliguriad. Hypotension

5. Which one has the good prognosis with acute nephritic syndrome


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a. Children with crescentsb. Children without crescentsc. Adult with crescentd. None of the above

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QMU Section 6