The Urinary Sysytem

1. Substances that are actively secreted into the renal tubule may include ________.
a. K+ and glucose
b. H+ and glucose
c. K+ and H+
d. H2 and H+

2. The rate of excretion is equal to ________.

a. Filtered load x secretion rate/absorption rate
b. Filtered load + secretion rate – reabsorption rate
c. Filtered load – secretion rate + reabsorption rate
d. Secretion rate – filtered load + reabsorption rate

3. Functions associated with the loop of Henle include ________.

a. Water reabsorption and creation of an osmotic gradient
b. Secretion of inulin
c. Reabsorption of glucose and water
d. Hormonal control of water secretion

4. By the end of the proximal tubule in a normal kidney, ________.

a. The filtrate glucose concentration is 0 mg
b. All of the responses are correct
c. The filtration volume is reduced by 70%
d. None of the listed responses is correct

5. In a normal kidney, the filtrate that leaves the glomerulus and enters the proximal tubule
may contain each of the following except ______.
a. Albumin
b. Urea
c. Glucose
d. Na+ and HCO3-
 Proteins such as albumin are too large to filter across the glomerular
capillaries and, consequently, remain in the blood plasma to travel on to
the efferent arteriole.

6. Place the path of filtrate through the listed nephron structures in order:
a. collecting duct
b. proximal convoluted tubule
c. glomerulus
d. loop of Henle
 a. D, b, c, a
b. A, b, c, d
c. B, a, d, c
d. C, b, d, a

7. The juxtaglomerular apparatus ________.

a. consists of both granular cells and specialized epithelial cells called the macula
densa
b. None of the listed responses are correct.
c. All of the listed responses are correct.
d. is the site where the distal convoluted tubule is in contact with the nephron’s
afferent and efferent arterioles
e. is important in the regulation of blood pressure and volume

8. The three exchange processes in the renal tubules for the formation of urine, include each
of the following except ________.
a. Reabsorption
b. Excretion
c. Filtration
d. Secretion

9. The transport process utilized by the proximal tubule to reabsorb glucose from the filtrate
into tubular cells is ________.
a. secondary active transport
b. primary active transport
c. simple diffusion
d. facilitated diffusion
10. Place in order the path of blood flow through the kidney circulation:
a. afferent arteriole
b. efferent arteriole
c. glomerular capillary
d. vasa recta
e. renal vein
a. b, c, d, e, a
b. c, b, d, a, e
c. a, c, b, d, e
d. c, a, b, d, e

11. Given the following data, renal blood flow is ________.

PPAH = 4 mmole/L
UPAH = 950 mmole/L
V = 2 mL/min
hematocrit = 48%
 a. 989.6 mL/min
b. 475 mL/min
c. 913.5 mL/min
d. Equal to GFR
 Find clearance
 Then find Renal Blood Flow with ((clearance)/(1 – (hematocrit/100))

12. The kidneys filter approximately 180 L of plasma per day, but only excrete about 1.5 L of
urine in that time, regardless of most changes in mean arterial pressure. This is because
________.
a. the kidneys are not very efficient
b. many substances are reabsorbed at nearly 100%
c. the arterial pressure is the same in all arteries
d. we often drink enough water to replenish the lost urine

13. The clearance of ________ is the most precise way to measure GFR.
a. PAH
b. Inulin
c. Sodium
d. Creatinine

14. Calculate is the amount of solute excreted under the following conditions:
GFR = 150 mL/min
Plasma concentration = 0.1 mmole/mL
Amount reabsorbed = 8 mmole/min
Amount secreted = 3 mmole/min
a. 10 mmole/min
b. 15 mmole/min
c. 20 mmole/min
d. 4 mmole/min

15. What is a function of the afferent arteriole?

a. to bring blood to the glomerular capillaries
b. to bring filtrate to the glomerular capillaries
c. to bring blood away from the glomerular capillaries
d. to bring blood to the peritubular capillaries

16. During micturition, ________.

a. parasympathetic input to the bladder is inhibited
b. sympathetic input to the bladder is activated
c. somatic motor neuron input to the external urethral sphincter is inhibited
d. somatic motor neuron input to the external urethral sphincter is excited

17. What is the relationship between afferent arteriole and efferent arteriole diameter?
a. The afferent arteriole and the efferent arteriole have the same diameter.
 b. There is no relationship between the afferent arteriole and efferent arteriole
diameter.
c. The afferent arteriole has a larger diameter than the efferent arteriole.
d. The afferent arteriole has a smaller diameter than the efferent arteriole.

18. Intrinsic control of glomerular filtration rate (GFR) can occur ________.
a. when baroreceptors in the aortic arch are activated
b. through myogenic regulation and via tubuloglomerular feedback
c. when mean arterial pressure falls below 80 mm Hg
d. due to an increase in sympathetic or parasympathetic input

19. What conclusions can be made from the following data regarding Substance X?
GFR = 130 mls/min
PX = 25 mmole/L
UX = 125 mmole/L
V = 4 mL/min
a. Secreted
b. Reabsorbed
c. Not filtered
d. Filtered and reabsorbed

20. If the efferent arteriole is vasoconstricted, which of the following increases?

a. Glomerular capillary pressure
b. None of the listed responses are correct.
c. glomerular filtration rate
d. glomerular filtration pressure
e. All of the listed responses are correct.

21. In addition to waste removal and regulation of cellular osmolarity, the kidneys' other
functions include ________.
a. activation of vitamin D3
b. secretion of erythropoietin
c. All of the listed responses are correct.
d. Gluconeogenesis
e. None of the listed responses is correct.

22. Calculate the net glomerular filtration pressure (GFP) when the following pressures exist
at a glomerulus:
PGC = 56 mm Hg
PBC = 14 mm Hg
∏BC = 0 mm Hg
∏GC = 32 mm Hg
a. +38 mm Hg
b. –10 mm Hg
c. 0 mm Hg
d. +10 mm Hg
  GFP = Kf ((PGC - PBC) – (∏GC - ∏BC))

23. Which of the following structures would is not in the kidneys?

a. Pelvis
b. Bowman’s capsule
c. Juxtamedullary nephron
d. Urethra

24. Urine is carried from the collecting duct to which structure?

a. Loop of Henle
b. Urethra
c. Renal pelvis
d. Ureter

25. Filtrate may first be referred to as urine at the end of the ________.
a. proximal tubule
b. renal pelvis
c. collecting duct
d. ureter

26. Water reabsorption is controlled by hormones in the ________.

a. distal convoluted tubule and the collecting duct
b. proximal convoluted tubule and distal convoluted tubule
c. loop of Henle
d. Glomerular capillaries

27. In kidney renal tubules, all of the following substances normally are excreted into urine
except __________.
a. hydrogen ions
b. None of the listed responses is correct.
c. potassium ions
d. glucose

28. Which of the following substances is not secreted into the filtrate in the distal convoluted
tubule?
a. Water
b. Potassium ions
c. Bicarbonate
d. Hydrogen ions

29. Which of the following does not result in an increase in GFR?

a. Increased resistance in the afferent arteriole
b. Increased resistance in the efferent arteriole
c. relaxation of mesangial cells
d. increased glomerular pressure
30. Which is unlikely to be a consequence of kidney disease?
a. Edema
b. Electrolyte imbalance
c. Hyperglycemia
d. Anemia

31. One factor that favors filtration at the glomerulus is ________.

a. high capillary blood pressure
b. high osmotic pressure in the glomerular capillaries
c. high concentration of proteins in the plasma
d. high fluid hydrostatic pressure in Bowman's capsule

32. While both the proximal and distal tubules are used for reabsorption of filtrate, they differ
in several ways. Which of the following is a false statement about the differences
between the proximal and distal tubules?
a. The proximal tubule is "leakier" than the distal tubule.
b. Distal tubule cells possess glucose transporters.
c. Proximal tubule cells have larger numbers of mitochondria.
d. Distal tubule cells express hormone receptors while proximal tubule cells do not.

33. In a healthy kidney, glucose ________.

a. simply diffuses across the membranes of the proximal tubule
b. is filtered at the glomerulus
c. is excreted in the urine
d. is actively transported in the distal tubule

34. The nephron is the functional unit of the kidney because ________.
a. the nephron consists of vascular parts and tubular parts
b. the nephron is essentially continuous with the external environment
c. the nephron filters blood plasma, reabsorbs critical molecules, and excretes the
rest
d. ach kidney has a million nephrons

35. The functions of the kidneys include ________.

a. regulation of plasma pH
b. regulation of plasma ion composition
c. maintenance of body fluid osmolarity
d. All of the listed responses are correct.
e. regulation of plasma volume

36. Glucose reabsorption from the renal filtrate along tubule epithelial cell is due to
________ from the luminal side and ________ from the basolateral membrane.
a. osmotic pressure; simple diffusion
b. osmosis; simple diffusion
c. secondary active transport; facilitated diffusion
d. primary active transport; secondary active transport
37. Para-aminohippuric acid (PAH) is used under clinical conditions to estimate and assess
healthy kidney clearance function because ________.
a. All of the listed responses are correct.
b. it is not reabsorbed by any segment of the nephron
c. PAH clearance rate equals the renal flow rate of the kidney
d. it is filtered at the glomerulus
e. any remnants in renal capillaries are completely secreted

38. The kidney's inner region is called the ________.

a. renal pelvis
b. adrenal gland
c. renal medulla
d. renal cortex

39. The ability of the nephron to filter substances based on size and charge is due to each of
the following except __________.
a. basal lamina (basement membrane)
b. hydrostatic pressure
c. capillary endothelium
d. epithelium of the Bowman's capsule

40. In a healthy kidney, glucose ________.

a. simply diffuses across the membranes of the proximal tubule
b. is filtered at the glomerulus
c. is excreted in the urine
d. is actively transported in the distal tubule

41. The urine of an individual contains glucose when ________.

a. loop of Henle is hyperactive
b. blood plasma sugar levels are abnormally low (hypoglycemia)
c. blood plasma glucose concentration has reached renal threshold
d. blood pressure is abnormally low (hypotension)

42. In and around the urinary bladder, skeletal muscle are located in the ________.
a. internal urethral sphincter
b. ureters
c. detrusor muscle
d. external urethral sphincter

43. By the end of the proximal tubule, approximately 70% of the water and solutes have been
reabsorbed from the filtrate. The filtrate is still iso-osmotic to blood plasma. What types
of transport occurs at the proximal tubule to allow for the filtrate and blood plasma to be
iso-osmotic to one another?
a. both water and solutes are reabsorbed by active transport
b. active transport of many solutes and osmosis for water reabsorption
 c. both solutes and water are reabsorbed by simple diffusion
d. active transport of water and simple diffusion of many solutes

44. If clearance of a substance is greater than GFR, the substance is ________.

a. only filtered, but not reabsorbed or secreted
b. reabsorbed more than it is secreted
c. never filtered
d. secreted more than it is reabsorbed

45. The renal corpuscle is the site where ________.

a. sodium ions are reabsorbed
b. glucose reabsorption occurs
c. the steep medullary osmotic gradient is established
d. blood plasma is filtered at the glomerulus

46. Put the following in the appropriate sequence to indicate the pathway a substance must
travel to be reabsorbed:
a. basolateral membrane of the tubular epithelial cells
b. peritubular space
c. luminal membrane of the tubular epithelial cell
d. capillary pore of the peritubular capillary
a. a, b, c, d
b. a, c, b, d
c. c, b, a, d
d. c, a, b, d

47. Secretion differs from filtration in that ________.

a. secretion involves movement of substances from the tubule lumen back into the
blood plasma while filtration involves movement from the blood plasma to the
tubule lumen
b. filtration is selective because it is carrier mediated while secretion is reliant upon
Starling forces
c. secretion is selective because it is carrier mediated while filtration is not selective
because it is reliant upon Starling forces
d. secretion is the process of moving substances out of the body while filtration is
the process of moving substances of the tubules

48. The proximal tubule is where ________.

a. the reabsorption of the majority of ions, organic molecules, and vitamins occurs
b. the tubular cells are impermeable to water
c. hormonally regulated reabsorption of Na+ occurs
d. hormonally regulated secretion of H+ occurs

49. Which part of the nephron always has low permeability to water, regardless of hormone
levels?
a. proximal tubule
 b. descending loop of Henle
c. collecting duct
d. ascending loop of Henle

The Respiratory System

1. One effect of carbon monoxide is to ________.

a. shift the hemoglobin-oxygen dissociation curve to the left
b. decrease the affinity of hemoglobin for oxygen
c. increase the affinity of hemoglobin for O2
d. decrease the affinity of hemoglobin for CO2

2. Central chemoreceptors are stimulated by ________.

a. H+ ions in arterial blood
b. H+ ions produced in cerebrospinal fluid
c. H+ ions that cross the blood-brain barrier
d. None of the listed responses are correct.

3. Which of the following statements is false?

a. Oxygen binding to hemoglobin shows positive affinity.
b. The binding of oxygen to hemoglobin is a linear function.
c. The fewer oxygen molecules bound to hemoglobin, the lower the affinity of
hemoglobin for oxygen.
d. The PO2 in systemic veins is 40 mm Hg.

4. Which of the following gases has a greater partial pressure in blood as it enters
pulmonary capillaries?
a. CO2
b. H2
c. CO
d. O2

5. If carbonic anhydrase activity decreased, which of the following would increase in the
blood plasma?
a. only the PCO2
b. pH, PCO2, and Cl-
c. only the pH
d. only Cl-

6. Which of the following can result in a decreased PO2 in arterial blood?

a. Emphysema
b. All of the listed responses are correct.
c. Hyperventilation
d. Pulmonary edema
7. Which of the following does not influence the ventilation-perfusion ratio?
a. An airway obstruction
b. Damage to systemic capillaries
c. Gravity
d. Damage to the pulmonary capillaries

8. The respiratory receptors of the brain receive input from ________.

a. irritant receptors
b. central chemoreceptors
c. pulmonary stretch receptors
d. All of the listed responses are correct.
e. peripheral chemoreceptors

9. Approximately 79% of the total atmospheric pressure is taken up by nitrogen. At the top
of Mount Everest, PATM = 250 mm Hg. Calculate the PN2 at Mount Everest.
a. 200 mm Hg
b. 197.5 mm Hg
c. 600 mm Hg
d. 160 mm Hg

10. Just prior to expiration, the PO2 decreases and PCO2 increases in the pulmonary alveoli due
to ________.
a. All of the listed responses are correct.
b. rapid diffusion of gases across the respiratory membranes
c. the increased partial pressure of water vapor
d. inhaled air mixing with air in anatomical dead space

11. In the chloride shift, chloride ions are exchanged for ________ across the erythrocyte
membrane.
a. O2
b. CO2
c. H+
d. HCO3-
12. Which of the following statements about exercise and respiration is false?
a. Minute ventilation is controlled by both humoral and neurogenic mechanisms.
b. The increased ventilation during exercise is referred to as “exercise apnea.”
c. Feedforward mechanisms help to increase ventilation in preparation for exercise.
d. Negative feedback mechanisms help prevent hyperventilation.

13. Conditions that would shift the hemoglobin-oxygen dissociation curve to the right
include a decrease in ________.
a. pH
b. Temperature
c. PCO2
d. PO2
14. Which of the following statements related to "the bends” is false?
a. Dissolved nitrogen gas bubbles can cause air embolisms in blood vessels and
lodge in joints and the nervous system.
b. Ascending too quickly after diving in deep water causes the pH of body fluids to
increase.
c. Diving deep increases water pressure, which causes more gases (such as nitrogen)
to dissolve into the blood.
d. Ascending too quickly after diving in deep water causes nitrogen gas to come out
of the blood as bubbles into body fluids.

15. Approximately 79% of the total atmospheric pressure is taken up by nitrogen. At the top
of Mount Everest, PATM = 250 mm Hg. Calculate the PN2 at Mount Everest.
a. 200 mm Hg
b. 197.5 mm Hg
c. 600 mm Hg
d. 160 mm Hg

16. On average, the number of oxygen molecules bound to heme groups in hemoglobin in
systemic venous blood is ________.
a. Two
b. One
c. Four
d. Three

17. For oxygen gas in air and dissolved in water, at equilibrium, ________.
a. the partial pressure of oxygen in the air is greater than the partial pressure of
oxygen in the water
b. the concentration of oxygen in the air is less than the concentration of oxygen in
the water
c. the partial pressure of oxygen in air is equal to the partial pressure of oxygen in
water
d. the concentration of oxygen in the air is equal to the concentration of oxygen in
the water

18. Which of the following factors decrease hemoglobin affinity for oxygen at the peripheral
tissues?
a. Bohr effect and carbamino effect
b. Haldane effect and Bohr effect
c. Haldane effect and chloride shift
d. carbamino effect and chloride shift

19. Each of the following occurs if bronchioles are constricted, except ________.
a. PO2 decreases
b. VA/Q decreases
c. VA increases
 d. PCO2 increases

20. During inspiration, the diaphragm and external intercostals ________, and the volume of
the thoracic cage ________.
a. relax; decreases
b. contract; increases
c. contract; decreases
d. relax; increases

21. In a premature newborn with respiratory distress syndrome, lung compliance (a measure
of how easily a tissue or organ can stretch) will likely improve with an increase in
________.
a. the amount of surfactant
b. lung elasticity
c. the surface tension inside alveoli
d. the thickness of the respiratory membrane

22. Which structures are part of the respiratory membrane?

a. Alveolar walls and pulmonary capillaries
b. Internal intercostals and external intercostals
c. Parietal pleura and visceral pleura
d. Alveolar macrophages and pulmonary capillaries

23. For what reason can expiration can be considered to be a passive (quiet) process?
a. The rapid change in compliance during expiration
b. The relaxation of the diaphragm and intercostal muscles
c. The contraction of the diaphragm and intercostal muscles

24. Arrange these airways in the anatomical order that a breath of inhaled air encounters
them:
a. Larynx
b. Trachea
c. Pharynx
d. Bronchioles
e. Bronchi
a. a, b, c, d, e
b. c, a, b, d, e
c. d, a, b, c, e
d. c, a, b, e, d

25. Which of the following structures allow gas exchange?

a. Secondary bronchi
b. Bronchi
c. Terminal bronchioles
d. Alveoli
 26. Airway resistance is increased by each of the following, except ________.
a. mucus secretion
b. increasing transpulmonary pressure
c. asthma
d. smooth muscle contraction

27. External respiration processes include each of the following except the __________.
a. exchange of oxygen and carbon dioxide between the blood and tissues
b. transportation of oxygen and carbon dioxide by the blood
c. production of ATP by oxidative phosphorylation
d. exchange of oxygen and carbon dioxide between the lung air spaces and the blood
28. The amount of air reaching the alveoli per minute depends on the following except
________.
a. Palv (intra-alveolar pressure)
b. lung compliance
c. amount of surfactant in the alveoli
d. airway resistance
29. Airway resistance can be decreased by ________.
a. Acetylcholine
b. Epinephrine
c. Histamine
d. Mucous
30. The cells and structures that defend against bacteria and foreign particles entering the
lungs include each of the following except the ________.
a. mucus escalator
b. goblet cells
c. macrophages
d. type II alveolar cells

31. Put the events of inspiration* in the correct order

a. Pip decreases
b. Transpulmonary pressure increases
c. Diaphragm and intercostals contract
d. Palv decreases to less than Patm
*Where: Pip = intrapleural pressure; Palv= intra-alveolar pressure; Patm= atmospheric pressure
a. a, b, c, d
b. b, c, a, d
c. b, a, c, d
d. c, a, b, d

32. A patient has an upper respiratory infection (URI). This means that his infection is not in
his ________.
a. Larynx
b. Lungs
c. Nasal cavity
33. According to Boyle’s law, at a constant temperature, ________.
a. the volume of a container of gas and the pressure of the gas within are inversely
related
b. the partial pressure of oxygen in the atmosphere is about 160 mmHg, or 21% of
total atmospheric pressure
c. oxygen moves from the alveoli to the blood plasma down a pressure gradient
d. the concentration of a gas in a liquid is directly proportional to the partial pressure
of the gas in the air above the liquid

34. Put the following structures of the chest wall in the correct order, going from most
superficial to deepest:
a. Parietal pleura
b. Intercostal muscle
c. Visceral pleura
d. Intrapleural space
e. Lungs
a. e, b, d, c, a
b. a, b, c, d, e
c. b, a, d, c, e
d. b, a, d, e, c

35. Functions of the respiratory system include ________.

a. helping to maintain blood pH
b. defense against pathogens
c. enabling vocalization
d. All of the listed responses are correct.

36. The pleural fluid surrounding each lung ________.

a. helps the lungs adhere to the thoracic cage
b. generates a pressure that is greater than atmospheric
c. is a liter or more in volume
d. creates friction as the lungs move within the thoracic cavity

37. The direction and magnitude of airflow during breathing is determined by changes in
________ pressure.
a. Atmospheric
b. Alveolar
c. Transpulmonary
d. Intrapleural

38. Type I alveolar cells ________.

a. are simple squamous epithelial cells adapted for exchange
b. secrete a chemical known as surfactant
c. are phagocytic
d. are elastic
 39. Which of the following is the lowest pressure at rest following a quiet expiration?
a. Atmospheric
b. Intrapleural
c. Intra-alveolar
d. Transpulmonary

40. Structures within the conducting zone include the ________.

a. Alveoli
b. Respiratory bronchioles
c. Terminal bronchioles

41. Pulmonary surfactant helps to ________.

a. decrease surface tension
b. decrease lung compliance
c. allow large alveoli to collapse into smaller ones
d. increase surface tension in the water lining the alveoli

Fluid and Electrolyte Balance

1. Which of the following hormones acts directly on the collecting duct of the kidney to
enhance the reabsorption of water?
a. antidiuretic hormone (ADH)
b. aldosterone
c. atrial natriuretic peptide (ANP)
d. renin

2. When mean arterial pressure increases, which of the following increase(s) in response?
a. ADH and aldosterone levels
b. GFR and ADH levels
c. water reabsorption
d. GFR and urine volume

3. An antidiuretic hormone (ADH) receptor antagonist would ________.

a. increase peripheral resistance through vasoconstriction of arterioles
b. prevent the release of ADH into the circulatory system
c. cause aquaporins to be inserted into the apical membranes of collecting duct cells
d. prevent aquaporins from being inserted into the apical membranes of collecting
duct cells

4. If a person with a normal body fluid osmolarity drinks a large quantity of water, which of
the following would occur if the kidneys could not excrete any of the water?
a. increased urine output
b. hypovolemia and increased plasma osmolarity
c. cell shrinkage
d. hypervolemia and decreased plasma osmolarity
5. An ACE (angiotensin converting enzyme) inhibitor is used to treat ________.
a. hypertension since ACE inhibition decreases the rate of urine production
b. hypertension since ACE inhibition results in decreased secretion of anti-diuretic
hormone and aldosterone
c. hypotension since ACE inhibition results in increased secretion of anti-diuretic
hormone and aldosterone
d. hypotension since ACE inhibition decreases the rate of glomerular filtration

6. Which of the following statements does not describe the movement of water across the
late distal tubule and collecting duct?
a. It a passive process.
b. Water flows from the blood plasma to tubule lumen.
c. Water flows occurs through channels called aquaporins.
d. It is driven by the medullary osmotic gradient.

7. If a person drinks 200 mL of seawater, how does the body correct for the increase in
plasma osmolarity?
a. by decreasing the release of antidiuretic hormone (ADH)
b. by increasing the release of antidiuretic hormone (ADH)
c. by increasing the release of aldosterone
d. by decreasing the release of atrial natriuretic peptide (ANP)

8. When mean arterial pressure (MAP) decreases, which of the following increase in
response?
a. GFR and water excretion
b. Urine volume and water excretion
c. ADH levels and water reabsorption
d. GFR and urine volume

9. In the absence of ADH, which of the following decrease?

a. blood plasma osmolarity and urine volume
b. urine osmolarity and aquaporin synthesis
c. the medullary osmotic gradient
d. urine volume and aquaporin synthesis

10. Angiotensin II stimulates the ________.

a. release of angiotensinogen and angiotensin I
b. release of both aldosterone and ADH
c. release of both renin and aldosterone
d. vasodilation of arterioles

11. Hemorrhage would tend to increase the secretion of each of the following, except
________.
a. ADH
b. Erythropoietin
c. Atrial natriuretic peptide
 d. Aldosterone

12. The organ(s) that regulate water loss to maintain water balance is (are) the ________.
a. Lungs
b. Liver
c. Kidneys
d. Skin

13. Put the following events of the renin-angiotensin-aldosterone system in the correct order:
a. Angiotensin I is converted to angiotensin II.
b. Renin is secreted by the granular cells.
c. Aldosterone is released from the adrenal glands.
d. Renin converts angiotensinogen into angiotensin I.
e. Cells in the macula densa detect a decrease in the flow of fluid (or ion concentration) in
the distal tubule.
a. e, b, d, a, c
b. e, c, d, b, a
c. c, e, a, d, b
d. c, e, d, a, b

14. Which of the following is not true of thirst?

a. Thirst can actually increase plasma volume if it leads to ingestion of fluid.
b. Thirst is a physiological mechanism that maintains fluid and electrolyte balance.
c. High osmolarity stimulates thirst.
d. Angiotensin II stimulates thirst.

15. The effects of angiotensin II on the central nervous system are to ________.
a. inhibit secretion of antidiuretic hormone from the posterior pituitary gland
b. increase activity of the respiratory control center
c. act on the medulla oblongata to decrease blood pressure
d. increase thirst, increase cardiac output, and cause peripheral vasoconstriction

16. When insufficient water intake leads to dehydration, what compensatory mechanism
preserves plasma volume and homeostatic osmolarity?
a. Increase the amount of water excreted into the filtrate at the collecting duct.
b. Increase the glomerular filtration rate at the glomerular capillaries.
c. Reduce the concentration of sodium ions in the excreted urine.
d. Increase the amount of water that is reabsorbed from the filtrate at the collecting
duct.

17. The primary function of the vasa recta is to ________.

a. maintain the medullary concentration gradient
b. promote sodium and water excretion in the nephron
c. fine-tune water reabsorption to maintain plasma volume
d. establish the medullary concentration gradient
 18. Angiotensin II leads to a change in kidney function by ________.
a. promoting vasodilation of systemic arterioles
b. reducing thirst and reducing the amount of antidiuretic hormone (ADH)
c. preventing the release of aldosterone and antidiuretic hormone (ADH)
d. initiating the release of aldosterone and antidiuretic hormone (ADH)

19. The signals controlling ADH release come from ________.

a. osmoreceptors in the hypothalamus
b. the macula densa
c. arterial baroreceptors
d. All of the listed responses are correct.

20. The plasma can gain or lose water and/or solutes by ________.
a. exchange with extracellular connective tissue, such as bone
b. All of the listed responses are correct.
c. Respiration
d. exchange with the lumen of the GI tract

21. An osmotic gradient exists in the renal medulla because various parts of the loop of
Henle differ from each other. Which of the following contribute to the osmotic gradient?
a. permeability to water
b. All of the listed responses are correct.
c. directionality of fluid movement
d. active transport of solutes

22. People suffering from central diabetes insipidus (a disorder of the hypothalamus or
pituitary gland) may have increased ________.
a. urine volume and ADH levels
b. urine osmolarity and ADH levels
c. plasma osmolarity and urine osmolarity
d. plasma osmolarity and urine volume

23. When compared to filtrate entering the descending limb of the loop of Henle, filtrate
leaving the ascending limb of the loop of Henle is ________ in volume and ________.
a. lower; hyper-osmotic
b. lower; hypo-osmotic
c. higher; hypo-osmotic
d. lower; iso-osmotic

24. Plasma solute concentration directly or indirectly affects ________.

a. mean arterial pressure
b. changes in plasma volume
c. All of the listed responses are correct.
d. the amount of water in the various body fluid compartments

Cardiovascular System
1. Following filtration of blood plasma, not all solutes are filtered due to their large size,
hydrophilic nature, and lack of transcytosis. These nonpermeating plasma solutes
contribute to the capillary ________.
a. central venous pressure
b. capillary hydrostatic pressure
c. interstitial fluid osmotic pressure
d. colloid osmotic pressure

2. The velocity of blood flow is ________ through the capillaries than the blood flow
through the aorta because the overall cross-sectional area of all capillaries is ________ in
comparison to the aorta.
a. faster; larger
b. the same; the same
c. faster; smaller
d. slower; larger

3. By which mechanism are exchangeable proteins transported across a capillary endothelial

cell?
a. By simple diffusion through endothelial cells
b. By simple diffusion through capillary pores
c. They cannot be transported.
d. By transcytosis

4. The total flow rate of blood is ________ in the arterial system compared to the venous
system, while the velocity of flow is ________ in arteries compared to veins of
comparable size.
a. None of the listed responses is correct.
b. the same; greater
c. lesser; the same
d. greater; the same
e. the same; lesser

5. What is the relationship between blood flow and resistance?

a. Inversely proportionate
b. Directly proportionate
c. Indirectly proportionate

6. As blood flows through the systemic circuit, in which vessels will velocity and pressure
undergo the greatest decline?
a. Arteries
b. Capillaries
c. Veins
d. Venules
e. Arterioles
7. Which of the following is (are) the same in both the pulmonary and systemic circuits?
a. All of the listed responses are correct.
b. Pressure gradient
c. Blood flow rate
d. Vessel resistance

8. Which of the following scenarios would lead to arteriole vasoconstriction in an organ?

a. Excessive blood flow
b. Excessive carbon dioxide levels
c. Suppressed oxygen levels

9. Which of the following terms could be used to characterize veins?

a. Pressure reservoir and high resistance
b. High compliance and volume reservoir
c. Low compliance and high resistance

10. Which category of blood vessel has the thickest layers of elastic tissue and smooth
muscle?
a. Veins
b. Capillaries
c. Arterioles
d. Arteries

11. Capillaries contain which of the following structures?

a. Smooth muscle
b. Elastic connective tissue
c. Fibrous connective tissue
d. Endothelium

12. The lymphatic system contains ________.

a. arterioles only
b. arteries only
c. veins and capillaries
d. veins and arteries

13. What is the relationship between blood flow and a pressure gradient?
a. Directly proportionate
b. Inversely proportionate
c. Indirectly proportionate

14. Which term is used to describe the hollow interior of some organs, such as blood vessels?
a. Chamber
b. Capillary
c. Epithelium
d. Lumen
15. What is the function of the skeletal muscle “pump?”
a. To enhance artery blood distribution and return blood to the heart.
b. To increase venous blood pressure to return blood to the heart.
c. To increase capillary blood pressure and promote filtration.

16. By which mechanism are small, water-soluble substances transported across a capillary
from the blood plasma to the interstitial fluid?
a. By simple diffusion through endothelial cell membranes.
b. They cannot be transported.
c. By transcytosis.
d. By simple diffusion through capillary pores.

17. ________ is the pressure of blood contained in the large veins that lead to the heart.
a. Central venous pressure
b. Cardiac output
c. Mean arterial pressure
d. Stroke volume

18. Blood vessel resistance is dependent on ________.

a. All of the listed responses are correct.
b. blood viscosity
c. vessel radius
d. vessel length

19. Within a capillary at the arteriole end, the following pressures are measured:

a filtration pressure of 42 mmHG

an absorption pressure of 28 mmHG

The net filtration pressure (NFP) for this capillary is ________ mmHg.
a. 70
b. 42
c. 14
d. 28

20. Differences between arterioles and metarterioles include the fact that arterioles
________.
a. have a continuous smooth muscle layer in their walls
b. All of the listed responses are correct.
c. allow blood to bypass capillary beds
d. have an endothelial lining

21. Which of the following contain one-way valves?

a. Only precapillary sphincters
b. Only metarterioles
c. Both lymphatic vessels and veins
 d. Only lymphatic vessels
e. Only veins

22. Fenestrated capillaries are found in organs that ________.

a. have been damaged due to disease
b. need rapid diffusion of solutes
c. have a very restricted blood flow
d. need to limit solute diffusion into organs

23. Bulk flow across a capillary is the combination of ________ (which allows for transport
of water and solutes from the blood plasma to the interstitial fluid) and ________ (which
allows for transport of water and solutes from the interstitial fluid to the blood plasma).
a. passive transport; active transport
b. absorption; filtration
c. filtration; absorption
d. active transport; passive transport

24. The pressure exerted by fluid within the capillaries is called capillary ________ pressure.
a. partial gas
b. osmotic
c. net filtration
d. hydrostatic

25. During which phase of contraction is blood pressure highest?

a. Ventricular systole
b. Arterial systole
c. Venous diastole
d. Ventricular diastole

26. In terms of maintaining blood pressure or responding to inevitable fluctuations in blood

pressure, when everything is considered, the immediate danger posed by ________, is far
greater than that posed by a ______________.
a. hypertension; hypotension
b. hypotension; hypertension
c. hyperglycemia; hypoglycemia
d. hypoglycemia; hyperglycemia

27. Blood flow is increased to skeletal and cardiac muscle during exercise by ________.
a. epinephrine binding to alpha receptors
b. flow autoregulation
c. active hyperemia
d. acetylcholine binding to nicotinic receptors

28. Calcium channel blockers bind to Ca2+ channel proteins in vascular smooth muscle and
cause ________.
a. dilation of vessels, lowering blood pressure
 b. constriction of vessels, lowering blood pressure
c. dilation of vessels, raising blood pressure
d. constriction of vessels, raising blood pressure

29. The sequence of negative feedback events that use baroreceptors to keep blood pressure
within set-point is referred to as ________.
a. thermoregulatory reflex
b. hormonal control
c. hypertension
d. the baroreceptor reflex

30. During the measurement of blood pressure with a sphygmomanometer, diastolic blood
pressure is recorded when ________.
a. Korotkoff sounds are first heard through the stethoscope
b. Korotkoff sounds are no longer heard through the stethoscope
c. turbulent sounds are heard through the stethoscope

31. A patient's blood pressure is determined by sphygmomanometry to be 185/117. At what

pressure did the Korotkoff sounds disappear and why?
a. less than 117 mmHg, because cuff pressure is below diastolic and no longer
causes turbulent blood flow
b. less than185 mmHg, because the cuff pressure is no longer compressing the artery
c. less than 68 mmHg, because cuff pressure must be less than pulse pressure
d. less than mean arterial pressure

32. At rest, the majority of cardiac output is distributed to ________.

a. the largest organ(s)
b. the brain
c. skeletal muscle(s)
d. tissue(s) with the greatest metabolic demand

33. A decrease in which of the following would also cause mean arterial pressure (MAP) to
decrease?
a. Heart rate
b. Stroke volume
c. All of the listed responses are correct.
d. Total peripheral resistance

34. As part of the baroreceptor reflex response to hemorrhage, which of the following
increases?
a. Heart rate and total peripheral resistance
b. Urine output and vasodilation
c. Vasodilation and heart rate

35. A change in vascular resistance in response to stretch of blood vessels is called

________.
 a. myogenic response
b. mean arterial pressure
c. vasodilation
d. cardiac output

36. Control of mean arterial blood pressure by the central nervous system is controlled
primarily by the ________.
a. medulla oblongata
b. hypothalamus
c. cerebral cortex
d. vagus nerve

37. The organ that plays the greatest role in regulating blood pressure by altering blood
volume is the ________.
a. Kidney
b. Lung
c. Heart
d. Liver

38. Mean arterial pressure (MAP) is based on ________.

a. systolic blood pressure minus diastolic blood pressure
b. heart rate, stroke volume, and total peripheral resistance
c. Korotkoff sounds heard through the stethoscope during a blood pressure reading
d. the sum of systolic and diastolic blood pressure

39. Hypertension can be caused by ________.

a. hormone imbalance
b. All of the listed responses are correct.
c. Genetics
d. kidney disease

40. All of the following would cause an increase in blood pressure except ________.
a. a decrease in arterial diameter
b. sympathetic stimulation
c. an increase in arterial resistance
d. a decrease in cardiac output

41. Arterial baroreceptors are located in the aorta and carotid arteries so that pressure (and
flow) to the ________ can be closely monitored.
a. pulmonary circuit and lungs
b. heart and lungs
c. brain and pulmonary circuit
d. brain and systemic circuit

42. Congestive heart failure on the left side of the heart results in ________.
a. pulmonary edema
 b. a net filtration of zero in the systemic capillaries
c. systemic edema

43. In active hyperemia ________.

a. low oxygen levels cause arteriolar smooth muscle to relax and vasodilate
b. the autonomic nervous system controls arteriolar smooth muscle to relax and
vasodilate
c. stretching blood vessel walls tends to make them constrict
d. decreased blood flow causes arteriolar smooth muscle to relax and vasodilate

44. In an effort to bring mean arterial pressure back to normal after a hemorrhage, total
peripheral resistance ________ because the blood flow to most organs ________.
However, blood flow to the ________ and ________ is maintained because these organs
are not greatly influenced by the baroreceptor reflex.
a. stays the same; stays the same; brain; heart
b. decreases; increases; muscles; GI tract
c. increases; decreases; muscles; heart
d. increases; decreases; brain; heart

45. Which part(s) of the heart is (are) innervated by sympathetic nerves?

a. Both the SA node and myocardium
b. Only the SA Node
c. Only the myocardium

46. What is the effect of mean arterial pressure in the presence of norepinephrine,
vasopressin, or angiotensin II?
a. Increased MAP by causing vasoconstriction
b. Decreased MAP by causing vasodilation
c. No observable effect upon MAP
d. All of the listed responses are correct.

47. Reactive hyperemia is ________.

a. a result of changes in blood flow (rather than metabolic rate)
b. controlled by the autonomic nervous system
c. a result of changes in metabolic rate (rather than blood flow)
d. controlled by the somatic nervous system