Kidney and Nephron Physiology

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MCAT Biological and Biochemical Foundations of Living Systems › Kidney and Nephron Physiology

Questions 1 - 10
1

A renal afferent arteriole has a larger radius than the efferent arteriole. What is the effect of this larger radius on the function of the kidney?

Reabsorption in the nephron tubules is increased

Glomerular filtration rate is decreased

Antidiuretic hormone (ADH) secretion is decreased

Blood flow to the kidney is decreased

Afferent arteriole flow is decreased

Explanation

A renal afferent arteriole is directed toward the glomerulus, while a renal efferent arteriole is directed away from the glomerlus. If the radius of the afferent arteriole is increased, there is more flow through it toward the glomerulus, and if there is a smaller radius in the efferent arteriole, there is a resultant back pressure in the glomerulus. This is can be imagined as trying to squeeze a high-pressure hose through a small pipe. This pressure increases the force within the glomerulus to increase filtration, and subsequently increase reabsorption.

Antidiuretic hormone (ADH) secretion has a neglible effect on the radius of renal arterioles. Blood flow to the kidney is increased when afferent arteriole radius is increased (this also increases the arteriole flow).

2

Cortisol is a stress hormone that is produced in the                     , the                     portion of adrenal gland.

adrenal cortex . . . outer

adrenal cortex . . . inner

adrenal medulla . . . inner

adrenal medulla . . . outer

Explanation

The adrenal gland is situated superior to the kidney, and is responsible for the production of several key hormones.

One such hormone is cortisol. Cortisol is often released when an individual is highly stressed over an extended period. It is a steroid hormone that functions to increase blood glucose levels by inducing gluconeogenesis, the process that converts glycogen stores in the liver to glucose. Cortisol is released from cells in the adrenal cortex. Recall that the adrenal cortex is the outer portion of the gland, whereas the adrenal medulla is the inner portion of the gland.

Aldosterone is another hormone that is released by cells in the adrenal cortex, and is essential for sodium reabsorption in the kidney. Epinephrine is released from the adrenal medulla in response to stimulation by the sympathetic nervous system.

3

Which of the following structures will be found in the renal medulla?

I. Glands that secrete aldosterone

II. Loop of Henle

III. Distal convoluted tubule

II only

I only

I and II

I and III

Explanation

Recall that the renal medulla is the inner portion of the kidney. A nephron spans both the renal cortex and the renal medulla. Structures such as the glomerulus (capillary bed), Bowman's capsule, and the proximal and distal convoluted tubules are found in the renal cortex, whereas the loop of Henle is found in the renal medulla. The collecting duct (the structure that transports urine to the renal pelvis) spans both the renal cortex and the renal medulla.

As mentioned above, distal tubules are found in the renal medulla and function to reabsorb sodium ions. Reabsorption of sodium ions inside the nephron (for example in the distal tubules) is facilitated by the hormone aldosterone. Aldosterone is a steroid hormone that is produced in glands inside the adrenal cortex (in the adrenal gland, rather than the kidney).

4

Which components of the nephron can be found in the renal medulla?

The loop of Henle and the collecting duct

The loop of Henle and the glomerulus

The proximal and distal convoluted tubules

The entire nephron can be found within the cortex of the kidney

Explanation

The loop of Henle descends into the medulla before ascending back into the cortex. The collecting duct, which ends the nephron, extends into the medulla.

5

The main function of the Loop of Henle is to                     .

establish a concentration gradient

secrete potassium

absorb sodium

reabsorb water

Explanation

The main function of the Loop of Henle is to establish a concentration gradient so that water can be reabsorbed from the collecting duct and avoid being lost as urine. Although the ascending limb does absorb water, this water would be lost as urine if it were not for the concentration gradient established in the medulla of the kidney. Neither sodium nor potassium is absorbed in the Loop of Henle.

6

Which of the following would be a symptom associated with diabetes mellitus?

Increased urine volume

Decreased urine volume

More concentrated urine

Less-frequent urination

Explanation

Diabetes mellitus is the product of decreased insulin effectiveness in the body. As a result, blood glucose levels are extremely high. When filtrate enters the nephron through Bowman's capsule, glucose is generally transported as well. In a healthy individual, this glucose is rapidly removed from the filtrate in the proximal convoluted tubule. In a diabetes patient, however, the level of glucose in the filtrate can overwhelm the reabsorption of the tubule, resulting in glucose in the urine. This increases urine osmolarity, causing the filtrate to retain water. The result is an increase in urine volume, resulting in more frequent urination.

7

What of the following are not involved in the flow of filtrate through nephrons?

Renal artery

Ascending Loop of Henle

Proximal convoluted tubule

Collecting duct

Explanation

The correct path of filtrate through a nephron starts in the renal corpuscle, which is comprised of the glomerulus and Bowman's capsule. Filtrate then passes through the proximal convoluted tubule, where the majority of reabsorption takes place. It then travels through the descending and ascending limbs of the Loop of Henle, creating the counter current multiplier gradient that will allow urine to be concentration in the collecting duct. From the Loop of Henle, filtrate enters the distal convoluted tubule for final reabsorption before entering the collecting duct and being trasported to the bladder.

The renal artery is used to carry blood into the kidneys. Filtrate originates from the renal artery, but it is not a part of the nephrons.

8

Which of the following processes occurs in the kidney?

The kidney uses all of the listed processes

Secretion

Reabsorption

Filtration

Explanation

The kidney uses all three of the following processes: filtration, secretion and reabsorption. All three of these processes aid in allowing the body to filter waste products from the blood while retaining nutrients, salts, and water when needed.

Filtration occur when filtrate is separated from blood in the renal corpuscle. Reabsorption is the removal of ions from the filtrate to retain salts. Secretion is the input of salts to the filtrate to eliminate them. All of these processes occur in the nephrons.

9

What is the main function of the Loop of Henle within each nephron?

The Loop of Henle creates a countercurrent multiplier system

The Loop of Henle is the primary site of glucose and amino acid reabsorption

The Loop of Henle is the site at which the hormone vasopressin takes its greatest effect

The Loop of Henle contains Bowman's capsule, which is where filtrate first enters the nephron

Explanation

The Loop of Henle creates a countercurrent multiplier system. As the filtrate descends through the Loop of Henle, water leaves the filtrate and is reabsorbed, making the filtrate very concentrated. When the Loop of Henle ascends, salt ions leave the filtrate and are reabsorbed making the filtrate less concentrated. This creates a strong concentration of ions in the interstitial fluid toward the bottom of the loop, as compared to the concentration at the top. When filtrate flows down the collecting duct, this gradient helps concentrate the urine by removing water.

10

Carbonic anhydrase is a very important enzyme that is utilized by the body. The enzyme catalyzes the following reaction:

A class of drugs that inhibits this enzyme is carbonic anhydrase inhibitors (eg. acetazolamide, brinzolamide, dorzolamide). These drugs are commonly prescribed in patients with glaucoma, hypertension, heart failure, high altitude sickness and for the treatment of basic drugs overdose.

In patients with hypertension, carbonic anhydrase inhibitors will prevent the reabsorption of sodium chloride in the proximal tubule of the kidney. When sodium is reabsorbed back into the blood, the molecule creates an electrical force. This electrical force then pulls water along with it into the blood. As more water enters the blood, the blood volume increase. By preventing the reabsorption of sodium, water reabsorption is reduced and the blood pressure decreases.

When mountain climbing, the atmospheric pressure is lowered as the altitude increases. As a result of less oxygen into the lungs, ventilation increases. From the equation above, hyperventilation will result in more being expired. Based on Le Chatelier’s principle, the reaction will shift to the left. Since there is more bicarbonate than protons in the body, the blood will become more basic (respiratory alkalosis). To prevent such life threatening result, one would take a carbonic anhydrase inhibitor to prevent the reaction from shifting to the left.

Carbonic anhydrase inhibitors are useful in patients with a drug overdose that is acidic. The lumen of the collecting tubule is nonpolar. Due to the lumen's characteristic, molecules that are also nonpolar and uncharged are able to cross the membrane and re-enter the circulatory system. Since carbonic anhydrase inhibitors alkalize the urine, acidic molecules stay in a charged state.

Which of the following statement(s) will contradict carbonic anhydrase inhibitors' usefulness in patients with hypertension?

Water is only reabsorbed in the collecting tubule of the kidneys

The reabsorption of will create an electrochemical gradient

The reabsorption of will pull cations across the lumenal side of the proximal tubule

None of these

All of these

Explanation

In patients with hypertension, the blood volume is too high resulting in high blood pressure. carbonic anhydrase inhibitors will prevent water absorption by preventing sodium chloride reabsorption. As described from the passage, without sodium reabsorption at the proximal tubule, there will be no electrochemical drive for the reabsorption of water. carbonic anhydrase inhibitors mainly work on the proximal tubule where the majority of water reabsorption occurs.

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