Module Name Week ANATOMY

: URINARY SYSTEM : : 1st WEEK

1. Which of the following structure is present in the most anterior part of the hilum of the kidney: a) Ureter b) Renal artery c) Renal vein d) Suprarenal gland

2. All of the following are the anterior relation of the left kidney EXCEPT: a) Stomach b) Left renal colic c) Small intestine d) Spleen

3. Arrange the muscle related to the posterior relation to the both kidney: I. Psoas major II. Transversus abdominus III. Quadratus Lumborum a) I, II, III b) I, III, II c) III, II, I

4. Choose the CORRECT statement regarding the renal capsule: I. True capsule is adherent to the kidney tissue. II. Fatty capsule is directly intact with the kidney tissue. III. Fatty capsule is surrounding the fibrous capsule. IV. Renal fascia is surrounding the perinephric fat. a) I, II and III b) I, II and IV c) I, III and IV d) II, III and IV

5. Choose the CORRECT statement regarding the left kidney: I. Its hilum lies at the level of L1 II. The upper pole reaches the upper border of the 11th rib. III. It is supply by renal artery that arises from the abdominal aorta at the level of T2. IV. Kidney segmentation include apical, anterior superior, anterior inferior, posterior superior, posterior inferior, and lower. a) I only b) I and II c) I and III d) I and IV

PHYSIOLOGY 1. All of the following are the role of kidney in homeostatic function EXCEPT: a) Maintenance of blood pH. b) Maintenance of water balance. c) Maintenance of electrolyte balance. d) Maintenance of body temperature.

2. Which of the following is secreted in order to regulate the arterial blood pressure: a) Renin b) Erythropoietin c) Prostaglandin d) Thromboxane A2

3. All of the following are the normal contents of the excreted urine EXCEPT: a) Urea b) Creatinine c) Water d) Sodium e) RBC

4. High renal blood flows reflect a high O2 consumption of the kidney. Is the above statement true or false? Give reason for your answer.

5. Which of the following regarding the glomerular filtration is false? a. The bowmans capsule pressure is about 18mmHG b. The filtration pressure equal to glomerular capillary pressure minus colloid osmotic pressure and Bowmans capsule pressure. c. The glomerular capillary pressure is 60mmHg d. The filtration pressure is about 18 mmHg

6. Which of the following is the factor of glomerular filtration coefficient? a. Receptor of filtrating membrane b. Surface area of filtrating membrane c. Permeability of filtrating membrane d. B and C

7. Which of the following is false regarding the factors affecting glomerular filtration rate? a. Increase renal blood flow decrease the glomerular filtration rate b. Sympathetic stimulation decrease the glomerular filtration rate c. Afferent arterial constriction decrease the glomerular filtration rate d. Increase intrapelvic pressure above 28mmHg will stop the filtration

8. Which of the following is true regarding the diameter of glomerular vessels to glomerular filtration rate? a. Decrease glomerular filtration rate when afferent arteriole dilate b. Increase glomerular filtration rate when efferent arteriole dilate c. Decrease glomerular filtration rate when efferent arteriole dilate d. Severe efferent arteriole constrict increase the glomerular filtration rate

9. Which one is false? a. Hypoproteinaemia increase filtration rate b. Increase permeability increase glomerular filtration rate c. Globulin and fibrinogen can pass glomerular capillary membrane d. Mild efferent arteriole constriction increase glomerular filtration rate

10. Inulin has the following characteristics EXCEPT a) It is a polysaccharide b) It has a MW 5200, therefore it is freely filtered through glomeruli c) It is bounded to plasma protein, so it is present in the same concentration in glomerular filtrate and glomerular blood d) It is non-toxic

11. Regarding the inulin, all of the following is true EXCEPT a) Neither reabsorbed nor secreted b) Normal inulin clearance is 125ml/hr c) Inulin is used as a measure for GFR d) Less therapeutic use clinically compared to creatinine

12. Creatinine clearance is a) Less desirable compared to inulin b) An abnormal constituent of normal urine c) Secreted in distal convoluted tubule d) End metabolic product of creatine

13. All can be calculated primarily from Para Aminohippuric acid (PAH) clearance EXCEPT a) Effective Renal Plasma Flow b) Actual Renal Plasma Flow c) Renal Blood Flow d) Filtration Fraction

14. Regarding normal calculation of PAH, which one of the following is correct? a) Effective Renal Plasma Flow = 630ml/hr b) Actual Renal Plasma Flow = 700m/min c) Renal Blood Flow = 1723ml/min

15. Which one is NOT the function of juxtaglomerular complex: A. Secrete rennin. B. Regulation of arterial blood pressure. C. Secrete erythropoietin. D. Autoregulate glomerular filtration rate.

16. According to myogenic hypothesis, increase in systemic arterial pressure will cause: A. Relaxation of the afferent arteriolar smooth muscle. B. Contraction of the efferent arteriolar smooth muscle. C. Relaxation of both afferent and efferent arteriolar smooth muscle. D. Contraction of the afferent arteriolar smooth muscle.

17. In afferent arteriolar vasodilator feedback mechanism, the dilatation is due to: A. Increase flow of glomerular filtration into the tubules. B. Increased sodium and chloride ion concentration at macula densa. C. Decreased ion concentration at macula densa. D. Decreased stretch on the afferent arteriolar smooth muscle.

18. In efferent arteriolar vasoconstrictor feedback mechanism, the constriction is due to: A. Decreased reabsorption of sodium and chloride ions from the filtrate. B. Secretion of renin from juxtaglomerular cells. C. Increased glomerular filtration rate. D. Increased stretch on the efferent arteriolar smooth muscle.

19. Kidney helps to return high arterial blood pressure to normal by: A. Renin secretion. B. Increasing the blood flow inside the kidney. C. Afferent arteriolar vasodilatation feedback mechanism. D. Efferent arteriolar vasoconstrictor feedback mechanism

20. All are true about glucose reabsorption in proximal convoluted tubules except ? A. B. C. D. It is called facilitated diffusion. Under normal condition, glucose is completely absorbed. It is secondary active process. It cannot occur against concentration gradient.

21. How many sodium reabsorb from the proximal tubules? A. B. C. D. 50%. 40%. 65%. 10%.

22. Which is true about the ascending limb of loop of henle? A. B. C. D. It divided into 3 regions. The water permeability of the thick ascending limb is negligible. The tubular fluid that leaves loop of henle is hypertonic. The thin ascending limb are highly permeable to sodium , chloride and water.

23. All are true about function of loop of henle except? A. B. C. D. reabsorption of 15-20% of the filtered water reabsorption of 50% of the filtered sodium and potassium reabsorption of chlorides mechanism for urinary concentration and dilution

24. Which are true about distal tubules and collecting ducts? A. reabsorption of sodium , potassium and hydrogen are under control of aldosterone hormone B. reabsorption of water is under control of aldosterone hormone C. reabsorption of urea from outer medullary part of collecting duct D. ADH plays role in reabsorption of sodium potassium and hydrogen.

HISTOLOGY

1. What is the function of inner cellular layer of renal capsule? a. maintaining the shape of the kidney b. give nutritional and support supply for the kidney c. adjustment against functional volume n pressure changes d. releasing prostaglandin and medullipin pepide for controlling systemic blood pressure.

2. Renal lobe is form of? a. medullary ray and mass of cortical tissues surrounding b. renal column and the mass of cortical tissues surrounding at its base and side c. medullary ray and mass of cortical tissues surrounding at its apex and side d. a medullary pyramid and the mass of cortical tissues surrounding at its base and side

3. Which of the following features of the renal vasculature that help in existence of a high hydrostatic pressure for glomerular filtration EXCEPT ? a. short course of the renal artery arising directly from the abdominal aorta. b. straight course of the glomerular tuft of capillaries. c. the well-developed internal elastic lamina of the afferent arterioles. d. coiled course of the glomerular tuft of capillaries.

4. Which of the following is the composition of renal interstitium EXCEPT ? a. Delicate reticular fibre supporting parenchyma b. Small collagen bundles around the blood vessel c. Highly hydrated matrix of polysaccharide d. Myofibroblast and mononuclear cell.

5. Each nephron composed of EXECPT ? a. collecting tubule b. distal convoluted tubule c. renal corpuscle d. Henles loop e. proximal convoluted tubule

6. a. b. c. d.

All of the following is structure of renal corpuscle except Bowmans capsule Glomerulus Vasa recta Mesangium

7. a. b. c. d.

Parietal layer of Bowmans capsule is made of Simple squamous epithelium Simple columnar epithelium Stratified squamous epithelium Transitional epithelium

8. a. b. c. d.

Glomerulus capillaries is lined by Simple squamous epithelium Simple columnar epithelium Fenestrated endothelium Continuous endothelium

9. a. b. c. d.

All of the following is true concerning mesangium except Consists of mesangial cell and matrix Have supportive function Lack of actin and myosin Have phagocytic function

10. Which of the following is true concerning glomerular filtration barrier a. Diaphragm of the filtration slit can hold particle less than 10nm b. There is no electrical barrier in the basal lamina c. Collagen type III is present in the physical barrier d. Non of the above

11. Which one of the following is true regarding PCRT? a) More frequently seen near renal corpuscle in the medulla b) Appear as rounded or oval cross sections c) Basophilic basal striation d) Spherical nucleus located near to apex

12. Compared to PCRT, DCRT is distinguished by: a) Lined by more short cuboidal cells 5-8 per cross section b) Larger diameter

c) More distinctive apical brush border d) Dark eosinophilic cytoplasm State whether the following is true (A) or false (B) 13. PCRT has indistinct boundaries between adjacent cells 14. The descending and ascending thin limb is lined by simple squamous epithelium 15. Urine passes from collecting tubules into cortical collecting ducts which gives branch of medullary collecting ducts

BIOCHEMISTRY 1) A. B. C. D. The kidney represents: (pg 59) 0.5% of the body weight 0.4% of the body weight 0.3% of the body weight 0.2% of the body weight

2) A. B. C. D.

All of the following are metabolic conversion by the kidney except: (pg 59) Gluconeogenesis Glycogenolysis Lipid metabolism Ammoniagenesis

3) Renal gluconeogenesis increase in postprandial conditions. (pg 60) A. True B. False

4) A. B. C. D.

Systemic acidosis occur if the kidney fail to produce enough (pg 63) Lactate Arginine Ammonia Ammonium

5) Ammonia is produced in the renal tubules by the action of the enzyme glutaminase and R-glutamate dehydrogenase. (pg 62) A. True B. False

6. Which of the following may cause abnormal increase of urine (polyuria)? A. Acute nephritis B. Heart failure C. Hyperparathyroidism D.Burns

7. Which of the following is true regarding the properties of the urine of a patient suffering from Diabetes Insipidus? A. Production of urine of lower then normal specific gravity B.Fruitty odour C.Gives pale yellow or colourless urine D.Causes polyuria

8. Which of the following conditions causes anuria? A.Haemorrhage B.Heart failure C.Late stage renal failure D.Diabetes Mellitus

9.Greenish brown cloured urine is caused by A. Presence of oxidized homogenistic acid B.Diabetes Insipidus C. Fever D. Presence of cholebilirubin

10. Which of the following is not true regarding the properties of the normal urine? A.Physiological increase during nervousness B.Mainly excretes alkaline phospatase C.Devoid of deposits D.Normally aromatic

11. During protein catabolism, .. is produced by end product of liver. a. Urea b. Uric Acid c. Creatinine d. Creatine 12. Uric acid is the catabolic end product of a. Porphyrine b. Purines c. Pyrimidines d. Pyridoxine 13. Bence jones preteinurial characterized by a. Non-heat coagulability b. Heat coagubility at 100C c. Heat coagubility at 45C to 60C d. Pecipitation at 25C

14. Ethereal sulphate is synthesized from the .. amino acid a. Neutral b. Acidic c. Basic d. Sulphur containing 15.Which statements about obstructive jaundice is true? a. Conjugated bilirubin in serum is normal b. Total bilirubin in serum is decreased c. Bile salts are present in urine d. Serum alkaline phosphatase is decreased 16.After urea, .. are the most abundant substances in urine. a. Sodium b. Ammonia c. Sulfates d. Chloride 17.All of the following are pathological causes of proteinuria, except a. Severe muscle exercise b. Heart failure c. Nephritis d. Diabetes Mellitus