GMS 6401 CORRECT EXAMS ANSWERS AND
QUESTIONS SET A+
✔✔advanced chronic kidney disease (CKD) can cause: - ✔✔salt sensitive hypertention
- due to high Na diet, renal Na retention usually occurs in advanced CKD leading to
hypertension. dietary Na restriction is required
✔✔The nephron consists of the renal tubule and the glomerulus that supplies it. -
✔✔True
✔✔Podocytes are specialized endothelial cells lining the inside of the glomerular
capillary. - ✔✔False; the podocytes are epithelial cells on the outside of the glomerulus,
in bowman's space. podocytes give rise to the foot processes that form from the slit
pores
✔✔The proximal convoluted tubules of each nephron are located entirely in the renal
medulla - ✔✔False; all the proximal convoluted tubules are located in the renal cortex
✔✔The renal tubule is an example of a polarized epithelial with the Na-K ATPase
located only on the inside (luminal surface) of the tubule - ✔✔False; the renal tubule is
polarized by the Na/K ATPase is on the peritubular side only, to facilitate net Na
reabsorption
✔✔The kidneys receive a rich parasympathetic innervation. - ✔✔F. There are no
parasympathetic nerves to the kidney, but abundant sympathetic innervation.
✔✔Inulin is a perfect marker for glomerular filtration rate (GFR) because it is freely
filtered and not reabsorbed or secreted - ✔✔True
✔✔The amount of inulin excreted is always less than the amount filtered. - ✔✔F. The
amount filtered (GFR x Pin) is exactly equal to the amount excreted (V x Uin)
, ✔✔Creatinine is an endogenous substance widely used to assess GFR in man. As GFR
falls plasma creatinine increases - ✔✔True
✔✔The estimated GFR (eGFR) obtained from a plasma creatinine measurement must
be corrected based on the sex, age and race of the patient - ✔✔True
✔✔If the fractional clearance of substance x is less than 1.0, this means that the
substance has not been reabsorbed - ✔✔False. f the clearance of x is < clearance of
inulin (so the fractional clearance of x is <1.0) some of the filtered x MUST have been
reabsorbed by the tubule
✔✔All the filtered glucose is excreted in the urine. - ✔✔F. Normally all filtered glucose is
reabsorbed in the proximal tubule by an active process coupled to Na reabsorption
✔✔The fractional clearance of phosphate is 0.2 which means that about 80% of the
filtered phosphate is reabsorbed by the tubule - ✔✔true
✔✔A positive free water clearance implies that more water relative to solute (osm) is
leaving the body, ie. The urine is dilute relative to plasma - ✔✔true
✔✔At high urine flow rates, the blood urea nitrogen (BUN) concentration will rise. -
✔✔F. High urine flow implies less tubular water reabsorption, thus lower tubular urea
concentration to drive passive urea reabsorption. High BUN occurs when urine flow is
very low, as in dehydration
✔✔Most of the para-amino hippuric acid (PAH) excreted in the urine, arrives in the
tubule by active secretion into the loop of Henle and the collecting duct - ✔✔F. Most of
the PAH in the urine does arrive by tubular secretion BUT only in the proximal tubule
which has the PAH transporters
✔✔The presence of the efferent arteriole (a resistance vessel "downstream" of the
glomerulus, ensures a high glomerular capillary blood pressure - ✔✔True
✔✔The only site of restriction to the filtration of protein within the glomerular wall is the
is at the endothelial surface - ✔✔F. The endothelial cells provide the first barrier with
both charge and physical restriction by the endothelial glycocalyx. Then the glomerular
basement membrane (GBM) provides a charge and physical barrier by the presence of
the collagen scaffold. The final barrier to filtration is the epithelial slit pore and its
diaphragm
✔✔An anionic dextran with a molecular radius of 36 angstrom is filtered more easily at
the glomerulus compared to a neutral dextran of the same size - ✔✔F. The neutral
dextran is restricted only due to its size. The anionic dextran is restricted due to both
QUESTIONS SET A+
✔✔advanced chronic kidney disease (CKD) can cause: - ✔✔salt sensitive hypertention
- due to high Na diet, renal Na retention usually occurs in advanced CKD leading to
hypertension. dietary Na restriction is required
✔✔The nephron consists of the renal tubule and the glomerulus that supplies it. -
✔✔True
✔✔Podocytes are specialized endothelial cells lining the inside of the glomerular
capillary. - ✔✔False; the podocytes are epithelial cells on the outside of the glomerulus,
in bowman's space. podocytes give rise to the foot processes that form from the slit
pores
✔✔The proximal convoluted tubules of each nephron are located entirely in the renal
medulla - ✔✔False; all the proximal convoluted tubules are located in the renal cortex
✔✔The renal tubule is an example of a polarized epithelial with the Na-K ATPase
located only on the inside (luminal surface) of the tubule - ✔✔False; the renal tubule is
polarized by the Na/K ATPase is on the peritubular side only, to facilitate net Na
reabsorption
✔✔The kidneys receive a rich parasympathetic innervation. - ✔✔F. There are no
parasympathetic nerves to the kidney, but abundant sympathetic innervation.
✔✔Inulin is a perfect marker for glomerular filtration rate (GFR) because it is freely
filtered and not reabsorbed or secreted - ✔✔True
✔✔The amount of inulin excreted is always less than the amount filtered. - ✔✔F. The
amount filtered (GFR x Pin) is exactly equal to the amount excreted (V x Uin)
, ✔✔Creatinine is an endogenous substance widely used to assess GFR in man. As GFR
falls plasma creatinine increases - ✔✔True
✔✔The estimated GFR (eGFR) obtained from a plasma creatinine measurement must
be corrected based on the sex, age and race of the patient - ✔✔True
✔✔If the fractional clearance of substance x is less than 1.0, this means that the
substance has not been reabsorbed - ✔✔False. f the clearance of x is < clearance of
inulin (so the fractional clearance of x is <1.0) some of the filtered x MUST have been
reabsorbed by the tubule
✔✔All the filtered glucose is excreted in the urine. - ✔✔F. Normally all filtered glucose is
reabsorbed in the proximal tubule by an active process coupled to Na reabsorption
✔✔The fractional clearance of phosphate is 0.2 which means that about 80% of the
filtered phosphate is reabsorbed by the tubule - ✔✔true
✔✔A positive free water clearance implies that more water relative to solute (osm) is
leaving the body, ie. The urine is dilute relative to plasma - ✔✔true
✔✔At high urine flow rates, the blood urea nitrogen (BUN) concentration will rise. -
✔✔F. High urine flow implies less tubular water reabsorption, thus lower tubular urea
concentration to drive passive urea reabsorption. High BUN occurs when urine flow is
very low, as in dehydration
✔✔Most of the para-amino hippuric acid (PAH) excreted in the urine, arrives in the
tubule by active secretion into the loop of Henle and the collecting duct - ✔✔F. Most of
the PAH in the urine does arrive by tubular secretion BUT only in the proximal tubule
which has the PAH transporters
✔✔The presence of the efferent arteriole (a resistance vessel "downstream" of the
glomerulus, ensures a high glomerular capillary blood pressure - ✔✔True
✔✔The only site of restriction to the filtration of protein within the glomerular wall is the
is at the endothelial surface - ✔✔F. The endothelial cells provide the first barrier with
both charge and physical restriction by the endothelial glycocalyx. Then the glomerular
basement membrane (GBM) provides a charge and physical barrier by the presence of
the collagen scaffold. The final barrier to filtration is the epithelial slit pore and its
diaphragm
✔✔An anionic dextran with a molecular radius of 36 angstrom is filtered more easily at
the glomerulus compared to a neutral dextran of the same size - ✔✔F. The neutral
dextran is restricted only due to its size. The anionic dextran is restricted due to both
