Barkley Renal/Genitourinary Exam
PRACTICE QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS |DETAILED
RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT
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Renal Physiology, Assessment & Diagnostic Testing
1. Which structure is primarily responsible for ultrafiltration of
plasma in the nephron?
A. Loop of Henle
B. Distal convoluted tubule
C. Glomerulus
D. Collecting duct
Answer: C. Glomerulus
The glomerulus filters plasma through the glomerular capillary wall
into Bowman's space.
2. Which hormone increases water reabsorption in the collecting
ducts?
A. Aldosterone
B. Antidiuretic hormone
C. Renin
D. Atrial natriuretic peptide
Answer: B. Antidiuretic hormone (ADH)
ADH increases aquaporin-2 channels in collecting duct cells, allowing
greater water reabsorption.
,3. Renin is primarily released by which renal cells?
A. Podocytes
B. Juxtaglomerular cells
C. Mesangial cells
D. Principal cells
Answer: B. Juxtaglomerular cells
Juxtaglomerular cells release renin in response to decreased renal
perfusion, sympathetic stimulation, or reduced sodium delivery to the
macula densa.
4. Which substance is most commonly used clinically to estimate
glomerular filtration rate?
A. Bilirubin
B. Creatinine
C. Albumin
D. Urea nitrogen
Answer: B. Creatinine
Serum creatinine is used in equations that estimate GFR, although it
is influenced by muscle mass and other factors.
5. A patient has a serum creatinine of 2.0 mg/dL. Compared with a
creatinine of 1.0 mg/dL, this generally indicates:
A. Increased GFR
B. Decreased GFR
C. Increased renal blood flow
D. Normal kidney function
Answer: B. Decreased GFR
Serum creatinine generally rises as GFR falls, although the
relationship is not linear.
,6. Which finding is most characteristic of nephrotic syndrome?
A. RBC casts
B. Heavy proteinuria
C. Severe dysuria
D. WBC casts
Answer: B. Heavy proteinuria
Nephrotic syndrome is characterized by substantial proteinuria,
hypoalbuminemia, edema, and often hyperlipidemia.
7. Which finding is most characteristic of nephritic syndrome?
A. Massive proteinuria without hematuria
B. Hematuria with RBC casts
C. Isolated glucosuria
D. Severe hypokalemia
Answer: B. Hematuria with RBC casts
Nephritic syndromes reflect glomerular inflammation and commonly
produce hematuria, RBC casts, hypertension, and reduced kidney
function.
8. What is the normal direction of renal blood flow through the
glomerulus?
A. Efferent arteriole → afferent arteriole
B. Afferent arteriole → glomerular capillaries → efferent arteriole
C. Renal vein → glomerulus → renal artery
D. Collecting duct → glomerulus
Answer: B. Afferent arteriole → glomerular capillaries → efferent
arteriole
Blood enters the glomerulus through the afferent arteriole and exits
through the efferent arteriole.
, 9. Which renal structure is primarily responsible for establishing the
medullary concentration gradient?
A. Proximal tubule
B. Loop of Henle
C. Glomerulus
D. Ureter
Answer: B. Loop of Henle
The countercurrent multiplication system of the loop of Henle
establishes the medullary osmotic gradient needed for urine
concentration.
10. Which portion of the nephron normally reabsorbs the greatest
percentage of filtered sodium and water?
A. Proximal tubule
B. Distal tubule
C. Collecting duct
D. Thin ascending limb
Answer: A. Proximal tubule
The proximal tubule reabsorbs approximately two-thirds of filtered
sodium and water along with substantial amounts of glucose, amino
acids, and bicarbonate.
11. Which substance is normally almost completely reabsorbed in
the proximal tubule?
A. Creatinine
B. Glucose
C. Uric acid
D. Potassium
PRACTICE QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS |DETAILED
RATIONALES |HINTED COMPLETE
EXAM PREP GRADED A+*INSTANT
DOWNLOAD PDF
Renal Physiology, Assessment & Diagnostic Testing
1. Which structure is primarily responsible for ultrafiltration of
plasma in the nephron?
A. Loop of Henle
B. Distal convoluted tubule
C. Glomerulus
D. Collecting duct
Answer: C. Glomerulus
The glomerulus filters plasma through the glomerular capillary wall
into Bowman's space.
2. Which hormone increases water reabsorption in the collecting
ducts?
A. Aldosterone
B. Antidiuretic hormone
C. Renin
D. Atrial natriuretic peptide
Answer: B. Antidiuretic hormone (ADH)
ADH increases aquaporin-2 channels in collecting duct cells, allowing
greater water reabsorption.
,3. Renin is primarily released by which renal cells?
A. Podocytes
B. Juxtaglomerular cells
C. Mesangial cells
D. Principal cells
Answer: B. Juxtaglomerular cells
Juxtaglomerular cells release renin in response to decreased renal
perfusion, sympathetic stimulation, or reduced sodium delivery to the
macula densa.
4. Which substance is most commonly used clinically to estimate
glomerular filtration rate?
A. Bilirubin
B. Creatinine
C. Albumin
D. Urea nitrogen
Answer: B. Creatinine
Serum creatinine is used in equations that estimate GFR, although it
is influenced by muscle mass and other factors.
5. A patient has a serum creatinine of 2.0 mg/dL. Compared with a
creatinine of 1.0 mg/dL, this generally indicates:
A. Increased GFR
B. Decreased GFR
C. Increased renal blood flow
D. Normal kidney function
Answer: B. Decreased GFR
Serum creatinine generally rises as GFR falls, although the
relationship is not linear.
,6. Which finding is most characteristic of nephrotic syndrome?
A. RBC casts
B. Heavy proteinuria
C. Severe dysuria
D. WBC casts
Answer: B. Heavy proteinuria
Nephrotic syndrome is characterized by substantial proteinuria,
hypoalbuminemia, edema, and often hyperlipidemia.
7. Which finding is most characteristic of nephritic syndrome?
A. Massive proteinuria without hematuria
B. Hematuria with RBC casts
C. Isolated glucosuria
D. Severe hypokalemia
Answer: B. Hematuria with RBC casts
Nephritic syndromes reflect glomerular inflammation and commonly
produce hematuria, RBC casts, hypertension, and reduced kidney
function.
8. What is the normal direction of renal blood flow through the
glomerulus?
A. Efferent arteriole → afferent arteriole
B. Afferent arteriole → glomerular capillaries → efferent arteriole
C. Renal vein → glomerulus → renal artery
D. Collecting duct → glomerulus
Answer: B. Afferent arteriole → glomerular capillaries → efferent
arteriole
Blood enters the glomerulus through the afferent arteriole and exits
through the efferent arteriole.
, 9. Which renal structure is primarily responsible for establishing the
medullary concentration gradient?
A. Proximal tubule
B. Loop of Henle
C. Glomerulus
D. Ureter
Answer: B. Loop of Henle
The countercurrent multiplication system of the loop of Henle
establishes the medullary osmotic gradient needed for urine
concentration.
10. Which portion of the nephron normally reabsorbs the greatest
percentage of filtered sodium and water?
A. Proximal tubule
B. Distal tubule
C. Collecting duct
D. Thin ascending limb
Answer: A. Proximal tubule
The proximal tubule reabsorbs approximately two-thirds of filtered
sodium and water along with substantial amounts of glucose, amino
acids, and bicarbonate.
11. Which substance is normally almost completely reabsorbed in
the proximal tubule?
A. Creatinine
B. Glucose
C. Uric acid
D. Potassium
