Diseases, 8th Edition
Authors: Scott F. Gilbert,Daniel E. Weiner.
,Chapter 1: Overview of Kidney Structure and Function
Clinical/Application Multiple Choice Questions (15)
Question 1
A 58-year-old man with long-standing hypertension develops progressive chronic
kidney disease. Imaging demonstrates marked thinning of the renal cortex while the
medulla is relatively preserved. Which renal structure has sustained the greatest
functional loss?
A. Renal pelvis
B. Renal cortex
C. Minor calyx
D. Renal capsule
Correct Answer: B. Renal cortex
Explanation
The renal cortex contains the glomeruli and the proximal and distal convoluted
tubules, making it the primary site of filtration and much of tubular processing.
Cortical loss significantly reduces nephron number and glomerular filtration.
Why the other options are incorrect
• A. Renal pelvis: Collects urine but does not perform filtration.
• C. Minor calyx: Serves as a drainage pathway.
• D. Renal capsule: Provides structural protection but has no direct filtration
function.
Question 2
A researcher measures renal blood flow in a healthy volunteer. Which structure
receives the largest proportion of renal blood flow under normal physiological
conditions?
A. Renal cortex
B. Renal papilla
, C. Inner medulla
D. Renal pelvis
Correct Answer: A. Renal cortex
Explanation
Most renal blood flow is directed to the cortex because glomerular filtration occurs
there and cortical nephrons are abundant.
Incorrect options
• B. Renal papilla: Receives much less blood flow.
• C. Inner medulla: Has relatively low perfusion to preserve osmotic gradients.
• D. Renal pelvis: Functions as a collecting chamber rather than a vascular
organ.
Question 3
A patient develops complete obstruction of the left ureter by a kidney stone. Initially,
which renal process is most directly impaired?
A. Glomerular filtration
B. Erythropoietin production
C. Vitamin D activation
D. Renin synthesis
Correct Answer: A. Glomerular filtration
Explanation
Urinary obstruction increases hydrostatic pressure within Bowman's space, reducing
the filtration pressure and lowering GFR.
Incorrect options
• B. Erythropoietin production: May decline later with chronic kidney disease, not
immediately.
• C. Vitamin D activation: Usually preserved initially.
• D. Renin synthesis: May change depending on perfusion but is not the
immediate consequence.