MPP 3202 UNIVERSITY OF MISSOURI Exam 4, May, 2016

1. MAJOR functions of the kidneys include a. Secretion of ADH b. Filtration of urine into Bowman’s Space c. Regulation of extracellular fluid composition and volume d. Excretion of excess CCK and secretin 2. The glomerulus of every nephron a. Is dispensible (unnecessary) for renal function b. Is located in the renal cortex c. Is responsible for reabsorbing most of the water d. Is the final point in the nephron before renal filtrate becomes urine 3. Severe blood loss or dehydration producing in a drop in renal blood flow results in and . a. Decreased GFR, activation of the renin-angiotensin–aldosterone system b. Decreased GFR, activation of ANP release c. Increased GFR, decreased water reabsorption d. No change in GFR, reversal of flow through the Loop of Henle 4. For any solute entering the glomerular capillary bed, the amount of it that ends up being excreted in urine is equal to a. The amount filtered plus the amount reabsorbed minus the amount secreted b. The amount filtered minus the amount secreted plus the amount reabsorbed c. The amount filtered minus the amount reabsorbed plus the amount secreted d. The amount filtered minus the mount reabsorbed minus the amount secreted 5. Glomerular filtration normally produces a filtrate that is a. Similar in composition to urine, except with more blood cells present b. Similar in composition to plasma, except with little or no protein c. Little different from what will eventually become urine d. So high in water that reabsorption of water via active transport is the only way to prevent dehydration 6. Tubuloglomerular feedback is a. The major determinant of whether protein is restricted from glomerular filtration b. Relatively unimportant for control of glomerular filtration c. A result of renin release d. Is a negative feedback mechanism serving as the major means of autoregulatory control of renal blood flow and glomerular filtration rate 7. Renal clearance of glucose is measured in a patient in the clinic The relevant data are: Glucose concentration in plasma = 2000 mg/L Glucose concentration in urine = 1000 mg/L Urine volume (2 hr) = 2 L = 2L/2hr = 1L/hr What is the clearance of glucose, and what does this suggest about this patient? a. 0.5 L/hr, this patient is normal b. 0.5 mg/hr, this patient is in heart failure c. 0.5 L/hr, this patient may have diabetes d. 2 L/hr, this patient pees way too much 8. Most of the water and sodium that are filtered at the glomerulus are a. Also secreted in the Loop of Henle b. Reabsorbed in the proximal convoluted tubule c. Reabsorbed in the thick limb of the ascending Loop of Henle d. Reabsorbed in response to atrial natriuretic peptide (ANP) 9. Biff eats an entire cup of table salt, with no water. What is the result of this stunt? a. Biff’s ADH levels fall to almost nothing and he urinates excessive amounts of water b. Biff’s ADH levels increase and his urine is highly concentrated with respect to sodium c. Biff’s ADH levels increase, but he excretes a high volume, dilute urine d. Biff gets a call from Johnny Knoxville offering a spot in the next Jackass movie. 10. The main site of action of ADH is a. The hypothalamus b. The posterior pituitary c. The distal convoluted tubule d. The medullary collecting duct 11. In response to blood loss, activation of the renin-angiotensin-aldosterone system results in a. Excretion of a dilute urine b. Reabsorption of sodium, water, and potassium c. Reabsorption of sodium and water, and excretion of potassium d. A decrease in thirst 12. Under normal conditions, most H+ secreted into the proximal tubules a. Combines with filtered phosphate buffer and is excreted b. Combines with filtered bicarbonate (HCO3-), thus promoting excretion of carbonic acid (H2CO3) c. Combines with filtered bicarbonate, thus allowing net bicarbonate reabsorption via CO2 d. Combines with potassium (K+) to form potassium hydride (KH) which kills bacteria, thus preventing bladder infections 13. Digestion of food and absorption of nutrients depends on a. Physical grinding by the espohagus until the pieces are small enough to be absorbed b. The combination of physical grinding and mixing of food particles and liberation of nutrients through enzymatic action c. Secretion of digestive enzymes from the liver and gallbladder d. Neural stimulation of enzyme action by the enteric nervous system 14. The stomach performs all of the following functions EXCEPT a. Digestion and absorption of most of a meal b. Both storage and physical grinding down of food c. Secretion of digestive juice including acid and proteolytic enzyme d. Emptying of chyme into the small intestine 15. What is the function of the microvillus (brush border)-located enzyme, enteropeptidase (aka enterokinase)? a. Breakdown of the disaccharide, maltase, into two molecules of glucose b. Digestion of fat (triglyceride) into free fatty acids + monoglyceride c. Activation of luminal cholecystokinin (CCK) d. Activation of pancreatic enzymes after they enter the duodenum 16. Glucose is absorbed a. Via primary active transport b. Via secondary active transport along with sodium c. Solely via passive diffusion d. Only after it has been bound by gastric intrinsic factor (IF) 17. During digestion of a meal, the major motility patterns seen in the small intestine are a. The migrating myoelectric complex (MMC) b. The MMC and receptive relaxation c. The MMC and peristalsis d. Peristalsis and segmentation 18. Why are bile salts important in the digestion and absorption of dietary fat? a. They are recycled b. They help emulsify fat globules for efficient digestion c. They are required for absorption of vitamin B12 d. They digest triglycerides to monoglyceride and free fatty acids 19. Which of the following is NOT true about Chylomicrons? a. They are the transport vehicle for dietary fat b. They contain an inner core packed with triglyceride c. They are too large to pass directly into the blood d. They proceed from the intestine directly to the liver via the portal vein 20. Gastrin stimulates , secretin stimulates , and cholecystokinin stimulates . a. Intestinal acid secretion, pancreatic enzyme secretion, pancreatic bicarbonate secretion b. Gastric acid and pepsinogen, pancreatic bicarbonate, pancreatic digestive enzymes c. Gastric acid and motility, pancreatic triglyceride, and pancreatic enteropeptidase d. Receptive relaxation, gastric histamine, inhibition of gallbladder contraction 21. Metabolism is a. Only active during the fed state b. The sum total of ATP-yielding and ATP-using reactions c. Operating more or less normally during diabetes d. Depressed during exercise 22. On an average day’s racing during the Tour de France, a rider expends about 4000 kcal. Added to his resting (basal) metabolic rate of 1500 kcals, that means the rider’s total expenditure is about 5500 kcal per day. How much energy does the rider need to consume per day in order to stay in energy balance? a. 4000 kcal b. 1500 kcal c. 5500 kcal d. 3500 kcal 23. Which of the following would NOT be increased in response to a meal? a. Glycolysis b. Gluconeogenesis c. Insulin release d. Protein synthesis 24. At about 1 week of starvation, what metabolic fuel accounts for MOST of the body’s energy use? a. Protein b. Glycogen c. Urea d. Fatty acids 25. Hormonal control of metabolism is centered on regulation of what variable? a. Fat content in adipose tissue b. Liver glycogen content c. Blood glucose levels d. Plasma glucagon levels 26. Which of the following statements is NOT true? a. Insulin’s and glucagon’s respective effects are mediated by the SAME cell surface receptor b. In insulin resistance, the liver produces excess VLDL, and not enough LDL receptors c. Diabetics often urinate glucose since the Tm (transport maximum) for glucose has been exceeded d. Glucagon is a catabolic hormone 27. Our intestine is home to almost 10 times the number of cells—mostly as bacteria—as we have in all our other tissues combined. Thus, we are host to an enormous population of gut microbes. In class, we learned that 1) ingestion of artificial sweeteners such as saccharine (used in diet soda) can produce an INCREASE in blood glucose similar to that produced by ingestion of sugar, and that 2) this unexpected effect of saccharine may be mediated by an effect of saccharine on activity of gut microbes. How do the gut bacteria do this? So far, we don’t know—the mechanistic link between the microbes and this metabolic effect in the host remains unknown. From what you know about blood glucose regulation, which of the following seems a plausible, testable hypothesis for how gut bacteria might cause a rise in blood glucose in the host. a. They could be activating a signal to trigger insulin release b. They could be activating a signal to inhibit glucagon release c. They could be stimulating lipogenesis d. They could be activating a signal to stimulate glycogenolysis or gluconeogenesis (or both) 28. Low density lipoprotein (LDL) in plasma is derived from very low density lipoprotein (VLDL) that is released by the liver. LDL has been called the “bad cholesterol” in the blood. Recent studies have found that LDL can cause apoptotic death of pancreatic beta cells. Why might this be important? a. Loss of beta cells results in less glucagon released into plasma b. Loss of beta cells could adversely affect insulin secretion c. Loss of beta cells would result in less release of cholecystokinin, thus blocking fat absorption d. alpha + beta = gamma. Without beta cells, no gamma cells could be produced.