MCQs on Glomerular Function of Kidney: Biochemistry

The renal system covers the glomerular function, tubular function, acid-base homeostasis,  biochemical assessment,  and clinical correlations. The glomerulus is mainly involved in the filtration of the blood for the excretion of waste products while retaining most of the proteins. 

The renal tubules function in secretion, reabsorption, and excretion of electrolytes, ions, organic acids, and urea. The renal tubules help regulate the osmolality, volume, and pH of the blood. 

Glomerular Function of Kidney

Multiple Choice Questions

1) The following are the endocrine function of the kidney, Except
a) Erythropoietin secretion
b) Synthesis of Vit D3
c) Synthesis of Prostaglandins
d) Synthesis of Angiotensin

2) Normally, proteins with a molecular weight higher than 65kda are retained in the plasma.

Some small size protein is filtered through the kidney by which of the following mechanism?
a) Protein channels
b) Endocytosis
c) Cotransport with Na+
d) None of the above

3) The rate of filtration in the kidney depends on..............................................
a) Glomerular Permeability
b) Capillary hydrostatic pressure
c) Oncotic pressure
d) All of the above

4) Which of the following factor increases the glomerular filtration rate (GFR)?
a) Antidiuretic hormone
b) Arterial Natriuretic peptide
c) Dopamine
d) Nitric oxide

5) Under the normal condition, the glomerular filtrate in the Bowman's capsule of nephron consists of the following, EXCEPT:
a) Proteins such as albumin and globulin
b) Metabolic waste products such as urea, creatinine
c) Amino Acids, Glucose, Organic Acids
d) Major electrolytes such as sodium, chloride, potassium, bicarbonate

6) The glomerular filtration rate is the rate at which fluid is filtered into Bowman's capsule and it is typically expressed in ml/min or liter/day. 

The GFR for healthy adults is 180 L/day which is equivalent to approximately...................................
a) 90 ml/min
b) 120 ml/min
c) 150 ml/min
d) 180 ml/min

7) The glomerular filtration rate is determined by the balance of hydrostatic and colloidal osmotic pressure. 

Which of the following promote glomerular filtration?
a) hydrostatic pressure of glomerular capillary
b) oncotic pressure of the glomerular capillary
c) hydrostatic pressure of Bowman's capsule
d) Oncotic pressure of Bowman's capsule

8) Choose the correct net filtration pressure when
            the hydrostatic pressure of glomerular capillary = 45 mmHg
            the oncotic pressure of the glomerular capillary = 25 mmHg
            the hydrostatic pressure of Bowman's capsule = 10 mmHg
            the oncotic pressure of Bowman's capsule = 0 mmHg

a) 5
b) 10
c) 15
d) 20

9) Increase in glomerular hydrostatic pressure and GFR is determined by
a) Increased arterial pressure
b) Decreased afferent arterial resistance
c) The moderate increase in efferent arterial resistance
d) All of the above

10) Which of the following hormones or autocoids increases the glomerular filtration rate by decreasing the vascular resistance?
a) Norepinephrine
b) Endothelin
c) Prostaglandin
d) Epinephrine

11) Which of the following chain of events promotes the secretion of renin from the kidney that in turn increases angiotensin II secretion and increases arterial resistance?


12) The Renal Plasma flow is best measured by…...................................?
a) Para-amino hippuric acid Test
b) GFR estimation
c) Inulin Clearance Test
d) Creatinine Clearance

13) What is 'Creatinine Clearance'?
a) Is a sensitive marker for urolithiasis
b) Is a sensitive marker of tubular function
c) Is a sensitive marker of glomerular function
d) Is a sensitive marker for measurement of skeletal muscle mass

14) Proteinuria can be defined as the presence of protein in urine greater than one of the following values?
a) 30 mg/dl
b) 300mg/dl
c) 1 gm/dl
d) 3 gm/dl

15) Presence of myoglobin in urine signifies
a) Overload proteinuria
b) Tubular proteinuria
c) Glomerular proteinuria
d) Postrenal proteinuria

16)  The blood flow through the kidney is autoregulated with a myogenic response and tubuloglomerular feedback mechanism. 

Which of the following statement is false regarding tubuloglomerular feedback?
a) Increased mean arterial pressure lead to an increase in renal blood flow and GFR
b) Increase delivery of sodium ions in macula densa increases renal blood flow and GFR
c) Decrease delivery of sodium ion in macula densa increases renal blow flow and GFR
d) All of the above

17) What is the filtration fraction (FF) when; 

Glomerular capillary hydrostatic pressure = 45 mmHg 

Bowman's space hydrostatic pressure =25 mm/Hg 

Colloidal Osmotic pressure in the glomerular capillaries = 10 mmHg 

Glomerular capillary filtration coefficient (Kf)= 10ml/ mmHg

Renal plasma flow (RPF) = 500 ml/min
Hint: Filtration fraction (FF)= GFR/RPF

a) 0.15
b) 0.30
c) 0.25
d) 0.20

18) The stimulation of sympathetic neurons to the kidney causes the vasoconstriction of arterioles and has a greater effect on afferent arterioles. 

Which of the following is not the consequence of sympathetic neuron activation?
a) Decreased renal plasma flow and GFR
b) Decreased the hydrostatic pressure of glomerular capillaries
c) Decreased Plasma oncotic pressure
d) Increased Filtration fraction

19) The release of angiotensin causes constriction of afferent arterioles and has a greater effect on efferent arterioles. 

Which of the following is not the consequence of angiotensin release?
a) Increased renal plasma flow
b) Increased Glomerular filtration rate
c) Increased Filtration fraction
d) Increased plasma oncotic pressure

20) Which of the following statement is true regarding renal plasma flow?
a) The renal blood flow is approximately 25% of cardiac output
b) Vasoconstriction of renal arterioles leads to a decrease in renal blood flow
c) Vasodilatation of renal arterioles leads to an increase in renal blood flow
d) All of the above

Multiple Choice Answers:

1-d) Synthesis of Angiotensin

The kidney does not directly synthesize prostaglandins as an endocrine function. However, prostaglandins can be synthesized in various tissues throughout the body, including the kidneys, and they play important roles in regulating kidney function and blood flow. Prostaglandins are involved in maintaining renal blood flow, modulating salt and water balance, and regulating the renin-angiotensin-aldosterone system, which is involved in blood pressure regulation.

2-b) Endocytosis

Small proteins can be filtered through the kidney by endocytosis. In certain parts of the renal tubules, particularly the proximal tubules, small proteins that have been filtered by the glomerulus can be taken up by the tubular cells through endocytosis. The proteins are engulfed by specialized structures called endocytic vesicles or endosomes, which then transport the proteins across the tubular epithelium. Once inside the tubular cells, these proteins can undergo further processing or reabsorption before being returned to the bloodstream or excreted in the urine.

3-d) All of the above

The rate of filtration in the kidney, specifically in the glomerulus, is influenced by several factors, including glomerular permeability, capillary hydrostatic pressure, and oncotic pressure.
a) Glomerular permeability: The permeability of the glomerular filtration barrier, which consists of the fenestrated endothelium, basement membrane, and podocytes, determines what substances can pass through and be filtered. The size and charge of molecules affect their ability to cross the filtration barrier and be filtered into the glomerular filtrate.
b) Capillary hydrostatic pressure: The pressure exerted by the blood within the glomerular capillaries is called the capillary hydrostatic pressure. This pressure tends to push fluid and solutes out of the capillaries and into the Bowman's capsule, promoting filtration.
c) Oncotic pressure: Also known as colloid osmotic pressure, oncotic pressure is exerted by plasma proteins, particularly albumin. It is a form of osmotic pressure that draws fluid back into the capillaries. Oncotic pressure opposes filtration by pulling fluid back from the glomerular filtrate into the blood.

4-c) Dopamine

5-a) Proteins such as albumin and globulin

Under normal conditions, the glomerular filtrate in the Bowman's capsule of the nephron consists of various substances, including metabolic waste products, nutrients, and electrolytes. However, proteins such as albumin and globulin are typically not present in the glomerular filtrate.
The glomerular filtration barrier, which consists of the fenestrated endothelium, basement membrane, and podocytes, serves as a selective barrier that allows smaller molecules to pass through while retaining larger molecules such as proteins. The filtration of proteins is normally prevented, and they are retained in the bloodstream.

6-b) 120 ml/min.

GFR reflects the kidneys' ability to remove waste products and excess fluids from the blood. Normal GFR Values: For young adults typically ranges from 90 to 120 mL/min/1.73 m² and for older adults  can decrease to as low as 60 mL/min/1.73 m² in healthy aging individuals.

7-a) hydrostatic pressure of glomerular capillary 

8-b) 10

9-d) All of the above 

10-c) Prostaglandin

11-d

12-a) Para-amino hippuric acid Test (PAH test).

The para-amino hippuric acid (PAH) test is a diagnostic tool used to assess renal plasma flow (RPF), which is a measure of blood flow through the kidneys. The PAH test provides valuable information about kidney function by indirectly assessing renal blood flow.

13-c) Is a sensitive marker of glomerular function. 

Creatinine is filtered out of the blood by the kidneys and excreted into urine at a relatively constant rate. Creatinine clearance is an important indicator of kidney function. It helps assess how well the kidneys are filtering waste products from the blood.

14-b) 300mg/dl. 

In healthy individuals normal protein excretion is typically less than 150 mg per day. Consistently higher levels of protein excretion may indicate underlying kidney disease or other medical conditions.

15-a) Overload proteinuria
16-b) Increase in delivery of sodium ions in macula densa increases renal blood flow and GFR
17-d) 0.20
18-c) Decreased Plasma oncotic pressure
19-a) Increased renal plasma flow
20-d) All of the above