Tubular Function of Kidney & Electrolyte Balance : MCQ

The renal system covers the glomerular functiontubular functionacid-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. 

Tubular Function of Kidney and Electrolyte Balance
Multiple Choice Questions

1) Urine is a fluid excreted by the kidney passed through ureters, stored in the bladder, and discharged through the urethra. 
Which of the following are not the characteristics of urine?
a) pH 5.0 to 6.0
b) Specific gravity- approximately 1.024
c) Amber color
d) Turbid

2) Transport of sodium in the renal tubules involves:
a) Na+/K+-ATPase located on the luminal membrane of proximal tubules
b) Na+/K+-ATPase located on the membrane of distal tubules
c) The entry of sodium into tubular cells by passive transport
d) Na+ is neither reabsorbed nor secreted in the renal tubules

3) Glucose is almost completely reabsorbed in the proximal tubules and no detectable amount of sugar is present in urine from healthy individuals. 
The renal threshold for glucose is............................
a) 100 mg/dl
b) 140 mg/dl
c) 180 mg/dl
d) 220 mg/dl

4) What is the site of reclamation of bicarbonate?
a) Glomerulus
b) Proximal Tubules
c) Loop of Henle
d) Distal Tubules

5) In Renal tubular acidosis type I, which of the following statement is true?
a) Bicarbonate reabsorption is impaired
b) Hydrogen ion secretion is impaired
c) Urinary pH is acidic below 5.5
d) Aldosterone action is impaired.

6) Amino acids are transported via specific transporter that is present in which of the following regions?
a) Proximal tubules
b) Loop of Henle
c) Distal tubules
d) Collecting ducts

7) Approximately 90% of filtered calcium is reabsorbed in the nephron. 
Which of the following hormone increases absorption of calcium in an autocrine manner?
a) Parathyroid hormone
b) Antidiuretic hormone
c) Vit D3
d) Erythropoietin

8) The reabsorption of phosphate occurs via a secondary transport system. 
Which of the following ion is co-transported with the phosphate ion?
a) Calcium
b) Sodium
c) Potassium
d) Magnesium

9) The urea is passively reabsorbed from the renal tubules along with sodium and water reabsorption.  The passive reabsorption is also facilitated by specific urea transports on..........................................?
a) Proximal tubules
b) Loop of Henle
c) Distal Tubule
d) Collecting duct

10) Which of the following tubular absorption process require ATP?
a) The movement of molecules or ions moving down their concentration gradient
b) The movement of impermeable molecules across the membrane down their concentration gradient associated with proteins
c) A protein-mediated transport against the concentration gradient
d) None of the above

11) Which of the following transporters is not the symporter that facilitates the transport of both molecules inside the membrane?
a) Na+/K+ transporter
b) Na+/Glucose transporter
c) Na+/Phosphate transporter
d) Na+/Amino acid transporter

12) The following transporter is an example of a uniport system, EXCEPT
a) Na+/K+ ATPase
b) Na+/H+ ATPase
c) Na+/Ca++ ATPase
d) Na+/Phosphate ATPase

13) What is the reabsorption rate of glucose in a patient with uncontrolled diabetes mellitus with: 
Glomerular filtration rate = 120 ml/min,
Plasma glucose concentration = 350 mg/ml,
Urine glucose concentration 2000 mg/ml,
Total urine volume 4.32 L or 3mL/min


a) 320 mg/min
b) 360 mg/min
c) 400 mg/ml
d) 440 mg/ml

14) The proximal tubules undergo isosmotic reabsorption with the osmolality close to 300 mOsm/kg (similar to plasma). 
Which of the following process helps maintain the osmolality?
a) Two-thirds of the filtered water and potassium are reabsorbed through the kidney
b) Two-thirds of the filtered sodium is reabsorbed in the proximal tubules
c) Na+ coupled cotransport of glucose, amino acid, and organic acids  occurs in proximal tubules
d) All of the above

15) About 80% of filtered bicarbonate is reabsorbed in proximal tubules. 
Which of the following enzymes or transporter is involved in the reabsorption of bicarbonate?
a) Na+/K+ ATPase basolateral surface
b) Na+/H+ ATPase in the luminal surface
c) Carbonic anhydrase in tubules and proximal tubules
d) All of the above

16) Which of the following parts of the nephrons is important for the concentration of urine and has the highest osmolality?
a) Proximal tubules
b) Loop of Henle
c) Distal tubules
d) Collecting ducts

17) Renal tubular acidosis type I is the result of the low arterial blood pH, accumulation of fixed acids, and hypokalemia.  
Which of the following statement is true about this type of acidosis?
a) Bicarbonate reabsorption in proximal tubules is impaired
b) Hydrogen ion secretion in the distal tubules is impaired
d) Aldosterone secretion/action is impaired
d) None of the above

18) Renal tubular acidosis IV is the result of the inability to secrete potassium leading to hyperkalemia, decreased hydrogen secretion, and metabolic acidosis. 
Which of the following is true about renal tubular acidosis IV?
a) Bicarbonate reabsorption in proximal tubules is impaired
b) Hydrogen ion secretion in the distal tubules is impaired
d) Aldosterone secretion/action is impaired.
c) Urinary pH is acidic below 5.5

19) The thiazide diuretics inhibit the reabsorption of sodium and chloride by inhibiting Na+ Cl- a co-transporter system that is present in........................................?
a) Proximal tubules
b) Loop of Henle
c) Early Distal tubules
d) Late Distal tubules

20) Which of the following is not the function of late distal tubules and collecting ducts?
a) Reabsorption of sodium and water
b) Site of action of aldosterone 
c) Reabsorption of hydrogen ions
d) Site of ADH action


Multiple Choice Answers:
1-d) Turbid
2-a) Na+/K+-ATPase located on the luminal membrane of proximal tubules
3-c) 180 mg/dl
4-b) Proximal Tubules
5-b) Hydrogen ion secretion is impaired
6-a) Proximal tubules
7-c) Vit D3
8-b) Sodium
9-d) Collecting duct
10-c) A protein-mediated transport against the concentration gradient
11-a) Na+/K+ transporter
12-d) Na+/phosphate ATPase
13-b) 360 mg/min
14-d) All of the above
15-d) All of the above
16-b) Loop of Henle
17-d) Aldosterone secretion/action is impaired
18-b) Hydrogen ion secretion in the distal tubules is impaired
19-c) Early Distal tubules
20-c) Reabsorption of hydrogen ions

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