Which statement BEST distinguishes metabolic acidosis from respiratory acidosis?
  • metabolic alkalosis with respiratory compensation
  • metabolic acidosis with respiratory compensation
  • both collecting ducts and late distal tubules.
  • Metabolic acidosis is a disturbance in blood pH caused by something other than an abnormal PCO2.
In the proximal tubule, hydrogen ions are transported into the filtrate by
  • both Na+/H+ countertransporters and H+ primary active transporters.
  • angiotensin converting enzyme (ACE)
  • both parathyroid hormone and 1,25-dihydroxy vitamin D3
  • A decrease in estrogen stimulates the production of interleukin-6 that then stimulates osteoclastactivity.
In the early portion of the collecting duct (in cortical interstitial fluid), an increase in water permeability willresult in a(n)
  • A decrease in estrogen stimulates the production of interleukin-6 that then stimulates osteoclastactivity.
  • nephrogenic diabetes insipidus
  • increase in hydrogen ion secretion from the kidneys.
  • decrease in filtrate volume.
The activity of the respiratory system can increase pH by
  • cause cells to shrink due to an increase in the osmolarity of extracellular fluid.
  • increase the production of erythrocytes.
  • a hyperventilation-induced decrease in PCO2.
  • phosphate
Which of the following conditions is NOT indicative of a decrease in plasma osmolarity?
  • conversion to carbon dioxide.
  • reabsorption only.
  • neural hyperexcitability
  • peripheral chemoreceptors.
Fluid and electrolyte balance occur when
  • increased number of open Na+/K+ channels in the apical membrane
  • both the gastrointestinal tract and bone
  • solutes and water enter and exit the plasma at the same rate.
  • impermeable to water and contains Na+/K+/Cl- cotransporters
In both the proximal and distal tubules, the reabsorption of sodium involves the active transport of sodiumacross the basolateral membrane.
  • decrease in filtrate volume.
  • urea
  • ADH
  • True
The role of a buffer is to
  • both Na+/H+ countertransporters and H+ primary active transporters.
  • limit the change in pH with changing hydrogen ion concentrations.
  • both collecting ducts and late distal tubules.
  • increasing the synthesis of sodium channels in principal cells.
A substance is in negative balance when
  • principal cells apical membrane
  • osteoblasts
  • it exits plasma at a greater rate than it enters plasma.
  • solutes and water enter and exit the plasma at the same rate.
Receptors for ADH are located where?
  • principal cells apical membrane
  • proximal tubule apical membrane
  • principal cells basolateral membrane
  • proximal tubule basolateral membrane
A greater plasma volume than normal is called
  • calcitonin only
  • decrease.
  • hypervolemia.
  • osteoclasts
Antidiuretic hormone increases water reabsorption by increasing the permeability of the distal tubule andcollecting duct to water.
  • False
  • intercalated cells
  • principal : causes insertion of aquaporin-2 into the apical membrane
  • True
The balance of a solute depends solely on its intake to and output from the body.
  • False
  • kidney
  • True
  • renin
In the renal tubules, where is the Na+/K+ pump located?
  • increase the production of erythrocytes.
  • in the basolateral membrane of the proximal tubules
  • both the gastrointestinal tract and bone
  • increased number of open Na+/K+ channels in the apical membrane
Plasma can gain solutes and/or water from which of the following?
  • in the basolateral membrane of the proximal tubules
  • both parathyroid hormone and 1,25-dihydroxy vitamin D3
  • hyperexcitability of afferent neurons
  • both the gastrointestinal tract and bone
Which of the following is NOT a mechanism of dissipating heat during exercise?
  • respiratory compensation
  • secretion of ADH
  • neural hyperexcitability
  • an osmotic gradient
What hormone decreases plasma calcium levels?
  • parathyroid hormone
  • calcitonin only
  • reabsorption of bicarbonate
  • buffering of hydrogen ions
The maximum osmolarity of urine is 1200 mOsm to 1400 mOsm.
  • decrease.
  • False
  • urea
  • True
Sodium-glucose cotransporters are located where?
  • proximal tubule basolateral membrane
  • principal cells basolateral membrane
  • proximal tubule apical membrane
  • granular : afferent arteriole
Which type of cell carries out bone formation?
  • osteoblasts
  • disuse osteoporosis
  • angiotensin II
  • calcitonin
Hyperkalemia refers to high levels of potassium in the plasma.
  • False
  • amount secreted into the distal tubule.
  • kidney
  • True
Which of the following correctly describes water movement across the epithelial cells lining the collectingduct?
  • Sodium is actively transported across the basolateral membrane of both the proximal and distaltubule.
  • Sodium is transported across the basolateral membrane by the Na+/K+ pump and across the apicalmembrane by secondary active transport.
  • Water can permeate the apical membrane through aquaporin-2 and the basolateral membranethrough aquaporin-3, but aquaporin-2 is only present in the presence of ADH.
  • In the digestive system, the seawater would draw more water out of the bloodstream than would beabsorbed, leading to severe dehydration.
The most important buffer system in the extracellular fluid is
  • an increase in thirst
  • respiratory acidosis with renal compensation
  • a hyperventilation-induced decrease in PCO2.
  • bicarbonate.
Urea diffuses from the collecting duct into the medullary interstitial fluid maintaining to the medullaryinterstitial fluid osmotic gradient.
  • kidney
  • True
  • glutamine
  • False
The effects of antidiuretic hormone (ADH) are not restricted to regulating water movement; it also affectssodium reabsorption by
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • increasing the synthesis of sodium channels in principal cells.
  • both parathyroid hormone and 1,25-dihydroxy vitamin D3
  • principal : causes insertion of aquaporin-2 into the apical membrane
What would the following blood values indicate? Blood pH = 7.3, [HCO3-] is high, PCO2 is high.
  • metabolic alkalosis with respiratory compensation
  • respiratory alkalosis with renal compensation
  • respiratory acidosis with renal compensation
  • respiratory compensation
The primary function of atrial natriuretic peptide (ANP) is to
  • distension of the atrial wall due to an increase in plasma volume
  • increase sodium secretion thereby decreasing sodium reabsorption.
  • increased plasma sodium
  • impermeable to water and contains Na+/K+/Cl- cotransporters
Seawater has an osmolarity of around 1000 mOsm, mostly from dissolved sodium. Given what you knowabout the osmolarity in most of the cells in the body, why is it dangerous to drink seawater?
  • Sodium is actively transported across the basolateral membrane of both the proximal and distaltubule.
  • increasing the synthesis of sodium channels in principal cells.
  • In the digestive system, the seawater would draw more water out of the bloodstream than would beabsorbed, leading to severe dehydration.
  • both digestive tract and metabolism
What hormone stimulates the release of aldosterone?
  • osteoblasts
  • calcitonin
  • disuse osteoporosis
  • angiotensin II
A person must void what volume of urine per day?
  • an increase in thirst
  • True
  • 440 mL
  • Sodium is actively transported across the basolateral membrane of both the proximal and distaltubule.
What hormone increases calcium resorption from bone?
  • angiotensin converting enzyme (ACE)
  • parathyroid hormone
  • loss of bicarbonate
  • an osmotic gradient
If nothing else is removed from the filtrate once it reaches the late distal tubules, the urine excreted wouldhave which of the following properties?
  • It will cause the student's cells to swell.
  • an osmotic gradient
  • respiratory alkalosis with renal compensation
  • low osmolarity and large volume
What would the following blood values indicate? Blood pH = 7.3, [HCO3-] is low, PCO2 is low.
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • reabsorption of bicarbonate
  • metabolic acidosis with respiratory compensation
  • both HCO3-/Cl- countertransporters and Na+/HCO3- cotransporters.
How might a high-fat diet cause metabolic acidosis?
  • increase in plasma osmolarity
  • breakdown of fat into fatty acids
  • production of phosphoric acid and sulfuric acid
  • buffering of hydrogen ions
Which of the following ions acts as a buffer to minimize changes in intracellular pH?
  • increase.
  • phosphate
  • osteoclasts
  • excessive vomiting
If hydrogen ions are added to a solution, the pH will
  • osteoclasts
  • True
  • False
  • decrease.
1,25-dihydroxy vitamin D3 acts to increase the absorption of calcium in the digestive tract and increasereabsorption of calcium in the distal tubules of the kidney.
  • renin
  • False
  • kidneys decrease the reabsorption of bicarbonate.
  • True
A primary source of acid from internal respiration is CO2.
  • increase.
  • True
  • False
  • increase sodium secretion thereby decreasing sodium reabsorption.
The last step to synthesis of 1,25-dihydroxy vitamin D3 occurs in what organ?
  • kidney
  • True
  • lungs : kidneys
  • aldosterone
Defense mechanisms against acid-base disturbances include buffers, respiratory, and renal compensation.
  • False
  • aldosterone
  • urea
  • True
What hormone activates the cAMP second messenger system in principal cells of the distal tubules andcollecting ducts?
  • False
  • ADH
  • True
  • sodium
What enzyme converts angiotensin I into angiotensin II?
  • angiotensin converting enzyme (ACE)
  • atrial natriuretic peptide
  • both the gastrointestinal tract and bone
  • an osmotic gradient
Hyperkalemia refers to an excess of what?
  • aldosterone
  • potassium
  • glutamine
  • kidney
The osmotic gradient in the medullary region of the kidneys is established and maintained by which of thefollowing?
  • increase sodium secretion thereby decreasing sodium reabsorption.
  • principal : causes insertion of aquaporin-2 into the apical membrane
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • Na+/K+/Cl- cotransporters in the ascending limb of the loop of Henle
The transport of material across the gastrointestinal tract normally leads to a net gain of solutes and water bythe body.
  • True
  • False
  • intercalated cells
  • kidney
ADH increases the insertion of aquaporin-2 where?
  • principal cells apical membrane
  • proximal tubule apical membrane
  • increased potassium secretion
  • production of phosphoric acid and sulfuric acid
What is the secondary defense against changes in pH that requires minutes to be activated?
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • respiratory compensation
  • increased potassium secretion
  • increased plasma sodium
During hyperventilation, why do some people detect a tingling sensation in their hands and feet?
  • hyperexcitability of afferent neurons
  • metabolic acidosis with respiratory compensation
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • nephrogenic diabetes insipidus
Aldosterone stimulates an increase in sodium reabsorption at the same time it stimulates an increase inpotassium secretion.
  • glutamine
  • decrease.
  • False
  • True
What is the force that moves water out of the distal tubules and collecting ducts?
  • reabsorption only.
  • metabolic acidosis with respiratory compensation
  • an osmotic gradient
  • excessive vomiting
Renin is released by ________ cells of the ________.
  • increase in hydrogen ion secretion from the kidneys.
  • principal cells apical membrane
  • granular : afferent arteriole
  • increased plasma sodium
ACE inhibitors prevent angiotensin converting enzyme (ACE) from performing its role in the body. Whichstatement best describes why doctors prescribe ACE inhibitors?
  • Metabolic acidosis is a disturbance in blood pH caused by something other than an abnormal PCO2.
  • ACE inhibitors reduce blood pressure by blocking the conversion of angiotensin I to angiotensin II.
  • metabolic acidosis with respiratory compensation
  • low osmolarity and large volume
Which of the following is NOT a metabolic disturbance that can result in a metabolic acidosis?
  • neural hyperexcitability
  • skeletal muscle
  • excessive vomiting
  • reabsorption of bicarbonate
Which type of cell carries out bone resorption?
  • aldosterone
  • osteoclasts
  • hypervolemia.
  • an osmotic gradient
Angiotensin II acts directly in the hypothalamus to stimulate what?
  • increase.
  • increase in hydrogen ion secretion from the kidneys.
  • an increase in thirst
  • bicarbonate.
Consumption of salty foods without drinking water will increase plasma osmolarity and cause cells toshrink.
  • True
  • increase.
  • aldosterone
  • False
Plasma volume is directly related to blood pressure.
  • liver
  • angiotensin II
  • parathyroid hormone
  • True
If a person is normovolemic and consumes a large quantity of a hyperosmotic solution, it will
  • cause cells to shrink due to an increase in the osmolarity of extracellular fluid.
  • bicarbonate.
  • both Na+/H+ countertransporters and H+ primary active transporters.
  • True
Aldosterone increases the number of potassium channels where?
  • principal cells basolateral membrane
  • proximal tubule apical membrane
  • principal cells apical membrane
  • adrenal cortex : increases in plasma potassium
The hemorrhage-induced decrease in blood flow to the kidneys will
  • increase in hydrogen ion secretion from the kidneys.
  • increase the production of erythrocytes.
  • increased potassium secretion
  • increase sodium secretion thereby decreasing sodium reabsorption.
The bone can supply calcium to the plasma by what process?
  • decrease.
  • resorption
  • reabsorption of bicarbonate
  • calcitonin
Which of the following is a source of water input?
  • impermeable to water and contains Na+/K+/Cl- cotransporters
  • reabsorption of bicarbonate
  • both digestive tract and metabolism
  • angiotensin converting enzyme (ACE)
Antidiuretic hormone binds to receptors on ________ cells in the collecting ducts and distal tubules where it________.
  • both Na+/H+ countertransporters and H+ primary active transporters.
  • principal : causes insertion of aquaporin-2 into the apical membrane
  • principal cells apical membrane
  • increased number of open Na+/K+ channels in the apical membrane
In order to compensate for a hyperventilation, the
  • bicarbonate.
  • True
  • kidneys decrease the reabsorption of bicarbonate.
  • cause cells to shrink due to an increase in the osmolarity of extracellular fluid.
What stimulates atrial natriuretic peptide release?
  • distension of the atrial wall due to an increase in plasma volume
  • solutes and water enter and exit the plasma at the same rate.
  • increased number of open Na+/K+ channels in the apical membrane
  • increase in hydrogen ion secretion from the kidneys.
What regulates the rate of water loss?
  • aldosterone.
  • True
  • kidney
  • distension of the atrial wall due to an increase in plasma volume
Bicarbonate crosses the apical membrane of the proximal tubule by
  • increased number of open Na+/K+ channels in the apical membrane
  • conversion to carbon dioxide.
  • secretion of ADH
  • breakdown of fat into fatty acids
What enzyme converts angiotensinogen into angiotensin I?
  • calcitonin
  • urea
  • False
  • renin
Which of the following conditions triggers the release of renin?
  • increased number of open Na+/K+ channels in the apical membrane
  • 7-dehydrocholesterol
  • buffering of hydrogen ions
  • low blood pressure
A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.3, andbicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
  • amount secreted into the distal tubule.
  • metabolic acidosis with respiratory compensation
  • ACE inhibitors reduce blood pressure by blocking the conversion of angiotensin I to angiotensin II.
  • both the gastrointestinal tract and bone
Which of the following is an effect of the transporters in the proximal tubules?
  • increased number of open Na+/K+ channels in the apical membrane
  • increased potassium secretion
  • reabsorption of bicarbonate
  • decreased renin secretion
What would the following blood values indicate? Blood pH = 7.5, [HCO3-] is high, PCO2 is high.
  • skeletal muscle
  • metabolic acidosis with respiratory compensation
  • metabolic alkalosis with respiratory compensation
  • increased potassium secretion
Angiotensinogen is synthesized by what organ?
  • hypervolemia.
  • liver
  • True
  • kidney
How does severe diarrhea cause a metabolic acidosis?
  • loss of bicarbonate
  • loss of hydrogen ions
  • osteoblasts
  • reabsorption only.
Which of the following is NOT a response to hemorrhage?
  • decreased renin secretion
  • increased number of open Na+/K+ channels in the apical membrane
  • increase in plasma osmolarity
  • decrease in filtrate volume.
Potassium channels located where are necessary for its reabsorption?
  • peripheral chemoreceptors.
  • production of lactic acid
  • proximal tubule basolateral membrane
  • principal cells apical membrane
When an increase in hydrogen ions remains after one hour, this will lead to a(n)
  • secretion of ADH
  • buffering of hydrogen ions
  • Metabolic acidosis is a disturbance in blood pH caused by something other than an abnormal PCO2.
  • increase in hydrogen ion secretion from the kidneys.
What is the strongest stimulus for the release of antidiuretic hormone from the posterior pituitary?
  • increase in plasma osmolarity
  • decrease in filtrate volume.
  • decreased number of open sodium channels in the apical membrane
  • metabolic alkalosis with respiratory compensation
Exposure of the skin to sunlight converts ________ to vitamin D3.
  • principal cells apical membrane
  • skeletal muscle
  • secretion of ADH
  • 7-dehydrocholesterol
Under which of the following conditions do cell volumes not change and the osmolarity in both extracellularand intracellular fluids remain the same?
  • principal cells
  • osmotic equilibrium
  • skeletal muscle
  • reabsorption only.
What hormone decreases calcium levels in blood?
  • atrial natriuretic peptide
  • osteoclasts
  • calcitonin
  • calcitonin only
What hormone increases water reabsorption by inserting aquaporin-2 proteins into the apical membrane ofprincipal cells?
  • calcitonin only
  • True
  • ADH
  • False
Alterations in acid-base balance that originate from the respiratory system involve alterations in CO2 contentwithin the blood.
  • False
  • principal cells
  • respiratory alkalosis with renal compensation
  • True
The hydrogen ion concentration or pH of arterial blood is regulated by the combined actions of the ________and ________.
  • parathyroid hormone
  • principal cells
  • lungs : kidneys
  • high : decrease
The regulation of sodium and water balance in the kidneys occurs primarily through the unique action ofwhich cells in the distal tubules and collecting ducts?
  • high : decrease
  • decrease in filtrate volume.
  • intercalated cells
  • principal cells
Aldosterone is released from the ________ in response to ________.
  • it exits plasma at a greater rate than it enters plasma.
  • principal cells apical membrane
  • adrenal cortex : increases in plasma potassium
  • metabolic acidosis with respiratory compensation
Which of the following best describes sodium movement in the proximal tubule?
  • Sodium is transported across the basolateral membrane by the Na+/K+ pump and across the apicalmembrane by secondary active transport.
  • In the digestive system, the seawater would draw more water out of the bloodstream than would beabsorbed, leading to severe dehydration.
  • decreased renin secretion
  • neural hyperexcitability
Under severe acidic conditions, the proximal tubules can convert ________ into bicarbonate.
  • excessive vomiting
  • neural hyperexcitability
  • resorption
  • glutamine
A decrease in plasma calcium will initiate an increase in the release of which of the following?
  • respiratory acidosis with renal compensation
  • metabolic alkalosis with respiratory compensation
  • both parathyroid hormone and 1,25-dihydroxy vitamin D3
  • both Na+/H+ countertransporters and H+ primary active transporters.
As the body becomes dehydrated, the osmolarity of the body fluids decreases.
  • decrease.
  • glutamine
  • True
  • False
Kidneys compensate for changes in plasma volume and osmolarity by adjusting the rate of water
  • loss of bicarbonate
  • an osmotic gradient
  • reabsorption only.
  • increase in plasma osmolarity
Which of the following is associated with actions of aldosterone on principal cells?
  • conversion to carbon dioxide.
  • increased potassium secretion
  • proximal tubule basolateral membrane
  • principal cells apical membrane
How might heavy exercise cause metabolic acidosis?
  • production of lactic acid
  • granular : afferent arteriole
  • proximal tubule apical membrane
  • principal cells apical membrane
The thick ascending limb of the loop of Henle is impermeable to water.
  • False
  • urea
  • skeletal muscle
  • True
From where is ADH released?
  • low blood pressure
  • posterior pituitary
  • loss of hydrogen ions
  • production of lactic acid
In the proximal tubule, sodium moves from the lumen into the tubule epithelial cell by diffusion throughsodium channels.
  • kidney
  • True
  • False
  • both HCO3-/Cl- countertransporters and Na+/HCO3- cotransporters.
A student in your physiology lab is thirsty and decides to sneak a drink of deionized or distilled water. Thestudent drinks a fairly large quantity of this water in a short period of time. What will happen to thestudent's cells?
  • adrenal cortex : increases in plasma potassium
  • both collecting ducts and late distal tubules.
  • It will cause the student's cells to swell.
  • principal : causes insertion of aquaporin-2 into the apical membrane
A patient is exhibiting several signs of acid-base imbalance. Blood tests reveal that blood pH is 7.5, andbicarbonate and carbon dioxide levels in blood are both low. What is the state of this patient?
  • production of phosphoric acid and sulfuric acid
  • respiratory alkalosis with renal compensation
  • proximal tubule basolateral membrane
  • principal cells basolateral membrane
If plasma volume is below normal, the changes originated by the kidneys will be able to return the plasmaosmolarity back to normal.
  • principal cells
  • True
  • False
  • glutamine
In diabetes insipidus, why does polyuria occur?
  • A lack of ADH decreases water reabsorption.
  • metabolic alkalosis with respiratory compensation
  • both parathyroid hormone and 1,25-dihydroxy vitamin D3
  • principal cells basolateral membrane
Potassium secretion is regulated by
  • aldosterone.
  • angiotensin II
  • decrease.
  • calcitonin only
The regulation of acid-base balance in the kidneys occurs primarily through the unique action of which cellsin the distal tubules and collecting ducts?
  • decrease in filtrate volume.
  • lungs : kidneys
  • intercalated cells
  • reabsorption only.
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