50. A healthy 54-year-old man who is participating in a study on renal function has been following a high-sodium diet for the past 2 weeks. Which of the following findings in serum are most likely in this man on day 14 compared with prediet values? Na+ Atrial Natriuretic Peptide Angiotensin II 00000000 2606000E ↑ T 4 4 4 →→ →→→ ↑ T ↑ ↑ ↓ T T 1 ↑ ↓ ↓ ↑
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- Describe the effect of ADH on renal collecting tubules.What is suggested by the presence of white blood cells found in the urine?49. A healthy 27-year-old man ingests 500 mL of hypertonic saline (5%). Which of the following laboratory findings is most likely? OA) Decreased plasma arginine vasopressin concentration B) Decreased plasma osmolality OC) Decreased urine flow rate OD) Increased free water clearance
- 42. An investigator is conducting a clinical study of the effects of ADH (vasopressin) on whole body fluid balance. The plan is to produce increased circulating concentrations of ADH. Following a 5% change from baseline, which of the following will be the most effective physiologic stimulus for increasing ADH secretion in this study? A) Decrease in blood pressure B) Decrease in blood volume C) Increase in serum osmolality D) Increase in fluid intake E) Increase in hematocrit40. During an experiment, a drug that specifically dilates the efferent arterioles of the kidney is infused into an experimental animal. Which of the following sets of renal changes is most likely to occur in response to the drug? 4 A) B) E) F) G) Absolute Proximal Tubule Reabsorption ↑ ↑ ↑ Renal O₂ Consumption ↑ ↓ ↑ Filtration Fraction ↑ ↑(45) A 72 year old man is brought to the emergency department following a myocardial infarction. He dies in cardiogenic shock 12 hours later. Histologic examination of renal tissues obtained at autopsy shows swollen, pale tubular epithelial cells with normal appearing nuclear. Which of the following processes most likely caused these changes? (A) Decreased intracellular protein concentration (B) Exhaustion of intracellular glucose (C) Inadequate intracellular synthesis of ATP (D) Increased membrane permeability of water (E) Opening of Na+ channels in the plasma membranes
- What happens to blood concentration of plasma proteins in an individual with renal disease that results in either (a) damage to the filtration membrane or (b) decreased filtration at the filtration membrane?33. The rate of HCO3-reabsorption in the renal tubules is increased by which of the following? OA) A decrease in the filtered load of HCO3 O B) An increase in arterial Pco₂ C) An increase in extracellular fluid volume OD) An increase in serum Cl-concentration O) E Inhibition of renal carbonic anhydrase activity50. During an in vitro experiment studying aldosterone secretion, an isolated adrenal gland is perfused with various concentrations of potassium and angiotensin II. Which of the following combinations of potassium and angiotensin II will cause the greatest increase in aldosterone secretion? Angiotensin II A) B) C) D) E) F) G) 1) Potassium Increased Increased Increased Normal Normal Normal Decreased Decreased Decreased increased unchanged decreased increased unchanged decreased increased unchanged decreased
- 17. A 55-year-old man comes to the physician for a routine health maintenance examination. Blood pressure is 170/98 mm Hg. Diagnostic studies show stenosis in the lett renal artery The right renal artery is normal. Which of the following findings is most likely on further evaluation? OA) Decreased extracellular fluid volume B) Decreased plasma aldosterone concentration C) Increased plasma renin activity D) Increased serum potassium concentration OE) Increased 24-hour urinary sodium excretion26. An investigator is interested in measuring renal plasma flow in an experiment. The clearance of which of the following compounds would best approximate this parameter? OA) p-Aminohippurate OB) Bicarbonate OC) Inulin D) Potassium E) Sodium OF) Water29. A 3-month-old boy is brought to the emergency department because of a 2-day history of lethargy. Physical examination shows no other abnormalities. The results of laboratory studies are shown: Serum Na+ CI- A) Angiotensin-converting enzyme B) Aquaporin C) 11a-Hydroxylase D) Renin E) Vasopressin receptors Osmolality Specific gravity Osmolality Urine 165 mEq/L (N=139-146) 130 mEq/L (N=95-105) 334 mOsmol/kg H₂O (N=282-295) 1.001 117 mOsmol/kg H₂O (N>200) He is admitted to the hospital. His urine output is increased. His serum ADH (vasopressin) concentration is 24 pg/mL (N=1-5); aldosterone and renin concentrations are within the referenc ranges. The urine osmolality remains unchanged after administration of 1-deamino-8-arginine vasopressin. An MRI of the brain and pituitary gland shows no abnormalities. Ultrasonograp shows normal kidneys. The most likely underlying cause of the findings in this patient is a defect in which of the following?