front 1 A patient receives rapid isotonic volume expansion, and vascular capacitance does not change. Which immediate arterial pressure response is expected? A) It falls transiently B) It increases C) It remains fixed D) It oscillates only | back 1 B. It increases |
front 2 If arterial pressure falls below the renal-body fluid equilibrium point, which salt-water relationship occurs? A) Output exceeds intake B) Intake equals output C) Intake exceeds output D) Output becomes zero | back 2 C. Intake exceeds output If arterial pressure falls below the renal-body fluid equilibrium point (the point at which renal output equals salt-water intake), the renal-pressure natriuresis mechanism reduces the output of salt and water. Consequently, the intake of salt and water exceeds the output |
front 3 A patient’s arterial pressure is chronically below the renal equilibrium point. Which response tends to restore pressure? A) Salt-water loss lowers pressure B) Salt-water retention raises pressure C) Natriuresis lowers blood volume D) Diuresis lowers venous return | back 3 B. Salt-water retention raises pressure |
front 4 The renal-body fluid mechanism returns arterial pressure toward its equilibrium point over time. Which control principle describes this? A) Near-infinite feedback gain B) Positive feedback gain C) Zero feedback gain D) Baroreceptor resetting | back 4 A. Near-infinite feedback gain |
front 5 Which two variables primarily determine long-term arterial pressure? A) Heart rate; stroke volume B) Baroreceptors; chemoreceptors C) Hematocrit; plasma proteins D) Renal curve; salt-water intake | back 5 D. Renal curve; salt-water intake |
front 6 A patient has a chronic new mean arterial pressure. According to the renal-body fluid model, what must have changed? A) Cardiac contractility alone B) Renal curve or intake C) Brainstem reflexes only D) Venous valves only | back 6 B. Renal curve or intake |
front 7 Chronic arterial pressure elevation increases renal salt-water output partly by decreasing which influence? A) Sympathetic and hormonal activity B) Plasma protein filtration C) Tubular sodium delivery D) Vascular capacitance | back 7 A. Sympathetic and hormonal activity |
front 8 When arterial pressure rises chronically, what happens to sympathetic activity and salt-retaining hormonal signals? A) Both increase B) Sympathetic increases only C) Hormones increase only D) Both decrease | back 8 D. Both decrease |
front 9 When blood pressure falls, which neurohormonal response helps reduce renal salt-water output? A) SNS inhibition; natriuretic hormones B) SNS activation; antinatriuretic hormones C) Parasympathetic activation; nitric oxide D) Baroreceptor activation; sodium excretion | back 9 B. SNS activation; antinatriuretic hormones |
front 10 A patient with low blood pressure retains salt and water beyond the direct pressure effect. Which mechanism contributes ? A) Increased antinatriuretic hormones B) Decreased sympathetic activity C) Increased pressure natriuresis D) Decreased tubular reabsorption | back 10 A. Increased antinatriuretic hormones |
front 11 Which pair of abnormalities makes blood pressure more salt sensitive? A) High GFR; low aldosterone B) Low TPR; high capacitance C) Nephron loss; antinatriuretic excess D) Low protein; high filtration | back 11 C. Nephron loss; antinatriuretic excess |
front 12 Excess antinatriuretic hormone formation predisposes to salt-sensitive hypertension by impairing which process? A) Pulmonary gas exchange B) Renal salt-water excretion C) Red cell production D) Cardiac valve closure | back 12 B. Renal salt-water excretion |
front 13 A drug acutely increases total peripheral resistance throughout the body. What immediately happens to arterial pressure? A) It remains unchanged B) It equals venous pressure C) It falls immediately D) It rises immediately | back 13 D. It rises immediately |
front 14 If vascular resistance increases everywhere except inside the kidneys, what happens to the renal-body fluid equilibrium pressure? A) It shifts lower B) It does not change C) It becomes unregulated D) It shifts higher | back 14 B. It does not change |
front 15 Why does isolated systemic vasoconstriction outside the kidneys fail to chronically reset arterial pressure? A) Kidney equilibrium remains unchanged B) Cardiac output cannot change C) Baroreceptors permanently compensate D) Sodium intake becomes irrelevant | back 15 A. Kidney equilibrium remains unchanged |
front 16 A patient’s total peripheral resistance rises along with intrarenal vascular resistance. What long-term outcome may occur? A) Hypotension from natriuresis B) Normal pressure from kidneys C) Hypertension from renal shift D) Edema without pressure change | back 16 C. Hypertension from renal shift |
front 17 Increased extracellular fluid volume raises blood volume, which next increases which variable? A) Bowman hydrostatic pressure B) Pulmonary wedge pressure only C) Glomerular oncotic pressure D) Mean circulatory filling pressure | back 17 D. Mean circulatory filling pressure |
front 18 A patient’s mean circulatory filling pressure increases after extracellular fluid expansion. Which hemodynamic effect follows next? A) Decreased cardiac output B) Increased venous return C) Decreased arterial pressure D) Increased renal obstruction | back 18 B. Increased venous return |
front 19 If kidney function is normal, increased arterial pressure helps restore extracellular fluid volume by increasing excretion of what? A) Protein and glucose B) Urea and creatinine C) Salt and water D) Calcium and albumin | back 19 C. Salt and water |
front 20 An increase in cardiac output can indirectly raise arterial pressure through which mechanism? A) Reduced renal resistance B) Increased vascular capacitance C) Tissue blood flow autoregulation D) Decreased peripheral resistance | back 20 C. Tissue blood flow autoregulation |
front 21 Which pairing best distinguishes direct and indirect effects of increased cardiac output on arterial pressure? A) Natriuresis; diuresis B) Flow effect; autoregulation effect C) Baroreflex; chemoreflex D) Oncotic pressure; hydrostatic pressure | back 21 B. Flow effect; autoregulation effect |
front 22 When excess blood flows through a tissue, local arterioles constrict to return flow toward normal. What process is this? A) Autoregulation B) Pressure diuresis C) Capillary filtration D) Micturition | back 22 A. Autoregulation |
front 23 A patient eats a very high-salt meal. Which sequence best explains how extracellular fluid volume increases afterward? A) Osmolality falls; thirst decreases B) Osmolality rises; thirst increases C) ADH falls; water intake decreases D) Sodium exits; plasma volume falls | back 23 B. Osmolality rises; thirst increases |
front 24 Excess salt in extracellular fluid stimulates thirst primarily because it causes which initial change? A) Plasma proteins decrease B) Blood volume immediately falls C) Fluid osmolality increases D) Renin release stops | back 24 C. Fluid osmolality increases |
front 25 A patient with chronic severe hypertension develops increased cardiac workload and dies from ischemic heart disease. Which terminal event is emphasized as a common cause of death? A) Pulmonary embolism B) Brain herniation C) Uremic coma D) Heart attack | back 25 D. Heart attack |
front 26 High blood pressure damages a major cerebral blood vessel, followed by death of major brain regions. What event is being described? A) Cerebral infarct B) Hydrocephalus C) Nephrotic syndrome D) Tabes dorsalis | back 26 A. Cerebral infarct |
front 27 Which organ is almost always injured by longstanding high blood pressure, eventually causing uremia and death? A) Liver B) Kidneys C) Pancreas D) Spleen | back 27 B. Kidneys |
front 28 A patient with severe kidney failure is maintained on dialysis. What must be carefully controlled each dialysis session? A) Brainstem reflex tone B) Plasma fatty acid binding C) Body fluid volume D) Erythrocyte lifespan | back 28 C. Body fluid volume |
front 29 A dialysis patient requires removal of the correct amount of which substances to maintain normal body fluid volume? A) Protein and glucose B) Urea and creatinine C) Calcium and phosphate D) Water and salt | back 29 D. Water and salt |
front 30 A small adrenal gland tumor secretes excessive aldosterone and causes hypertension with sodium retention. What disorder is this? A) Primary aldosteronism B) Two-kidney Goldblatt hypertension C) Minimal change nephropathy D) Central diabetes insipidus | back 30 A. Primary aldosteronism |
front 31 When arterial pressure falls too low, the kidneys release which protein enzyme to help restore pressure? A) Aldosterone B) Renin C) Angiotensin II D) Angiotensinase | back 31 B. Renin |
front 32 Renin is synthesized and stored in juxtaglomerular cells in which inactive precursor form? A) Angiotensinogen B) Angiotensin I C) Prorenin D) Angiotensin II | back 32 C. Prorenin |
front 33 Juxtaglomerular cells are modified smooth muscle cells located mainly in which vessel walls? A) Efferent arterioles distally B) Cortical veins near pelvis C) Vasa recta near medulla D) Afferent arterioles proximally | back 33 D. Afferent arterioles proximally |
front 34 Most renin released from juxtaglomerular cells enters which compartment before circulating systemically? A) Renal blood B) Bowman capsule C) Ureter lumen D) Renal pelvis | back 34 A. Renal blood |
front 35 Renin acts enzymatically on angiotensinogen to release which peptide? A) Angiotensin II B) Angiotensin I C) Aldosterone D) Bradykinin | back 35 B. Angiotensin I |
front 36 Angiotensin-converting enzyme forms angiotensin II by removing how many amino acids from angiotensin I? A) Two amino acids B) Four amino acids C) Six amino acids D) Eight amino acids | back 36 A. Two amino acids |
front 37 Angiotensin-converting enzyme is especially present in the endothelium of which vessels? A) Renal afferent arterioles B) Portal venous vessels C) Lung vessels D) Cerebral vessels | back 37 C. Lung vessels |
front 38 Angiotensin II persists in blood only briefly because it is rapidly degraded by which enzymes? A) Angiotensinases B) Kinases C) Phosphatases D) Carbonic anhydrases | back 38 A. Angiotensinases |
front 39 Which pair represents the two principal arterial pressure–raising effects of angiotensin II? A) Natriuresis; vasodilation B) Diuresis; thirst suppression C) Vasoconstriction; renal retention D) Protein loss; plasma dilution | back 39 C. Vasoconstriction; renal retention |
front 40 Angiotensin II decreases renal excretion of which substances to help elevate arterial pressure? A) Protein and glucose B) Calcium and fatty acids C) Urea and creatinine D) Salt and water | back 40 D. Salt and water |
front 41 Angiotensin II promotes aldosterone secretion from which organ? A) Kidney B) Adrenal gland C) Liver D) Pituitary | back 41 B. Adrenal gland |
front 42 A patient has a tumor of renin-secreting juxtaglomerular cells. Which downstream change directly drives severe hypertension? A) Excess angiotensin II formation B) Excess sodium loss C) Loss of aldosterone secretion D) Loss of renal arteriolar tone | back 42 A. Excess angiotensin II formation |
front 43 After systemic arterial pressure reaches a new stable level in renal hypertension, which pressure returns almost to normal? A) Portal venous pressure B) Bowman capsule pressure C) Renal arterial pressure D) Bladder pressure | back 43 C. Renal arterial pressure |
front 44 Hypertension can occur when one renal artery is constricted while the other kidney’s artery is what? A) Also constricted B) Completely occluded C) Surgically removed D) Normal | back 44 D. Normal |
front 45 Stenosis of a single renal artery in a person with two kidneys causes which named hypertension model? A) Two-kidney Goldblatt hypertension B) Primary aldosteronism C) One-kidney endocrine hypertension D) Malignant nephrotic hypertension | back 45 A. Two-kidney Goldblatt hypertension |
front 46 Two-kidney Goldblatt hypertension is commonly modeled by stenosis of what structure? A) Both ureters B) One renal artery C) Both renal veins D) One adrenal vein | back 46 B. One renal artery |
front 47 In two-kidney Goldblatt hypertension, which kidney secretes excess renin? A) Normal kidney only B) Both kidneys equally C) Constricted kidney D) Contralateral kidney only | back 47 C. Constricted kidney |
front 48 In two-kidney Goldblatt hypertension, the constricted kidney retains salt and water because of which local change? A) Increased renal arterial pressure B) Increased renal venous pressure C) Increased renal plasma proteins D) Decreased renal arterial pressure | back 48 D. Decreased renal arterial pressure |
front 49 Which pairing best distinguishes primary aldosteronism from juxtaglomerular cell tumor hypertension? A) Adrenal aldosterone excess; renin excess B) Renin excess; aldosterone deficiency C) ADH excess; angiotensinase deficiency D) Sodium loss; water loss | back 49 A. Adrenal aldosterone excess; renin excess |
front 50 Which statement best compares renin and angiotensin II persistence in blood? A) Renin lasts longer B) Angiotensin II lasts longer C) Both last hours D) Both last seconds | back 50 A. Renin lasts longer |
front 51 A patient has excess extracellular salt and drinks more water. Which final volume effect follows thirst stimulation? A) Intracellular volume collapses B) Extracellular volume increases C) Plasma volume always decreases D) Renal blood flow ceases | back 51 B. Extracellular volume increases |
front 52 Which chronic hypertension complication sequence is most accurate? A) Kidney injury; uremia; death B) Liver fibrosis; ascites; death C) Bladder reflux; micturition; death D) Proteinuria; hydronephrosis; death | back 52 A. Kidney injury; uremia; death |
front 53 Which intervention is especially important for patients maintained on an artificial kidney? A) Prevent all sodium filtration B) Maintain normal fluid volume C) Increase renin secretion D) Block all thirst signals | back 53 B. Maintain normal fluid volume |
front 54 In two-kidney Goldblatt hypertension, why does the “normal” kidney retain salt and water? A) Its renal artery is stenosed B) Circulating RAAS hormones act on it C) It loses all pressure natriuresis D) Its ureter becomes obstructed | back 54 B. Circulating RAAS hormones act on it |
front 55 In two-kidney Goldblatt hypertension, renin from the ischemic kidney causes formation of which circulating mediators that affect the opposite kidney? A) NO and bradykinin B) EPO and calcitriol C) ADH and ANP D) Angiotensin II and aldosterone | back 55 D. Angiotensin II and aldosterone |
front 56 A patient has congenital aortic narrowing beyond the head and arm branches but before the renal arteries. Which diagnosis best fits? A) Coarctation of the aorta B) Two-kidney Goldblatt hypertension C) Primary aldosteronism D) Preeclampsia | back 56 A. Coarctation of the aorta |
front 57 In coarctation of the aorta, the constriction is classically located in which position? A) Distal to renal arteries B) Proximal to head branches C) Distal head branches; proximal renal arteries D) Within both renal arteries | back 57 C. Distal head branches; proximal renal arteries |
front 58 A patient with coarctation has high upper-body arterial pressure. Which mechanism best explains this finding? A) Low upper-body resistance B) Excess renal salt excretion C) Low cardiac output D) High collateral vascular resistance | back 58 D. High collateral vascular resistance |
front 59 In coarctation of the aorta, lower-body blood flow is carried mainly through which vessels? A) Pulmonary collateral arteries B) Small body-wall collaterals C) Renal arcuate arteries D) Portal venous collaterals | back 59 B. Small body-wall collaterals |
front 60 A pregnant patient develops hypertension from preeclampsia. Which event usually causes the hypertension to subside? A) Delivery of the baby B) Increased salt intake C) Renal artery stenting D) Sympathetic activation | back 60 A. Delivery of the baby |
front 61 Which placental mechanism is believed to contribute to preeclampsia? A) Excess placental perfusion B) Placental renin destruction C) Placental ischemia; toxic factors D) Fetal aldosterone deficiency | back 61 C. Placental ischemia; toxic factors |
front 62 Endothelial dysfunction in preeclampsia decreases release of which vasodilator? A) Endothelin B) Angiotensin II C) Aldosterone D) Nitric oxide | back 62 D. Nitric oxide |
front 63 In preeclampsia, glomerular membrane thickening directly causes which renal effect? A) Increased renal blood flow B) Increased sodium excretion C) Reduced glomerular filtration D) Increased ureteral pressure | back 63 C. Reduced glomerular filtration |
front 64 Acute neurogenic hypertension can occur after strong stimulation of which system? A) Parasympathetic nervous system B) Renin-angiotensin system C) Sympathetic nervous system D) Lymphatic nervous system | back 64 C. Sympathetic nervous system |
front 65 A patient develops acute hypertension after bilateral destruction of the tractus solitarius. Which reflex pathway has been interrupted? A) Baroreceptor afferent pathway B) Micturition reflex pathway C) Ureterorenal pain reflex D) Macula densa signaling | back 65 A. Baroreceptor afferent pathway |
front 66 Cutting the nerves leading from baroreceptors can cause which blood pressure abnormality? A) Chronic salt wasting B) Acute neurogenic hypertension C) Primary aldosteronism D) Two-kidney Goldblatt hypertension | back 66 B. Acute neurogenic hypertension |
front 67 The tractus solitarius relevant to acute neurogenic hypertension is located in which region? A) Cerebral cortex B) Lumbar spinal cord C) Renal medulla D) Medulla oblongata | back 67 D. Medulla oblongata |
front 68 Obesity often causes chronic hypertension partly by activating which renal neural pathway? A) Renal sympathetic nerves B) Renal parasympathetic nerves C) Pudendal motor nerves D) Pelvic sensory nerves | back 68 A. Renal sympathetic nerves |
front 69 In obesity-related hypertension, increased renal sympathetic activity impairs which renal pressure-control mechanism? A) Glomerular protein filtration B) Renal pressure natriuresis C) Bladder emptying reflex D) Ureteral peristalsis | back 69 B. Renal pressure natriuresis |
front 70 Across monogenic hypertensive disorders, what final common pathway appears to raise blood pressure? A) Increased salt reabsorption B) Increased renal salt excretion C) Reduced extracellular fluid volume D) Reduced vascular resistance | back 70 A. Increased salt reabsorption |
front 71 Monogenic hypertension ultimately expands which fluid compartment? A) Intracellular fluid volume B) Cerebrospinal fluid volume C) Plasma-free water only D) Extracellular fluid volume | back 71 D. Extracellular fluid volume |
front 72 In obese patients with primary hypertension, cardiac output is increased partly because extra adipose tissue requires what? A) Less vascular resistance B) More blood flow C) Less renal perfusion D) More baroreceptor firing | back 72 B. More blood flow |
front 73 In overweight patients, sympathetic nerve activity is especially increased in which organ system? A) Liver B) Lungs C) Kidneys D) Spleen | back 73 C. Kidneys |
front 74 Many obese patients have twofold to threefold increases in which pressure-raising hormones? A) ANP and nitric oxide B) EPO and calcitriol C) Bradykinin and prostaglandins D) Angiotensin II and aldosterone | back 74 D. Angiotensin II and aldosterone |
front 75 In obesity-related hypertension, why must arterial pressure rise for adequate salt-water excretion? A) Kidneys fail to excrete adequately B) Cardiac output becomes too low C) Adipose tissue absorbs sodium D) Baroreceptors increase natriuresis | back 75 A. Kidneys fail to excrete adequately |
front 76 Salt-sensitive hypertension can occur in chronic renal disease because of which structural loss? A) Nephron loss B) Podocyte hypertrophy C) Ureteral dilation D) Bladder denervation | back 76 A. Nephron loss |
front 77 Normal aging can predispose to salt-sensitive hypertension primarily through which renal change? A) Increased nephron regeneration B) Increased renal protein synthesis C) Gradual nephron loss D) Reduced aortic resistance | back 77 C. Gradual nephron loss |
front 78 What is the first step in treating primary hypertension? A) Immediate renal surgery B) High-sodium diet trial C) Chronic dialysis D) Lifestyle modification | back 78 D. Lifestyle modification |
front 79 Which two broad drug classes are used to treat hypertension? A) Vasodilators and diuretics B) Antibiotics and antivirals C) Anticoagulants and antiplatelets D) Bronchodilators and mucolytics | back 79 A. Vasodilators and diuretics |
front 80 Natriuretic/diuretic drugs treat hypertension primarily by promoting loss of which substances? A) Protein and glucose B) Calcium and phosphate C) Salt and water D) RBCs and albumin | back 80 C. Salt and water |
front 81 Vasodilator drugs treat hypertension primarily by producing which vascular effect? A) Increased vascular resistance B) Reduced vascular resistance C) Increased renal artery stenosis D) Reduced pressure natriuresis | back 81 B. Reduced vascular resistance |
front 82 A pregnant patient’s hypertension is linked to placental ischemia, endothelial dysfunction, reduced glomerular filtration, and impaired natriuresis. Which diagnosis is most likely? A) Primary aldosteronism B) Preeclampsia C) Coarctation of the aorta D) Essential hypertension | back 82 B. Preeclampsia |
front 83 A drug lowers blood pressure by blocking angiotensin II or aldosterone-related effects. Which vasodilator mechanism is being used? A) Direct renal tubular secretion B) RAAS blockade C) Chemoreceptor activation D) CNS ischemic stimulation | back 83 B. RAAS blockade |
front 84 Which set correctly lists mechanisms that respond to pressure changes over minutes? A) Baroreceptors; chemoreceptors; CNS ischemia B) RAAS; stress relaxation; capillary fluid shift C) ADH; thirst; volume loading D) Natriuresis; diuresis; salt sensitivity | back 84 B. RAAS; stress relaxation; capillary fluid shift |
front 85 A patient’s arterial pressure changes, and vascular smooth muscle gradually adjusts vessel diameter over minutes. Which mechanism is this? A) Stress relaxation B) Baroreceptor firing C) Chemoreceptor activation D) Cerebral infarction | back 85 A. Stress relaxation |
front 86 A minutes-scale pressure control mechanism shifts fluid across tissue capillary walls. What is the purpose of this shift? A) Move fluid into or out of circulation B) Destroy renal juxtaglomerular cells C) Prevent all venous return D) Increase plasma protein filtration | back 86 A. Move fluid into or out of circulation |
front 87 Which statement best describes the purpose of pressure diuresis and pressure natriuresis? A) Retain fluid during hypertension B) Eliminate excess volume during hypertension C) Increase vascular capacitance during shock D) Raise renin during salt loading | back 87 B. Eliminate excess volume during hypertension |
front 88 At arterial pressures above the renal-body fluid equilibrium point, which relationship between renal output and intake is expected? A) Output equals intake B) Output is less than intake C) Output exceeds intake D) Intake becomes zero | back 88 C. Output exceeds intake |
front 89 At arterial pressures below the renal-body fluid equilibrium point, which relationship is expected? A) Salt-water output exceeds intake B) Salt-water output equals intake C) Salt-water intake falls to zero D) Salt-water intake exceeds output | back 89 D. Salt-water intake exceeds output |
front 90 Which equation explains why an acute increase in total peripheral resistance raises arterial pressure? A) AP = GFR/RPF B) AP = CO × TPR C) AP = RBF/RVR D) AP = ECF/NaCl | back 90 B. AP = CO × TPR |
front 91 In tissue autoregulation, excess local blood flow produces which vascular response? A) Local vasodilation B) Local vasoconstriction C) Venous thrombosis D) Capillary rupture | back 91 B. Local vasoconstriction |
front 92 Autoregulation after increased cardiac output raises arterial pressure mainly by increasing which variable? A) Total peripheral resistance B) Plasma albumin concentration C) Bowman capsule pressure D) Urinary glucose excretion | back 92 A. Total peripheral resistance |
front 93 A patient consumes excess NaCl and then drinks more water. What happens to extracellular fluid volume? A) It decreases B) It remains fixed C) It increases D) It becomes intracellular only | back 93 C. It increases |
front 94 Excess NaCl accumulation increases ECF volume partly by stimulating which pituitary-mediated response? A) Increased ADH release B) Decreased ADH release C) Increased renin release D) Decreased aldosterone release | back 94 A. Increased ADH release |
front 95 Which paired responses to excess extracellular NaCl increase extracellular fluid volume? A) Thirst and ADH release B) Natriuresis and diuresis C) Baroreceptors and chemoreceptors D) Albuminuria and protein washdown | back 95 A. Thirst and ADH release |
front 96 Accumulation of which ion is the main determinant of extracellular fluid volume A) Potassium B) Calcium C) Sodium D) Magnesium | back 96 C. Sodium |
front 97 A patient has hypertension caused by excess extracellular fluid accumulation. Which type of hypertension is this? A) Neurogenic hypertension B) Volume-loading hypertension C) Coarctation hypertension D) Essential-only hypertension | back 97 B. Volume-loading hypertension |
front 98 In primary volume-loading hypertension, what occurs during stage 1? A) Cardiac output increases B) Total peripheral resistance decreases C) Cardiac output decreases D) Blood volume decreases | back 98 A. Cardiac output increases |
front 99 In primary volume-loading hypertension, what occurs during stage 2? A) Cardiac output becomes zero B) Total peripheral resistance increases C) Blood volume disappears D) ADH becomes absent | back 99 B. Total peripheral resistance increases |
front 100 Volume-loading hypertension can be caused by excess secretion of which hormone? A) Erythropoietin B) Calcitriol C) Aldosterone D) Angiotensinase | back 100 C. Aldosterone |
front 101 Excess aldosterone promotes volume-loading hypertension primarily by increasing retention of which substances? A) Salt and water B) Protein and glucose C) Calcium and phosphate D) Urea and creatinine | back 101 A. Salt and water |
front 102 Renin is best described as what type of molecule released by the kidneys when arterial pressure falls too low? A) Steroid hormone B) Protein enzyme C) Plasma dye D) Structural protein | back 102 B. Protein enzyme |
front 103 Juxtaglomerular cells are located mainly where? A) Afferent arteriole walls proximal to glomeruli B) Collecting duct walls near papillae C) Vasa recta walls in medulla D) Ureter walls near trigone | back 103 A. Afferent arteriole walls proximal to glomeruli |
front 104 Juxtaglomerular cells are modified versions of which cell type? A) Skeletal muscle cells B) Smooth muscle cells C) Podocyte epithelial cells D) Red blood cells | back 104 B. Smooth muscle cells |
front 105 When arterial pressure decreases, what happens to prorenin in juxtaglomerular cells? A) It splits to release renin B) It converts to aldosterone C) It becomes angiotensinase D) It exits through urine | back 105 A. It splits to release renin |
front 106 Released renin enters renal blood and then does what? A) Remains only in Bowman capsule B) Circulates throughout the body C) Enters only the ureter D) Becomes trapped in podocytes | back 106 B. Circulates throughout the body |
front 107 Angiotensinogen is also known by which term? A) Renin substrate B) ACE product C) Aldosterone precursor D) Angiotensinase substrate | back 107 A. Renin substrate |
front 108 Which statement best describes angiotensin I? A) Mild vasoconstrictor converted by ACE B) Powerful vasodilator degraded by renin C) Steroid hormone from adrenal cortex D) Enzyme stored in JG cells | back 108 A. Mild vasoconstrictor converted by ACE |
front 109 Angiotensin II raises total peripheral resistance mainly by acting on which vessels? A) Arterioles B) Veins C) Lymphatics D) Ureters | back 109 A. Arterioles |
front 110 Angiotensin II raises venous return primarily through which effect? A) Venous vasoconstriction B) Venous vasodilation C) Venous valve destruction D) Venous protein leakage | back 110 A. Venous vasoconstriction |
front 111 Angiotensin II increases extracellular fluid volume by causing which renal effect A) Increased salt-water excretion B) Decreased salt-water excretion C) Increased protein filtration D) Decreased sodium reabsorption | back 111 B. Decreased salt-water excretion |
front 112 A patient with hyperaldosteronism has increased sodium retention and hypokalemia. Which adrenal layer and renal target best match aldosterone action? A) Zona fasciculata; proximal tubule B) Zona glomerulosa; principal cells C) Zona reticularis; intercalated cells D) Adrenal medulla; collecting ducts | back 112 B. Zona glomerulosa; principal cells |
front 113 Angiotensin II promotes renal sodium and water retention through which combination of effects? A) Dilates arterioles; increases urine output B) Blocks aldosterone; inhibits tubules C) Constricts arterioles; stimulates tubules D) Relaxes vessels; increases natriuresis | back 113 C. Constricts arterioles; stimulates tubules |
front 114 A patient eats a high-salt diet. What is the expected effect on renin release? A) Renin rises markedly B) Renin decreases C) Renin becomes angiotensinogen D) Renin release is unchanged | back 114 B. Renin decreases |
front 115 Renin release increases most strongly under which condition? A) High salt intake B) High blood pressure C) High extracellular volume D) Low salt intake | back 115 D. Low salt intake |
front 116 In one-kidney Goldblatt hypertension, what causes the first rise in arterial pressure? A) Normal renal perfusion pressure B) Excess pressure natriuresis C) Renin-Ang II-aldosterone activation D) Complete aldosterone suppression | back 116 C. Renin-Ang II-aldosterone activation |
front 117 In one-kidney Goldblatt hypertension, poor flow through a constricted renal artery initially causes which response? A) Reduced renin and natriuresis B) Increased renin and aldosterone C) Increased GFR and diuresis D) Reduced angiotensin II formation | back 117 B. Increased renin and aldosterone |
front 118 In one-kidney Goldblatt hypertension, what sustains the second rise in arterial pressure? A) Loss of all renal perfusion B) Reduced sympathetic activity C) Excess nitric oxide release D) Salt-water retention raising pressure | back 118 D. Salt-water retention raising pressure |
front 119 Why must aortic pressure rise in one-kidney Goldblatt hypertension? A) To suppress all aldosterone B) To eliminate kidney blood flow C) To normalize distal renal pressure D) To increase ureteral pressure | back 119 C. To normalize distal renal pressure |
front 120 In two-kidney Goldblatt hypertension, the ischemic kidney releases renin that causes which mediators to affect the opposite kidney? A) NO and prostaglandins B) EPO and calcitriol C) Angiotensin II and aldosterone D) ADH and oxytocin | back 120 C. Angiotensin II and aldosterone |
front 121 An older patient develops renal hypertension from scattered ischemic renal tissue that secretes renin. Which cause is most likely? A) Patchy ischemic kidney disease B) Coarctation of the aorta C) Acute neurogenic hypertension D) Primary aldosteronism | back 121 A. Patchy ischemic kidney disease |
front 122 In coarctation of the aorta, why can blood flow in arms and legs remain approximately normal long term? A) Renin stops completely B) Local autoregulation compensates C) ADH blocks vascular resistance D) Baroreceptors regenerate arteries | back 122 B. Local autoregulation compensates |
front 123 In preeclampsia, endothelial dysfunction decreases nitric oxide release. Which renal-pressure consequence follows? A) Improved natriuresis B) Impaired pressure natriuresis C) Increased GFR only D) Complete salt wasting | back 123 B. Impaired pressure natriuresis |
front 124 Where do carotid and aortic baroreceptor nerves connect in the brainstem? A) Pons B) Hypothalamus C) Tractus solitarius D) Cerebellar cortex | back 124 C. Tractus solitarius |
front 125 Loss of normal baroreceptor signals causes the vasomotor center to do what? A) Become less active B) Stop sympathetic output C) Release renin directly D) Become more active | back 125 D. Become more active |
front 126 Obesity-related sympathetic activation impairs which renal pressure mechanism A) Glomerular protein restriction B) Ureterorenal reflex C) Pressure natriuresis D) Micturition reflex | back 126 C. Pressure natriuresis |
front 127 Which mechanism can cause monogenic hypertension by directly altering renal tubular epithelial cells? A) Reduced adipose blood flow B) Increased nitric oxide release C) Increased Na or Cl transport D) Decreased aldosterone synthesis | back 127 C. Increased Na or Cl transport |
front 128 Some monogenic hypertension syndromes increase synthesis or activity of hormones that stimulate what? A) Renal tubular salt-water reabsorption B) Renal tubular salt-water excretion C) Pulmonary vascular relaxation D) Cerebral baroreceptor firing | back 128 A. Renal tubular salt-water reabsorption |
front 129 Which set correctly lists obesity-related causes of primary hypertension? A) Lower CO; lower SNS; natriuresis B) Higher CO; higher SNS; impaired natriuresis C) Lower RAAS; lower adipose flow; diuresis D) Lower leptin; lower Ang II; salt wasting | back 129 B. Higher CO; higher SNS; impaired natriuresis |
front 130 In obesity-associated primary hypertension, why is cardiac output increased? A) Extra fat requires blood flow B) Baroreceptors stop firing C) Aldosterone is completely absent D) Kidneys excrete more sodium | back 130 A. Extra fat requires blood flow |
front 131 In obesity, increased leptin release is linked to which hypertension-promoting effect? A) Reduced sympathetic activity B) Increased sympathetic activity C) Increased pressure natriuresis D) Reduced cardiac output | back 131 B. Increased sympathetic activity |
front 132 With high salt intake, which essential hypertension subtype can operate at higher arterial pressures? A) Salt-insensitive essential hypertension B) Salt-sensitive essential hypertension C) Acute neurogenic hypertension D) One-kidney Goldblatt hypertension | back 132 B. Salt-sensitive essential hypertension |
front 133 During severe bleeding, which pressure control responses are classified as nervous reflex responses? A) Baroreceptors, CNS, chemoreceptors B) Aldosterone, ADH, thirst C) RAAS, stress relaxation, fluid shift D) Diuresis, natriuresis, autoregulation | back 133 A. Baroreceptors, CNS, chemoreceptors |
front 134 Which long-term mechanism helps restore arterial pressure and blood volume over days to years after severe bleeding? A) Baroreceptor firing B) Chemoreceptor activation C) CNS ischemic response D) Aldosterone | back 134 D. Aldosterone |