Renal and Immune Systems
Practice Exam 3
Supplemental Instruction
Iowa State University / Leader: / Kristina
Course: / AnS 214
Instructor: / Keating
Date: / 10/29/2014

1.  A “foreign” molecule which can invoke the immune response is called a(n):

a.  Hapten

b.  antibody

c.  immunoglobulin

d.  antigen

2.  Active artificially acquired immunity is a result of:

a.  Antibodies passed on from mother to baby through breast milk.

b.  Vaccination.

c.  Injection of an immune serum.

d.  Antibodies passed on from mother to fetus through the placenta.

3.  Complement proteins work by:

a.  Forming pores in the membranes of target cells.

b.  Phagocytosis of target cells.

c.  Neutralization of antigens.

d.  Producing antibodies.

4.  Cytotoxic T cells kill target cells:

a.  By secreting antibodies.

b.  By phagocytosis.

c.  By releasing oxidizing agents.

d.  Through insertion of perforins into the target’s membrane.

5.  Lymphocytes that develop immunocompetence in the thymus are:

a.  T lymphocytes.

b.  NK cells.

c.  B lymphocytes.

d.  Cytotoxic T cells.

6.  The immune cell that allows for subsequent recognition of an antigen, resulting in a secondary response, is called a(n):

a.  Helper T cell.

b.  Memory cell.

c.  Antigen-presenting cells.

d.  Plasma cell.

7.  These molecules are secreted by leukocytes and macrophages and result in a fever.

a.  Histamine

b.  Antibodies

c.  Pyrogens

d.  Heparin

8.  When a localized area exhibits increased capillary filtration, hyperemia, and swelling, it is an indication that:

a.  Inflammation is occurring.

b.  Antigens are present.

c.  An immune response is underway.

d.  Fever is developing.

9.  Which of the following is a nonspecific barrier defense?

a.  Macrophages

b.  Natural killer cells

c.  Mucous membranes

d.  Complements

10.  Which statement below is characteristic of a secondary humoral response?

a.  It results in less memory cell circulation.

b.  It results in less antibody secretion.

c.  It triggers fever.

d.  It occurs much more rapidly than a primary response.

11.  Which of the following is a characteristic of a secondary immune response?

a.  A secondary immune response is started by naïve lymphocytes, while the primary immune response is initiated by memory cells.

b.  A secondary immune response does produce as many antibodies compared to a primary immune response.

c.  A secondary immune response is slower than a primary immune response.

d.  A secondary immune response lasts longer than a primary immune response.

12.  In the list below, which type of cell is involved in adaptive immunity?

a.  Natural killer cells

b.  Neutrophils

c.  B cells

d.  Macrophages

13.  Which of the following is not a sign of inflammation?

a.  Redness

b.  Fever

c.  Swelling

d.  Pain

14.  Humoral immunity is provided by:

a.  T cells.

b.  Interferons.

c.  Antibodies.

d.  Complement proteins.

15.  ______is the property of lymphocytes that prevents them from attacking the body’s own cells.

a.  Immunological memory

b.  Self-tolerance

c.  Antigenicity

d.  Immunocompetence

16.  Self-reactive B cells are eliminated in the:

a.  Lymph nodes.

b.  Thymus.

c.  Spleen.

d.  Bone marrow.

17.  Which is correctly matched?

a.  Helper T cells: recognize virus-infected cells

b.  B cells: suppress the immune response once the foreign antigen has been cleared from the body.

c.  Cytotoxic T cells: activated by antigens bound to MHC I

d.  Regulatory T cells: make antibodies

18.  MHC II proteins are found on:

a.  Cytotoxic T cells.

b.  Antigen-presenting cells.

c.  Red blood cells.

d.  Helper T cells.

19.  Infected cells of the pancreas would display a foreign antigen fragment on a(n):

a.  Immunoglobulin A

b.  MAC membrane complex

c.  MHC I

d.  MHC II

20.  Without this cell, there is no immune response?

a.  Cytotoxic T cell

b.  B cell

c.  Macrophages

d.  Helper T cell

21.  How is Na+ reabsorbed?

a.  Osmosis

b.  Facilitated diffusion

c.  Active transport using ATP

d.  Diffusion

22.  Major calyces are:

a.  Cone-shaped structures located in the renal medulla.

b.  Large branches of the renal pelvis.

c.  The expanded ends of renal pyramids.

d.  Expanded ends of nephrons.

23.  Micturition is:

a.  A sacral reflex.

b.  Only present in males.

c.  A mechanism for concentrating urine.

d.  Production of urine.

24.  The basic functional unit of the kidney is the:

a.  Major calyx.

b.  Nephron.

c.  Glomerulus.

d.  Loop of Henle.

25.  The blood supply to the nephron is the:

a.  Renal artery.

b.  Segmental artery.

c.  Interlobular artery.

d.  Afferent arteriole.

26.  The Bowman’s capsule and glomerulus make up the:

a.  Collecting system.

b.  Renal corpuscle.

c.  Papilla.

d.  Loop of Henle.

27.  The most important factor affecting the glomerular filtration rate is:

a.  Blood hydrostatic pressure.

b.  Capsular hydrostatic pressure.

c.  Capsular osmotic pressure.

d.  Blood osmotic pressure.

28.  When the concentration of ADH increases:

a.  More salt is secreted by the nephron.

b.  Less water is reabsorbed by the nephron and collecting duct.

c.  Less urine is produced.

d.  The specific gravity of the urine decreases.

29.  Which process results in increased glomerular filtration in response to hormone release?

a.  Tubuloglomerular response

b.  Renin-angiotensin mechanism

c.  Myogenic mechanism

d.  Countercurrent mechanism

30.  Which structure is the muscular tube that delivers urine to the bladder?

a.  Urethra

b.  Papillary duct

c.  Renal pelvis

d.  Ureter

31.  Which substance would NOT normally be expected in urine?

a.  Protein

b.  Nitrogenous waste

c.  Sodium

d.  Chloride

32.  Arrange the following structures in the correct sequence in which urine passes through them to the external environment. (1) ureter, (2) renal pelvis, (3) calyx, (4) urinary bladder, (5) urethra

a.  3, 4, 1, 5, 2

b.  2, 4, 1, 3, 5

c.  3, 2, 1, 4, 5

d.  1, 2, 3, 4, 5

33.  In situations where there is an extreme change in blood pressure (mean arterial pressure less than 80 or greater than 180 mm Hg), extrinsic controls take precedence over intrinsic controls.

a.  True

b.  False

34.  Water can leave the ascending limb of the loop of Henle.

a.  True

b.  False

35.  The descending limb of the loop of Henle is relatively impermeable to solutes and freely permeable to water.

a.  True

b.  False

36.  If the efferent arteriole constricts while the afferent arteriole remains unchanged, the glomerular filtration rate:

a.  Cannot be determined.

b.  Increases.

c.  Does not change.

d.  Decrease.

37.  Which of the following statements about the urinary system is INCORRECT?

a.  It metabolizes vitamin D to its active form.

b.  It produces erythropoietin, which stimulates red blood cell formation.

c.  It produces renin, which helps regulate blood pressure.

d.  It carries out the majority of gluconeogenesis in the body.

38.  The renal hilum lies on the ______surface of the kidney.

a.  Inferior

b.  Medial

c.  Superior

d.  Lateral

39.  The renal ______is continuous with the ureter.

a.  Medulla

b.  Cortex

c.  Pelvis

d.  Glomerulus

40.  Which of the following cells in the kidney play a major part in the regulation of body water and Na+ balance?

a.  Principle cells

b.  Granular cells

c.  Intercalated cells A

d.  Intercalated cells B

41.  All of the following are layers of the filtration membrane in the glomerular membrane, except the:

a.  Fenestrated endothelium

b.  Basement membrane

c.  Renal capsule

d.  Visceral membrane

42.  The ______can contract, changing the total surface are of the capillaries available for filtration in the glomerulus.

a.  Macula densa

b.  Juxtaglomerular cells

c.  Intercalated cells

d.  Mesangial cells

43.  All of the following functions are carried out the renal tubules, except:

a.  Filtration

b.  Reabsorption

c.  Secretion

d.  Formation of urine

44.  All of the following would stimulate the release of renin from granular cells. Except

a.  Hemorrhaging or dehydration.

b.  Inhibition by the macula densa cells.

c.  Stimulation of the granular cells by the sympathetic nervous system.

d.  Reduced stretching of the granular cells.

45.  Which of the following is the countercurrent multiplier in the kidney?

a.  The vasa recta

b.  The loop of Henle of a juxtamedullary nephron

c.  The proximal convoluted tubule

d.  Bowman’s capsule around the glomerulus

46.  Which of the following substances is the largest component of urine by weight after water?

a.  Uric acid

b.  Creatinine

c.  Urea

d.  Inulin

47.  Which of the following is a function of the urinary system?

a.  Filter plasma

b.  Regulate blood pressure

c.  Regulate pH

d.  All of the above

Essay Questions

Immune System

1.  The immune system has two lines of the defense the and defense systems. In the first line of defense and are the first barriers to foreign invaders. The second line of defense includes antimicrobial proteins, , , and . One of the most important defenses is the response. Its four signs include , , , and . One internal defense of the innate immune system is phagocytosis. First the phagocyte must be mobilized; this occurs in four steps , , , and . Phagocytosis begins when a adheres to a . The phagocyte then forms a pseudopod that engulfs the particle and forms a . This will fuse with a forming a phagolysosome. The particles in the phagolysosome will be . Finally, they will undergo to remove the waste. The second line of defense is the adaptive immune system which has , is , and is . The adaptive response is executed through the action of that mature in bone marrow and that mature in the thymus. They must gain and before they are ready to fight infections. One branch of the adaptive immune system is the response which leads to the production of antibodies. Antibodies combine with antigens to form an . They can also defend against antigens by four processes , , , and . When stimulated a B cell will form with the same antigen-specific receptors. Most of these cells will become which will mark antigens for destruction. The rest of the cells will become . These provide a way for the body to react if it encounters the same antigen in the future. Active humoral immunity can come from an or . Passive humoral immunity can come from or . A second branch of the adaptive immune system is the response. T helper cells come from cells and cytotoxic T cells come from cells. Helper cells are activated by . Helper cells stimulate to divide faster to create more antibodies, activate , and other immune cells. MHC proteins signal a foreign antigen, while MHC proteins self.

Renal System

1.  Kidneys function as the major organ. They regulate blood pH, volume, and composition. The kidney can regulate blood glucose levels through . There are three layers of protective tissue around the kidneys. The which anchors the kidney in place, the which acts as a cushion, and the which provides protection from infection. The structural unit of the kidney is the . If this structure is contained in the cortex it is called a . If it extends far into the medulla it is called a . Nephrons are made up of a , which is the glomerulus and its capsule, and a . The renal tubule contains the visceral layer and a . This includes foot processes known as and filtration . The renal tubule continues to include the , , , and . The formation of urine occurs in three steps. In the first step, , blood is filtered through the filtration membrane. Glomerular cells degrade large molecules that make it through the filter. The rate of filtration can be controlled via two intrinsic mechanisms. In the mechanism glomerular filtration rate is controlled by constriction or dilation of afferent arterioles. In the mechanism GFR is controlled by macula dense cells releasing a compound in response to high levels of salt. Under extreme stress, extrinsic controls take over and the sympathetic nervous system releases . This triggers the release of to activate angiotensinogen to angiotensin I and ultimately to angiotensin II. The second step of urine formation is . More reabsorption takes place in the . In the DCT and collecting ducts reabsorption is hormonally controlled. Parathyroid hormone controls the absorption of , antidiuretic hormone controls absorption, and aldosterone and anti natriuretic hormone control reabsorption. The final step in urine formation is .

ESSAY TOPICS

Below are sample essay questions. For each, draft the response you would provide on an actual exam. Use key words and topic sentences to make an outline of a potential essay. Make sure to draw any diagrams required. Note: Most of these questions can most easily be answered with a schematic representation accompanied by brief descriptions of the drawn elements. In other words: if it helps – DRAW A PICTURE.

IMMUNE SYSTEM:

1.  Explain how phagocytes are mobilized and then discuss what happens during the event of phagocytosis.

2.  Trace the path of activation for a T cell. Be sure to note the differences in post-activation functions of TC and TH cells. Trace the path of activation for a B cell. Be sure to note the differences in post-activation functions of plasma and memory cells. Explain why re-exposure to an antigen will not illicit clinical sickness.

RENAL SYSTEM

  1. Discuss renal autoregulation of the glomerular filtration rate.
  1. Trace the path of filtrate from the glomerulus to the collecting duct.
  1. Discuss the renin-angiotensin-aldosterone axis with respect to its role in the regulation of kidney function.