Urianry system booklet

Anatomy of the urinary system (MCQ)
1. All of the following is true
about the kidney except:
a) Lies in the upper
posterior part of the
abdominal wall
b) The right is lower than
the left
c) Has 6 anatomical
segments
d) Retroperitoneal organ
2. The hilum includes the
following structures
except:
a) renal corpuscle
b) ureter
c) renal artery
d) renal vein
3. The hilum of the kidney
lies at the level of:
a) T 12
b) L 1
c) L 2
d) L 3
4. The areas of the kidney
related to the following
organs are covered by
Greater sac except:
a) Liver
b) Small intestine on the right
c) Small intestine on the left
d) Stomach
5. The lesser sac of the
peritoneum covers:
a) Spleen related area
b) Liver related area
c) Small intestine related area
d) Pancreas relatd area
6. The right kidney is related
anteriorly to:
a) Body of the pancreas
b) Right colic flexure
c) Descending colon
d) Spleen
7. The left kidney is related
anteriorly to the folowing
except:
a) Supra renal gland
b) Descending colon
c) Duodenum
d) Splenic artery
8. Psoas major muscle is
related to:
a) Upper posterior half of the
kidney
b) Lower two thirds of the
kidney medially
c) Lower two thirds of the
kidney intermediately
d) Lower two thirds of the
kidney laterally

9. The following structures
are posterior relations of
the kidney except:
a) Subcostal nerve
b) Subcostal artery
c) Ilioinguinal nerve
d) Splenic artery
10. The fibrous layer of the
fibrous capsule is formed
of:
a) Loose areolar connective
tissue
b) Dense regular connective
tissue
c) Dense irregular connective
tissue
d) None of the above
11. The renal fascia is
attached laterally to:
a) Fascia transversalis
b) Fascia over the diaphragm
c) Fascia over the renal
vessels
d) All of the above
12. The kidney includes the
following anatomical
segments:
a) Apical
b) Anterior superior
c) Posterior
d) Lower
e) All of the above
13. Paranephric fat is a fat
surrounding the fibrous
capsule ( )
14. Second part duodenum is a
posterior relation of the
right kidney( )
15. The kidney is a
retroperitoneal structure
( )
16. Concerning urinary bladder
which of the following is
false:
a) It acts as a reservoir for
urine.
b) In infants it is an abdominal
organ and ovoid in shape
c) In adults it is a pelvic organ
may be ovoid or tri-sided
pyramid.
d) It has 4 surfaces and 4
angles.
17. Obturator vessels and
nerve are posterior
relations to
a) Urinary bladder
b) Ureters
c) Urethra

18. One of the following is a
posterior relation in a
female bladder:
a) Anterior vaginal fornix
b) Pubic bone
c) Anterior wall of fundus and
body of uterus
d) Uterovesical pouch of
peritoneum
19. Point of meeting of the
base and inferolateral
surfaces of the bladder
forms:
a) Apex of the bladder
b) Posterosuperior angle of the
bladder
c) Neck of the bladder
20. Which of the following
ligaments is not related to
the neck of the bladder?
a) Pubovesical ligament
b) Puboprostatic ligament
c) Median umbilical ligament
21. Triangular area in the
mucosa of the posterior
wall of bladder is:
a) Trigone
b) Rugae
c) Uvula vesicae
d) Interureteric bar
22. Lymph drainage of the
bladder finally reaches
the:
a) Internal iliac lymph node
b) Pre-aortic lymph nodes
c) Para-aortic lymph nodes
23. Concerning male urethra
one of the following is
false:
a) S shaped duct about 8
inches in length
b) Begins at the neck and
extends through the
prostate
c) It is divided into 4 parts
d) The membranous part is the
shortest, narrowest and
least dilatable part

24. One of the following parts of the male urethra shows 2
dilatations:
a) Prostatic urethra
b) Membranous urethra
c) Spongy urethra
25. Which parts of the male urethra are drained by the internal iliac
lymph nodes:
a) Prostatic, Membranous urethra
b) Prostatic, Spongy urethra
c) Membranous, Spongy urethra
d) Membranous urethra only.
26. Sphincter urethrae is a/an ……………… relation of the female
urethra:
a) Superior
b) Anterior
c) Posterior
d) Inferior

ANSWERS:
1. C
2. A
3. B
4. D
5. A
6. B
7. C
8. B
9. D
10. B
11. A
12. F
13. False
14. False
15. True
16. B
17. A
18. A
19. C
20.C
21. A
22.C
23.C
24.C
25.A
26.A

Essay
1- Give an account on the anatomical location of the two kidneys
2- Mention the kidney size and shape
3- Enumerate the structures present in the hilum
4- How to identify the side of the kidney (right or left)
5- Mention the vertebral level of the kidneys
6- Mention the surface area of the kidney ( on the front of the abdomen and on
the back of the abdomen )
7- Enumerate the anterior and posterior relations of both kidneys including the
muscles, peritoneum, and structures.
8- Define the ureter
9- Mention the ureter width, lenght , start & end
10- Give an account on divisions of the ureter
11- Mention the sites of ureteric constrictions
12- Dicuss the course and relations of the ureter
13- Mention the surface anatomy of the ureter
14- Mention the blood supply , nerve supply , and lymphatic drainage of the ureter
15- Define the urinary bladder
16- Mention the site and the shape of the urinary bladder
17- Mention the surfaces and relations of the urinary bladder
18- Give an account on the ligaments attached to the bladder
19- Dicuss the fascia surrounding the bladder
20-Mention the peritoneal relation of the bladder
21- Give an account of the trigone and the interior of the bladder
22-Enumerate the factors preventing urine reflux to the ureter during bladder
contraction
23-Mention the blood supply , lymphatic drainage , and the nerve supply of the
urinary bladder
24-Define the urethra
25-Give an account on prostatic urethra
26-Describe the internal features of the prostatic urethra
27- Give an account on membranous part of the male urethra

28-Discuss the penile urethra
29- Compare between the arterial supply , venous drainage , nerve supply and
lymphatic drainage of male urethra
30-Give an account on the female urethra

Histology of the urinary system (MCQ)
1. The renal medulla is highly
vascular than the renal
cortex:
a. True
b. False
2. Area cribrosa is …………….
a. Medullary pyramids
b. Corticomedullary junction
c. Renal papillae
d. Renal vasculature
3. Extensions from the cortex
into the medulla are known as
renal columns while those
from the medulla into the
cortex are known as medullary
rays
a. True
b. False
4. …………….. is formed of
medullary ray + surrounding
cortical tissue
a. Renal lobe
b. Renal lobule
5. Each renal lobe surrounded by
renal column on each side
a. True
b. False
6. ………………… confined to the
renal cortex:
a. Renal corpuscle
b. Proximal convoluted tubule
c. Loop of henle
d. All of the above
7. All of the following are true
except:
a. The interlobar arteries
runs along the renal
columns while the
interlobular arteries runs
along the medullary rays
b. Intralobular arteries =
afferent arterioles
c. Arcuate arteries runs along
the apices of the renal
pyramids
d. Glomerular capillaries
connecting between
afferent & efferent
arterioles

8. Peritubular capillaries are
found along all of the
following except:
a. Subcapsular nephrons
b. Intermediate nephrons
c. Short looped nephrons
d. Juxtamedullary nephrons
9. In vasa recta ,the lining
endothelium of the ascending
capillary is fenestrated while
that lining the descending is
continuous
a. True
b. False
arrangement considering the
venous drainage is not true:
a. Outer cortex >> superficial
cortical veins >> interlobular
veins >> arcuate veins >>
interlobar >> renal vein >>
IVC
b. Deep cortex >> deep
cortical veins >> interlobular
veins >> arcuate veins >>
interlobar >> renal vein >>
IVC
c. Outer cortex >> superficial
cortical veins >> stellate
veins >> interlobular veins >>
arcuate veins >> interlobar
>> renal vein >> IVC
d. Medulla >> interlobar veins
>> renal vein >> IVC
11. One of the following
concerning PCT is not true:
a) It begins at the vascular
pole of bowman’s capsule
b) Its proximal segments are
responsible for obligatory
reabsorption of water and
solutes.
c) Its last segment is mainly
concerned with secretion of
creatinine.
12. Concerning Light microscopic
features of the PCT which is
true:
a) Has a well developed apical
brush border so that the
lumen is narrow.
b) Eosinophilic basal striations
c) Indistinct boundaries
between adjacent cells
d) All of the above.

13. One of the following is a
characteristic of the lateral
cell membrane of the cells
lining the PCT:
a) Shows thousands of
microvilli with canaliculi.
b) Extensive intercellular
interdigitations extending
from the apex and becomes
more prominent near the
base.
c) Numerous deep infoldings
that form elongated
branching processes
extending beneath
neibouring cells.
d) None of the above.
14. Concerning loop of henle:
a) Begins in the cortex as a
continuation of the PCT
b) Has a u Shaped course in
the medulla
c) Continues as distal
convoluted tubules.
d) Plays a key role in
countercurrent exchange
multiplier mechanism.
e) All of the above
15. DCRT in relation to the PCRT
is characterized by:
a) Larger diameter lined by
smaller number of cuboidal
cells.
b) Cells show more distinctive
apical brush border.
c) Cells show dark eosinophilic
cytoplasm.
d) Cells contain spherical apical
nuclei.
16. Basal cell membrane of the
DCRT is characterized by:
a) No brush border
b) Less numerous
interdigitations than PCRT
c) Extensive deep infoldings
forming prominent basal
cytoplasmic compartments
d) All of the above
17. Principal cells compared to
intercalated cells are
characterized by:
a) They are more numerous
than intercalated cells
b) Their apical surface shows
few short microvilli.
c) Their cytoplasm have scanty
organelles
d) All of the above.

18. The function of adventitia
of ureter is :
a- Folding of the mucosa in
the empty state
b- Distensibility of the wall of
ureter when fill
c- Separating the ureter from
retroperitoneal structure
d- All of the above
19. The content of musculosa
a- Smooth muscle fibers
b- Loose areolar lamina propria
c- Fibroelastic coat
d- All of the above
20. Mucosa of the urinary
bladder contain
a- Elastic fibers
b- Small blood vessels
c- Lymph vessels
d- Both A&B
21. All of this events occurs
when bladder is full except
a- Epthilum stretched &
thinner
b- Cells are flattened
c- Plaques are internalized as
vesicles
d- Filaments pull vesicles to
luminal surface
22. Which cause bladder
returning to its original size?
a- Filament
b- Plaques
c- Urio epithelium
d- All of the above
23. Which structure of the
bladder play a role in adaption
o volume changes?
a- Fibroelastic fibers
b- Urioepithelium
c- Plaques
d- Filaments
24. Osmotic barrier consists of
a- Occluding junction
b- Plaques
c- Laminal membrane
d- All of the above
25. Thick & thin urioepithelium
occurs in
a- Ureter
b- Urinary bladder
c- Urthera
d- All of the above

26. Function of osmotic barrier is :
a- Prevent water to enter cells
b- Prevent solids to exit cells
c- Protection of the bladder
d- All of the above
27. Function of the CT masculosa in the urinary passage is
a- Distension of the bladder
b- Separation of ureter from retroperitoneal structure
c- Supporting ureter
d- None of the above
28. Which structure formed internal uretheral sphincter
a- Inner circular smooth muscle
b- Outer circular smooth muscles
c- Longitudinal smooth muscle
d- All of the above

Answers:
1. B
2. C
3. A
4. B
5. B
6. A
7. C
8. D
9. B
10. A
11. A
12. D
13. B
14. E
15. D
16. C
17. D
18. C
19. A
20.B
21. C
22.A
23.D
24.D
25.B
26.D
27.A
28.B

Essay:
1. Compare between the renal cortex & medulla.
2. Mention the labels of this diagram of a longitudinal section of the
kidney.
3. Discuss the basis of renal lobulation then mention the contents of the
renal lobes & lobules.
4. Mention the structures within the renal interstitium.
5. Enumerate parts of the nephron.
6. Classify nephrons according to the position of renal corpuscles.
7. Mention the structural features of renal vasculature that help create
a high hydrostatic pressure in the glomerular capillaries.
8. Enumerate the structures of intrarenal arterial vasculature.
9. Discuss the intrarenal venous drainage at the different levels of the
kidney.
10. Mention the 3 capillary networks of the kidney & the function of each.
11. Mention the characteristic features of the fenestrated endothelium
in the glomerular capillaries.
12. Discuss the functions of the mesangial cells.
13. Discuss the structure of the renal filtration barrier.
14. Compare between the histological structures of PCRT & DCRT.
15. Compare between the two types of cells in the collecting ducts.
16. Mention the lining epithelium in the different parts of the collecting
tubules & ducts.
17. Mention the lining epithelium of the different segments of the Loop
of Henle.
18. Compare between the bladder in the full & empty states.
19. Discuss the consistency & function of the urinary bladder barrier.
20.Compare between parts of the male urethra.
21. Discuss the lining epithelium of the female urethra.
22.Discuss the histological adaptations of the ureter to its function.

Biochemistry of urinary system (MCQ)
1. Percentage of blood supply of
the kidney to the CO is :
a. 10 %
b. 25 %
c. 30 %
d. 40 %
2. All of the following are food
reserves for kidney except :
a. Glycogen
b. Neutral Lipids
c. Phospholipids
d. Phosphocreatine
3. Which of the following is the
most dominant fuel for kidney
during starvation :
a. Ketone bodies
b. Proteins
c. Glucose
d. Lactate
4. All the following is true about
renal medulla except :
a. Have glycolytic enzymes
b. They can form glycogen
c. They can release glucose
d. They don't have glucose
phosphatase
5. The least important substrate
for gluconeogenisis in kidney is
:
a. Glutamate
b. Alanine
c. Lactate
d. Glycerol
6. Which of the following is true
:
a. Phosphorylase isn't found in
cortex
b. HMS can't occur in kidney
c. Renal gluconegenesis is
cortical
d. Glycogen is made in renal
cotex
7. Glucagon stimulates renal
gluconeogenesis :
a. True
b. False
8. Gluconeogenesis decreases in
all parts of the body in post-
prandial conditions :
a. True
b. False

9. Which increases glucose
release during fasting first ?
a. Gluconeogenisis
b. Glycogenolysis
c. None of the above
10. Patients with renal failure
tends to have :
a. Hypercholestrolemia
b. Hypoglycemia
c. Hyperlipideamia
d. Polyciathemia
e. None of the above
11. Formation of active form
of Vitamin D is completed in :
a. Kidney
b. Liver
c. Skin
d. Intestine
12. The enzyme having
important role in acidosis is :
a. Glutaminase
b. L-glutamate dehydrogenase
c. Carbonic anhydrase
d. All of the above
13. Acidosis occurs in renal
failure due to :
a. Deficiency in NH3
b. Increase in NH3
c. Non Buffering of non
volatile acids
d. Increase in ammonium
chloride
14. All of the following can
cause abnormal increase of
urine volume except:
a. diabetes mellitus
b. diabetes insipidus
c. hyperparathyroidism
d. fever
15. We can find polyuria with
increased specific gravity in
case of:
a. diabetes insipidus
b. fever
c. diabetes mellitus
d. none of the above
16. Oliguria:
a. abnormal increase in urine
volume
b. occurs in late stages of
renal failure
c. urine volume less than 200
ml/day
d. b&c

17. Specific gravity of urine is
high in all of the following
conditions except:
a. fever
b. diabetes mellitus
c. oliguria
d. diabetes insipidus
18. Urine can be colourless in
case of:
a. fever
b. obstructive jaundice
c. alkaptonuria
d. diabetes insipidus
19. In case of
alkaptonuria,urine becomes:
a. deep orange
b. greenish
c. pale yellow
20. An hour after a meal,the
urine is:
a. acidic
b. alkaline
c. neutral
21. Long standing urine:
a. alkaline
b. cloudy
c. acidic
d. a&b
22. non nitrogenous organic
components of urine includes:
a. urea
b. creatine
c. uric acid
d. oxalic acid
23. NPN includes the following
except:
a. amino acids
b. purines
c. glucuronic acid
d. creatine
24. urea retention occurs in:
a. fever
b. nephritis
c. D.M
d. all of the above
25. all of the following is true
about urea except:
a. synthesized in kidneys
b. 20-40 g/day in urine
c. the end product of protein
catabolism
d. decreased excretion in liver
diseases
26. concerning ammonia
excretion;
a. defense mechanism against
acidosis
b. derived from glutamine
c. excreted as ammonium
chloride
d. all of the above

27. uric acid excretion
increases in:
a. gout
b. liver diseases
c. leukemia
d. all of the above
28. the end product of purine
catabolism is:
a. urea
b. ammonia
c. uric acid
d. creatine
29. indican is aproduct of:
a. protein catabolism
b. tryptophan putrifaction
c. purine oxidation
d. fat metabolism
30. tubular defect in
reabsorption of
cystiene,arginine,lycine and
ornithine is called:
a. cystinurea
b. alkaptonurea
c. phenylketonurea
d. hematourea
31. creatine excretion
increased in:
a. pregnancy
b. hyperthyroidism
c. myopathy
d. starvation
e. all of the above
32. the presence of
albuminurea during pregnancy
indicates:
a. ectopic pregnancy
b. preclamsia
c. eclamsia
d. all of the above
33. bence jones protein is
detected in urine in case of:
a. multiple myeloma
b. leukemia
c. lymphosarcoma
d. all of the above
34. ketonuria occurs in:
a. uncontrolled D.M
b. prolonged starvation
c. fever
d. a and b
35. bile salts appear in urine in
case of:
a. obstructive jaundice
b. hepatic jaundice
c. haemolytic jaundice
d. renal stones

Answers:
1. B
2. C
3. A
4. C
5. B
6. C
7. B
8. B
9. B
10. B
11. A
12. D
13. A
14. d
15. c
16. c
17. d
18. d
19. d
20. b
21. d
22. D
23. C
24. B
25. A
26. D
27. D
28. C
29. B
30. A
31. E
32. C
33. D
34. D
35. A
Essay
1. Enumerate metabolic pathways in the kidney
2. Mention the source of energy in the fed state & the fast state
3. Compare between the renal cortex and medulla through carbohydrates
metabolism
4. Compare between postprandial and after 60 hrs of fasting according
to the CHO metabolism
5. Give an account on the metabolic function of the kidney as an
endocrinal organ
6. List the physical properties of urine
7. Discuss three physical properties of urine normally and cases of
abnormalities

8. Mention the normal urine volume per day and mention causes of
polyuria and oliguria physiologically and pathologically
9. Enumerate cases can cause :
Oliguria
Polyuria
10. Mention the specific gravity of urine and mention cases in which it
increases or decreases
11. Give a reason that in diabetes mellitus the urine specific gravity is
high
12. Mention the normal urine color and three abnormal cases in which its
color is abnormal
13. In a case of uncontrolled diabetes mellitus discuss:
The specific gravity of urine
The urine color
Urine odor
Urine volume per day
14. Define alkaline tide and mention the normal reaction of urine
15. Discuss the possible causes of urine turbidity
16. Enumerate possible deposits can be found in urine
17. Give the normal constituents of urine
18. Enumerate NPN in urine
19. Give a short account on urea in urine normally and causes of its
increase or decrease abnormally
20.Enumerate inorganic constituents of urine and mention the 4 cations
present in urine
21. Enumerate abnormal constituents of urine
22.Give the physiological and pathological causes of albuminuria
23. Give an account on Bence-Jones proteins in urine
24. Discuss abnormal sugar levels in urine
25.Discuss three abnormal constituents of urine
26.Give an account on indicant in urine

Physiology of the urinary system (MCQ)
1. The renal blood flow per
minute is:
a) 1000 ml/min
b) 1300 ml/min
c) 250 ml/min
2. All of the following
statements about the kidney
are correct except:
a) It has high blood flow and
high O2 consumption
b) Out of 7oo ml flowing
through the glomeruli per
minute ,only 1.2 ml nearly is
excreted in urine
c) The mean pressure of blood
in the glomeruli is 60 mmHg
d) The mean capillary
preassure in the peritubular
capillary system is 13 mmHg
statements about the kidney
functions are correct except:
a) It helps in Regulation of the
arterial blood pressure
b) Plays a role in Increasing
RBCS count
c) Helps in the Maintanence of
normal blood PH
d) Promotes excretion of uric
acid that results from
aminoacids metabolism
e) Excrete creatinine that
results from break down of
creatin in muscles
4. A patient with normal kidney
function and suffering from
galactosaemia is
a) Expected to have excess
galactose in his urine
b) Expected to have less
galactose in his urine
5. The filtration pressure is
about:
a. 60 mmHg
b. 18mmHg
c. 32mmHg
6. GFR equals :
a. 120 mmHg
b. 12.5ml/min
c. 60mmHg

7. All of the following can lead
to increased glomerular
filtration rate except:
a. increased renal blood
flow
b. afferent arterioles
vasoconstriction
c. mild vasoconstriction of
the efferent arterioles
d. decreased intrapelvic
pressure
8. Concerning glomerular
filtration rate ,the false
statement is:
a. equal to the filtration
pressure times the
filtration coefeicient
b. 125ml/min
c. increased by sympathetic
stimulation
d. efferent arteriolar
vasodilatation decreases
it
9. When the kidney is severely
diseased,all is true except:
a. glomerular capillaries
permeability increases
b. fibrinogen could appear
in urine in small amounts
c. albumin appears in large
amounts
d. globulin can appear in the
urine
10. Plasma clearance of a
substance(ml/min)=
a. UxP/V
b. PxV/U
c. UxV/P
11. Concerning inulin,all is true
except:
a. molecular weight of 5200
b. bound to plasma proteins
c. same concentration in
the glomerular filtrate
and the blood
d. not toxic
12. Inulin clearance:
a. equals the GFR
b. 125ml/min
c. a&b
13. If a substance has
clearance less than that of
inulin:
a. it indicates nothing
b. indicates secretion of
the substance
c. indicates reabsorbtion of
the substance

14. Creatinine:
a. secreted by the distal
convoluted tubules
b. value of plasma
creatinine is low
c. nonspecific chromogens
lead to high value of
creatinine in plasma
d. cannot be used to
determine the GFR
15. The ratio of glomerular
filtration rate to the renal
plasma flow:
a. filtration fraction
b. plasma clearance
c. 20%
d. a&c
16. Sodium is reabsorbed at
PCRT by :
a. Passive diffusion
b. 1ry active transport
c. 2ry active transport
d. Osmosis
17. Percentage of sodium
absorbed at PCRT :
a. 55%
b. 65%
c. 75%
d. 85%
18. Mechanism of re-
absorption of Cl :
a. Passive
b. Active
c. 2ry active
d. Osmosis
19. Which of the following is
true :
a. Water reabsorbed at
DCRT is obligatory
b. PCRT is impermeable to
water
c. ADH doesn't control
water re absorption at
PCRT
d. 55 % of water is re-
absorbed at PCRT
20. Phosphate re-absorption is
controlled by :
a. Aldosterone
b. Thyroxine
c. Parathormone
d. GH
21. Most of potassium is
reabsorbed at :
a. DCRT
b. Collecting duct
c. PCRT
d. Ascending Loop of Henle

22. Glucose re-absorption is
mediated by :
a. 2ry active transport
b. Facilitated diffusion
d. All of the above
23. Dilution and concentration
of urine is determined by :
a. Loop of Henle
b. PCRT
c. DCRT
d. Collecting duct
24. The fluid leaving Loops of
Henle :
a. Hypotonic
b. Isotonic
c. Hypertonic
25. Percentage of water
reabsorbed at DCRT and
collecting duct :
a. 10 %
b. 15 %
c. 20 %
d. 25 %
26. Urea is absorbed at which
level in DCRT :
a. Cortical
b. Outer Medullary
c. Inner Medullary
d. Papillary
used to indicate the
absorption maximal ?
a. Glucose
b. Fructose
c. Galactose
d. Lactose
28. The maximal absorption for
tubule in male is :
a. 375 mg / min
b. 300 mg / min
c. 200 mg / min
d. 150 mg / min
29. Maxima are measured in :
a. Mg / sec
b. Mg / min
c. Gm / min
d. Gm / sec
used in secretory maxima ?
a. PAH
b. Creatinine
c. Glucose
d. Inulin

31. The function of adventitia
of ureter is :
a- Folding of the mucosa in
the empty state
b- Distensibility of the wall
of ureter when fill
c- Separating the ureter
from retroperitoneal
structure
d- All of the above
32. The content of musculosa
a- Smooth muscle fibers
b- Loose areolar lamina
propria
c- Fibroelastic coat
d- All of the above
33. Mucosa of the urinary
bladder contain
a- Elastic fibers
b- Small blood vessels
c- Lymph vessels
d- Both A&B
34. All of this events occurs
when bladder is full except
a- Epithelium stretched &
thinner
b- Cells are flattened
c- Plaques are internalized
as vesicles
d- Filaments pull vesicles to
luminal surface
35. Which cause bladder
returning to its original size?
a- Filament
b- Plaques
c- Urio epithelium
d- All of the above
36. Which structure of the
bladder play a role in adaption
o volume changes?
a- Fibro elastic fibers
b- Urioepithelium
c- Plaques
d- Filaments
37. Osmotic barrier consists of
a- Occluding junction
b- Plaques
c- Laminal membrane
d- All of the above
38. Thick & thin urioepithelium
occurs in
a- Ureter
b- Urinary bladder
c- Urthera
d- All of the above

39. Function of osmotic barrier
is :
a- Prevent water to enter
cells
b- Prevent solids to exit
cells
c- Protection of the bladder
d- All of the above
40. Function of the CT
masculosa in the urinary
passage is
a- Distension of the bladder
b- Separation of ureter
from retroperitoneal
structure
c- Supporting ureter
41. Which structure formed
internal uretheral sphincter
a- Inner circular smooth
muscle
b- Outer circular smooth
muscles
c- Longitudinal smooth
muscle
d- All of the above
42. All of the following are
true concerning the myogenic
theory except:
a. Hypertension >> stretch
on the wall of afferent
arteriole >> vasodilatation
>> increase in the renal
blood flow & filtration
rate
b. Hypertension >> stretch
on the wall of afferent
arteriole >>
vasoconstriction >>
decrease in the renal
rate
c. Hypotension >> decrease
the stretch on the wall
of afferent arteriole >>
vasodilatation >>
rate
d. Hypotension >> increase
the stretch on the wall
of afferent arteriole >>
vasodilatation >>
rate

true concerning arteriolar
vasodilator feedback
mechanism except:
a. Macula densa act as
sensors to Na & Cl level
in the filtrate
b. It’s the major mechanism
regulating RBF
c. It increases when ABP
remains low for more
than 20 mins
d. Decreased RBF >>
decreased Na & Cl level
at macula densa >>
arteriolar vasodilatation
>> increasing RBF & GFR
to the normal
44. Decreased Na & Cl level at
macula densa results in all of
the following except:
a. Afferent arteriolar
vasodilatation
b. Direct mild efferent
arteriolar
vasoconstriction
c. Severe efferent
arteriolar VC
d. Rennin release from JG
cells
45. The main mechanism
autoregulating RBF in
prolonged hypotension:
mechanism
b. Efferent arteriolar
mechanism
c. Afferent arteriolar
vasoconstrictor feedback
mechanism
d. Efferent arteriolar
vasoconstrictor feedback
mechanism
46. ………… will increase RBF:
vasodilatation
b. Hypertension
c. Efferent arteriolar
vasoconstriction
d. A & B
e. All of the above

47. All The following
statements about Tubular
transport maxima for a
certain substance are correct
except
a. It indicates the maximum
amount of a substance in
(mg), which can be
absorbed or secreted
/minute.
b. normally , its value
changes according to the
metabolic needs of the
individual.
c. The glucose tubular
maximum can be
calculated as
d. Tubular maximum for
PAH measures the
secretory power of the
tubules.
e. Threshold level for
glucose excretion in urine
is nearly 180 mg %
48. In absence of ADH ,the
urine osmolality is:
a. Normal
b. Less than that of the
plasma
c. Zero
d. Greater than that of the
plasma
e. Equal to that of the
plasma
49. The transport maxima of a
certain substance is:
a. Measured in ml plasma/
min
b. Dependent on plasma
conc of a substance
c. Dependent on the GFR
d. May be reduced in kidney
disease
50. The ADH:
a. Enhances water
reabsorbtion in PCT
b. Enhances water
reabsorbtion mainly in
the collecting ducts
c. Has no effect on the
permeability of any
segment of nephron to
urea
d. Increases permeability
of distal tubules to both
Na & water

51. Which of the following parts
of the nephron normally
impermeable to water:
a. Ascending limb of loop of
henile
b. PCT
c. DCT
d. descending limb of loop
of henile
52. urine concentration:
a. is due to active
reabsorbtion of water
b. is completed in loop of
henile
c. occurs progressively
along PCT
d. is related to osmolality
of the medullary
interstitium
e. is independent of the
ADH
53. because a countercurrent
is present in the kidney :
a. the GFR is constant
b. urine becomes acidified
c. renal response to PTH is
reduced
d. there is persistent
hyperosmolality in the
medullary interstitium
54. In a normal individual who
drinks 1 litre of 0.9% NaCl
solution
a. the urine volume
increases
b. the plasma osmolality
increases
c. the amount of Na in urine
increases
d. Aldosterone secretion
increases
e. A and C
f. B and D
55. Urine concentration
depends on :
a. trapping of water in renal
tubules
b. trapping of solutes in
medullary interstitium
c. the active process of
secretion
d. removal of excess water
by vasarecta
e. b and d
f. a and c
56. all of the following is tue
about H ions except:
a. most reactive anions
b. interact with negatively
charged molecules
c. increases in alkalosis
d. all of the above

57. carbon dioxide is
considered as:
a. fixed acid
b. organic acid
c. volatile acid
58. regarding fixed acids:
a. non volatile
b. add 50-100 mmol of H /day
c. sulphuric and phosphoric
acid
d. all of the above
59. all of the following are
organic acids except:
a. lactic acid
b. acetoacetic acid
c. sulphuric acid
d. beta hydroxy butyric acid
60. lactic acidosis occurs in:
a. uncontrolled diabetes
mellitus
b. hypovolaemic chock
c. SLE
d. hyperventilation
61. the most powerful defense
mechanism against cahnges in
pH is:
a. acid base buffer system
b. respiratory system
c. the kidney
d. the liver
62. concerning bicarbonate
buffer system:
a. pKa =6.1
b. present in all body fluids
c. weak system
d. all of the above
63. pKa of phosphate buffer
system is:
a. 6.8
b. 6.1
c. 7.4
d. 8
64. most of the buffering
power of the cells results
from:
a. intracellular proteins
b. haemoglopin
c. bicarbonate buffer
d. phosphate buffer
65. respiratory control of pH
has aduration of:
a. fraction of seconds
b. 1-12 minutes
c. several hours
d. several days
66. Increase blood CO2 will
lead to :
a- Increase PH
b- Increase bicarbonate
c- Increase loss of water
d- All of the above

67. CO2 extract mainly by:
a- Kidney
b- Intestine
c- Lung
68. Which PH isn't compatible
with life?
a- 7.8
b- 7.7
c- 7
d- All of the above
acids not extracted by lung?
a- Volatile acid
b- Fixed acid
c- Orangic acid
d- All of the above
70. Increasing acidity blood
will lead to :
a- Increase NAHCO3
b- Activation of bicarbonate
of buffer system
c- Increase carbonic acid
d- All of the above
71. Concentration of
bicarbonate in body is equal
to
a- 20mmol/L
b- 22mmol/L
c- 24mmol/L
d- 26mmol/L
72. Bicarbonate buffer system
present
a- Extracellulary
b- Incellulary
c- Interstium
d- All of the above
73. Base is regulated by
a- Lung
b- Kidney
c- Liver
74. Acids is regulated by
a- Lung
b- Kidney
c- Liver
75. pKa of the phosphate
buffer system
a- 6.1
b- 6.8
c- 7.4
d- 7.8

76. Main sources of water in
body
a- Food
b- Oxidation of food
c- Liquid
d- All of the above
77. Water in urine is
controlled indirectly by
a- ADH
b- Thirst
c- Na balance
d- All of the above
78. Which nuclei controlled
major secretion of ADH
a- Preoptic nuclei
b- Paraventricalor
c- Supraoptic
d- All of the above
79. Osmoreceptors are
a- Located in third ventricle
b- Preoptic hypothalamus
c- Sensitive to osmolality
ICF
d- All of the above
80. Increase Na in
extracellular
a- Increase ADH
b- Increase water
conservation
c- Loss of water
extracellulary
d- All of the above
81. Osmoreceptor respond
mainly to
a- Na
b- K
c- Urea
d- Glucose
82. Increasing arterial blood
pressure will lead to
a- increase blood fluid
b- increase baroreceptor
reflex
c- both A& B
d- none of the above
83. The kidney regulates PH by
controlling…………….
84. The respiratory system
regulates ph by controlling………
‫السؤالين‬‫اختيارتهم‬‫اهي‬
a. PCO2 in arterial blood
b. PCO2 in the in venous
blood
c. Only HCO3 in the plasma
d. HCO3 in the plasma and
secretion of H ions

85. If we add an acid to the
blood lowered the PH to 7 ,
respiratory system can return
the PH to ……………….
a. 7,4
b. 7.6
c. 7,2
d. 7,3
e. c+d
86. PCO2 affects ventilation
directly by…….
87. PCO2 affects ventilation
indirectly by…….
‫السؤالين‬‫اختيارتهم‬‫اهي‬
a-chemoreceptors in the
medulla oblongata by Hco3
b- chemoreceptors in the
medulla oblongata by H
c- chemoreceptors in aortic and
carotid bodies
d- baroreceptors in aortic arch
88. The main enzyme in
controlling reabsorption of
Hco3 is
a- Glutaminase
b- Glutamic acid dehydrogenase
c- carbonic anhydrase
d- bicarbonate dehydrogenase
89. Limiting PH of urine is
a-7,4
b- 6,9
c- 8
d- 4,5
90. Kidney regulates PHco3
by………..
a- Reabsorption
b- Generation
c- Both
D- None

Answers:
1. b
2. a
3. d
4. a
5. d
6. d
7. b
8. c
9. b
10. c
11. b
12. c
13. c
14. c
15. d
16. B
17. B
18. A
19. C
20.C
21. C
22.D
23.A
24.A
25.B
26.C
27.A
28.A
29.B
30.A
31. C
32.A
33.B
34.C
35.A
36.D
37.D
38.B
39.D
40.A
41. B
42.B
43.C
44.B
45.D
46.D
47.B
48.B
49.D
50.B
51. A
52.D
53.D
54.E
55.E
56.a
57.c
58.d
59.c
60.b
61. c
62.d
63.a
64.a
65.b
66.B
67.C
68.A
69.B
70.D
71. C
72.D
73.B
74.A
75.B
76.C
77.C
78.C
79.A
80.B
81. A
82.C
83.A
84.D
85.E
86.B
87.C
88.C
89.D
90.C

Essay:
1. Give an account on the homeostatic function of the kidney
2. discuss the kidney as endocrinal organ
3. mention the major constituents of the urine
4. Give an account on the metabolic waste products excreted in the urine
5. List the abnormal constituents which its pathway of excretion is the
urine
6. Give a short account on the energy supply of the kidney during
starvation and fed state
7. Give a short account on the kidney as a metabolic organ
8. Give a reason for the high glomerular filtration rate
9. Discuss the glomerular filtration dynamics
10. Enumerate factors affecting glomerular filtration rate
11. Discuss three factors affecting glomerular filtration rate
12. Mention the effect of each of the following on the glomerular
filtration rate:
Intrapelvic pressure
Colloid osmotic pressure
Arterial blood pressure
Renal blood flow
Sympathetic stimulation
13. Define plasma clearance and mention how to be measured
14. Mention how to measure :
the rate of clearance of certain substance from plasma
the rate of excretion of certain substance in urine
15. Discuss the inulin clearance is used as a measure for glomerular
filtration rate GFR
16. Mention what do we mean by a certain substance has a clearance less
or more than that of inulin
17. Give a reason for the creatinine is used for measurement of GFR
inspite its secretion in the proximal tubules
18. From the para-aminohippuric acid clearance discuss how to calculate:
Effective renal plasma flow

Actual renal plasma flow
Renal blood flow
Filtration fraction
19. Discuss the effect of the glomerular diameter of blood vessels on the
glomerular filtration
20.Discuss the permeability of glomerular capillaries as a factor
affecting glomerular filtration
21. Define the filtration co-efficient and filtration rate
22.Give an account on:
23.Glomerular filtration
24.Tubular reabsorption
25.Tubular secretion
26.Discuss the myogenic hypothesis?
27.Discuss the juxtaglomerular hypothesis?
28.Discuss the mechanisms for auto regulation of RBF?
29.What will happen if the BP lower remain low for more than 10-20 minutes?
30.Compare between the mechanisms of auto regulation of GFR and RBF?
31. What is the filtration fraction?
32.What are the functions of PCRT?
33.What are the functions of loop of henle?
34.Discuss the reabsorption of the loop?
35.What are the functions of DCRT and collecting ducts?
36.Discuss the active transport of sodium in PCRT?
37.Discuss how the glucose and amino acid reabsorbed in PCRT?
38.Compare between 2 ways of secretion of H ions?
39.Discuss the primary active secretion of potassium?
40.Discuss the reabsorption of urea?
41. Compare between active transport and passive diffusion in general?
42.Discuss the glucose tubular maximum?
43.Discuss the PAH tubular maximum?
44.How to create diluted urine?
45.How to create concentrated urine?
46.Discuss the counter current system?
47.Discuss the counter current exchanger of vasa recta?
48.Describe the counter current system
49.Discuss the first step in urine concentrating mechanisms

50.Mention the four mechanisms for creating medullary interstitial
hyperosmolality
51. Discuss the counter current multiplier mechanism
52.Discuss the second step in urine concentrating mechanism
53.Describe the function of vasa recta as a counter-current exchanger
54.Draw the vasa recta as counter-current exchanger in the kidney
55. Classify acids in our body and discuss one of them
Volatile acids
Fixed acids
Organic acids
57.In certain abnormal circumstances, organic acids may accumulate
causing acidosis. Discuss
58.List the physiological defense mechanisms in our body against changes
in H concentration
59. Explain the most rapid defense mechanism in our body against
changes in H concentration
The bicarbonate buffer system
The phosphate buffer system
The protein buffer system
61. Give reasons for:
The phosphate buffer system is more effective In intracellular
fluid
The phosphate buffer system is effective in buffering the tubular
fluid in the kidneys
62.Discuss the role of hemoglobin in the buffer system
63.Discuss the role of respiration in the regulation of the acid-base
balance
64.Discuss the renal regulation of PH
65.Explain two mechanisms by which kidneys can regulate P(HCO-3)
66. Discuss the reabsorption of P(HCO-3) as a mechanism for PH
regulation

67.Discuss the role of ammonia in the renal mechanisms for PH regulation
68.Discuss the role of phosphate in the renal mechanisms for PH
regulation
69.Give the causes of :
Respiratory acidosis
The respiratory alkalosis
The metabolic acidosis
The metabolic alkalosis
70.-Compare between metabolic and respiratory acidosis
-Compare between metabolic and respiratory alkalosis
According to:
Definition
Causes
Regulation mechanism
Diagnostic signs
71. Discuss the effect of acidosis and alkalosis on the body
72.Mention the water sources in our body and enumerate routes for its
loss
73.Give an account on the direct mechanisms by which the body regulates
water balance (thirst center, ADH)
74.Give an account on the indirect mechanisms that affect water balance
( sodium balance regulators)
75.Give an account on the osmoreceptors (osmosodium receptors)
76.Discuss the mechanisms by which the body can regulate:
Increas in plasma osmolality
Decrease in blood volume
77.Explain the role of osmoreceptors in regulating the water balance
indirectly
78.Give the reason for that the osmosreceptors respond to Na changes in
ECF but not K changes

Microbiology & parasitology of urinary system (MCQ)
1. Concerning proteus ,the false
statement is :
a. gram negative,highly motile
capsulated bacteria
b. non lactose fermenting
c. characterized by their fishy
odour
d. urease positive
2. Dienes phenomenon :
a. the resulting swarming of
growth of two identical
proteus cultures coalesce
without signs of demarcation
on the same plate of
inhibitory medium
b. the ability of proteus to
hydrolyze urea rapidly
c. all of the above
3. Proteus can be cause of :
a. meningitis
b. pneumonia
c. urinary tract infections
d. all of the above
4. Concerning pseudomonas, the
false statement is :
a. oxidase positive
b. grow at 42 C
c. facultative anaerobe
d. characterized by pigment
production on nutrient agar
5. Pseudomonas is sensitive to :
a. heat and drying
b. cetrimide
c. most of antibiotics
6. Staph.saprophyticus:
a. coagulase negative
b. nonvobiocin sensitive
c. can cause urinary tract
infections in women of child
bearing age
d. a&c
7. Regarding enterococci,the
true statement is :
a. gram positive cocci in pairs
or short
chains,capsulated,non motile
b. is B haemolytic only
c. ferments mannitol with gas
production
d. a&c

8. Concerning Schitosoma,the
true statement is :
a. multiple intestinal caeca
b. operculated eggs
c. no radial stage
d. females posses a
gynecophoric canal
9. Regarding the male schitosoma
haematobium,all true except:
a. possess a gynaecophoric
canal
b. the intestinal caeca reunite
post equatorially
c. the genital pore at the top
of the gynaecophoric canal
just above the ventral
sucker
d. globular large testes
10. Female schitosoma
haematobium:
a. the genital pore is below the
ventral sucker
b. the suckers are well
developed
c. ovary is post equatorially
d. a&c
11. Schistosoma haematobium
eggs mature in :
a. capillaries of the vesical
plexus
b. water outside man
c. submucosa of the urinary
bladder wall
12. When the eggs hatch:
a. give rise to miracidia which
cannot live in water more
than 48 hours
b. inside the snail miracidia
develop into first and
second generation sporocyte
then radial stage followed
by cercariae
c. the cycle inside the snail
takes about 2 days
13. Schistosomule is:
a. cercariae without tail
before penetration of the
skin
b. the infective stage
c. cercariae without tail after
penetration of the skin

14. Concerning stage of
invasion and maturation of
schistosoma haematobium:
a. considered as the incubation
period prior to egg
deposition
b. the clinical picture is still
not specific
c. manifested by inflammatory
reactions
d. all of the above
15. Related to ovideposition
and egg extrusion:
a. stage of invasion and
maturation
b. stage of established
infection
c. stage of late infection
16. Can produce tissue
damage:
a. living adults
b. eggs and dead adults
c. all of the above
considered as complications of
schistosoma haematobium
infection except:
a. hydronephrosis
b. pseudoelephantiasis of the
penis
c. cor pulmonale
d. lobar pneumonia

Answers:
1. a
2. d
3. d
4. c
5. a
6. d
7. c
8. c
9. c
10. d
11. c
12. d
13. c
14. d
15. b
16. b
17. d
Essay:
1- Mention the morphlogy of escerichia coli
2- Mention cultural characters of escerichia coli
3- Give an account of biochemical reactions of escerichia coli
4- Discuss antigenic structure of escerichia coli
5- Explain the occurrence of escerichia coli
6- Give an account on the pathogenesis of escerichia coli
7- Mention the morphlogy of klebsiella
8- Mention cultural characters of klebsiella
9- Give an account of biochemical reactions of klebsiella
10-Discuss antigenic structure of klebsiella
11- Give an account on the pathogenesis of klebsiella
12-Discuss the laboratory diagnosis of klebsiella
13-Mention the morphology of proteus

14-Give an account on the cultural characters of proteus
15-Define the Dienes phenomenon
16-Enumerate the biochemical reactions of proteus
17-Explain the antigenic structure of proteus
18-Give an account on the epidemiological typing of proteus
19-Discuss the pathogenesis and diseases produced by proteus
20- Mention the laboratory diagnosis of proteus
21-Mention the morphology of pseudomonas
22- Mention tha habitat of pseudomonas
23- Enumerate the biochemical reactions of pseudomonas
24- Enumerate the criteria to identify pseudomonas
25- Give an account on the sensivity of pseudomonas to physical and
chemical agents
26- Explain the antigenic structure of pseudomonas
27- Discuss the pathogenesis and diseases produced by
pseudomonas
28- Mention the laboratory diagnosis of pseudomonas
29- Explain the treatment of pseudomonas
30- Explain staphylococcus saprophyticus according to its
definition, morphology ,& biochemical reactions
31-Mention the morphology of enetrococci
32- Give 5 points about the culture of enterococci
33- Mention the biochemical reaction of enterococci
34- Give an account on enterococci resistance
35- Mention the different life cycles of Schistasomia haematobium
36- Mention the urinary complication of S.haematobium
37- Mention three ways that cause exit of the S.egg to lumen of
the bladder
38- Mention the immunological methods of diagnosis of
S.haematobium
39- Compare between the following :
a- Male & female schistosomia haematobium
b- Methods of diagnosis

c- Miraciduim & circariae
d- Cerical penetration & schistosomal migration in the clinical
features
e- Living adult & dead adult worms in producing inflammation
f- Stage of invasion & stage of established eggs in their manifestions

Pathology of the urinary system (MCQ)
1. primary GN includes the
following except:
a. IgA nephropathy
b. amyloidosis
c. acute diffuse GN
d. minimal change diseases
2. All of the following is antibdy
mediated injury in GN except:
a. ativation of classical
complement pathway
b. Ag-Ab complex
c. cytotoxic antibody
d. activation of alternative
pathway
3. The commonest mechanism of
primary GN is;
a. cell mediated injury
b. complex formation
c. cytotoxic Ab
d. heriditary mechanism
4. The following is true about
circulating immune complex
nephritis :
a. the complex is trapped in
the circulation
b. the antigen is glomerular in
origin
c. type III hypersensitivity
d. deposited only
intramembranous
5. Antiglomerular basement
membrane nephritis is:
a. autoimmune disease
b. targets glomerular
basement membrane
collagen
c. example of insitu comlex
nephritis
d. all of the above
6. Focal segmental lesion means:
a. all glomeruli are
affected
b. 50% of glomeruli are
affected
c. one segment is affected
d. b and c
7. FM is used for the following
except:
a. podocytes
b. composition of deposits
c. severity of the case
d. pattern of the disease
clinical manifestations of
acute nephritic syndrome
except:
a. severe edema
b. hypertension
c. proteinuria
d. azotemia

9. Concerning post-streptococcal
GN,the false statement is:
a. common especially among
children
b. the bacterial strain is
nephritogenic
c. there is
hypocomplementenemia
d. the immune complex
deposits
subendothelially
10. Electron microscope is
useful in :
a. detect changes not seen
by LM
b. determine the site of
deposition of immune
complex
c. determine the presence
of antibodies and
complement
d. a&b
11. Concerning flurescence
microscopy, all true except:
a. we could see the linear
pattern of immune
complex deposition only
in nephritic syndrome
b. used to detect the
presence of different
antibodies and
complement
c. the granular pattern
could be seen in cases of
in situ immune complex
against fixed antigens
d. A & C
12. Immune complex deposits
could be present in :
a. Mesangial area
b. Subendothelially
c. Subepithelially
d. All of the above
13. Elevation of blood urea and
serum creatinine:
a. azotemia if clinical signs
are present
b. uremia if clinical signs
are present
c. azotemia if clinical signs
are not present
d. b&c
14. Regarding the microscopic
appearance of acute nephritic
syndrome,all true except:
a. diffuse increase in
mesangial cells
b. linear deposition of IgG
and C3

c. may be associated with
crescent formation
d. scattered subepithelial
deposits
15. Goodpasture symdrome:
a. rapid progressive loss of
renal function
b. acute renal failure with
hempotysis
c. there is cross reaction
with anti-GBM antibodies
and alveolar basement
membrane
d. b&c
16. In rapidly progressive
glomerulonephritis:
a. rapid and progressive loss
of renal function
b. crescent in more than
50% of the glomeuli
c. proliferation of parietal
cells
d. all of the above
17. The most common
glomerular disease worldwide:
a. Focal segmental
glomerulosclerosis
b. Membranous
GlomeruloNephritis
c. Berger’s disease
d. Membranoproliferative
GlomeruloNephritis
statements about
Membranoproliferative
GlomeruloNephritis are
correct except:
a. Type I MPGN is more
common than type II
b. Type II is considered as
an autoimmune disease
c. Type II shows granular
deposits of Ig along the
capillary wall and
mesangium in LM
d. Both types have poor
prognosis
19. Most of the cases of rapid
progressive glomerulonephritis
progress to chronic GN
a. True
b. False
20. The most common cause of
recurrent hematuria is
a. Focal segmental
glomerulosclerosis
b. Membranous
GlomeruloNephritis
d. Membranoproliferative
GlomeruloNephritis

21. Most of the cases of
berger’s disease present with
NS
a. True
b. False
statements about chronic GN
are incorrect except:
a. The kidneys are
symmetrically enlarged
and fibrotic
b. The external surface
shows grayish granular
appearance
c. It’s more common among
old age group
d. Characterized by
irreversible impairment of
renal functions
23. In IgA nephropathy the
LM picture is very diagnostic
showing tram-track
appearance by silver stain
a. True
b. False
24. Patients suffering from
chronic GN usually die from:
a. Haematuria
b. Circulatory shock
c. Uremia
d. Hypotension
diseases show diffuse
thickening of the GBM with
“tram-track” appearance
a. Type I MPGN
b. Type II MPGN
d. Focal Segmental
Glomerulosclerosis
e. A and b
26. ATN is characterized by
a- Destruction of tubular
epithelium
b- Acute suppression
c- Deterioration of renel
function
d- All of the above
27. ATN is classified according
to
a- Symptoms
b- Prognosis
c- Causes
d- Clinical picture
28. Nephrotoxic ATN
characterized by
a- Patchy of PCT
b- Extensive necrosis of PCT
c- Focal rupture of BM
d- All of the above

29. Nephrotoxic is charatrized
by all of the following except
a- Caused by mercury
b- Occlusion of tubular lumen
by fibers
c- Better prognosis
d- Present with fluid over load
30. Which occurred in third
day of ATN
a- Increase BUN
b- Decrease UOP
c- Chronic renel failure
d- All of the above
31. In which phase acute renel
failure occurred
a- Intuition
b- Maintains
c- Recovery
d- All of the above
predisposing factor except
a- Reduction urine
b- Hematouria
c- Obstructionof urine
d- Vit A definicy
33. Which of stones are more
common
a- Cystine stone
b- Uric acid stone
c- Calcium stone
d- Infection stone
34. Staghorn stone contain
a- Magnesium
b- Calcium
c- Cystine
d- All of the abive
35. Which type of renel stones
associated with clinical
symptoms
a- Calcium scalcium stones
b- Infection stone
c- Cystine stone
d- Uric acid stone
36. Which type of stones
associated with hereditary
history
a- Calcium
b- Infection
c- Cysuria
d- Uric acid stones

37. Acute obstruction of
kidney charticized by
a- Insidious obstruction
b- Hydronephrosis
c- Cessation of urine
d- Parital obstruction
38. Chronic obstruction of the
kidney charticized by all
except
a- Insidious obstruction
b- Hydronephrosis
c- Cessation of urine
d- Parital obstruction
39. Unilateral hydronephrosis
occurs in
a- At the level of urinary
bladder
b- Above the level of urinary
bladder
c- Both A&B
40. Intrinsic factor in bilateral
hydronephrosis charcticized
by
a- Posterior uretheral valve
b- Ureteic calculi
c- Enlarged prostate
d- Pelvic tumour
41. Clinical features of
bilateral hydronephrosis
a- Silent
b- Hypertension
c- Pyonephrosis
d- Stone formation
42. Which of the those cause
hydronephrosis
a- Enlargment of the kidney
b- Incomplete obstruction
c- Complete obstruction
d- All of the above

Answers:
1. B
2. A
3. B
4. C
5. D
6. D
7. A
8. A
9. D
10. D
11. D
12. D
13. D
14. B
15. D
16. D
17. C
18. C
19. A
20.C
21. B
22.D
23.B
24.C
25.E
26.D
27.C
28.B
29.B
30.B
31. A
32.B
33.C
34.A
35.B
36.C
37.C
38.C
39.B
40.A
41. B
42.B

Essay:
1- Classify GN according to pathogenesis.
2- Compare between different cytotoxic antibodies.
3- Compare between circulating & in situ immune complexes.
4- Discuss the factors determining glomerular localization of immune
complex deposits.
5- Compare between azotemia & uremia.
6- Discuss the non-immunologic mechanisms of glomerular injury.
7- Discuss possible light microscopic pictures of glomeruli in glomerular
diseases.
8- Enumerate the characteristic clinical features acute nephritic syndrome.
9- Discuss the pathogenesis of acute nephritic syndrome.
10- Mention the causes of nephritic syndrome.
11- Discuss the clinical picture of post-streptococcal GN.
12- Write a short account on the morphology of post-streptococcal GN.
13- Discuss the prognosis of post streptococcal GN.
14- Discuss the pathogenesis of RPGN.
15- Discuss briefly the pathogenesis of Goodpasture syndrome.
13- Discuss the clinical presentation and their pathogenesis of the
nephritic syndrome?
14- Compare between el clinical presentation of Nephrotic and
nephritic syndromes?
15- Classify the types of the nephritic syndrome?
16- What is the pathogenesis and fate of minimal change disease?
17- Compare between the microscopic picture, pathogenesis and
fate of both FSGS and MGN?
18- Compare between type I and II of PMGN?
19- You have a patient with Berger's disease :
a. discuss the incidence of this disease
b. the clinical picture you will see
c. the microscopic picture
d. the prognosis
20- What are the glomerulonephritis which commonly progressed to
chronic GN?

21- Tabulate the main differences between Ischemic &
Nephrotoxic ATN.
22- Discuss the clinical phases of ATN.
23- Explain the predisposing factors to urolithiasis.
24- Enumerate types of stones.
25- Enumerate fates & complications of stone.
26- Compare between acute & chronic UT obstruction.
27- Explain the etiology of unilateral hydronephrosis.
28- Explain the etiology of bilateral hydronephrosis.
29- Discuss the morphology of a hydronephrotic kidney.
30- Discuss the clinical picture & complications of hydronephrosis.
31- Enumerate the predisposing factors of UTI:
32- Compare between ascending & hematogenous UTIs.
33- Describe the morphology of bilharzial cystitis.
34- Discuss the clinical features of acute pyelonephritis.
35- Enumerate the complications of acute pyelonephritis.
36- Compare between renal morphology in acute & chronic
pyelonephritis.
37- Discuss the types of renal tuberculosis.
38- Differentiate between: Renal Cell Carcinoma & Nephroblastoma.
39- Classify Transitional tumors of the bladder.
40- Enumerate the risk factors of transitional bladder tumors.
41- Discuss method of spread & clinical features of transitional
bladder tumors.
42- Compare between the cytological types of transitional bladder
tumors.
43- Describe the morphology of adult polycystic kidney.

Pharmacology of urinary system (MCQ)
1. The following statements
about furosemide are true:
a. It causes hyperkalemia
b. It’s useful in treatment of
congestive heart failure
c. It’s not effective orally
d. it causes metabolic alkalosis
2. Chlorothiazide can ulter
electrolyte balance by causing
hyperkalemia and hypocalcemia
a. true
b. false
3. undesirable effects of
thiazide diuretics include all
of the following except:
a. hyperuricemia
b. hyperglycemia
c. hyperlipidemia
d. k retention with excess
water loss
4. which of the following
diuretics could be added to
the therapeutic regimen of
apatient receiving direct
vasodilator for treatment of
hypertension
a. acetazolamide
b. spironolactone
c. mannitol
d. hydrochlorothiazide
5. furosemide acts by which of
the following mechanisms :
a. inhibition of Na/Cl
reabsorbtion in DCT
b. inhibition of aldosterone
c. inhibition of Na absorbtion
in cortical collecting tubules
d. inhibition of Na/Cl
reabsorbtion in ascending
limb of loop of henile
e. inhibition of carbonic
anhydrase enzyme
6. in the kidney which of the
following is inhibited by
thiazide diuretics:
a. Na/cl reabsorbtion in early
part of distal convoluted
tubule
b. Water removal by osmosis
c. Reabsorbtion of Ca
d. Aldosterone action on
nephron
e. Excretion of chloride
7. hydro chlorothiazide may be
useful in treatment all of the
following except:
a. hypertension
b. congestive heart failure
c. hypokalemia
d. edema

8. One of the following drug
names is not an example of
Thiazides:
a) Hydrochlorothiazide
b) Metolazone
c) Amiloride
d) Indapamide.
9. Site of action of thiazides is:
a) PCRT
b) PCRT and Loop of Henle
c) Diluting DCT and early
collecting duct
d) Late collecting duct
10. One of the following
Thiazide is effective in renal
failure:
a) Hydrochlorothiazide
b) Metolazone
c) Indapamide.
11. One of the following is not
true about Thiazides:
a) Decrease Ca++ urinary
execretion.
b) K-channel opener
c) Ca channels openers
indications for Thiazides
except:
a) Hypotension
b) Congestive heart failure
c) Nephrogenic Diabetes
Insipidus
d) Renal stones
an adverse effect for
Thiazides:
a) Hypernatremia
b) Hypocalcemia
c) Hypouricemia
d) Hyperglycemia
Answers:
1. B
2. B
3. D
4. D
5. D
6. A
7. C
8. C
9. C
10. B
11. C
12. A
13. D

Essay:
1- Define diuretics
2- Mention the major classes of diuretics
3- Mention the mechanism of the action of the carbonic anhydrases
inhibitors
4- Mention the pharmacokinetics of the action of the carbonic
anhydrases inhibitors
5- Enumerate the clinical indications of the action of the carbonic
6- enumerate the adverse effect of the action of the carbonic
7- discuss the action and effects of loop diuretics
8- give an account on the pharmacokientics of loop diuretics
9- enumerate the clinical indications of loop diuretics
10-give an account on the adverse effects of the loop diuretics
11- Discuss the mechanism of action and effects of thiazides
12-Mention the pharmacokinetics of thiazides
13-Enumerate clinical indications of thiazides
14-Enumerate the adverse effects of thiazides
15-Discuss the mechanism of action and effects of potassium sparing
diuretics
16-Mention the pharmacokinetics of potassium sparing diuretics
17-Enumerate clinical indications of potassium sparing diuretics
18-Enumerate the adverse effects of potassium sparing diuretics
19-Discuss the mechanism of action and effects
20- Mention the pharmacokinetics of osmotic diuretics
21-Enumerate clinical indications of osmotic diuretics
22- Enumerate the adverse effects of osmotic diuretics
23- Give an account on diuretics combination

Embryology of all Genitourinary Module
Embryo of the kidney & ureter
1. In congenital polycystic kidney ,the cysts are found in the following
site:
a) Bowman’s capsule
b) Junction bet PCT and loop of henile
c) Junction bet dCT and loop of henile
d) Junction bet DCT and collecting ducts
e) None of the above
2. The collecting tubules of the kidney develop from:
a) metanephric vesicle
b) coelemic epithelium
c) ureteric buds
d) paramesonephric ducts
3. The PCT of the kidney is formed by
a) metanephric vesicle
b) coelemic epithelium
c) ureteric buds
d) pmetanephrousaramesonephric ducts
4. The ureteric bud is developed from:
a) metanephrogenic cap
b) mesonephric duct
c) pronephric duct
d) mesonephric tubules
5. All of the following statements are correct except :
a) mesonephric duct originates from pronephric duct
b) mesonephric tubules are more caudal and numerous than pronephric
tubules
c) mesonephric duct is called the wolffian duct
d) the ureter is developed from metanephric vesicle
Answers: DCABD

Embryology of the bladder & urethera
I. Choose the embryological origin of the following:
1. Urinary bladder
2. Female urethera
3. Vestibule of the vagina
4. Prostatic urethera
5. Membranous urethera
6. Penile urethera
7. Median umibilcal lifament
a. Primitive urogential sinus
b. Definitive urogenital sinus
c. Allantois
d. Constriction in between the primitive & definitive urogenital
sinus
e. Pelvic part of the def. urogenital sinus
f. Phallic part of urogenital sinus
II. Choose the congenital anomaly that follows the following
descriptions:
1. Obliteration of the proximal or distal part of the allantois
2. Failure of obliteration of the allantois
3. Absence of the anterior abdominal wall & the anterior wall of
the bladder
4. The presence of the uretheral orifice on the ventral surface of
the penis
5. The presence of the uretheral orifice on the dorsal surface of
the penis
6. In complete cloacal septum
a. Urachal fistula
b. Urachal cyst

c. Urachal sinus
d. Ectopia vesicae
e. Recto-vesical fistula
f. Hypospadius
g. Epispadius
Answers:
I.
1. A
2. D
3. B
4. D & E
5. E
6. F
7. C
II.
1. C
2. A
3. D
4. F
5. G
6. E
MCQ on embryo of testis and ovary
1. All the following are true about primordial gonadal cells except:
a. they form primary sex cords
b. they are endodermal in origin.
c. they form spermatocytes.
d. failure of migration lead to gonadal dysgenesis.
2. tunica albugina is derived from?
a. endoderm
b. mesoderm
c. ectoderm

3. factors that lead to descend of testis:
a. The gubernaculum.
b. Increase intra abdominal pressure.
c. Testosterone /H.
d. All the above.
4. The testis is completely descend to the testis at the any month?
a. 4
b. 7
c. 8
d. 9
5. the origin of follicular cell is
a. ceolomic epithelium
b. primordial gonadal cell
c. gonadal ridge.
d. All the above.
6. the origin of primodium follicle (follicle cell and oogonia)is:
a. endoderm
b. mesoderm
c. ectoderm
d. a,b
7. the interstitial leyding cell are derived from…
a. ceolomic epithelium
b. primordial gonadal cell
c. gonadal ridge.
8. the ovarian ligament is derived from ..
a. the gubernaculums.
b. paramesonephric duct.
c. mesonephric duct.
d. non of the above.

9. ovarian hypoplasia occurs in..
a. turner syndrome
b. klinflter syndrome.
c. goodpasture yndrome.
d. all the above.
Answers:
1-a
2-b
3-d
4-c
5-a
6-d
7-c
8-a
9-a
1. Germ cells don’t appear in the genital ridges until the:
a. Sixth week of development
b. Fifth week of development
c. Fourth week of development
d. Third week of development
2. Which of the following cells arise from the wall of the yolk sac:
a. Intermediate mesoderm
b. coelomic epithelium
c. Primordial germ cells
d. All of the above.
3. The testis cords become horseshoe shaped by the ………… month:
a. Third
b. Fourth
c. Fifth
d. Non of the above

4. One of the following is not a congenital anomaly of the testis:
a. Gonadal dysgenesis
b. Klinefelter syndrome
c. Cryptorchidism
d. Turners syndrome
5. The structure/s that pass through the inguinal canal in female
is/are :
a. Round ligament of the uterus
b. Few lymph vessels
c. Ligament of the ovary
d. Both A & B
e. All of the above
6. Most common anomaly in female ovary is:
a. Swyer syndrome
b. Turner syndrome
c. Femal pseudo-hermaphrodites
d. None of the above
Answers:
1. A
2. C
3. B
4. D
5. D
6. C
Development of duct system
1. The paramesonephric ducts gives all of the following except :
a) Uterus
b) Uterine tubes
c) Upper part of vagina
d) Ovaries

2. All of the following are derivatives from the mesonephric ducts
except:
a) Fallopian tube
b) vas deference
c) epididymis
d) seminal vesicle
3. in female ,Wolffian ducts regress completely leaving the following
vestigial remnants except :
a) epoophron
b) paroophoron
c) prostatic utricle.
d) Gartner’s duct
4. Arcuate uterus results from :
a) non-fusion of the Mullarian duct
b) non-fusion of the mesonephric ducts
c) non canalization) of the Mullarian ducts
d) none of the above
5. the prostate is origionated from
a) endoderm
b) ectoderm
c) mesoderm
d) all of the above
6. concerning the mullerian duct ,all are true excpt:
a) it give rise to uterus
b) it gives prostatic utricle in male
c) lies medial to mesonephric duct
d) it shares in the formation of vagina
7. the prostate is developed from

a) mesonephriv duct
b) paramesonephriv duct
c) ectodermal buds off the urethra
d) endodermal buds off the urethra
8. the prostatic utricle is a derivative of
a) paramesonephric ducts
b) ureteric bud
c) mesonephric duct
d) pronephrous
9. the mesonephric duct in female gives rise to:
a) fallopian tubes
b) gartener’s duct
c) uterus
d) round ligament of uterus
none of the above
Answers:
1. d
2. a
3. c
4. a
5. a
6. c
7. d
8. a
9. b

MCQ on development of external genitalia
1. Cloacal folds are formed by :
a. Endodermal cells of yolk sac
b. Celoemic epithelium
c. Mesenchymal cells of primitive streak
d. None of the above
2. Anal folds are formed of which part of cloacal folds :
a. Cranial
b. Caudal
3. Which week in which indifferent stage of external genitalia is
completed?
a. 4th
b. 5th
c. 6th
d. 7th
4. Scrotum is formed from :
a. Urethral folds
b. Genital swelling
c. Anal folds
d. Cloacal folds
5. Formation of urethral opening dorsal to the penis is :
a. Hypospadius
b. Exstrophy of the bladder
c. Micropenis
d. Epispadius
6. Cloacal fold forms the urethral groove
a. True
b. False

7. Micropenis may occur due to pituitary dysfunction
a. True
b. False
8. The urethral fold in female develops to :
a. Labia majora
b. Labia minora
c. Clitoris
d. Vestibule
9. The counter part of phallus in female is :
a. Clitoris
b. Vestibule
c. Labia minora
d. Labia majora
Answers
1. C
2. B
3. C
4. B
5. D
6. B
7. A
8. B
9. A

Development of gonads
1- What are the steps for the development of the gonads?
2- What are the sources of the indifferent gonad?
3- Discuss the development of the process vaginalis?
4- What are the factors of descending the testis from the abdomen to
the pelvis?
5- What are the congenital anomalies of the testis?
6- Discuss the steps of development of the ovary?
7- Discuss the descend of the ovary to its normal place?
8- What are the congenital anomalies of the ovary?
9- Compare between the development of testis and the ovary?
Development of duct system
1- What is the fate of the mesonephric duct in both male and female?
2- What is the course of the mullerian duct?
3- What is the fate of the mullerian duct in both male and female?
4- Discus the steps of development of the uterus?
5- Discuss the different origin of the vagina?
6- What are the congenital anomalies of the female genital ducts?
Development of the urinary system
1- Discuss the development occur in:
a. Prophros
b. Mesonephric
c. Metanephros
2- What are the late changes occur in the Metanephros stage?
3- Discuss the congenital anomalies of the kidney?
4- Discuss the development of the ureter and its anomalies?
5- Discuss the development of the urinary bladder?
6- What is the fate of the primitive urogenital sinus?
7- What are the different part of the male urethra and show it's
embryonic origin?
8- What are the congenital anomalies of the urethra?

Urianry system booklet

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