Can you paraphrase the following rationale for me, thankyou!
Urinary System
1. Blood in the renal arcuate arteries flows next into whichvessels?
a. Afferent arterioles
b. Efferent arterioles
c. Glomerular capillaries
d. Interlobar arteries
e. Interlobular arteries
Rationale:
The blood that goes to kidneys passes thru the INTERLOBARARTERIES first before flowing in the renal arcuate arteries. Thenit goes to INTERLOBULAR ARTERIES passing thru AFFERENT ARTERIOLESthen GLOMERULAR CAPPILLARIES before reaching EFFERENTARTERIOLES.
2. Which cell type comprises the visceral layer ofBowman capsule?
a. Endothelial cells
b. Juxtaglomerular cells
c. Mesangial cells
d. Podocytes
e. Extraglomerular mesangial (or Lacis) cells
Rationale:
The inner wall of Bowman's capsule is a visceral layer, and itis composed of podocytes that closely surround the glomerularcapillary tuft. Thus making Podocytes highly specialized cells ofthe kidney glomerulus that wrap around capillaries and thatneighbor cells of the Bowman’s capsule. This cell plays an activerole in glomerular filtration by preventing plasma proteins fromentering the urinary filtrate by providing a barrier comprisingfiltration slits between foot processes, which act as dynamicnetwork of cellular extensions.
3. Which type of epithelium lines the thick ascendinglimb of the loop of Henle?
a. Pseudostratified columnar
b. Simple columnar
c. Simple cuboidal
d. Simple squamous
e. Transitional (urothelium)
Rationale:
The loop of Henle consist of two long loop lengths: one is theshort loop that descends to the cortical-medullary border, and along loop, which ascend to the renal papilla. Furthermore, thereare 3 parts of Loop of Henle. (a) The short Henle loops have adescending thin limb and a thick ascending limb. The long Henleconsists of thin descending and ascending thin limb followed bypars recta of the distal tubule. (b) The thin parts of the loop ofHenle are lined with a single-layer flat epithelium with a highpermeability for water (and ions via solvent drag) through a weaktight junction (zonula occludens). (c) The thick ascending limb ofthe Henle loop is lined by simple cuboidal cells without a brushborder. These cells are specialized to perform a secretion andreabsorption of the substance resulting to the production ofurine.
4. Which cell is a modified smooth muscle cell thatsecretes renin?
a. Macula densa cells
b. Mesangial cells
c. Podocytes
d. Juxtaglomerular cells
e. Endothelial cells
Rationale:
Juxtaglomerular cells are located near glumerulus that highlythat synthesize, store, and secrete the enzyme renin. They are madeup of specialized smooth muscle cells mainly resides on the wallsof the afferent arterioles (and some in the efferent arterioles)that transport the blood to the glomerulus. In synthesizing renin,they play a crucial role in the renin–angiotensin system and thusplay the role in self- regulation of the kidney.
5. Epithelial cell membrane domains containing manystiffened plaques of protein are an important feature in which partof the urinary system?
a. Juxtaglomerular apparatus
b. Bladder mucosa
c. Collecting ducts
d. Renal pyramids
e. Membranous urethra
Rationale:
The urinary bladder functions as storage reservoir for urine.Anatomically, urinary bladder is located in the pelvic cavity,posterior to the symphysis pubis, and below the parietalperitoneum. It composed of smooth muscle lining wall that iscovered by a bladder mucosa thus separating muscle from theurine.
6. An immunohistochemical technique using antibodiesagainst aquaporins to stain a section of kidney would be expectedto stain cells in which structures most intensely?
  a. Collecting ducts
  b. Lining of the major and minor calyces
c. Proximal convoluted tubules
  d. Distal convoluted tubules
  e. Glomeruli
Rationale:
Immunohistochemical technique is used to detect antibody thatwas present in the specimen. Therefore, antibodies will aggregatewhere the antigens are. Since aquaporin antibodies is the basis ofimmunohistochemical technique stain, the target of the antibodiesare the aquaporin that was found in the kidney which located atsegment of collecting ducts.
7. What type of epithelium lines the prostaticurethra?
a. Simple columnar
b. Pseudostratified columnar
c. Stratified squamous
d. Simple squamous
e. Transitional (urothelium)
Rationale:
The transitional epithelium are the unique cell type structurethat possess a high plasticity and defense mechanism for urethra.The urothelium stretch when filling phase of micturition reflextakes in place resulting umbrella cells to increase in size thusactivation of the sensory fibers.
8. A 14-year-old patient presents in the nephrologyclinic with fatigue, malaise, anorexia, abdominal pain, and fever.She reports a loss of 6 lb in the past 2 months. Serum gammaglobulin and the immunoglobulins IgG, IgA, and IgM are allelevated. Her serum creatine is 1.4 mg/dL (normal 0.6-1.2 mg/dL)and urinalysis of glucose and protein are 2+ on a dipstick test,confirmed by laboratory at 8.0 g/ dL and 0.95 g/dL, respectively. Arenal biopsy is prepared for light microscopy, and an infiltratecontaining lymphocytes, plasma cells, and eosinophils is foundamong tubules having cells with prominent brush borders. Which oneof the following statements correctly pertains to these epithelialcells?
a. Impermeable to water despite presence of ADH
b. The primary site for the reduction of the tubular fluidvolume
c. The site of the countercurrent multiplier
d. The site of action of aldosterone e. Indirectly involved inthe release of renin
Rationale:
The primary site for the reduction of the tubular fluid volumetakes place mainly in proximal convoluted tubule of the nephron.Since prominent brush borders are present to the biopsy that can beonly seen in PCT, PCT are the affected cell.
9. A 45-year-old man presents with nephrolithiasis orkidney stones. The process of calcium oxalate stone formation asseen in this patient begins with Randall plaques found in thebasement membranes of which one of the following structures foundonly in the renal medulla?
a. Proximal convoluted tubules
b. Distal convoluted tubules
c. Thin loops of Henle
d. Afferent arterioles
e. Collecting ducts
Rationale:
Randall’s plaque is plaque of calcium deposited in the tissue ofthe renal papilla. Large amounts of Randall’s plaque plays a vitalrole as pre requisite to form a kidney stone. Calcification happensat the basement of loop of henle and from there, Randell plaquesspread throughout kidney toward urothelium. Due to the failure onurothelium, plaques can be exposed to urine resulting to formationof renal stones. Renal stones are formed within the collectingducts of kidney resulting to growth of crystals into stones thatlater will calcified. This calcified stones located in the basementmembrane of the loops of Henle, from which it extended into themedullary cavity.
10. A 15-year-old male presents with hematuria, hearingloss, lens dislocation, and the onset of cataracts. Geneticanalysis reveals a mutation in the COL4A5 gene. Transmission EMexamination of a renal biopsy confirms that the disorder hasaffected a component of the renal corpuscles in which damagedisrupts normal glomerular filtration. Which one of the followingstructures would most likely be abnormal in the TEM of thispatient’s biopsy?
a. Pedicels
b. Filtration slits
c. Slit diaphragms
d. Glomerular basement membranes
e. Fenestrated endothelium of glomerular capillaries
Rationale:
COL4A5 is a gene mutation that causes a changes to a proteincalled collagen. Collagen was known important to the structure andfunction of the kidney. This changes to protein can lead on hearingloss and eye problem. This gene is known to be present to thosepatients who is suffering Alport syndrome. Alport syndrome is adisease that damages the blood vessels inside the kidney thatresult to loss of kidney function. It is known to cause hematuriaby the attacking the glomerular basement membrane. Glomerularbasement membrane is a unique thick basement membrane that keepskidney’s filtration barrier. The glomerular basement membrane ismade up of podocyte and endothelial cell basement membranesthroughout glomerulogenesis.
