Excretory System MCQ for RRB & SSC and other Competitive exams
41
What is polycystic kidney disease (PKD)?
✓ Answer:
B
A genetic disorder characterised by the growth of numerous fluid-filled cysts in the kidneys leading to progressive kidney failure
Polycystic Kidney Disease (PKD) is a genetic disorder where multiple fluid-filled cysts develop in both kidneys, gradually enlarging the kidneys and replacing functional tissue, leading to CKD and eventual kidney failure. Types: ADPKD (Autosomal Dominant PKD) - most common hereditary kidney disease - mutation in PKD1 or PKD2 genes - manifests in adulthood (30-50 years) - Adult PKD. ARPKD (Autosomal Recessive PKD) - rare, presents in infancy/childhood - severe. Features: flank pain, haematuria, hypertension, palpable kidneys, recurrent UTIs. Associated with intracranial (berry) aneurysms - risk of subarachnoid haemorrhage. Treatment: Tolvaptan (vasopressin receptor antagonist), manage complications, dialysis/transplant.
42
What is the role of the kidney in blood pressure regulation?
✓ Answer:
B
The kidney regulates blood pressure through the RAAS system, control of blood volume via water/sodium regulation, and production of vasoactive substances
The kidneys are central to long-term blood pressure regulation through multiple mechanisms: 1) RAAS (Renin-Angiotensin-Aldosterone System) - Low BP > renin > angiotensin II (vasoconstrictor) + aldosterone (Na+/water retention) > increased BP. 2) Pressure natriuresis - High BP > increased Na+ and water excretion > decreased blood volume > reduced BP (negative feedback). 3) ADH - regulates water reabsorption > blood volume > BP. 4) Prostaglandins and Bradykinin - vasodilatory substances produced by kidneys - counterbalance RAAS. 5) ANP/BNP response - responds to atrial stretch (high volume) - kidneys excrete more Na+ and water. Renal artery stenosis > reduced kidney blood flow > excess renin > renovascular hypertension.
43
What is the role of the proximal convoluted tubule (PCT)?
✓ Answer:
B
It reabsorbs ~65% of filtered water, all glucose, all amino acids, and most electrolytes from the filtrate
The Proximal Convoluted Tubule (PCT) is the most active site of reabsorption in the nephron: ~65% of filtered water reabsorbed (obligatory - follows solutes), 100% of glucose reabsorbed (via SGLT2 and SGLT1 co-transporters), 100% of amino acids reabsorbed, ~65-70% Na+, Cl-, K+, HCO3- reabsorbed, Uric acid (mostly reabsorbed, some secreted), and Drugs and toxins secreted (penicillin, aspirin). The PCT has brush border (microvilli) on its luminal surface - increases surface area for reabsorption. The PCT is highly metabolically active and is the segment most vulnerable to ischaemia (ATN - Acute Tubular Necrosis).
44
What is the function of the distal convoluted tubule (DCT)?
✓ Answer:
B
It fine-tunes reabsorption of Na+, water, and secretion of K+ and H+ under hormonal control (aldosterone, ADH)
The Distal Convoluted Tubule (DCT) is the segment between the ascending Loop of Henle and the collecting duct. Its key functions: Aldosterone-regulated Na+ reabsorption and K+ secretion (via ENaC channels), PTH-regulated Ca2+ reabsorption (parathyroid hormone stimulates calcium reabsorption), H+ secretion (acid-base regulation), and fine-tuning of electrolyte balance. The DCT connects to the collecting duct, which is the final site of water regulation (ADH-dependent). Thiazide diuretics act on the DCT to block Na+-Cl- cotransporter - increased Na+ and water excretion - reduced blood pressure.
45
What is the renal pelvis?
✓ Answer:
B
The funnel-shaped structure at the centre of the kidney that collects urine from the calyces and funnels it into the ureter
The Renal Pelvis is the funnel-shaped, expanded upper end of the ureter located at the hilum (medial indentation) of the kidney. It collects urine from: Minor calyces (8-18) - receive urine from renal papillae (tips of medullary pyramids). Minor calyces merge into 2-3 Major calyces - merge into the Renal Pelvis - drains into Ureter. The renal pelvis is lined with transitional epithelium (urothelium). Pyelonephritis (kidney infection) = infection of the renal pelvis and kidney parenchyma. Hydronephrosis = dilation of renal pelvis due to urinary obstruction (stones, tumour).
46
What is diabetes insipidus?
✓ Answer:
B
A condition caused by ADH deficiency (or resistance) leading to production of large volumes of dilute urine and excessive thirst
Diabetes Insipidus (DI) is a condition characterised by the excretion of large volumes of dilute urine (polyuria - up to 20 L/day) and excessive thirst (polydipsia). Two types: Cranial DI (ADH deficiency - hypothalamus/posterior pituitary damage from head trauma, tumour, surgery. Treatment: Desmopressin - synthetic ADH) and Nephrogenic DI (ADH resistance - kidneys don't respond to ADH. Caused by lithium toxicity, hypercalcaemia, genetic. Treatment: thiazide diuretics - paradoxically reduce urine volume). Urine specific gravity very low (<1.005). Distinguished from Diabetes Mellitus (high blood glucose) - DI has no glucose in urine and normal blood sugar.
47
What is the role of the lungs as an excretory organ?
✓ Answer:
B
The lungs excrete carbon dioxide (CO2) and water vapour - waste products of cellular respiration
The Lungs are important excretory organs that eliminate: Carbon dioxide (CO2) - main waste product of aerobic cellular respiration - transported to lungs dissolved in plasma, as bicarbonate (HCO3-), and as carbaminohaemoglobin - exhaled. Water vapour - ~300-400 mL exhaled per day through breathing. Volatile substances - some drugs, alcohol (breathalysed!), acetone (in diabetic ketoacidosis - fruity breath). The lungs excrete approximately 200 mL of CO2/min at rest - rising dramatically during exercise. The lungs also help regulate blood pH by controlling CO2 levels (Henry's Law: CO2 + H2O = H2CO3 = H+ + HCO3-).
48
What is pyelonephritis?
✓ Answer:
B
Bacterial infection of the kidney parenchyma and renal pelvis
Pyelonephritis is a bacterial infection of the kidney (renal parenchyma and pelvis), most commonly caused by E. coli (~80%). It is usually an ascending infection - bacteria travel from urethra > bladder (cystitis) > ureter > kidney. Symptoms: high fever, rigors (chills), flank pain/loin pain, nausea, vomiting, dysuria (painful urination), pyuria (pus in urine). Distinguishing feature from cystitis: systemic features (fever, loin pain). Diagnosis: urine culture, blood culture, ultrasound. Treatment: antibiotics (trimethoprim, ciprofloxacin - 7-14 days for acute, longer for chronic). Can lead to renal abscess or sepsis if untreated.
49
What is a urinary tract infection (UTI)?
✓ Answer:
B
A bacterial infection of any part of the urinary tract - urethra (urethritis), bladder (cystitis), or kidneys (pyelonephritis)
Urinary Tract Infection (UTI) is one of the most common bacterial infections worldwide. Classification: Lower UTI = Urethritis (urethra) and Cystitis (bladder - most common). Upper UTI = Pyelonephritis (kidney - more serious). Most common organism: E. coli (~80%) - comes from bowel flora. More common in females (shorter urethra, closer to anus). Symptoms: dysuria (burning urination), frequency, urgency, haematuria, suprapubic pain, cloudy/foul-smelling urine. Diagnosis: Urine dipstick (nitrites, leucocytes), urine culture. Treatment: antibiotics (trimethoprim, nitrofurantoin, ciprofloxacin). Prevention: adequate hydration, personal hygiene, urinating after sex.
50
What is the significance of the vasa recta in the kidney?
✓ Answer:
B
They are capillary loops that run parallel to the loop of Henle, maintaining the medullary osmotic gradient without washing it away
The Vasa Recta are long, hairpin-shaped capillaries that dip alongside the loop of Henle into the renal medulla. They arise from the efferent arterioles of juxtamedullary nephrons. Their countercurrent flow (descending and ascending limbs flowing in opposite directions) allows them to: Maintain the medullary osmotic gradient established by the loop of Henle (by exchanging solutes and water, they prevent the gradient from being washed away by blood flow) and Supply nutrients and remove waste from medullary cells. Without functional vasa recta, the hyperosmotic gradient required for urine concentration would be lost. This is the countercurrent exchange mechanism.