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Question #46332

Difficulty: 8/10 | 🟢 Free

The Question

A patient exhibits severe acidemia due to impaired carbaminohemoglobin formation, leading to systemic CO2 accumulation. The kidneys attempt to compensate by maximizing H+ secretion. If a nephrotoxin simultaneously abolishes the counter-current multiplier mechanism, which of the following best explains why the renal compensation for acidosis will ultimately fail?

Options

  • A.

    The loss of medullary hypertonicity prevents adequate water reabsorption in the collecting duct, disrupting the luminal concentration gradient required for effective distal H+ secretion.

  • B.

    The absence of the NaCl gradient directly inhibits carbonic anhydrase in the proximal convoluted tubule, halting HCO3- regeneration.

  • C.

    Active secretion of H+ in the descending limb of the loop of Henle ceases because it is strictly coupled to the counter-current flow.

  • D.

    Obligatory water reabsorption in the proximal convoluted tubule is halted, diluting the filtrate and preventing the excretion of ammonia.

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Correct Answer

Step-by-Step Solution

Explanation

How the Examiner Thinks

Comparative_Analysis

Sharpen your ability to evaluate multiple scenarios and distinguish between competing potential answers.

Concepts Behind This Question

Hemoglobin-CO2 Binding Sites|Counter-Current Mechanism Multiplier|Micturition Reflex Control

Why This Question Is Tricky

Common Mistakes

Conceptual Pivot: Students typically compartmentalize the Counter-Current Mechanism strictly for water conservation (urine concentration) and PCT/DCT strictly for acid-base balance.

This question forces the synthesis of both concepts, highlighting that distal H+ secretion relies on the luminal concentration gradients and flow rates established by upstream water reabsorption, which is entirely dependent on medullary hypertonicity.

Quick Facts About This Question

Question Information

SubjectBiology
ChapterBreathing and Exchange of Gases - Class 11
ConceptHemoglobin-CO2 Binding Sites
Difficulty8
Cognitive Load5
Target Solve Time120 sec
AccessFree