Question at position 32 How does increased tubular reabsorption affect renal clearance?Has no effect on renal clearanceIncreases plasma volumeReduces urine productionDecreases renal clearanceIncreases renal clearance

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First, let's restate the question and the options to set the stage for analysis. Question: How does increased tubular reabsorption affect renal clearance?
Answer options: 1) Has no effect on renal clearance 2) Increases plasma volume 3) Reduces urine production 4) Decreases renal clearance 5) Increases renal clearance

Option 1: Has no effect on renal clearance. This is not correct because tubular reabsorption changes the amount of solute and water returned to the bloodstream, which directly reduces the amount excreted in urine, thereby affecting renal clearance.

Option 2: Increases plasma volume. While enhanced reabsorption can contribute to more fluid moving back into the bloodstream, claiming an automatic increase in plasma volume is an oversimplification. Plasma volume can be influenced by many factors (algorithms like capillary dynamics, diuretics, shifts between compartments), so this option misstates the direct relationship to renal clearance and is not the best descriptor.

Option 3: Reduces urine production. Increased reabsorption can lower the volume of urine produced because more water is reabsorbed back into the circulation. This statement is plausible in relation to urinary output, but it’s not the most direct way to describe how clearance is changed, since clearance depends on the excretion rate relative to plasma concentration. It’s a partially related consequence but not the clearest answer about clearance itself.

Option 4: Decreases renal clearance. This option accurately reflects the core idea: when more solute and water are reabsorbed, less is excreted in the urine per unit time, so the renal clearance (the rate at which the kidney removes a substance from the plasma) decreases. This aligns with the fundamental relationship: clearance = excretion rate / plasma concentration; if excretion rate falls due to reabsorption, clearance falls.

Option 5: Increases renal clearance. This is the opposite of what increased tubular reabsorption does. If reabsorption rises, more substance is returned to the blood rather than excreted, leading to lower, not higher, clearance. Therefore this choice contradicts the physiological effect.

To summarize the reasoning in a cohesive way, the key concept is that tubular reabsorption moves substances from the tubular fluid back into the blood. When reabsorption increases, the amount of that substance delivered out in the urine decreases, which lowers the renal clearance for that substance. The other options either misstate the primary effect on clearance, imply uncertain or indirect changes (like plasma volume), or state the opposite outcome (increased clearance).

Question at position 32 How does increased tubular reabsorption affect renal clearance?Has no effect on renal clearanceIncreases plasma volumeReduces urine productionDecreases renal clearanceIncreases renal clearance

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