Deck 29: Alterations of Renal and Urinary Tract Function

Question 1

A 25-year-old male was diagnosed with Goodpasture syndrome. Which of the following mechanisms would cause tissue injury?

A) Viral infection of the Bowman capsule
B) Production of antibodies against the glomerular basement membrane
C) Antigen-antibody complex deposition with complement activation
D) Abnormal activation of clotting factors and microclotting in the glomerulus

Answer 1

Production of antibodies against the glomerular basement membrane

Question 2

A 29-year-old female presents with flank pain and fever. She is most likely suffering from:

A) cystitis.
B) glomerulonephritis.
C) acute renal failure.
D) pyelonephritis.

Answer 2

pyelonephritis.

Question 3

A 30-year-old male is demonstrating hematuria with red blood cell casts and proteinuria exceeding 3 to 5 g/day, with albumin being the major protein. The most probable diagnosis is:

A) cystitis.
B) chronic pyelonephritis.
C) acute glomerulonephritis.
D) nephrotic syndrome.

Answer 3

acute glomerulonephritis.

Question 4

Acute poststreptococcal glomerulonephritis is primarily caused by:

A) swelling of mesangial cells in the Bowman space in response to the presence of bacteria.
B) antigen-antibody complex deposition in the glomerular capillaries and inflammatory damage.
C) inflammatory factors that stimulate cellular proliferation of epithelial cells.
D) accumulation of antiglomerular basement membrane antibodies.

Question 5

A 19-year-old female was involved in a motor vehicle accident during which she sustained a closed head injury. She is now experiencing detrusor sphincter dyssynergia. Which of the following is the most beneficial treatment?

A) Alpha 1-blocker
B) Beta 1-blocker
C) Acetylcholine blocker
D) Alpha 2-blocker

Question 6

A 25-year-old female presents with burning urination. She was diagnosed with a urinary tract infection. Which of the following organisms is most likely infecting her urinary tract?

A) Streptococcus
B) Candida albicans
C) Chlamydia
D) Escherichia coli

Question 7

A 35-year-old male received a traumatic brain injury in a motor vehicle accident. CT scan revealed a lesion above the pontine micturition center. Which of the following would be expected?

A) Dyssynergia
B) Detrusor hyperreflexia
C) Detrusor areflexia
D) Detrusor sphincter dyssynergia

Question 8

A complicated urinary tact infection:

A) involves several species of bacteria.
B) occurs in individuals with other health problems.
C) always causes urosepsis.
D) results in urethral obstruction.

Question 9

The most common condition associated with the development of acute pyelonephritis is:

A) cystitis.
B) renal cancer.
C) urinary tract obstruction.
D) nephrotic syndrome.

Question 10

Mechanisms for defense against urinary pathogens in women include:

A) the long length of the urethra.
B) alkaline pH of urine.
C) secretion of mucus that traps bacteria.
D) antimicrobial secretions from the prostate.

Question 11

A 25-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would be expected to occur?

A) Atrophy of the remaining kidney
B) Compensatory hypertrophy of the remaining kidney
C) Dysplasia in the remaining kidney
D) Renal failure

Question 12

A 28-year-old female presents with fever, chills, and flank pain. She is diagnosed with pyelonephritis. Her infection is located in the:

A) bladder.
B) renal pelvis.
C) renal tubules.
D) glomerulus.

Question 13

A 24-year-old female is diagnosed with renal calculus that is causing obstruction. Which of the following symptoms would she most likely experience?

A) Anuria
B) Hematuria
C) Pyuria
D) Flank pain

Question 14

A 75-year-old male complains to his physician of loss of urine with cough, sneezing, or laughing. Which of the following is the most likely diagnosis?

A) Urge incontinence
B) Stress incontinence
C) Overflow incontinence
D) Functional incontinence

Question 15

A 55-year-old male presents complaining of incontinence. Tests reveal that he has a lower urinary tract obstruction. Which of the following is of concern?

A) Vesicoureteral reflux and pyelonephritis
B) Formation of renal calculi
C) Glomerulonephritis
D) Increased bladder compliance

Question 16

A 45-year-old male presents with oliguria. He is diagnosed with chronic glomerulonephritis. Oliguria is related to:

A) thickening of the glomerular membrane and decreased renal blood flow.
B) increased glomerular capillary oncotic pressure and tubular obstruction.
C) activation of renin-angiotensin from decreased blood volume.
D) vasoconstriction of the efferent arterioles.

Question 17

A 15-year-old male was diagnosed with pharyngitis. Eight days later he developed acute glomerulonephritis. Which of the following is the most likely cause of this disease?

A) Klebsiella
B) Human immunodeficiency virus
C) Genital herpes virus
D) Group A $\beta$ -hemolytic streptococcus

Question 18

The most common type of renal stone is composed of:

A) magnesium.
B) struvite.
C) calcium.
D) phosphate.

Question 19

A 25-year-old female is diagnosed with urinary tract obstruction. She is expected to have hydronephrosis and a decreased glomerular filtration rate caused by:

A) decreased renal blood flow.
B) decreased peritubular capillary pressure.
C) increased hydrostatic pressure in the Bowman capsule.
D) stimulation of antidiuretic hormone.

Question 20

The most important factor in renal calculus formation is:

A) urine pH.
B) body temperature.
C) gender.
D) serum mineral concentrations.

Question 21

A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of renal failure is most likely to occur?

A) Prerenal
B) Intrarenal
C) Extrarenal
D) Postrenal

Question 22

A 35-year-old female was severely burned and is hospitalized. She is now suffering from acute tubular necrosis. Which of the following is the most likely diagnosis?

A) Prerenal
B) Intrarenal
C) Extrarenal
D) Postrenal

Question 23

Pruritus, seen in patients with end-stage renal disease, is caused by high levels of:

A) potassium.
B) calcium.
C) sodium.
D) magnesium.

Question 24

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. He is in acute renal failure caused by:

A) kidney stones.
B) immune complex deposition in the glomerulus.
C) inadequate renal blood flow.
D) obstruction of the proximal tubule.

Question 25

Bone fractures are a risk factor in chronic renal failure because:

A) calcium is lost in the urine.
B) osteoblast activity is excessive.
C) the kidneys fail to activate vitamin D.
D) autoantibodies to calcium molecules develop.

Question 26

A 54-year-old female is diagnosed with nephrotic syndrome. Which of the following is a common symptom of this disease?

A) Hematuria
B) Dysuria
C) Oliguria
D) Proteinuria

Question 27

Anemia accompanies chronic renal failure because of:

A) blood loss via the urine.
B) renal insensitivity to vitamin D.
C) inadequate production of erythropoietin.
D) inadequate retention of serum iron.

Question 28

A 60-year-old male is diagnosed with renal failure. Which of the following lab values would be most consistent with this diagnosis?

A) Elevated plasma creatinine level
B) Decreased plasma potassium level
C) Metabolic alkalosis
D) Increased urea clearance

Question 29

A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anemia. She is diagnosed with chronic renal failure. Anemia in this patient is caused by:

A) red blood cells being lost in the urine.
B) inadequate production of erythropoietin.
C) inadequate iron absorption in the gut.
D) red blood cells being injured as they pass through the glomerulus.

Question 30

A 42-year-old female is diagnosed with chronic renal failure. Treatment includes restricting:

A) fats.
B) complex carbohydrates.
C) proteins.
D) sugars.