Deck 18: Diseases of the Renal System

Question 1

What is the term for blood in the urine?

A) anemia
B) proteinuria
C) oliguria
D) azotemia
E) hematuria

Answer 1

E

Question 2

How long do the typical hemodialysis treatments take on average?

A) 30 minutes
B) 2 hours
C) 4 hours
D) 8 hours
E) 12 hours

Answer 2

C

Question 3

Which of the following symptoms is one of the first signs of renal insufficiency?

A) kidney pain
B) hematuria
C) microalbuminuria
D) increased urine output
E) low blood pressure

Answer 3

C

Question 4

Which hormone influences the reabsorption of sodium in the proximal tubule?

A) aldosterone
B) vasopressin
C) cortisol
D) testosterone
E) epinephrine

Question 5

Which mineral supplements might be beneficial for people with chronic kidney disease (HD and PD patients)?

A) iron and zinc
B) calcium and magnesium
C) calcium and phosphorous
D) boron and zinc
E) iron and magnesium

Question 6

Which tubular component in the kidney collects the glomerular filtrate?

A) loop of Henle
B) efferent tubule
C) afferent tubule
D) Bowman's capsule
E) distal tubule

Question 7

How many grams per serving of animal protein does the National Renal Diet recommend for people on kidney dialysis?

A) 16-20
B) 12-15
C) 9-11
D) 6-8
E) 3-5

Question 8

What is the recommended daily phosphorus intake for peritoneal dialysis patients?

A) 1.5-3.0 g/day
B) 0.8-1.0 g/day
C) 0.2-0.5 g/day
D) 2.0-4.0 g/day
E) 3.0-5.0 g/day

Question 9

Which vitamin supplements are typically indicated for people with chronic kidney disease (HD and PD patients)?

A) A, B₆, and E
B) B-complex, C and D
C) A, B₉, and K
D) B-complex, D, and E
E) A, C, and K

Question 10

The onset of renal failure is not usually apparent until what percentage of renal function is lost?

A) 50-70%
B) about 40%
C) 20-30%
D) about 15%
E) 5-10%

Question 11

What is the recommended daily potassium intake for hemodialysis patients?

A) 10-11 g/day
B) 8-9 g/day
C) 6-7 g/day
D) 4-5 g/day
E) 2-3 g/day

Question 12

What is a build-up of nitrogenous waste products (such as urea) in the blood and body fluids called?

A) anemia
B) proteinuria
C) oliguria
D) azotemia
E) hematuria

Question 13

Corticosteroids, cyclosporine, tacrolimus, mycophenolate mofetil, and sirolimus are all examples of which type of medication?

A) NSAIDs
B) analgesics
C) antibacterial agents
D) immunosuppressants
E) antivirals

Question 14

Which part of the nephron is involved in reabsorption of sodium ions and water, and secretion of potassium and hydrogen ions?

A) Bowman's capsule and loop of Henle
B) distal tubule and collecting duct
C) proximal tubule and loop of Henle
D) efferent tubule and afferent tubule
E) afferent tubule and collecting duct

Question 15

The functioning unit of the kidney is referred to as:

A) tubule
B) cortex
C) nephron
D) medulla
E) glomerulus

Question 16

Which of the following vegetables are low in potassium?

A) beans, artichokes, beets
B) squashes, broccoli, Brussels sprouts
C) cucumbers, celery, onions
D) carrots, lentils, parsnips
E) potatoes, pumpkins, legumes

Question 17

What is the GFR in patients with Stage 5 kidney disease?

A) less than 90 mL/min/1.73 m²
B) about 70 mL/min/1.73 m²
C) less than 45 mL/min/1.73 m²
D) about 25 mL/min/1.73 m²
E) less than 15 mL/min/1.73 m²

Question 18

Which of the following is the leading cause of kidney failure?

A) diabetes
B) hypotension
C) kidney trauma
D) heart disease
E) bacterial infection

Question 19

Which fruits are low in potassium?

A) bananas, cantaloupes, figs
B) oranges, papayas, prunes
C) apples, grapes, raspberries
D) kiwis, mangos, nectarines
E) avocados, pomegranates, raisins

Question 20

Which pituitary hormone works at the level of the collecting duct to either increase or decrease absorption of water in order to maintain plasma volume and thus blood pressure?

A) aldosterone
B) vasopressin
C) cortisol
D) testosterone
E) epinephrine

Question 21

Which of the following is a rich source of phosphorous?

A) sherbet
B) apple
C) sardine
D) spaghetti
E) white bread

Question 22

The interdialytic weight gain goal in HD patients should not exceed what percentage of body weight?

A) 2%
B) 5%
C) 9%
D) 12%
E) 15%

Question 23

What percentage of HD patients develop ischemic heart disease?

A) 5%
B) 10%
C) 20%
D) 30%
E) 40%

Question 24

Which vegetable is considered a high-sodium food?

A) olives
B) zucchini
C) broccoli
D) cucumber
E) cabbage

Question 25

What type of oral iron supplement causes less GI distress?

A) heme iron polypeptide
B) ferrous gluconate
C) ferrous fumarate
D) ferrous sulfate
E) polysaccharide

Question 26

KL is a 45-year-old male admitted to the hospital with an infection. He is on PD because of the congenital disease of the kidney. He does not have diabetes. HT: 6'  WT: 170 pounds (77 kg)  
What is the most likely source of his infection?

A) fistula
B) UTI
C) catheter
D) AV graft
E) prostate

Question 27

Prolonged exposure to elevations of PTH causes the development of which bone disease (characterized by rapid bone turnover with an excess of collagen production)?

A) rickets
B) osteomalacia
C) osteopenia
D) osteosarcoma
E) osteitis fibrosa cystica

Question 28

What is the common term used for nephrolithiasis?

A) kidney necrosis
B) kidney cancer
C) kidney stones
D) viral kidney infection
E) bacterial kidney infection

Question 29

Which food enhances the bioavailability of tacrolimus and cyclosporine?

A) spinach
B) legumes
C) grapefruit
D) chocolate
E) tomatoes

Question 30

KL is a 45-year-old male admitted to the hospital with an infection. He is on PD because of the congenital disease of the kidney. He does not have diabetes. HT: 6'  WT: 170 pounds (77 kg)  
Which of the following is likely true about KL's situation?

A) He goes to a dialysis center three times per week.
B) His caloric intake needs to be adjusted to account for calories in dialysate.
C) He will have to wait six weeks for the fistula to mature.
D) His prostate infection needs antibiotic therapy.
E) He is not a candidate for a kidney transplant.

Question 31

KL is a 45-year-old male admitted to the hospital with an infection. He is on PD because of the congenital disease of the kidney. He does not have diabetes. HT: 6'  WT: 170 pounds (77 kg)  
Approximately how many kilocalories does KL require daily?

A) 1,840 kcal
B) 1,930 kcal
C) 2,050 kcal
D) 2,200 kcal
E) 2,700 kcal

Question 32

Patients with acute kidney injury are prone to loss of which type of amino acids?

A) leucine and isoleucine
B) only essential amino acids
C) only nonessential amino acids
D) all essential and nonessential amino acids
E) only branched-chain amino acids

Question 33

What percentage of kidney transplant patients display dyslipidemia?

A) 10%
B) 25%
C) 40%
D) 55%
E) 70%

Question 34

KL is a 45-year-old male admitted to the hospital with an infection. He is on PD because of the congenital disease of the kidney. He does not have diabetes. HT: 6'  WT: 170 pounds (77 kg)  
KL visits a dietitian. What information will the dietician most likely share with him?

A) He has less of a dietary potassium restriction than he would on HD.
B) His dietary phosphorus is unrestricted.
C) His fluid intake must be ''output plus 1,000 cc.''
D) He needs to limit protein of high biological value.
E) He cannot consume any sweet fruits.

Question 35

Which meat is considered a high-sodium food?

A) chicken
B) pork loin
C) pepperoni
D) steak
E) fillet of salmon

Question 36

KL is a 45-year-old male admitted to the hospital with an infection. He is on PD because of the congenital disease of the kidney. He does not have diabetes. HT: 6'  WT: 170 pounds (77 kg)  
Approximately how many grams of protein does KL require each day?

A) 66 g
B) 78 g
C) 87 g
D) 93 g
E) 110 g

Question 37

Albumin is a primary carrier for which mineral?

A) boron
B) iron
C) zinc
D) calcium
E) magnesium

Question 38

For kidney stones that are composed of uric acid, avoidance of which kind of foods is recommended?

A) foods high in calcium
B) foods high in purines
C) foods high in aluminum
D) foods low in magnesium
E) foods low in oxalates

Question 39

During drug-nutrition interaction, which of the following medications decreases the absorption of calcium, magnesium, iron, and zinc?

A) isoniazid
B) tetracycline
C) antacid
D) antigout
E) cycloserine

Question 40

Medical and nutritional management of acute kidney injury typically aims to maintain BUN (blood urea nitrogen) in the range of:

A) 60-100 mg/dL
B) 80-100 mg/dL
C) 100-120 mg/dL
D) 120-130 mg/dL
E) 130-150 mg/dL

Question 41

The protein requirements for hemodialysis are slightly higher than for peritoneal dialysis.

Question 42

The enzyme _______________ is produced by the kidney and is necessary for the initiation of the renin-angiotensin control of fluid balance.

Question 43

Most commonly, kidney function is measured by the _______________.

Question 44

Diabetes, hypotension, and heart disease are the leading causes of kidney failure.

Question 45

CKD patients are unable to synthesize adequate amounts of endogenous _______________, a hormone that is made by renal tubular cells and important for production of red blood cells.

Question 46

Kidney stones typically consist of calcium salts, cystine, uric acid, or struvite.

Question 47

The dialysate for PD is available with a range of _______________ concentrations that alter its osmolality and assist in fluid removal.

Question 48

_______________ acute kidney injury results from a blockage of the ureter or neck of the bladder.

Question 49

The kidneys are two retroperitoneal organs approximately the size of a fist.

Question 50

Secondary hyperparathyroidism in dialysis patients can progress to severe, intractable forms of _______________ disease.

Question 51

Triglyceride levels are particularly reduced in PD patients due to the absorption of glucose from the dialysate.

Question 52

The use of active vitamin D sterols decreases calcium absorption in the intestine.

Question 53

Acute kidney injury is a disorder characterized by an abrupt increase in GFR that results in failure to maintain fluid, electrolyte, and acid-base balance.

Question 54

If serum sodium levels are elevated, sodium is exchanged with potassium so that homeostasis is restored.

Question 55

_______________ is a procedure that removes excessive and toxic by-products of metabolism from the blood, thus performing the filtrating function of the kidneys.

Question 56

The kidney's role in controlling both hydrogen and bicarbonate ions is a critical component of the maintenance of pH homeostasis.

Question 57

Deficiency of the active form of vitamin D is associated with impaired intestinal calcium absorption and secondary _______________.

Question 58

Waste products and excess fluids are removed from the body by the actions of diffusion, ultrafiltration, and _______________.

Question 59

The _______________ tubule of the kidney contains cells with a complex brush border, tight intercellular junctions, and large numbers of mitochondria.

Question 60

In general, the hemodialysis diet is high in protein and controls for intake of potassium, phosphorus, fluids, and sodium.

Question 61

Describe the procedure of hemodialysis.

Question 62

Describe the use of immunosuppressants for kidney transplants.

Question 63

Calcium citrate is a _______________-binder.

Question 64

Describe the signs and symptoms associated with inadequate kidney function.

Question 65

Low serum calcium levels often accompany CKD due to alterations in vitamin _______________ metabolism.

Question 66

Because serum vitamin _______________ levels are elevated in HD and PD patients, supplementation is not necessary.

Question 67

List the factors that increase protein requirements for people with chronic kidney disease.

Question 68

Describe the nutrition diagnoses that might coincide with CKD.

Question 69

Since most HD patients receive anticoagulation therapy, caution must be taken when supplementing with vitamin _______________ due to its role in promoting clot formation.

Question 70

_______________, the cause of more than 50% of all kidney stones, is defined as urinary calcium excretion greater than 300 mg per 24 hours in men or 250 mg per 24 hours in women.

Question 71

List the types of renal replacement therapy for CKD stage 5.

Question 72

Supplementation of _______________ -soluble vitamins is typically indicated for HD and PD patients due to increased losses during dialysis, anorexia, and poor dietary intake.

Question 73

_______________ is a surgical procedure in which a surgeon makes an incision in the back and creates a tunnel to the kidney to remove a kidney stone.

Question 74

Etiology of acute kidney injury is classified as prerenal, intrinsic, or _______________.

Question 75

_______________ is a network of thin-walled capillaries closely surrounded by a pear-shaped epithelial membrane called the Bowman's capsule.

Question 76

Explain why kidney stones are formed.

Question 77

It has been demonstrated that foods high in _______________, including dairy products, can actually prevent the formation of kidney stones.

Question 78

List the common sources of oral iron supplements.

Question 79

Outline the primary functions of the kidney.

Question 80

Discuss the etiology of acute kidney injury.