Pathophysiology Topic 9

Front 1

Which sequence of structures does urine pass through as it leaves the body?
1. ureter
2. renal pelvis
3. urinary bladder
4. major calyx
5. urethra
6. minor calyx

Back 1

A. 2,4,6,1,3,5
B. 4,2,6,1,3,5
C. 6,4,2,1,3,5
D. 2,6,4,5,3,1
E. 6,4,2,5,3,1

Hint 1

C. 6,4,2,1,3,5
- minor calyx
- major calyx
- renal pelvis
- ureter
- urinary bladder
- urethra

Front 2

The functional unit of the human kidney is the:

Back 2

A. nephron
B. collecting tubule (duct)
C. major calyx
D. minor calyx
E. pyramid

Hint 2

A. nephron

Front 3

One unique feature of the renal blood circulation is that:

Back 3

A. blood flows from arterioles into venules
B. blood flows from venules into arterioles
C. there is a double set of venues
D. there are two sets of capillaries

Hint 3

D. there are two sets of capillaries

Front 4

Which has the opposite effect on urine production from the others?

Back 4

A. decrease solutes in blood
B. decrease blood pressure
C. increase ambient temperature
D. dehydration
E. reduced water consumption

Hint 4

A. decreased solutes in blood

Front 5

The glomerular filtration rate is regulated by the:

Back 5

A. autonomic nervous system
B. renin-angiotensin system
C. atrial natriuretic factor
D. all of the above are correct
E. both A and B are correct

Hint 5

D. all of the above are correct
A. autonomic nervous system
B. renin-angiotensin system
C. atrial natriuretic factor

Front 6

If the following hypothetical conditions exist in the nephron, what would be the net (effective) filtration pressure?
Glomerular blood hydrostatic = 80 mmHg
Glomerular blood osmotic = 20 mmHg
Capsular hydrostatic = 30 mmHg

Back 6

A. 40 mmHg
B. 30 mmHg
C. 20 mmHg
D. 10 mmHg

Hint 6

B. 30 mmHg

Front 7

The capillaries of the glomerulus differ from other capillary networks in the body because they:

Back 7

A. have a larger area of anastomosis
B. branch from and drain into arterioles
C. lack endothelium
D. force filtrate from the blood

Hint 7

B. branch from and drain into arterioles

Front 8

Which is NOT a function of the kidney?

Back 8

A. water volume control
B. blood pressure control
C. urine storage
D. conversion of vitamin D to an active form

Hint 8

C. urine storage

Front 9

Potassium is secreted by the ___ and reabsorbed by the ___.

Back 9

A. Bowman capsule; loop of Henle
B. proximal convoluted tubule; distal convoluted tubule
C. loop of Henle; collecting ducts
D. distal convoluted tubule; proximal convoluted tubule
E. collecting ducts; loop of Henle

Hint 9

D. distal convoluted tubule; proximal convoluted tubule

Front 10

ADH causes water to :

Back 10

A. diffuse into the ascending limb of vasa recta
B. return to the systemic circulation
C. be reabsorbed at the proximal tubule.
D. both A and B are correct
E. A, B, and C are correct

Hint 10

D. both A and B are correct
A. diffuse into the ascending limb of vasa recta
B. return to the systemic circulation

Front 11

Water reabsorbed from the glomerular filtrate initially enters the:

Back 11

A. afferent arterioles
B. efferent arterioles
C. Bowman's capsule
D. glomerulus
E. vasa recta

Hint 11

E. vasa recta

Front 12

Plasma contains a much greater concentration of ___ than the glomerular filtrate.

Back 12

A. sodium
B. protein
C. urea
D. creatinine

Hint 12

B. protein

Front 13

An increase in water permeability of the distal convoluted tubules and collection duct is the result of:

Back 13

A. decrease in the production of ADH
B. an increase in production of ADH
C. a decrease in blood plasma osmolality
D. an increase in water content within tubular cells
E. none of the above are correct

Hint 13

B. an increase in production of ADH

Front 14

The descending loop of the nephron allows:

Back 14

A. sodium secretion
B. potassium secretion
C. hydrogen ion secretion
D. water reabsorption

Hint 14

D. water reabsorption

Front 15

Which most accurately describes the pressures affecting net glomerular filtration?

Back 15

A. blood osmotic opposes capsular hydrostatic and blood hydrostatic
B. blood hydrostatic opposes capsular hydrostatic and blood oncotic
C. capsular hydrostatic opposes blood osmotic and blood hydrostatic
D. none of the above is correct

Hint 15

B. blood hydrostatic opposes capsular hydrostatic and blood oncotic

Front 16

Tubular secretion of urea is accomplished in the:

Back 16

A. glomerulus
B. urethra
C. renal pelvis
D. distal convoluted tubule
E. none of the above

Hint 16

D. distal convoluted tubule

Front 17

Tubular reabsorption and tubular secretion differ in that:

Back 17

A. secretion adds material to the filtrate; reabsorption removes materials from the filtrate
B. secretion is a passive process; reabsorption is an active transport process
C. reabsorption tends to increase urine volume; secretion tends to decrease urine volume.
D. secretion adds materials to the blood; reabsorption removes materials from the blood

Hint 17

A. secretion adds material to the filtrate; reabsorption removes materials from the filtrate

Front 18

The kidneys: (more than one may be correct)

Back 18

A. conserve H+
B. conserve NH4+
C. eliminate H+
D. eliminate NH4+
E. conserve

Hint 18

C. eliminate H+
D. eliminate NH4+
E. conserve

Front 19

If a small person excretes about 1 liter of urine during a 24-hour period, estimate the total amount of glomerular filtrate formed.

Back 19

A. 4 liters
B. 10 liters
C. 18 liters
D. 100 liters

Hint 19

D. 100 liters

Front 20

Which should NOT appear in the glomerular filtrate (in any significant quantity) just after the process of glomerular filtration has been accomplished?

Back 20

A. protein
B. urea
C. glucose
D. both A and B are correct

Hint 20

A. protein

Front 21

The loop of Henle is to vasa recta as convoluted tubules are to:

Back 21

A. afferent arterioles
B. peritubular capillaries
C. efferent arterioles
D. renal arteries

Hint 21

B. peritubular capillaries

Front 22

The two "currents" used in the countercurrent exchange system are the:

Back 22

A. afferent and efferent arterioles
B. glomerulus and glomerular (Bowman) capsule
C. ascending and descending limbs
D. proximal and distal tubules
E. all of the above are correct

Hint 22

C. ascending and descending limbs

Front 23

The countercurrent exchange system:

Back 23

A. prevents water reabsorption from the collecting duct
B. concentrates sodium in the renal cortex
C. facilitates osmosis
D. concentrates chloride in the renal cortex
E. none of the above is correct

Hint 23

C. facilitates osmosis

Front 24

Atrial natriuretic factor (ANF):

Back 24

A. increases antidiuretic hormone (ADH) secretion
B. is produced by the kidney
C. increases urine output
D. decreases urine output

Hint 24

C. increases urine output

Front 25

A waste product of protein metabolism is:

Back 25

A. pepsinogen
B. trypsin
C. amino acid
D. urea
E. urine

Hint 25

D. urea

Front 26

Renal function test include:

Back 26

A. the urinalysis
B. BUN and serum creatinine
C. SGOT/SGPT
D. both A and B are correct
E. A, B, and C are correct

Hint 26

D. both A and B are correct

Front 27

Which substance is an abnormal constituent of urine?

Back 27

A. urea
B. glucose
C. sodium chloride
D. creatinine

Hint 27

B. glucose

Front 28

The presence of albumin in the urine would indicate probable damage to:

Back 28

A. glomeruli
B. renal columns
C. collecting tubules
D. pyramids
E. none of the above is correct

Hint 28

A. glomeruli

Front 29

Which statement is NOT true concerning urinary tract infections?

Back 29

A. once cystitis develops, pyelonephritis will certainly occur
B. they are usually caused by coliforms, especially E. coli
C. organisms probably enter bladder by the way of the urethra
D. the patient may be asymptomatic

Hint 29

A. once cystitis develops, pyelonephritis will certainly occur

Front 30

Renal calculi may be composed of:

Back 30

A. calcium oxalate
B. uric acid
C. cholesterol
D. all of the above are correct
E. both A and B are correct

Hint 30

E. both A and B are correct
A. calcium oxalate
B. uric acid

Front 31

Which can be characteristics of ureteral stones?

Back 31

A. severe pain in back
B. severe pain in abdomen
C. nausea and vomiting
D. all of the above are correct
E. both A and C are correct

Hint 31

D. all of the above are correct
A. severe pain in back
B. severe pain in abdomen
C. nausea and vomiting

Front 32

Which are predisposing factors for acute urinary tract infections? (more that one answer may be correct)

Back 32

A. congenital deformities of urinary tract
B. the sex of the patient
C. decreased urine flow
D. increased urine flow
E. increased fluid intake

Hint 32

A. congenital deformities of urinary tract
B. the sex of the patient
C. decreased urine flow

Front 33

A common cause of both pyelonephritis and cystitis is:

Back 33

A. urinary calculi
B. invading, ascending microorganisms, such as E. coli
C. allergy reactions
D. heavy metal

Hint 33

B. invading, ascending microorganisms, such as E. coli

Front 34

Uremia exhibits:

Back 34

A. polycythemia
B. retention of metabolic acids
C. low plasma calcium levels
D. increased erythropoiesis
E. both A and D are correct

Hint 34

B. retention of metabolic acids

Front 35

Pyelonephritis is: (more than one answer may be correct)

Back 35

A. an inflammation and infection of the urinary bladder
B. characterized by fever, chills, and flank pain
C. characterized by pyuria, bacteriuria, and hematuria
D. more common in young women than in young men

Hint 35

B. characterized by fever, chills, and flank pain
C. characterized by pyuria, bacteriuria, and hematuria
D. more common in young women than in young men

Front 36

Which renal condition usually has a history of recent infection with beta-hemolytic streptococci?

Back 36

A. pyelonephritis
B. chronic renal failure
C. nephrosis
D. glomerulonephritis
E. calculi

Hint 36

D. glomerulonephritis

Front 37

Which statement is NOT true concerning glomerulonephritis?

Back 37

A. significant damage to kidneys occurs during the body's response to an infection.
B. fever and flank pain occur
C. complement activation attracts neutrophils
D. it is characterized by hematuria, proteinuria, and the presence of casts.
E. approximately 90% of individuals develop chronic disease.

Hint 37

E. approximately 90% of individuals develop chronic disease.

Front 38

Nephrotic syndrome is associated with ___ to plasma ___.

Back 38

A. increased glomerular permeability; urea
B. decreased glomerular permeability; proteins
C. decreased glomerular permeability; tubular filtrate
D. increased glomerular permeability; proteins

Hint 38

D. increased glomerular permeability; proteins

Front 39

Causes of acute renal failure include:

Back 39

A. cholecystitis
B. stones and strictures in kidneys or ureters
C. heart failure leading to poor renal perfusion.
D. both B and C are correct
E. A, B, and C are correct

Hint 39

D. both B and C are correct
B. stones and strictures in kidneys or ureters
C. heart failure leading to poor renal perfusion.

Front 40

Which describe a patient in acute renal failure? (more than one answer may be correct)

Back 40

A. elevated serum creatinine
B. leukocytosis
C. low BUN
D. fever
E. oliguria

Hint 40

A. elevated serum creatinine
E. oliguria

Front 41

Which is NOT a characteristic of chronic renal failure?

Back 41

A. hyperkalemia
B. anuria
C. anemia
D. pruritus
E. acidosis

Hint 41

B. anuria

Front 42

Chronic renal failure:

Back 42

A. may result from hypertension
B. is usually the result of chronic inflammation of the kidney
C. may be treated with dialysis or transplants
D. all of the above are correct
E. both A and C are correct

Hint 42

D. all of the above are correct
A. may result from hypertension
B. is usually the result of chronic inflammation of the kidney
C. may be treated with dialysis or transplants

Front 43

An individual has an elevated blood level of urea and creatinine because of complete calculi blockage of one ureter. This is referred to as:

Back 43

A. prerenal disease
B. intrarenal disease
C. postrenal disease
D. preeclampsia
E. hypercalcemia

Hint 43

C. postrenal disease

Front 44

Nephrotoxins, such as antibiotics, may be responsible for:

Back 44

A. acute tubular necrosis
B. acure glomerulonephritis
C. pyelonephritis
D. cystitis

Hint 44

A. acure tubular necrosis

Front 45

Uremia, as seen in chronic renal failure. would include:

Back 45

A. metabolic acidosis
B. elevated BUN and creatinine
C. cardiovascular disturbances
D. all of the above are correct

Hint 45

D. all of the above are correct
A. metabolic acidosis
B. elevated BUN and creatinine
C. cardiovascular disturbances

Front 46

The earliest symptom of chronic renal failure is:

Back 46

A. pruritus
B. oliguria
C. polyuria
D. decreased BUN

Hint 46

C. polyuria

Front 47

In chronic renal failure, tubulointerstitial disease leads to:

Back 47

A. sodium retention
B. sodium wasting
C. no significant changes in sodium levels
D. increased phosphate excretion

Hint 47

B. sodium wasting

Front 48

Goodpasture syndrome is:

Back 48

A. prerenal failure
B. postrenal failure
C. chronic glomerulonephritis
D. pulmonary capillary and glomerular basement membrane antibodies
E. pruritus

Hint 48

D. pulmonary capillary and glomerular basement membrane antibodies

Front 49

Hypovolemia

Back 49

A. prerenal failure
B. postrenal failure
C. chronic glomerulonephritis
D. pulmonary capillary and glomerular basement membrane antibodies
E. pruritus

Hint 49

A. prerenal failure

Front 50

Uremia

Back 50

A. prerenal failure
B. postrenal failure
C. chronic glomerulonephritis
D. pulmonary capillary and glomerular basement membrane antibodies
E. pruritus

Hint 50

E. pruritis

Front 51

Exstrophy of the bladder occurs because of birth trauma.

Back 51

True or False

Front 52

Vesicoureteral reflux is caused by a congenitally malpositioned entry of the ureters into the bladder.

Back 52

True or False

Front 53

Children are at no greater risk for fluid and electrolyte imbalances than adults.

Back 53

True or False

Front 54

Grade V vasicoureteral reflux can be medically managed.

Back 54

True or False

Front 55

Polycystic kidney disease is an autosomal dominant disorder

Back 55

True or False

Front 56

Secondary enuresis occurs when the child has never been continent.

Back 56

True or False

Front 57

Nephrotic syndrome in children manifests as:

Back 57

A. proteinuria
B. hyperlipidemia
C. lipiduria
D. All of the above are correct
E. None of the above are correct

Front 58

Poststreptococcal glumerulonephritis in children:

Back 58

A. is a noninfectious renal disease
B. causes hypotension
C. causes dehydration
D. both B and C are correct

Front 59

Infants cannot concentrate urine because of:

Back 59

A. shorter tubular length
B. increased tubular weight
C. increased blood flow to the kidneys
D. both A and C are correct
E. A, B, and C are correct

Front 60

Vesicoureteral reflux causes urine to ___ up the ureters and places the young child at risk for ___.

Back 60

A. retrograde; glomerulonephritis
B. retrograde, nephrotic syndrome
C. retrograde; pyelonephritis
D. retrograde; cystitis

Front 61

Which manifestation may be associated with vesicoureteral reflux?

Back 61

A. recurrent urinary tract infections
B. poor growth
C. irritability
D. both A and B are correct
E. A, B, and C are correct

Front 62

Children are at risk for hemolytic uremic syndrome after:

Back 62

A. upper respiratory tract infection
B. vomiting or diarrhea
C. viral infection
D. all of the above are correct

Front 63

Organic causes of enuresis may include:

Back 63

A. congenital abnormalities of the urinary tract
B. a neurologic origin
C. diabetes insipidus
D. all of the above are correct

Front 64

Children with enuresis may be managed by:

Back 64

A. sleep interruption
B. psychotherapy
C. diet
D. all of the above are correct

Front 65

Which characterizes IgA nephropathy?

Back 65

A. no systemic immunologic disease
B. injury to the glomerulus is usually reversible
C. gross hematuria
D. all of the above are correct
E. both A and B are correct

Front 66

Identify the sequence of events in hemolytic uremic syndrome that cause anemia.
1. The damaged cells are removed from the circulation by the spleen.
2. The endothelial lining of the glomerular arterioles becomes swollen.
3. Narrowed vessels damage erythrocytes.
4. Split-products of fibrin appear in the urine and serum.

Back 66

A. 1, 3, 4
B. 2, 4, 1
C. 3, 1, 2
D. 2, 3, 1

Front 67

Which factor influence the prognosis of a child with nephroblastoma?

Back 67

A. the child's height
B. genetics
C. stage
D. congenital anomalies
E. B, C, and D are correct

Front 68

What causes neonate bladder outlet obstruction?

Back 68

A. polyps arising from the prostatic urethra
B. congenital urethral valves
C. impaired renal embryogenesis
D. both B and C are correct
E. A, B, and C are correct

Front 69

Small, normally developed kidney

Back 69

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 70

Facial anomalies

Back 70

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 71

Urethral opening on the dorsal surface of the penis; a cleft along the ventral urethra in girls

Back 71

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 72

Results from abnormal differentiation of renal tissue

Back 72

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 73

Exposed bladder mucosa through a fissure in the abdominal wall

Back 73

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 74

Urethral meatus opening on the ventral side of the penis

Back 74

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia

Front 75

Obstruction of the renal collection system

Back 75

A. hypospadias
B. epispadias
C. bladder exstrophy
D. hypoplastic kidney
E. renal dysplasia
F. bilateral agenesis
G. renal dysplasia