Rnwk4- 5-1 Path Kidney Entire Quizbank

Front 1

A 48-year-old woman presents with marked mental confusion, weight
loss, lethargy, and involuntary muscle twitching. She is known to have chronic renal failure secondary to chronic pyelonephritis. Serum urea nitrogen concentration has risen from 60 to 160 mg/dl over the last 3 weeks. Other anticipated findings might include (4 things)

Back 1

(1) hyperkalemia
(2) hypocalcemia
(3) metabolic acidosis
(4) anemia

Front 2

A 40-year-old-man comes to the hospital for dizziness and weakness of 1 day duration. He has had dyspepsia and acid
indigestion for many years. His admission serum urea nitrogen BUN is 50 mg/dl and creatinine is 1.0 mg/dl. He might have (2)

Back 2

peptic ulcer disease
blood in GI tract

Front 3

One of the earliest and most reliable signs of progressive renal failure is

Back 3

Impairment of urine concentrating ability

Front 4

Features are characteristic of the nephrotic syndrome 3?
Would you see hypo or hypertension?

Back 4

(A) marked proteinuria
(B) hypoalbuminemia
(C) edema

most likely hypo

Front 5

Each of the following statements about creatinine clearance measurements are true EXCEPT
(A) The creatinine clearance is sufficiently accurate to serve as a clinical first approximation of measurement of glomerular filtration rate (GFR).
(B) Creatinine is excreted to a small extent by the tubules; therefore it is not an exact measure of GFR.
(C) It is the clearance test most often used clinically.
(D) Creatinine excretion by the kidney is independent of the rate of urine flow except at very low flow rates (less than 0.5 ml/min).
(E) Creatinine is freely filtered at the glomerulus but a variable portion of the filtered load is reabsorbed by the renal tubules.

Back 5

Creatinine is freely filtered at the glomerulus but a variable portion of the filtered load is reabsorbed by the renal tubules.

Front 6

Acute oliguria may be seen with each of the following EXCEPT
(A) lipoid nephrosis
(B) hemolytic transfusion reaction
(C) crush injury with myoglobinuria
(D) hemorrhagic shock
(E) bilateral ureteral calculi

Back 6

lipoid nephrosis

Front 7

Complete permanent unilateral obstruction to the outflow of urine
ultimately results in

Back 7

transient hydronephrosis followed by generalized atrophy of kidney

Front 8

Failure of the renal tubule to produce ammonia will result in

Back 8

metabolic acidosis

Front 9

A patient with acute anuria NOT preceded by oliguria, is most likely to have

Back 9

post renal obstruction

Front 10

The hallmarks of the syndrome of inappropriate antidiuretic hormone production include

Back 10

(1) volume expansion, due primarily to an increase in total body water
(2) reduced plasma sodium concentration, reduced plasma osmolality, increased urine osmolality

Front 11

An increase in glomerular filtration rate can be brought about by (possibly more than one)
(1) decreased pressure in Bowman's capsule
(2) decreased efferent arteriolar resistance
(3) decreased afferent arteriolar resistance
(4) obstruction of the ureters

Back 11

1, 3

Front 12

The following clearance measurement(s) can be used as an approximation of the glomerular filtration rate
(1) creatinine clearance
(2) urea clearance
(3) insulin clearance
(4) glucose clearance

Back 12

creatinine, urea, insulin-

Front 13

In patients with chronic renal failure, one may expect to find which of the following?
(1) hypertension
(2) hyperphosphatemia
(3) hyperparathyroidism
(4) hypokalemia

Back 13

hypertension, hyperphosphatemia, hyperparathyroidism

Front 14

In patients with uremia, which of the following are frequently found at autopsy?
(1) hemorrhagic pneumonitis
(2) fibrinous pericarditis
(3) pancreatitis with ductal ectasia
(4) hemorrhagic enterocolitis

Back 14

frequently all of these

Front 15

Each of the following can result from chronic renal failure EXCEPT
(A) impaired absorption of Ca++ from the gut
(B) pericardial friction rub
(C) normocytic anemia
(D) hypophosphatemia
(E) metabolic acidosis

Back 15

all result from chronic renal failure except hypophosphatemia

Front 16

A patient with excessive protein breakdown in the gastrointestinal tract as a consequence of a bleeding peptic ulcer and with normal kidney function will show elevation of serum

Back 16

urea nitrogen

Front 17

Creatinine is a preferable test for renal disease over urea nitrogen because its level in the urine is independent of 3 things...

Back 17

protein metabolism
hydration and urinary volume

Front 18

What has to occur before you would see a significant rise in serum creatinine?

Back 18

75% of the functioning nephrons are destroyed

Front 19

Name four common clinical findings of uremia

Back 19

(1) anemia
(2) hyperkalemia
(3) low serum calcium levels
(4) metabolic acidosis

Front 20

Hematuria in the absence of other signs and symptoms is a common
presenting manifestation of?

Back 20

renal cell cancer

Front 21

Four potential causes of glucosuria are?

Back 21

(1) pregnancy
(2) chemical injury to renal tubules
(3) corticosteroid therapy
(4) increased intracranial pressure

Front 22

On microscopic examination of fresh urine sediment, you observe several red blood cell casts, many red blood cells, and only occasional white blood cells. There are also hyaline and granular casts present. The patient probably does NOT have (1 main thing)
He may have (give four Differential diagnosis)

Back 22

1. acute pyelonephritis (most likely not)
Differentials:
(A) acute post-streptococcal glomerulonephritis
(B) lupus glomerulonephritis
(C) renal involvement with polyarteritis .
(D) necrotizing glomerulonephritis of malignant hypertension

Front 23

The presence of RBC casts in a patient's urine could result from (name 2 things)

Back 23

(1) glomerular disease
2. tubular damage with hemorrhage

Front 24

Does anemia cause functional proteinuria?
If not what could cause it?

Back 24

no
(A) excessive exercise
(B) fever
(C) exposure to cold or heat
(D) emotional stress causing increased sympathetic nervous activity

Front 25

Dark yellow urine with yellow foam may result from (possibly)

Back 25

Urine with high bilirubin

Front 26

Hematuria is a frequent finding in (more than one is correct)
(1) malignant hypertension
(2) carcinoma of renal pelvis
(3) kidney trauma
(4) amyloidosis

Back 26

(1) malignant hypertension
(2) carcinoma of renal pelvis
(3) kidney trauma

Front 27

Hematuria is likely to occur in (more than one)
(1) papillary transitional cell carcinoma of renal pelvis, ureter or bladder
(2) renal cell carcinoma
(3) acute post-infectious glomerulonephritis
(4) malignant nephrosclerosis

Back 27

(1) papillary transitional cell carcinoma of renal pelvis, ureter or bladder
(2) renal cell carcinoma
(3) acute post-infectious glomerulonephritis
(4) malignant nephrosclerosis

Front 28

In a case of long-standing pyuria in which the routine bacterial cultures of the urine are repeatedly negative, a diagnosis to consider seriously is

Back 28

Tuberculosis of the urinary tract

Front 29

Red cell casts in the urine would be compatible with
(A) a ureteral calculus
(B) a transitional cell carcinoma of pelvis
(C) a foreign body in the urinary bladder
(D) anti-glomerular basement membrane antibody induced renal lesion

Back 29

anti-glomerular basement membrane antibody induced renal lesion

Front 30

Which one of the following findings on routine urinalysis is found only with lesions in the kidney?
(A) red cell casts
(B) white cells
(C) red cells
(D) squamous epithelial cells
(E) proteinuria

Back 30

red cell casts

Front 31

A routine postpartum urinalysis reveals a 3 plus clinitest and dipstick negative for glucose. The best interpretation of these findings is

Back 31

a reducing substance such as lactose is being excreted

Front 32

Urinalysis results include proteinuria, many red blood cells and red blood cell casts, and 1-2 white blood cells per high power field. Which disease fits?

Back 32

acute post-streptococcal glomerulonephritis

Front 33

The most common cause of myoglobinuria is

Back 33

trauma

Front 34

what do broad casts usually mean?

Back 34

end-stage renal disease

Front 35

The specific gravity of a first morning urine specimen from an
elderly man is 1.010. The patient most likely has

Back 35

advanced renal failure

Front 36

A telescoped urinary sediment (RBC and RBC casts; hyaline,
granular and cellular casts; renal failure casts; waxy casts and
oval fat bodies) is seen in cases of (2)

Back 36

Systemic lupus erythematosus
Goodpastures syndrome

Front 37

The definitive diagnostic test for the differentiation of myoglobinuria from hemoglobinuria is

Back 37

eletrophoresis of urine

Front 38

Urinalysis results are as follows: clear, pale yellow; pH 7.5; specific gravity 1.005; dipstick tests negative. This is probably NOT a first morning sample because of the

Back 38

specific gravity

Front 39

Each of the following urine crystals is considered abnormal
EXCEPT
(A) tyrosine
(B) triple phosphate
(C) cystine
(D) cholesterol
(E) leucine

Back 39

triple phosphate is normal

Front 40

In a consideration of adult polycystic disease of the kidney,is the disease at times unilateral?

Back 40

never

Front 41

In the usual adult type of polycystic kidneys, findings often include
(1) involvement of both kidneys
(2) another family member with the disease
(3) enlarged kidneys
(4) cysts in the liver

Back 41

(1) involvement of both kidneys
(2) another family member with the disease
(3) enlarged kidneys
(4) cysts in the liver

Front 42

In adult polycystic disease of the kidney describe disease characteristics

Back 42

(A) The disease is generally asymptomatic until early adult and middle life.
(B) Hematuria, hypertension and palpable abdominal masses are frequent clinical findings in symptomatic patients.

Front 43

In adult polycystic renal disease
(1) The majority of cases do not become apparent until the fourth decade of life or later.
(2) Hypertension is present sometime during the course.
(3) Approximately 15% of patients have one or more cerebral artery aneurysms.
(4) There may also be cysts within the liver, and pancreas.

Back 43

all of them

Front 44

A two-day-old infant has a mass in the left side of the abdomen
which transilluminates. An IVP reveals a normal functioning
kidney on the contralateral side and no excretion on the side of
the mass. The most likely diagnosis is

Back 44

multicystic kidney

Front 45

In the usual adult type of polycystic renal disease, findings often include
(1) involvement of both kidneys
(2) another family member with the disease
(3) enlarged kidneys
(4) renal failure during 5th decade of life

Back 45

all of these

Front 46

The disease is familial and generally asymptomatic until early adult or middle life. Hematuria, hypertension and palpable abdominal masses are frequent clinical findings in symptomatic patients.

Back 46

adult polycystic disease

Front 47

Which of the following applies to adult polycystic disease of the
kidneys
(A) usually clinically manifested by age 20
(B) first presentation is usually renal failure
(C) a sporadic non-genetic disease
(D) rapidly recurs in a transplanted kidney
(E) often cysts in the liver and/or berry aneurysms

Back 47

often cysts in the liver and/or berry aneurysms

Front 48

Adult polycystic disease is typically characterized by (more than one possible)
(1) autosomal dominant inheritance
(2) insidious onset of renal failure in middle age
(3) about a third of patients have hepatic cysts
(4) cystic dilatation of any part of the nephron

Back 48

(1) autosomal dominant inheritance
(2) insidious onset of renal failure in middle age
(3) about a third of patients have hepatic cysts
(4) cystic dilatation of any part of the nephron

Front 49

*Typical features of adult polycystic kidney disease include
(1) involvement of both kidneys
(2) autosomal dominant inheritance
(3) enlarged kidneys
(4) cysts in the liver

Back 49

(1) involvement of both kidneys
(2) autosomal dominant inheritance
(3) enlarged kidneys
(4) cysts in the liver

Front 50

*Features of adult polycystic kidney disease include each of the following EXCEPT
(A) cysts connect with nephron
(B) development in adult dialysis patients
(C) involvement of both kidneys
(D) involvement of various nephron segments
(E) occurrence of symptoms after age 15

Back 50

(B) development in adult dialysis patients

Front 51

The most common cause of urinary tract obstruction in children is

Back 51

ureteropelvic stenosis

Front 52

An important factor in the development of acute renal failure during therapy for leukemia and lymphoma is

Back 52

hyperuricemia

Front 53

Metabolic diseases leading to excessive excretion of materials which may form calculi in the urinary tract include
(1) hyperparathyroidism
(2) oxalosis
(3) gout
(4) nephrotic syndrome

Back 53

(1) hyperparathyroidism
(2) oxalosis
(3) gout

Front 54

What is the relationship of infection to renal calculi?
(A) infection is frequently a result of renal calculi.
(B) renal calculi may be the result of infection.
(C) both
(D) neither

Back 54

both

Front 55

An important condition causing renal calculi is

Back 55

hyperparathyroidism

Front 56

The crystalloids that are major constituents in 75-85% of renal calculi are calcium plus

Back 56

oxalate and phosphate

Front 57

A 36-year-old man with a radiopaque kidney stone is most likely to have

Back 57

idiopathic hypercalciuria

Front 58

Renal calculi
(1) may be the result of gout
(2) occur as a complication of hyperparathyroidism
(3) are more apt to form in an alkaline urine
(4) most frequently contain calcium, oxalate and phosphate

Back 58

(1) may be the result of gout
(2) occur as a complication of hyperparathyroidism
(3) are more apt to form in an alkaline urine
(4) most frequently contain calcium, oxalate and phosphate

Front 59

Metabolic diseases leading to excessive excretion of materials
which may form calculi in the urinary tract include all of the
following EXCEPT
(A) gout
(B) hyperoxaluria
(C) nephrotic syndrome
(D) cystinuria
(E) hyperparathyroidism

Back 59

nephrotic syndrome

Front 60

Each of the following is characteristic of ureteral calculi
EXCEPT
(A) often lodge at utero-pelvic junction, pelvic brim and at
vesicoureteral junction
(B) cause of excruciating flank pain radiating into groin and scrotum
(C) originate in ureteral lumen due to chronic ureteritis
(D) cause hematuria
(E) may lead to hydronephrosis

Back 60

originate in ureteral lumen due to chronic ureteritis

Front 61

Renal calculi are most commonly due to?

Back 61

unknown causes

Front 62

In a female with bacteriuria and recurrence with the same
organism after appropriate and apparently adequate treatment, one should be particularly concerned that the infection is

Back 62

renal origin

Front 63

Common features of the microscopic appearance of chronic pyelonephritis include
(1) periglomerular fibrosis
(2) interstitial fibrosis and chronic inflammation
(3) dilated tubules filled with protein casts
(4) necrotizing vasculitis

Back 63

(1) periglomerular fibrosis
(2) interstitial fibrosis and chronic inflammation
(3) dilated tubules filled with protein casts

Front 64

In what type of nephritis are bacteria localized in the renal tissue to produce the disease?

Back 64

pyelonephritis

Front 65

Macroscopically uneven involvement of various regions of the kidney is typical of

Back 65

acute pyelonephritis

Front 66

Morphologic changes seen with chronic pyelonephritis are
(1) interstitial chronic inflammatory cellular infiltrate
(2) pericapsular glomerular fibrosis
(3) protein casts in renal tubules
(4) hyalinized glomeruli

Back 66

(1) interstitial chronic inflammatory cellular infiltrate
(2) pericapsular glomerular fibrosis
(3) protein casts in renal tubules
(4) hyalinized glomeruli

Front 67

What is the most helpful in differentiating acute pyelonephritis from lower urinary tract infection?

Back 67

white cell casts in urine

Front 68

Pyelonephritis with renal papillary necrosis is often seen
with which of the following?
(1) bilateral involvement
(2) obstruction of urinary tract
(3) diabetes mellitus
(4) renal emboli

Back 68

(1) bilateral involvement
(2) obstruction of urinary tract
(3) diabetes mellitus

Front 69

A 38-year-old mother of five children died in an automobile
accident. At postmortem, both kidneys revealed irregular U-shaped depressions on their surfaces. Microscopically, there was periglomerular fibrosis, collections of lymphocytes and plasma cells in the interstitium with focal scarring. The tubules were focally dilated and contained eosinophilic proteinaceous material. Some tubules contained epithelial cells and neutrophils. The best diagnosis is

Back 69

pyelonephritis

Front 70

Acute pyelonephritis results from each of the following
EXCEPT
(A) oral contraceptives
(B) urinary tract obstruction
(C) renal calculi
(D) vesicoureteral reflux
(E) diabetes mellitus

Back 70

you really think oral contraceptives? thats only liver shits

Front 71

*Microscopic lesions of chronic pyelonephritis include
(1) interstitial fibrosis
(2) dilated tubules with protein casts
(3) periglomerular fibrosis
(4) necrotizing vasculitis

Back 71

(1) interstitial fibrosis
(2) dilated tubules with protein casts
(3) periglomerular fibrosis

Front 72

Renal papillary necrosis is LEAST likely to be caused by

Back 72

gout

Front 73

The most prevalent predisposing condition for recurrent pyelonephritis in children is

Back 73

vesicoureteral reflux

Front 74

Which of the following are significant predisposing conditions
for the development of acute pyelonephritis?
(1) female gender
(2) benign prostatic hyperplasia
(3) vesicoureteral reflux
(4) ureterolithiasis

Back 74

all four baby

Front 75

The kidney of a 38-year-old pregnant female with active, chronic
pyelonephritis would show
(1) dilated tubules with intraluminal eosinophilic proteinaceous material
(2) interstitial scarring
(3) lymphocytes and plasma cells in the interstitium
(4) periglomerular fibrosis

Back 75

all of these

Front 76

Necrotizing acute glomerulonephritis is commonly found with

Back 76

periarteritis nodosa

Front 77

In which glomerular disease is hematuria most prominent?

Back 77

acute post-infectious glomerulonephritis

Front 78

In what glomerular disease is hematuria most prominent?

Back 78

acute post-infectious glomerulonephritis

Front 79

Focal glomerulonephritis may result from each of the
following EXCEPT
(A) diabetes mellitus
(B) polyarteritis nodosa
(C) systemic lupus erythematosus
(D) subacute bacterial endocarditis

Back 79

diabetes mellitus

Front 80

The urine in post-streptococcal glomerulonephritis is characterized by

Back 80

red blood cell casts

Front 81

The majority of patients with acute post-streptococcal glomerulonephritis will

Back 81

recover completely

Front 82

Acute post-streptococcal glomerulonephritis ...
(1) greatest incidence in young children
(2) hematuria with RBC casts in urine
(3) subepithelial humps on electron microscopy
(4) spontaneous remission

Back 82

(1) greatest incidence in young children
(2) hematuria with RBC casts in urine
(3) subepithelial humps on electron microscopy
(4) spontaneous remission

Front 83

In glomerulonephritis, the one histologic finding which best
correlates with a poor prognosis is

Back 83

increase in epithelial cells with epithelial crescents

Front 84

Which of the following would theoretically decrease or prevent glomerular injury in post-streptococcal glomerulonephritis?
(1) eliminate polymorphonuclear leukocytes
(2) inhibit the conversion or activation of complement
(3) stabilize lysosomal membranes
(4) inhibit or block the R-E system and phagocytosis

Back 84

(1) eliminate polymorphonuclear leukocytes
(2) inhibit the conversion or activation of complement
(3) stabilize lysosomal membranes

Front 85

A patient with a streptococcal skin infection (pyoderma) develops
acute glomerulonephritis. Which of the following is likely to be
found in his renal biopsy?
(1) linear deposits of IgG in the glomeruli
(2) white blood cell casts in the urine
(3) diffuse thickening of the basement membrane
(4) subepithelial electron dense "humps"

Back 85

subepithelial electron dense "humps"

Front 86

Features of acute postinfectious glomerulonephritis include
(A) hematuria
(B) hypertension
(C) both
(D) neither

Back 86

both

Front 87

Renal disease with edema, hematuria, proteinuria, and
recent history of a sore throat is most likely to be seen with

Back 87

antigen-antibody complexes in glomeruli

Front 88

The ultrastructural observation of occasional large subepithelial
deposits in glomeruli suggests

Back 88

acute proliferative glomerulonephritis

Front 89

Acute postinfectious glomerulonephritis is LEAST likely
with

Back 89

hematoxylin bodies

Front 90

Complement plays a significant role in the pathogenesis of
glomerular lesions in ?

Back 90

(2) post streptococcal glomerulonephritis
(4) lupus nephritis

Front 91

A granular immunofluorescent pattern of IgG is present in

Back 91

membranous glomerulopathy

Front 92

Serum complement is typically decreased in
(1) membranoproliferative glomerulonephritis
(2) post-streptococcal glomerulonephritis
(3) systemic lupus erythematosus
(4) idiopathic membranous glomerulopathy

Back 92

(1) membranoproliferative glomerulonephritis
(2) post-streptococcal glomerulonephritis
(3) systemic lupus erythematosus

Front 93

Rapidly progressive glomerulonephritis may occur in patients with
each of the following EXCEPT
(A) Goodpasture's syndrome
(B) Henoch-Schonlein purpura
(C) lupus erythematosus
(D) membranous nephropathy
(E) Wegener's granulomatosis

Back 93

membranous nephropathy

Front 94

A poor prognosis in glomerulonephritis is indicated by presence of

Back 94

epithelial crescents

Front 95

Acute poststreptococcal glomerulonephritis is most likely to
occur following

Back 95

impetigo

Front 96

Acute post-infectious glomerulonephritis is caused by

Back 96

immune complex deposition

Front 97

A patient with IgA nephropathy (Berger's disease) usually
presents with

Back 97

recurrent hematuria

Front 98

The majority of patients with acute post-streptococcal
glomerulonephritis

Back 98

recover completely

Front 99

In which glomerular disease is hematuria most prominent?

Back 99

acute proliferative glomerulonephritis

Front 100

Which of the following is/are characteristic of lipoid nephrosis?
(1) is sometimes called "nil" lesion and shows little change
on light microscopy
(2) has a milder course and is more likely to remit with or
without therapy than membranous nephropathy
(3) is relatively often diagnosed in pediatric age group
patients presenting with nephrotic syndrome
(4) is frequently accompanied by hypertension

Back 100

(1) is sometimes called "nil" lesion and shows little change
on light microscopy
(2) has a milder course and is more likely to remit with or
without therapy than membranous nephropathy
(3) is relatively often diagnosed in pediatric age group
patients presenting with nephrotic syndrome

Front 101

The urine in post-streptococcal glomerulonephritis is
characterized by the presence of

Back 101

red blood cell casts

Front 102

In which glomerular disease is hematuria most prominent?

Back 102

acute post-streptococcal glomerulonephritis

Front 103

Minimal change lesion of nephrotic syndrome is synonymous with
each of the following EXCEPT
(A) epithelial cell disease
(B) foot process disease
(C) lipoid nephrosis
(D) membranous glomerulonephritis
(E) nil lesion disease

Back 103

membranous glomerulonephritis

Front 104

Immune complex glomerulonephritis is characterized by each of the
following EXCEPT
(A) aggregation of antigens and antibodies
(B) antigens of glomerular origin
(C) glomerulus is victim of its own filtration function
(D) granular humps along glomerular basement membrane
(E) trapped antigen antibody complexes within glomeruli

Back 104

antigens of glomerular origin

Front 105

Each of the following is true of acute poststreptococcal
glomerulonephritis EXCEPT
(A) becomes rapidly progressive glomerulonephritis in 50% of
children
(B) is a proliferative glomerulonephritis
(C) preceded by infective episode
(D) shows dome-shaped subepithelial humps
(E) usually affects children

Back 105

becomes rapidly progressive glomerulonephritis in 50% of children

Front 106

Immune complexes with dense glomerular deposits are seen
with each of the following renal disorders EXCEPT
(A) acute poststreptococcal glomerulonephritis
(B) diffuse lupus glomerulonephritis
(C) Goodpasture's syndrome
(D) membranoproliferative glomerulonephritis
(E) serum sickness

Back 106

Goodpasture's syndrome

Front 107

Does nephrotic syndrome cause edema? Why?

Back 107

edema due to altered plasma osmotic pressure

Front 108

A low serum complement level would favor what two renal diseases

Back 108

acute proliferative glomerulonephritis
lupus nephritis

Front 109

Complement is believed to play a significant role in the pathogenesis of the glomerular "deposits" in

Back 109

diabetic glomerulopathy

Front 110

In membranous nephropathy, where are the immune complexes in
relation to the glomerular capillary basement membrane?

Back 110

on the epithelial side

Front 111

Which is NOT characteristic of the nephrotic syndrome?
(A) proteinuria
(B) oval fat bodies in the urine
(C) elevated serum cholesterol
(D) edema or anasarca
(E) elevated blood urea nitrogen

Back 111

elevated blood urea nitrogen

Front 112

Lipoid nephrosis (minimal change disease) in children ...
(1) albuminuria
(2) normal glomeruli by light microscopy
(3) good prognosis
(4) immunoglobulin deposits in glomeruli

Back 112

(1) albuminuria
(2) normal glomeruli by light microscopy
(3) good prognosis

Front 113

Membranous nephropathy is more common in adults or children?

Back 113

adults than children

Front 114

Idiopathic minimal change glomerulopathy (lipoid nephrosis) shows what? in what region of the glomeruli?

Back 114

shows no early deposits in the mesangial region of the glomeruli

Front 115

Acute proliferative glomerulonephritis
(1) may cause the nephrotic syndrome
(2) may progress to chronic glomerulonephritis
(3) when it occurs in childhood it causes NO major lasting impairment in over 90% of the cases
(4) is often the result of Group A hemolytic streptococcal infections

Back 115

all of the above

Front 116

Renal amyloidosis associated with?

Back 116

multiple myeloma

Front 117

Which is the most characteristic and most common pathological
alteration of the kidney seen with idiopathic nephrotic syndrome (minimal change type)?

Back 117

foot-process blunting

Front 118

The list of causes of the nephrotic syndrome includes
(1) membranous glomerulonephritis
(2) diabetic glomerular sclerosis
(3) lipoid nephrosis
(4) pyelonephritis

Back 118

(1) membranous glomerulonephritis
(2) diabetic glomerular sclerosis
(3) lipoid nephrosis

Front 119

Glomerular lesions of diabetes mellitus include each of the
following EXCEPT a(n)
(A) nodular lesion consisting of a rounded, homogenous eosinophilic area of sclerosis within the glomerulus
(B) diffuse type of lesion consisting of widespread mesangial sclerosis and basement membrane thickening
(C) focal type of lesion consisting of localized areas of increased mesangial cellularity and at times fibrinoid necrosis
(D) exudative type of lesion referred to as the hyaline cap lesion

Back 119

focal type of lesion consisting of localized areas of increased mesangial cellularity and at times fibrinoid necrosis

Front 120

Pulmonary hemorrhage is often seen with

Back 120

) focal or diffuse necrotizing glomerulonephritis (WEGENER'S)

Front 121

The most common type of glomerular involvement in diabetes
mellitus is

Back 121

diffuse intercapillary glomerulosclerosis

Front 122

A histopathologic glomerular lesion which, when present, strongly
suggests diabetes mellitus is

Back 122

nodular glomerulosclerosis

Front 123

Nephrotic syndrome may be caused by
(1) essential hypertension
(2) membranous glomerulonephritis
(3) acute pyelonephritis
(4) minimal change disease

Back 123

membranous glomerulonephritis
minimal change disease

Front 124

The nephrotic syndrome is characterized by all of the following
EXCEPT
(A) generalized edema
(B) hematuria
(C) proteinuria
(D) hypoproteinemia
(E) hyperlipidemia

Back 124

hematuria

Front 125

A renal disease characterized by the presence of anti- glomerular
basement membrane antibodies is

Back 125

Goodpasture's disease

Front 126

The most characteristic feature of rapidly progressive glomerulonephritis is

Back 126

crescent formation

Front 127

Nephrotic syndrome is characterized by

Back 127

proteinuria, edema, hyperlipidemia

Front 128

Each of the following changes is frequently seen in kidney
disease produced by circulating antigen-antibody complexes EXCEPT
(A) decrease in serum complement
(B) proliferative glomerulonephritis
(C) a smooth linear sub-endothelial deposition of complement and immunoglobulins
(D) sub-epithelial deposits of electron-dense material
(E) proteinuria

Back 128

a smooth linear sub-endothelial deposition of complement and immunoglobulins

Front 129

Minimal change lesion and membranous glomerulonephritis share
which of the following characteristics?
(A) nephrotic syndrome
(B) IgG deposits in glomeruli
(C) good prognosis with steroid therapy
(D) capillary loop thickening by light microscopy

Back 129

nephrotic syndrome

Front 130

A patient with minimal change lesion is LEAST likely to have
(A) hypoproteinemia
(B) edema
(C) massive albuminuria
(D) hypertension
(E) hyperlipemia

Back 130

hypertension

Front 131

Electron-dense deposits in glomeruli represent

Back 131

antigen- antibody complexes

Front 132

T/F antigen-antibody complex deposits on basement membranes are seen in diabetic nephropathy?

Back 132

false

Front 133

t/f
Focal-segmental glomerulonephritis is commonly found in patients with Post-streptococcal glomerulonephritis

Back 133

false

Front 134

Immunologically-mediated renal disease is suggested by which of
the following?
(1) hypocomplementemia
(2) serum anti-glomerular basement membrane titer of 1/1200
(3) granular deposition of IgG and complement in glomeruli
(4) increasing antistreptolysin-0 titer

Back 134

a. hypocomplementemia
b. serum anti-glomerular basement membrane titer of 1/1200
c. granular deposition of IgG and complement in glomeruli
d. increasing antistreptolysin-0 titer

Front 135

T/F the following are features of kimmelstiel- Wilson disease:
thickened basement membrane
hyalinization of efferent arteriole
nodular glomerulosclerosis
occurs in diabetes

Back 135

true

Front 136

T/F the following is features of kimmelstiel- Wilson disease:
subepithelial glomerular deposits

Back 136

false

Front 137

Nodular intercapillary glomerulosclerosis is characteristic of

Back 137

diabetes mellitus

Front 138

A 10-year-old boy presents with puffy eyes and ankle edema.
Urinalysis reveals 4 plus protein and oval fat bodies without RBC
or RBC casts. These findings are most consistent with

Back 138

minimal change lesions

Front 139

Deposition of IgG on or in the glomerular basement membrane can
be seen in all of the following EXCEPT
(A) acute post-streptococcal glomerulonephritis
(B) minimal change glomerulonephritis
(C) lupus erythematosus glomerulonephritis
(D) Goodpasture's syndrome
(E) membranous nephropathy

Back 139

minimal change glomerulonephritis

Front 140

Membranous glomerulonephritis is
(1) a morphologic diagnosis
(2) due to an anti-glomerular basement membrane antibody
(3) a type of immune complex glomerulonephritis
(4) more common in children than adults

Back 140

- morphologic diagnosis
- a type of immune complex glomerulonephritis

Front 141

Membranous glomerulopathy and post-streptococcal glomerulonephritis are similar in that they both

Back 141

have glomerular immune complex deposits

Front 142

Nephrotic syndrome:
a. formations in urine?
b. albumin changes?
c. 24hr urine finds?

Back 142

a. oval fat bodies in urine
b. serum albumin of approximately 2g/dl
c. a 24-hr urine protein of 3.0 g or more

Front 143

Minimal change lesion and membranous glomerulonephritis share which of the following characteristics?

Back 143

causes the nephrotic syndrome

Front 144

A 12-year-old boy with septicemia develops hematuria,
hypertension, and oliguria. Microscopic examination reveals
enlarged glomeruli with diffuse mesangial and endothelial
hypercellularity. The best diagnosis is

Back 144

acute proliferative glomerulonephritis

Front 145

A patient with hemoptysis and renal failure has a renal biopsy
which reveals crescentic proliferative glomerulonephritis.
Immunofluorescence reveals linear deposits of IgG. The diagnosis is

Back 145

Goodpasture's syndrome

Front 146

A patient who has been receiving gold salts for rheumatoid arthritis develops severe edema and proteinuria. A renal biopsy
shows spikes of new basement membrane projecting toward
epithelial cells. Immunofluorescence is positive for IgG and C3 in a granular pattern. The diagnosis is

Back 146

membranous nephropathy

Front 147

A two-year-old boy with the nephrotic syndrome fails to respond
to steroid therapy. An open-wedge biopsy shows normal glomeruli.
Electron microscopy of three of these glomeruli reveals only foot
process blunting. Over the next two years the patient has
persistent proteinuria and mild azotemia. Focal segmental
glomerulosclerosis is suspected because

Back 147

this disorder affects the deep juxtamedullary glomeruli first, but could easily be missed on wedge biopsy.

Front 148

Glomerular diseases due to deposition of immune complexes include
(1) post-infectious acute proliferative glomerulonephritis
(2) minimal change nephropathy (lipoid nephrosis)
(3) lupus erythematosus glomerulonephritis
(4) Goodpasture's syndrome

Back 148

post-infectious acute proliferative glomerulonephritis
lupus erythematosus glomerulonephritis

Front 149

T/F The following may be histologically characterized by
focal glomerular lesions
membranous nephropathy

Back 149

false

Front 150

T/F The following may be histologically characterized by
focal glomerular lesions
a. nodular diabetic glomerulosclerosis
b. polyarteritis nodosa
c. schonlein-Henoch purpura
d. systemic lupus erythematosus

Back 150

true

Front 151

The glomerular lesion of systemic lupus includes
(1) hematoxylin bodies
(2) hyalin thrombi
(3) immunoglobulin deposition
(4) subendothelial dense deposits

Back 151

all of them

Front 152

Focal glomerulonephritis can result from all of the following EXCEPT
(A) diabetes mellitus
(B) polyarteritis nodosa
(C) systemic lupus erythematosus
(D) subacute bacterial endocarditis

Back 152

diabetes millitus does not cause focal glomerulonephritis

Front 153

In a patient with Hashimoto's thyroiditis with high titers of
thyroglobulin antibodies, the presence of the nephrotic syndrome
is seen with each of the following EXCEPT
(A) thickening of the basement membrane
(B) electron dense deposits in the basement membrane
(C) anti-glomerular basement membrane antibodies which cross
react with anti-follicular basement membrane
(D) fusion of foot processes
(E) presence of protein droplets in tubules

Back 153

anti- glomerular basement membrane antibodies which cross react with anti-follicular basement membrane

Front 154

Highly selective proteinuria is most likely to occur with

Back 154

minimal change nephropathy (lipoid nephrosis)

Front 155

T/F IgA deposits are present in the glomerular mesangium in Henoch- Schonlein pupura and Berger's disease

Back 155

true

Front 156

What is more typical of acute proliferative glomerulonephritis
than membranous glomerulonephritis?

Back 156

complete recovery

Front 157

Rapidly progressive glomerulonephritis is commonly seen in patients with
(1) Goodpasture's syndrome
(2) diabetes mellitus
(3) Wegener's granulomatosis
(4) membranous nephropathy

Back 157

Goodpastures syndrome
wegeners granulomatosis

Front 158

The morphologic lesion of classic phenacetin analgesic nephropathy is

Back 158

papillary necrosis

Front 159

Minimal change nephropathy is likely to have each of the following except?
(A) oval fat bodies in the urine
(B) red blood cell casts in the urine
(C) a serum albumin of 2 gm/dl
(D) urine protein of 3 gm/24 hours
(E) an elevated serum cholesterol

Back 159

red blood cell casts in the urine

Front 160

An example of an immune complex-mediated glomerulonephritis is

Back 160

lupus nephritis

Front 161

Which of the following is the result of anti-glomerular basement
membrane antibodies?
(A) Goodpasture's syndrome
(B) membranoproliferative glomerulonephritis
(C) membranous nephropathy
(D) minimal change disease

Back 161

goodpasture's syndrome

Front 162

Focal proliferative glomerulonephritis is seen as a part of each
of the following systemic diseases EXCEPT
(A) subacute bacterial endocarditis
(B) Wegener's granulomatosis
(C) systemic lupus erythematosus
(D) polyarteritis nodosa
(E) amyloidosis

Back 162

amyloidosis

Front 163

Diffuse thickening of the glomerular basement membrane on light microscopy, a granular appearance of IgG along the capillary walls on immunofluorescence, and sub-epithelial dense deposits on electron microscopy are characteristic of

Back 163

membranous nephropathy

Front 164

Crescentic glomerulonephritis is likely in?

Back 164

goodpasture's syndrome
Anti-GBM disease

Front 165

A 64-year-old man has had progressive severe proteinuria over the past two months. He has been receiving gold salts for rheumatoid arthritis for three months. Physical examination shows pitting pretibial edema. A renal biopsy shows proliferation. Silver stains demonstrate spikes of basement membrane projecting toward epithelial cells. Immunofluorescence is positive for IgG and C3 in a granular pattern. The diagnosis is

Back 165

membranous glomerulonephritis

Front 166

Nodular glomerulosclerosis is characteristic of

Back 166

diabetes mellitus

Front 167

Which of the following is NOT seen in a diabetic nephropathy?
(A) antigen-antibody complex deposits on basement membranes
(B) arteriosclerosis of afferent and efferent arterioles
(C) capsular drop
(D) diffuse intercapillary glomerulosclerosis
(E) nodular intercapillary glomerulosclerosis

Back 167

Antigen-antibody complex deposits on basement membranes is not see in diabetic nephropathy

Front 168

Where do the immune complexes lie in membranous nephropathy?

Back 168

epithelial side of the GBM

Front 169

The nephrotic syndrome is characterized by
(1) edema of a predominantly dependent character
(2) relatively normal glomerular function
(3) a reduction in colloid osmotic pressure of plasma proteins
(4) relatively normal aldosterone secretion

Back 169

a. edema of a predominantly dependent character
b. a reduction in colloid osmotic pressure of plasma proteins

Front 170

Causes of renal failure in diabetes mellitus include
(1) basement membrane thickening in the renal glomeruli
(2) atherosclerosis
(3) recurrent pyelonephritis with scarring
(4) hydronephrosis due to neurogenic bladder disease

Back 170

(1) basement membrane thickening in the renal glomeruli
(2) atherosclerosis
(3) recurrent pyelonephritis with scarring
(4) hydronephrosis due to neurogenic bladder disease

Front 171

The glomerular lesion of systemic lupus erythematosus with the
WORST prognosis is

Back 171

diffuse proliferative glomerulonephritis

Front 172

Necrotizing papillitis is often caused by

Back 172

diabetes mellitus

Front 173

Two weeks after methicillin therapy for a staphylococcal
infection, a 23-year-old woman develops hematuria, mild
proteinuria and signs of mild renal failure with fever
and a skin rash. She most likely has

Back 173

acute interstitial nephritis

Front 174

Phenacetin containing compounds are etiologic agents in

Back 174

chronic interstitial nephritis

Front 175

Methicillin and sulfonamide are etiologic agents in

Back 175

acute interstitial nephritis

Front 176

Acute renal papillary necrosis occurs with

Back 176

diabetes mellitus

Front 177

Renal papillary necrosis may be caused by
(1) diabetes mellitus
(2) pyelonephritis
(3) analgesic abuse
(4) sickle cell disease

Back 177

diabetes mellitus, pyelonephritis, analgesic abuse, sickle cell disease

Front 178

Chronic pyelonephritis features....
(1) patchy interstitial accumulation of lymphocytes and plasma cells
(2) periglomerular fibrosis
(3) uneven scarring of the kidneys
(4) focal tubular atrophy and interstitial fibrosis

Back 178

(1) patchy interstitial accumulation of lymphocytes and plasma cells
(2) periglomerular fibrosis
(3) uneven scarring of the kidneys
(4) focal tubular atrophy and interstitial fibrosis

Front 179

Which often causes necrosis in glomeruli and hematuria?
malignant hypertension or diabetic glomerulosclerosis

Back 179

just malignant hypertension

Front 180

Which renal vascular disease best fits the following description?
The essential lesion is sclerosis of small arteries and
arterioles. The effects of the vascular changes are reflected in the glomeruli, which early show a thickening of capillary
basement membranes, and, later, varying degrees of hyalinization and atrophy. The atrophy of the glomeruli and their tubules produces the renal shrinkage.

Back 180

arteriosclerosis

Front 181

In accelerated hypertension terminal arteries and arterioles in the kidneys may show of these options...
(A) necrotizing arteriolitis ("fibrinoid necrosis")
(B) concentric intimal proliferation ("onion skinning")

Back 181

both

Front 182

Malignant nephrosclerosis is best characterized morphologically
by

Back 182

arteriolar necrosis with fibrinoid deposition and intimal proliferation in the interlobular and afferent arterioles

Front 183

Benign nephrosclerosis is characterized morphologically by

Back 183

hyalinzation of afferent arterioles with ischemic atrophy of nephrons

Front 184

Patients with benign nephrosclerosis usually have
(1) hypertension
(2) chronic renal failure
(3) hyalinization of the afferent arterioles
(4) fibrinoid necrosis of glomeruli

Back 184

hypertension and hyalinization of the affferent arterioles

Front 185

Renal cortical petechiae are a common finding in

Back 185

malignant nephrosclerosis (flea bites?)

Front 186

Renal lesions caused by hypertension include
(1) hyaline arteriolar nephrosclerosis
(2) necrotizing arteriolitis
(3) hyperplastic arteriolar nephrosclerosis
(4) nodular glomerulosclerosis

Back 186

hyaline arteriolar nephrosclerosis
necrotizing arteriolitis
hyperplastics arteriolar nephrosclerosis

Front 187

The most common cause of renal artery stenosis in a 30-year-old
woman is

Back 187

fibromuscular dysplasia

Front 188

In malignant hypertension, arterioles in the kidney frequently exhibit
a. fibrinoid necrosis or amyloid deposits

Back 188

fibrinoid necrosis

Front 189

Which of the following alterations of the kidney are more
characteristic of malignant than benign hypertension?
(1) hyaline thickening of small blood vessels
(2) necrosis and fibrin deposits within glomeruli
(3) granular shrunken kidneys
(4) hyperplastic arteriolitis ("onion skinning")

Back 189

necrosis and fibrin deposits within glomeruli
hyperplastic arteriolitis ("onion skinning")

Front 190

Renal lesions in benign essential hypertension include each of
the following EXCEPT
(A) arteriolar hyaline deposition
(B) arteriolar smooth muscle hyperplasia
(C) equal involvement of afferent and efferent arterioles
(D) gross fine granularity and small kidney
(E) patchy ischemic atrophy of the kidney

Back 190

equal involvement of afferent and efferent usually thinner afferent

Front 191

Laboratory findings typical for acute tubular necrosis include
(1) urine osmolality approaching plasma osmolality
(2) renal tubular epithelium in urinary sediment
(3) urine Na concentration usually greater than 40 mEq/L
(4) urine-to-plasma ratio of creatinine greater than 100

Back 191

(1) urine osmolality approaching plasma osmolality
(2) renal tubular epithelium in urinary sediment
(3) urine Na concentration usually greater than 40 mEq/L

Front 192

A 53-year-old man with severe burns becomes hypotensive for 10 hours. His urine output subsequently decreases to 200 ml a day for 3 days. Laboratory evaluation on the third day would show
(1) urine osmolality approaching plasma osmolality value
(2) renal tubular cells in urinary sediment
(3) marked decrease in creatinine clearance
(4) urine-to-plasma ratio of creatinine greater than 100

Back 192

(1) urine osmolality approaching plasma osmolality value
(2) renal tubular cells in urinary sediment
(3) marked decrease in creatinine clearance

Front 193

In patients with acute renal tubular necrosis
(1) the disease may be secondary to ischemia related to a hypotensive episode
(2) the disease may result from the ingestion of toxic materials
(3) during recovery, the patients may have abnormal renal tubular functions even though the urine volume is quite large
(4) the disease is considered irreversible in the vast majority of the cases

Back 193

(1) the disease may be secondary to ischemia related to a hypotensive episode
(2) the disease may result from the ingestion of toxic materials
(3) during recovery, the patients may have abnormal renal tubular functions even though the urine volume is quite large

Front 194

Which is the most characteristic and most common pathologic
alteration of the kidney seen with the recovery phase of
acute renal failure?

Back 194

flattened basophilic epithelial cells in tubules

Front 195

Each of the following are examples of proximal tubular
dysfunctions EXCEPT
(A) familial cystinuria
(B) vitamin D resistant rickets
(C) galactosemia
(D) Wilson's disease (hepatolenticular degeneration)
(E) salt-losing nephropathy

Back 195

salt-losing nephropathy

Front 196

Acute renal failure is caused by each of the following EXCEPT
(A) shock
(B) hypokalemia
(C) nephrotoxic substance
(D) hepatorenal syndrome

Back 196

hypokalemia

Front 197

Which of the following laboratory profiles best describes acute
tubular necrosis?
(A) urine volume 640 ml/24hr, urinary Na 12 mEq/l, urine osmolality 1200 m0sm/Kg, urinary protein 3.46g/day, refractile fat bodies
(B) urine volume 160 ml/24hr, urinary Na 67 mEq/l, urine osmolality 320 m0sm/Kg, renal tubular cell casts
(C) urine volume 420 ml/24hr, urinary Na 20 mEq/l, urine osmolality 980 m0sm/Kg, RBC casts, gross hematuria
(D) urine volume 2800 ml/24hr, urinary Na 12 mEq/l, urine osmolality 48 m0sm/Kg

Back 197

urine volume 160 ml/24hr, urinary Na 67 mEq/l, urine osmolality 320 m0sm/Kg, renal tubular cell casts

Front 198

All of the following are documented causes of acute tubular
necrosis EXCEPT
(A) hypovolemic shock
(B) incompatible blood transfusion
(C) crushing injury of the leg and thigh
(D) antibiotics such as kanamycin
(E) plasma expanders such as mannitol

Back 198

(E) plasma expanders such as mannitol

Front 199

Acute tubular necrosis can be caused by
(1) mercury poisoning
(2) overwhelming sepsis
(3) extensive burns
(4) phenacetin

Back 199

(1) mercury poisoning
(2) overwhelming sepsis
(3) extensive burns

Front 200

Causes of renal tubular necrosis include each of the following
EXCEPT
(A) hypotension
(B) crush injury
(C) septicemia
(D) urinary tract obstruction
(E) mercuric chloride intoxication

Back 200

urinary tract obstruction

Front 201

The most common cause of acute renal failure is

Back 201

ischemia

Front 202

In early primary tubulointerstitial disease, features that help
distinguish it from glomerular disease include
(1) absence of persistent proteinuria
(2) absence of nephrotic syndrome
(3) presence of impaired concentrating ability
(4) presence of salt-washing

Back 202

(1) absence of persistent proteinuria
(2) absence of nephrotic syndrome
(3) presence of impaired concentrating ability
(4) presence of salt-washing

Front 203

A patient with renal cell carcinoma characteristically presents with

Back 203

hematuria

Front 204

The most common malignant tumor of the kidney is

Back 204

renal cell carcinoma

Front 205

In a patient with a renal cell carcinoma, early in its clinical
course, which of the following is the most common presenting
manifestation?

Back 205

painless hematuria

Front 206

All of the following may be true of Wilms' tumor EXCEPT
(A) these tumors contain a variety of cell and tissue components, all derived from mesoderm.
(B) patients usually present clinically with complaints referable to the tumor's enormous size.
(C) histologically, these tumors show evidence of primitive glomeruli and abortive tubules within a spindle cell stroma.
(D) the tumor is not an aggressive one and typically has a rather benign prognosis

Back 206

the tumor is not an aggressive one and typically has a rather benign prognosis.

Front 207

Which of the following features is most useful in distinguishing
renal cell carcinoma from renal cortical adenoma?

Back 207

size of tumor

Front 208

The initial clinical manifestation of Wilms' tumor is usually

Back 208

abdominal mass

Front 209

The initial clinical manifestation of adenocarcinoma of the kidney is usually

Back 209

hematuria

Front 210

Wilms' tumor of the kidney
(1) is more common in adults than children
(2) should be considered a teratoma
(3) is slow growing and radioresistant
(4) usually exhibits stromal, epithelial and blastema components

Back 210

usually exhibits stromal, epithelial and blastema components

Front 211

An important prognostic finding in renal cell carcinoma is

Back 211

invasion of the renal capsule

Front 212

The cellular appearance of a renal cortical adenoma most closely
resembles that of a

Back 212

renal cell carcinoma

Front 213

Which of the following statements characterize the behavior of
renal cell carcinomas?
(1) tendency to metastasize to lung and bone
(2) propensity for vascular invasion
(3) varied histological appearance; may resemble sarcoma
(4) high incidence of corticosteroid production by tumor cells

Back 213

(1) tendency to metastasize to lung and bone
(2) propensity for vascular invasion
(3) varied histological appearance; may resemble sarcoma

Front 214

Each of the following is characteristic of Wilms' tumor EXCEPT
(A) occurs primarily in infants under three years of age
(B) is bilateral about 5% of the time
(C) arises from embryonic nephrogenic tissue
(D) has a cure rate of less than 10%

Back 214

has a cure rate of less than 10%

Front 215

Some renal cell carcinomas cause
(A) hypercalcemia
(B) polycythemia
(C) both
(D) neither

Back 215

hypercalcemia and polycythemia

Front 216

Lindau-von Hippel disease causes

Back 216

renal cell carcinoma

Front 217

Renal neoplasms most often originate from

Back 217

tubular cells

Front 218

Patients with diabetes mellitus have an increased incidence of
(1) nodular glomerulosclerosis
(2) arteriolar nephrosclerosis
(3) acute pyelonephritis
(4) acute glomerulonephritis

Back 218

(1) nodular glomerulosclerosis
(2) arteriolar nephrosclerosis
(3) acute pyelonephritis

Front 219

A 50-year-old man with gross hematuria is LEAST likely to have
which of the following?

Back 219

wilm's tumor

Front 220

Unilateral hydronephrosis is likely to occur due to

Back 220

ureteral calculus

Front 221

Which of the following is the most common space-occupying lesion
in the adult kidney?

Back 221

simple cyst

Front 222

Conditions typically causing renal insufficiency include
(1) crescentic glomerulonephritis
(2) renal infarct
(3) malignant hypertension
(4) Wilms' tumor

Back 222

malignant hypertension and crescentic glomerulonephritis

Front 223

Which of the following renal lesions are caused by a
systemic disease?
(1) arterial nephrosclerosis
(2) Goodpasture's syndrome
(3) malignant nephrosclerosis
(4) nodular glomerulosclerosis

Back 223

(1) arterial nephrosclerosis
(2) Goodpasture's syndrome
(3) malignant nephrosclerosis
(4) nodular glomerulosclerosis

Front 224

Among renal diseases, those seen more commonly in children than
in adults include
(1) minimal change disease
(2) Wilms' tumor
(3) post-infectious glomerulonephritis
(4) transitional cell carcinoma of renal pelvis

Back 224

(1) minimal change disease
(2) Wilms' tumor
(3) post-infectious glomerulonephritis

Front 225

Complete morphologic and functional recovery of the kidney is
possible in
(1) post-infectious glomerulonephritis
(2) minimal change disease (lipoid nephrosis)
(3) toxic tubular necrosis
(4) ischemic tubular necrosis

Back 225

(1) post-infectious glomerulonephritis
(2) minimal change disease (lipoid nephrosis)
(3) toxic tubular necrosis
(4) ischemic tubular necrosis

Front 226

A patient with a transplanted kidney exhibits signs and symptoms
of rejection 3 weeks after transplantation. The most
characteristic histologic change in renal biopsy that is the
result of HLA incompatibility is

Back 226

lymphocytic infiltrates

Front 227

*Phenacetin abuse causes

Back 227

papillary necrosis

Front 228

Immune complexes in renal glomeruli may be found in each of the
following EXCEPT
(A) hepatitis B glomerulonephritis
(B) lipoid nephrosis
(C) lupus nephropathy
(D) membranoproliferative glomerulonephritis

Back 228

lipoid nephrosis

Front 229

Acute papillary necrosis (or necrotizing papillitis) occurs in
(1) diabetes mellitus
(2) obstructive urolithiasis
(3) abuse of phenacetin
(4) sickle cell disease

Back 229

(1) diabetes mellitus
(2) obstructive urolithiasis
(3) abuse of phenacetin
(4) sickle cell disease

Front 230

Acute renal allograft rejection is mediated by

Back 230

HLA antigen incompatibility

Front 231

Foreign body reaction to tubular casts in the renal medulla is
typical of

Back 231

multiple myeloma

Front 232

In uremia there is an increased serum concentration of
(1) parathyroid hormone
(2) urea
(3) creatinine
(4) triglycerides

Back 232

(1) parathyroid hormone
(2) urea
(3) creatinine
(4) triglycerides

Front 233

Renal lesions that may be caused by drugs include
(1) necrotizing vasculitis
(2) acute tubular necrosis
(3) interstitial nephritis
(4) membranous nephropathy

Back 233

(1) necrotizing vasculitis
(2) acute tubular necrosis
(3) interstitial nephritis
(4) membranous nephropathy

Front 234

Lesions of uremia include each of the following
EXCEPT
(A) chronic cystitis
(B) hyaline obliteration of glomeruli
(C) hyperplasia of parathyroid glands
(D) nephrocalcinosis
(E) pericarditis

Back 234

chronic cystitis

Front 235

Each of the following is a cause of acute renal failure EXCEPT
(A) acute pyelonephritis with papillary necrosis
(B) disseminated intravascular coagulation
(C) Kimmelstiel-Wilson disease (diabetic glomerulosclerosis)
(D) rapidly progressive glomerulonephritis
(E) tubular necrosis

Back 235

Kimmelstiel-Wilson disease (diabetic glomerulosclerosis)

Front 236

Membranous glomerulopathy and post-streptococcal glomerulonephritis are similar in that they both

Back 236

have an immune complex pattern of glomerular deposits

Front 237

The foot process of the glomerulus is an integral part of

Back 237

epithelial cell

Front 238

Colchicine relieves the pain of acute gout apparently by?

Back 238

inhibiting acute inflammatory effect of urate crystals

Front 239

Gout can occur secondarily to each of the following EXCEPT
(A) thiazide diuretic administration
(B) psoriasis
(C) starvation diets
(D) sodium bicarbonate administration
(E) polycythemia

Back 239

sodium bicarbonate administration

Front 240

Each of the following is a feature of primary gout EXCEPT
(A) the tophus
(B) presence of the basic defect at birth
(C) hyperuricemia
(D) amyloidosis
(E) renal lesions

Back 240

amyloidosis

Front 241

Conditions causing hyperuricemia include
(1) hemolytic anemia
(2) polycythemia vera
(3) leukemia
(4) Lesch-Nyhan syndrome

Back 241

(1) hemolytic anemia
(2) polycythemia vera
(3) leukemia
(4) Lesch-Nyhan syndrome

Front 242

A drug which interferes with synthesis of uric acid in primary gout is

Back 242

allopurinol

Front 243

A 56-year-old man has a protuberance on his external ear that has
ulcerated and contains white crystals. He has a long history of
intermittent bouts of acute arthritis and has a son who also has
arthritic attacks. One would
(1) anticipate a granulomatous or foreign body reaction in the ear lesion
(2) suspect that he has had or may develop similar lesions elsewhere
(3) not be surprised if he develops symptoms of coronary artery disease
(4) realize that renal failure is a serious and fairly frequent complication of his disease

Back 243

(1) anticipate a granulomatous or foreign body reaction in the ear lesion
(2) suspect that he has had or may develop similar lesions elsewhere
(3) not be surprised if he develops symptoms of coronary artery disease
(4) realize that renal failure is a serious and fairly frequent complication of his disease

Front 244

A patient who is being treated for chronic granulocytic leukemia
complains of severe flank pain and passes a small renal stone.
Probable pathogenetic factors in this complication include
(1) increased destruction of cells
(2) increased production of urates
(3) hyperuricemia
(4) decreased renal excretion of urates

Back 244

(1) increased destruction of cells
(2) increased production of urates
(3) hyperuricemia

Front 245

When there is excess production of uric acid, urate crystals are likely to form in the kidney because

Back 245

there is more uric acid in the urine

Front 246

The pathogenesis of gout includes
(A) hemoglobinopathy
(B) antigen-antibody complexes with complement activation
(C) increased cytochrome p450 in cells
(D) rupture of phagolysosomes containing crystals
(E) under-production and/or increased renal excretion of uric acid

Back 246

rupture of phagolysosomes containing crystals

Front 247

acute gouty arthritis is primary due to

Back 247

monosodium urate crystals within neutrophils in joint fluid

Front 248

In the majority of cases of primary gout there is

Back 248

no specific enzyme or renal defect identified