Alterations of Renal and Urinary Tract Flashcards
Which of the following is NOT a determinant of severity for obstructive uropathy? Location of the blockage Degree of completeness of the blockage Type of blockage Duration of the blockage
Type of blockage
The factors that determine severity for obstructive uropathy are locations of blockage, the degree of completeness, duration, involvement of one or both upper urinary tracts, and cause of the lesion.
When deposition of excessive amounts of extracellular matrix occurs, what is this process called? Tubulointerstitial fibrosis Compensatory hypertrophy Obligatory growth Compensatory growth
Tubulointerstitial fibrosis
Tubulointerstitial fibrosis is the deposition of excessive amounts of extracellular matrix. Compensatory hypertrophy is essential to recovery of renal function following an obstruction. Obligatory and compensatory growth together make up compensatory hypertrophy. Obligatory growth is the influence of somatostatin on nephrons. Compensatory growth is an unidentified hormone influencing nephrons.
Which of the following is a risk factor for postobstructive diuresis? Unilateral obstruction Hypertension Dehydration Neurogenic diabetes insipidus
Hypertension
Postobstructive diuresis is the rapid elimination of fluid after an obstruction is removed. The risk factors for this include bilateral obstruction, nephrogenic diabetes insipidus, hypertension, edema, congestive heart failure, and uremic encephalopathy.
A stone is composed of magnesium, ammonium, and phosphate. What type of urinary calculus is this? Calcium Struvite Uric acid Indinavir
Struvite
Struvite stones account for about 15% of stones and are composed of magnesium, ammonium, and phosphate. Uric acid stones account for about 7% of stones. Calcium oxalate or calcium phosphate stones account for 70% to 80%. Less common stone elements include cystine, 2,8-dihydroxyadeninuria, triamterene, indinavir, and ammonium acid urate.
Which of the following is NOT one of the factors that are required before a stone is formed? Supersaturation of one of the salts Precipitation from a liquid to a solid Aggregation Low concentration of salt
Low concentration of salt
Actually, a high concentration is required. Supersaturation is the presence of a higher concentration of salt within a fluid. Precipitation of the salts from a liquid to a solid, growth through crystallization or aggregation, and the presence or absence of stone inhibitors are other factors required for stone formation.
Which of the following is NOT a cause of lower urinary tract obstruction? Kidney stone Bladder neck dyssynergia Prostate enlargement Urethral stricture
Kidney stone
Kidney stones are actually considered upper urinary tract obstructions. The other choices are causes of lower urinary tract obstruction.
A person has uncontrolled or premature contractions of the detrusor muscle. Which of the following conditions is associated with this medical problem? Spinal cord injury Immune system dysfunction Congestive heart failure Renal carcinoma
Spinal cord injury
This person’s condition is detrusor hyperreflexia with vescicosphincter dyssynergia. It is defined as uncontrolled or premature contractions of the detrusor muscle associated with a neurologic disorder. This can be from spinal cord injury, Guillain-Barré syndrome, multiple sclerosis, and disk problems.
Which of the following is NOT a result of urodynamic testing?
Quantifies severity of obstruction
Determines bacterial cause of urinary tract infection
Measures detrusor contraction strength
Identifies the cause of urinary retention
Determines bacterial cause of urinary tract infection
The bacterial cause of a urinary tract infection is often detected by urine culture. Urodynamic testing identifies obstruction, quantifies its severity, and measures detrusor contraction strength.
Which of the following is TRUE regarding renal cell carcinoma?
It is associated with TP53.
Symptoms include hematuria.
Early stages produce a large abdominal mass.
Granular cell tumors have better prognosis.
Symptoms include hematuria
Symptoms include hematuria, flank pain, and flank or abdominal mass. Early stages are often silent. Clear cell tumors have a better prognosis. Overexpression of TP53 is demonstrated in bladder tumors.
A person is complaining of abdominal and back pain. You have diagnosed bacteria in the urine. What is the appropriate term for involvement of the upper urinary tract? Cystitis Pyelonephritis Urinary tract infection Asymptomatic bacteriuria
Pyelonephritis
Pyelonephritis indicates involvement of the upper urinary tract. Cystitis is inflammation of the bladder. A urinary tract infection is inflammation of the urinary epithelium followed by invasion and colonization by some pathogen. Asymptomatic bacteriuria is bacteria in the urine that does not provoke infection.
Which bacteria are the most common cause of urinary tract infections? Klebsiella Proteus Escherichia coli Staphylococcus
Escherichia coli
E. coli infections account for approximately 80% of UTIs. The second most common bacterial cause is Staphylococcus saprophyticus (10%), followed by Klebsiella, Proteus, and Pseudomonas.
Several factors contribute to bacterial virulence within the urinary tract. Which of the following is NOT one of the factors? Fimbriae expression Sidophore production Mucous production Biofilm formation
Mucous production
Mucus from the periurethral mucus-secreting glands trap bacteria in the urethra.
Fimbriae expression, the production of sidophores, and the formation of biofilm contribute to bacterial virulence
With which bacteria is acute glomerulonephritis associated? E. coli Staphylococcus Group A Streptococcus Klebsiella
Group A Streptococcus
Glomerulonephritis is an inflammation of the glomeruli and is often caused by a streptococcal infection. It usually occurs 7 to 10 days after streptococcal skin or throat infection.
