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Exam 2 Flashcards

1
Q

1.Which of the following statements about renal diseases is true?
A. Glomerular renal disease are usually immune-mediated
B. Vascular disorders induce renal disease by increasing renal perfusion
C. All structural components of the kidney are equally susceptible to disease
D. Tubulointerstitial renal disease usually result from antibody-antigen and complement interactions

A

A. Glomerular renal disease are usually immune-mediated

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2
Q

2.In glomerular disease, morphologic changes in the glomeruli included all of the following except
A. Cellular proliferation
B. Erythrocyte congestion
C. Leukocyte infiltration
D. Glomerular basement membrane thickening

A

B. Erythrocyte congestion

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3
Q

3.When all the renal glomeruli are affected by a morphologic change, this change is described as
A. Diffuse
B. Focal
C. Differentiated
D. Segmental

A

A. diffuse

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4
Q

4.In glomerular renal disease, glomerular damage results from
A. Deposition of infectious agents
B. A decrease in glomerular perfusion
C. Change in glomerular hemodynamics
D. Toxic substances induced by immune complex formation

A

D. Toxic substances induced by immune complex formation

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5
Q

5.Clinical features that are characteristic of glomerular damage include all of the following except
A. Edema
B. Hematuria
C. Proteinuria
D. Polyuria

A

D. Polyuria

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6
Q

6.Which of the following disorders frequently occurs after a bacterial infection of the skin or throat?
A. Acute glomerulonephritis
B. Chronic glomerulonephritis
C. Membranous glomerulonephritis
D. Rapidly progressive glomerulonephritis

A

A. Acute glomerulonephritis

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7
Q
  1. Which of the following disorders is characterized by cellular proliferation into Bowman’s space to form cellular “crescents”?
    A. Chronic glomerulonephritis
    B. Membranous glomerulonephritis
    C. Minimal change disease
    D. Rapidly progressive glomerulonephritis
A

D. Rapidly progressive glomerulonephritis

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8
Q
  1. Which of the following disorders is the major cause of nephritic syndrome in adults
    A. IgA nephropathy
    B. Membranoproliferative glomerulonephritis
    C. Membranous glomerulonephritis
    D. Rapidly progressive glomerulonephritis
A

C. Membranous glomerulonephritis

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9
Q
  1. Which of the following glomerular disease is the major cause of nephrotic syndrome in children?
    A. IgA nephropathy
    B. Minimal change disease
    C. Membranous glomerulonephritis
    D. Rapidly progressive glomerulonephritis
A

B. Minimal change disease

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10
Q
  1. Which of the following statements regard IgA nephropathy is true?
    A. It often follows mucosal infection
    B. It is associated with nephrotic syndrome
    C. It is characterized by leukocyte infiltration of the glomeruli
    D. It often occurs secondary to systemic lupus erythematosus
A

A. It often follows mucosal infection

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11
Q
  1. 80 % of patients who develop chronic glomerulonephritis previously had some type of glomerular disease. Which of the following disorders is implicated most frequently in the development of chronic glomerulonephritis?
    A. IgA nephropathy
    B. Membranoproliferative glomerulonephritis
    C. Poststreptococcal glomerulonephritis
    D. Rapidly progressive glomerulonephritis
A

D. Rapidly progressive glomerulonephritis

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12
Q
  1. Chronic renal failure often develops in each of the following disease except
    A. Amyloidosis
    B. Diabetes mellitus
    C. Diabetes insipidus
    D. Systemic lupus erythematosus
A

C. Diabetes insipidus

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13
Q
  1. Which of the following features characterize(s) nephrotic syndrome?
  2. Proteinuria
  3. Edema
  4. Hypoalbuminemia
  5. Hyperlipidemia

A. 1,2,3, are correct
B. 1 and 3 are correct
C. 4 is correct
D. All are correct

A

D. All are correct

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14
Q
  1. When a patient has nephrotic syndrome, microscopic examinations of the urine sediment often reveal
    A. Granular casts
    B. Leukocyte casts
    C. Red blood cell casts
    D. Waxy casts
A

D. Waxy casts

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15
Q
  1. Which of the following has not been associated with acute tubular necrosis?
    A. Antibiotics
    B. Galactosuria
    C. Hemoglobinuria
    D. Surgical procedures
A

B. Galactosuria

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16
Q
  1. Which formed element in urine sediment is characteristic of toxic acute tubular necrosis and aids in its differentiation from ischemic acute tubular necrosis?
    A. Collecting tubular cells
    B. Granular casts
    C. Proximal tubular cells
    D. Waxy casts
A

C. Proximal tubular cells

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17
Q
  1. Which of the following disorders is characterized by the urinary excretion of large amount of arginine, cystine, lysine, and ornithine?
    A. Cystinosis
    B. Cystinuria
    C. Lysinuria
    D. Tyrosinuria
A

B. Cystinuria

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18
Q
  1. Generalized loss of proximal tubular function is a characteristic of:
    A. Fanconi’s syndrome
    B. Nephrotic syndrome
    C. Renal glucosuria
    D. Renal tubular acidosis
A

A. Fanconi’s syndrome

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19
Q
  1. Which of the following changes is not associated with renal tubular acidosis?
    A. Decreased glomerular filtration rate
    B. Decreased renal tubular secretion of hydrogen ions
    C. Decreased proximal tubular reabsorption of bicarbonate
    D. Increased back-diffusion of hydrogen ions in the distal tubules
A

A. Decreased glomerular filtration rate

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20
Q
  1. Which of the following disorders is considered a lower urinary tract infection?
    A. Cystitis
    B. Glomerulonephritis
    C. Pyelitis
    D. Pyelonephritis
A

A. Cystitis

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21
Q
  1. Most urinary tract infections are caused by
    A. Yeast, such as candida spp.
    B. Gram-negative rods
    C. Gram-positive rods
    D. Gram-positive cocci
A

B. Gram-negative rods

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22
Q
  1. Which of the following formed elements when present in urine sediment is most indicative of an upper urinary tract infection
    A. Bacteria
    B. Casts
    C. Erythrocytes
    D. Leukocytes
A

B. Casts

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23
Q
  1. The most common cause of chronic pyelonephritis is
    A. Cystitis
    B. Bacterial sepsis
    C. Drug-induced nephropathies
    D. Reflux nephropathies
A

D. Reflux nephropathies

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24
Q
  1. Eosinophilluria, fever, and skin rash are characteristic clinical features of
    A. Acute pyelonephritis
    B. Acute interstitial nephritis
    C. Acute glomerulonephritis
    D. Chronic glomerulonephritis
A

B. Acute interstitial nephritis

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25
Q
  1. Cessation of the administration of a drug is fastest and most effective treatment for
    A. Acute pyelonephritis
    B. Acute interstitial nephritis
    C. Acute glomerulonephritis
    D. Chronic glomerulonephritis
A

B. Acute interstitial nephritis

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26
Q
  1. yeast is considered part of the normal flora in each of the following locations except in the
    A. Gastrointestinal tract
    B. Oral cavity
    C. Urinary tract
    D. Vagina
A

C. Urinary tract

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27
Q
  1. Acute kidney injury (AKI) can be caused by all the following except
    A. Hemorrhage
    B. Acute tubular necrosis
    C. Acute pyelonephritis
    D. Urinary tract obstruction
A

C. Acute pyelonephritis

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28
Q
  1. Which of the following statements about chronic kidney (CKD) is true?
    A. It can be reversed by appropriate treatment regimens
    B. It eventually progresses to end stage renal disease
    C. It is monitored by periodic determinations of renal blood flow
    D. Its onset involves a sudden decrease in the glomerular filtration rate
A

B. It eventually progresses to end stage renal disease

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29
Q
  1. Isosthenuria significant proteinuria and numerous casts of all types describe the urinalysis findings from a patient with
    A. Acute kidney injury
    B. Acute tubular necrosis
    C. Chronic kidney disease
    D. Renal tubular acidosis
A

C. Chronic kidney disease

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30
Q
  1. Approximately 75% of the renal calculi that form in patients contain
    A. Calcium
    B. Cystine
    C. Oxalate
    D. Uric acid
A

A. Calcium

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31
Q
  1. The formation of renal calculi is enhanced by
    A. An increase in urine flow
    B. The natural “acid-alkaline tide” of the body
    C. Increased protein in the urine ultrafiltrate
    D. Increases in chemical salts in the urine ultrafiltrate
A

D. Increases in chemical salts in the urine ultrafiltrate

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32
Q
  1. An overflow mechanism is responsible for the aminoaciduria present in
    A. Cystinosis
    B. Cystinuria
    C. Tyrosinuria
    D. Phenylketonuria
A

C. Tyrosinuria

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33
Q
  1. Which of the following hereditary diseases results in the accumulation and excretion of large amounts of homogentisic acid?
    A. Alkaptonuria
    B. Melanuria
    C. Phenylketonuria
    D. Tyrosinuria
A

A. Alkaptonuria

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34
Q
  1. Which of the following substances oxidizes with exposure to air, causing the urine to turn brown or black?
    A. Melanin
    B. Porphyrin
    C. Tyrosine
    D. Urobilinogen
A

A. Melanin

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35
Q
  1. Which of the following diseases is related to tyrosine production or metabolism?
    1.Tyrosinuria
    2.Melanuria
    3.Phenylketonuria
    4.Alkaptonuria
    A. 1,2,3, are correct
    B. 1 and 3 are correct
    C. 4 is correct
    D. All are correct
A

D. All are correct

36
Q
  1. Which of the following diseases can result in severe mental retardation if not detected and treated in the infant?
    1.Phenylketonuria
    2.Maple syrup urine disease
    3.Galactosuria
    4.Alkaptonuria

A. 1,2,3 are correct
B. 1 and 3 are correct
C. 4 is correct
D. All are correct

A

A. 1,2,3 are correct

37
Q
  1. Which of the following is a characteristic feature of type 2 diabetes mellitus?
    A. Daily insulin injections are necessary
    B. Onset of the disease is usually sudden
    C. There is a strong tendency to develop ketoacidosis
    D. The disease usually presents after 40 years of age
A

D. The disease usually presents after 40 years of age

38
Q
  1. Which of the following abnormalities is not a clinical feature of an infant with Galactosuria?
    A. Cataract formation
    B. Liver dysfunction
    C. Mental retardation
    D. Polyuria
A

D. Polyuria

39
Q
  1. Galactose is produced in the normal metabolism of
    A. Fructose
    B. Glucose
    C. Lactose
    D. Sucrose
A

C. Lactose

40
Q
  1. Which of the following is not a characteristic of diabetes insipidus?
    A. Polyuria
    B. Polydipsia
    C. Increased production of antidiuretic hormone
    D. Urine with a low specific gravity
A

C. Increased production of antidiuretic hormone

41
Q
  1. Which of the following statements about porphobilinogen is true?
    A. Porphobilinogen is red and fluoresces
    B. Normally, only trace amounts of porphobilinogen are formed
    C. Porphobilinogen is an intermediate product in bilirubin formation
    D. Porphobilinogen production is the rate-limiting step in heme synthesis
A

B. Normally, only trace amounts of porphobilinogen are formed

42
Q
  1. Porphyria is characterized by the body’s attempt to
    A. Increase heme degradation
    B. Increase heme formation
    C. Decrease globin synthesis
    D. Decrease iron catabolism
A

B. Increase heme formation

43
Q
  1. Which of the following statements regarding porphyrin and porphyrin precursors is true?
    1.Porphyria can be inherited or induced
    2.Porphyrin precursors are neurotoxins
    3.Porphyrins can be dark red or purple
    4.Porphyrin precursor accumulation causes skin photosensitivity

A. 1,2 and 3 are correct
B. 1 and 3 are correct
C. 4 is correct
D. All are correct

A

A. 1,2 and 3 are correct

44
Q
  1. The daily volume of urine excreted normally ranges from
    A. 100 to 600 mL/day
    B. 100 to 1800 mL/day
    C. 600 to 1800 mL/day
    D. 1000 to 3000 mL/day
A

C. 600 to 1800 mL/day

45
Q
  1. Another name for excessive thirst it
    A. Polydipsia
    B. Polyuria
    C. Hydrophilia
    D. Hydrostasis
A

A. Polydipsia

46
Q
  1. The excretion of large volumes of urine (> 3L/day) is called
    A. Glucosuria
    B. Hyperuria
    C. Polydipsia
    D. Polyuria
A

D. Polyuria

47
Q
  1. When the body is dehydrated, the kidneys
    A. Excrete excess solutes in a constant volume of urine
    B. Excrete solutes in as small volume of urine as possible
    C. Decrease the quantity of solutes excreted and decrease the urine volume
    D. Decrease the quantity of solutes excreted while holding the urine volume constant
A

B. Excrete solutes in as small volume of urine as possible

48
Q
  1. The excretion of less than 400 mL of urine per day is called
    A. Anuria
    B. Hypouria
    C. Nocturia
    D. Oligouria
A

D. Oligouria

49
Q
  1. All the following conditions may produce nocturia except
    A. Anuria
    B. Pregnancy
    C. Chronic renal disease
    D. Fluid intake at night
A

A. Anuria

50
Q
  1. Which of the following will not influence the volume of urine produced?
    A. Diarrhea
    B. Exercise
    C. Alcohol ingestion
    D. Carbohydrate ingestion
A

D. Carbohydrate ingestion

51
Q
  1. Which of the following solutes are present in the largest molar amounts in urine
    A. Urea, chloride, and sodium
    B. Urea, creatinine, and sodium
    C. Creatine, uric acid, and ammonium
    D. Urea, uric acid and ammonium
A

A. Urea, chloride, and sodium

52
Q
  1. Renal excretion is not involved in the elimination of
    A. Electrolytes and water
    B. Normal byproducts of fat metabolism
    C. Soluble metabolic wastes (eg urea, creatine)
    D. Exogenous substances (e.g drugs, x-ray contrast media)
A

B. Normal byproducts of fat metabolism

53
Q
  1. The concentration of which substances provides the best means of distinguishing urine from other body fluids
    A. Creatinine and urea
    B. Glucose and protein
    C. Uric acid and ammonia
    D. Water and electrolytes
A

A. Creatinine and urea

54
Q
  1. What is the definition of the osmolality of a solution?
    A. The density of solute particles per kilogram of solvent
    B. The mass of solute particles per kilogram of solvent
    C. The number of solute particles per kilogram of solvent
    D. The weight of solute particles per kilogram of solvent
A

C. The number of solute particles per kilogram of solvent

55
Q
  1. The osmolality of a solution containing 1.0 moles of urea is equal to that of a solution containing
    A. 1.0 mole of HCL
    B. 1.0 mole of H2PO4
    C. 0.5 mole of NaCl
    D. 0.5 mole of glucose
A

C. 0.5 mole of NaCl

56
Q
  1. The maximum osmolality that urine can achieve is determined by the
    A. Quantity of solutes ingested in the diet
    B. Presence of antidiuretic hormone in the collecting tubules
    C. Osmolality of the medullary interstitium
    D. Osmolality of fluid entering the collecting tubules
A

C. Osmolality of the medullary interstitium

57
Q
  1. Serum osmolality remains relatively constant, whereas the urine osmolality ranges from
    A. One-third to one-half that of serum
    B. One-third to equal that of serum
    C. One to three times that of serum
    D. Three to five times that of serum
A

C. One to three times that of serum

58
Q
  1. Osmolality is a measure of solute
    A. Density
    B. Mass
    C. Number
    D. Weight
A

C. Number

59
Q
  1. Which of the following solutes, if added to pure water, affects the specific gravity of the resultant solution more than it affects the specific gravity of the resultant solution more than it affects its osmolality?
    A. Sodium
    B. Chloride
    C. Potassium
    D. Glucose
A

D. Glucose

60
Q

17.Occasionally the specific gravity of a urine specimen exceeds that physiologically possible (i.e. >1.040) Which of the following substances when found in urine could account for such a high value?
A. Creatinine
B. Glucose
C. Mannitol
D. Protein

A

C. Mannitol

61
Q
  1. In a patient with chronic renal disease, in whom the kidneys can no longer adjust urine concentration, the urine specific gravity would be
    A. 1.000
    B. 1.010
    C. 1.020
    D. 1.030
A

B. 1.010

62
Q
  1. Which of the following features is not a colligative property?
    A. Boiling point elevation
    B. Freezing point depression
    C. Osmotic pressure depression
    D. Vapor pressure depression
A

C. Osmotic pressure depression

63
Q
  1. An advantage of freezing point osmometry over vapor pressure osmometry is its
    A. Increased turnaround time
    B. Use of a smaller volume of sample
    C. Ability to detect volatile substances.
    D. Decreased interference from plasma lipids
A

C. Ability to detect volatile substances

64
Q
  1. Osmolality measurements are considered to be more accurate assessment of solute concentration in the body fluids than are specific gravity measurements because
    A. All solutes contribute equally
    B. Heavy molecules do not interfere
    C. They are not temperature dependent
    D. They are less time consuming to perform
A

A. All solutes contribute equally

65
Q
  1. the freezing point of a urine specimen is determined to be -0.90 C. What is the osmolality of the specimen?
    A. 161 mOsm/kg
    B. 484 mOsm/kg
    C. 597 mOsm/kg
    D. 645 mOsm/kg
A

B. 484 mOsm/kg

66
Q
  1. The ultrafiltrate in the urinary space of the glomerulus has a specific gravity of
    A. 1.005 and a lower osmolality than the blood plasma
    B. 1.010 and the same osmolality as the blood plasma
    C. 1.015 and a higher osmolality than the blood plasma
    D. 1.035 and higher osmolality than the blood plasma
A

B. 1.010 and the same osmolality as the blood plasma

67
Q
  1. Which renal function is assessed using specific gravity and osmolality measurements?
    A. Concentrating ability
    B. Glomerular filtration ability
    C. Tubular excretion ability
    D. Tubular secretion ability
A

A.Concentrating ability

68
Q
  1. A fluid deprivation test is used to
    A. Determine renal plasma flow
    B. Investigate the cause of oliguria
    C. Asses renal concentrating ability
    D. Measure the glomerular filtration rate
A

C. Asses renal concentrating ability

69
Q
  1. A fluid deprivation test involves the measurements of serum and urine
    A. Density
    B. Osmolality
    C. Specific gravity
    D. Volume
A

B. Osmolality

70
Q
  1. The volume of plasma cleared per minute in excess of that required for solute elimination is called the
    A. Creatinine clearance
    B. Free-water clearance
    C. Osmolar clearance
    D. Renal clearance
A

B. Free-water clearance

71
Q
  1. A free-water clearance value of -1.2 would be expected from a patient experiencing
    A. Polyuria
    B. dehydration
    C. water diuresis
    D. excessive fluid intake
A

B. dehydration

72
Q
  1. Which of the following is an endogenous substance used to measure glomerular filtration rate?
    A. Urea
    B. Inulin
    C. Creatinine
    D. P-aminohippurate
A

C. Creatinine

73
Q
  1. Renal clearance is defined as the volume of
    A. Urine cleared of a substance per minute
    B. Plasma cleared of a substance in a time interval
    C. Plasma flowing through the kidney per minute
    D. Plasma containing the same amount of substance in 1mL of urine
A

B. Plasma cleared of a substance in a time interval

74
Q
  1. Creatinine is a good substance to use for a renal clearance test because it
    A. Is exogenous
    B. S reabsorbed
    C. Is affected by fluid intake
    D. Has constant plasma concertation
A

D. Has constant plasma concertation

75
Q
  1. Which of the following groups would expect to have the greatest 24-hr excretion of creatine?
    A. Infants
    B. Children
    C. Women
    D. Men
A

D. Men

76
Q
  1. Creatinine clearance results are “normalized” using an individual’s body surface area to account for variations in the individuals.
    A. Age
    B. Sex
    C. Dietary intake
    D. Muscle mass
A

D. Muscle mass

77
Q
  1. A 24-hour urine collection is preferred for determination of creatinine clearance because of diurnal variation in the
    A. Glomerular filtration rate
    B. Plasma creatinine
    C. Creatine excretion
    D. Urine excretion
A

A. Glomerular filtration rate

78
Q
  1. Which of the following situations results in an erroneous creatinine clearance measurement?
    A. 1 24-hour urine collection form an individual on a vegetarian diet
    B. 1 24-hour urine collection maintained at room temperature throughout the collection
    C. A plasma sample drawn at the beginning instead of during the 24-hour urine collection
    D. Creatinine determination made using the nonspecific alkaline picrate method (Jaffee reaction)
A

B. 1 24-hour urine collection maintained at room temperature throughout the collection

79
Q
  1. A 45-year-old female African American had her serum creatinine determined using a creatinine method that is not calibrated to an IDMS reference method. Her serum creatinine was 1.5 mg/dL; what is her eGFR using the appropriate MDRD equation?
    A. 40 mL/min 1.73 m^2
    B. 48 mL/min 1.73 m^2
    C. 51 mL/min 1.73 m^2
    D. 54 mL/min 1.73 m^2
A

B. 48 mL/min 1.73 m^2

80
Q
  1. The glomerular filtration rate is controlled by
    A. The renal blood flow
    B. The renal plasma flow
    C. The countercurrent mechanism
    D. Hormones (e.g., aldosterone, antidiuretic hormone)
A

A. The renal blood flow

81
Q
  1. For measurement of renal plasma flow, p-aminohippurate is an ideal substance to use because it
    A. Is easily measured in urine and plasma
    B. Is endogenous and does not require an infusion
    C. Is secreted completely in its first pass through the kidneys
    D. Maintains a constant plasma concentration throughout the test
A

C. Is secreted completely in its first pass through the kidneys

82
Q
  1. What percentage of the total cardiac output is received by the kidneys?
    A. 8 %
    B. 15 %
    C. 25 %
    D. 33 %
A

C. 25 %

83
Q
  1. Measuring the quantity of hydrogen ion excreted as titratable acids and ammonium salts in urine provides a measure of
    A. Tubular secretory function
    B. Tubular reabsorptive function
    C. Glomerular filtration ability
    D. Renal concentrating ability
A

A. Tubular secretory function

84
Q
  1. The oral ammonium chloride test evaluates the ability of the tubules to secrete
    A. Ammonium and chloride
    B. Phosphate and sodium
    C. Bicarbonate and chloride
    D. Ammonia and hydrogen
A

D. Ammonia and hydrogen

85
Q
  1. The following data are obtained from a 60-year-old female who is 4’8” and weights 88 lb.:
    Plasma creatinine: 1.2 mg/dL
    Urine creatinine: 500 mg/L
    Urine volume: 1440 mL/24 hours

A. Calculate the creatinine clearance
B. calculate the normalized creatinine clearance. (Determine the body surface area using equation 4.7)
Are the results normal for this patient?

A

A. 42 mL/min
B. 53 ml/min
C. Yes

86
Q
  1. calculate the osmolar and free-water clearance using the following patient data.
    Serum osmolality: 305 mOm/kg
    Urine osmolality: 250 mOsm/kg
    Urine volume: 300 mL/2 hours
    A. is this individual excreting more water than is necessary for solute removal? Yes/no
    B. is the osmolar clearance “normal” (i.e., 2.0 to 3.0 mL/min)? yes/no
    C. from the free-water clearance result obtained, is the urine hypo-osmotic or hyperosmotic?
A

A. Yes
B. Yes
C. Hypo-osmotic

UA (5 decks)

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