OS 206 E3 Samplex 2010 Flashcards
This statement describes a normal kidney.
A. The superior pole of the right kidney is
palpable by bimanual examination,
B. Its lateral border is almost on the same plane
horizontally as the medial border.
C. It has an average size of 10 X 5 X 2.5 with
equal corticomedullary thickness on
ultrasound.
D. Its immediate covering after the fibrous
capsule is the perirenal fat layer.
E. It becomes retroperitoneal after it has
migrated to the posterior abdominal wall.
D
A patient sustained a stab wound in the right
subcostal area. On exploration, the kidney was
lacerated at its anteromedial surface. The
following are possible expected associated
injuries. Which is unlikely?
A. perforation of the hepatic flexure of the colon
B. perforation of the third part of the
duodenum
C. laceration of the inferior surface of the liver
D. transection of the renal pelvis
B
How is the renal pelvis related to the renal artery
and renal vein at the hilum of the kidney?
A. The renal vein is anterior to the renal
artery and renal pelvis.
B. The renal artery is mainly posterior to the
renal pelvis.
C. The renal vein is posterior to the renal artery.
D. There is no constant disposition of the
structures in the renal hilum
A
Dissection of extravasated blood from a lacerated
kidney will seep through the perirenal fat before it
contacts the Gerota’s fascia. There will be a
preferential passage of the blood in this direction when the fascia remains intact.
A. medially across the midline to the other
kidney
B. inferiorly towards the pelvis
C. laterally into the posterior abdominal wall
D. superiorly into the hapatorenal fossa
A
This statement describes the renal pelvis.
A. It is formed by the union of the major and
minor calyces.
B. It is located mainly within the renal sinus.
C. It tapers distally as it merges distinctively
with the ureter.
D. It hardly becomes dilated in obstruction of
the middle third of the ureter.
E. It cannot be clearly delineated from the
ureter on contrast examination of the urinary
system.
B
The renal plexus of nerves has contributions from
the following EXCEPT
A. celiac ganglion and aortic plexus
B. celiac plexus
C. splanchnic nerves
D. testicular plexus
D
A 1.5 mm renal stone that has migrated down the
renal pelvis can most likely be radiologically
found to be impacted at which area?
A. L2 level
B. area of the urinary bladder
C. at the pelvic brim
D. at the level of the coccyx
B
The only true ligament that provides support for
the urinary bladder.
A. pubovesical ligament B. puboprostatic ligament C. median umbilical folds D. middle umbilical ligament E. A and B
E
An important landmark used to identify the
ureteral orifices when viewing the interior of the
bladder by means of an endoscope
A. interureteric fold B. the vulva of the bladder C. the apex of the trigone D. torus tubarius E. the junction of the smooth and wrinkled mucosa
A
A prostatic malignancy may spread
hematogenously to the following areas. Which is
an unlikely site?
A. the lumbar vertebrae
B. the liver
C. the lungs
D. the sacral bones
B
The urinary bladder derives its nerve supply from
the following EXCEPT
A. pelvic splanchnic nerves
B. vesical plexus
C. sympathetic fibers from T11 to L2
D. sacral plexus
D
Normally when the bladder is distended, there is
no reflux of urine from the urinary bladder to the
ureters because of
A. the presence of a sphincter in the ureteral
orifice
B. the presence of a detrusor muscle in the
bladder
C. the oblique entry of the ureter into the
substance of the bladder wall
D. the insertion of the ureter into the upper part
of the bladder wall
E. the tonic contraction of the ureter itself
C
Blood filtered by the kidney will be excreted as
urine which will have this directional flow
A. minor calyx > renal papillae > renal pelvis >
renal sinus > ureter
B. minor calyx > major calyx > renal sinus >
renal pelvis > ureter
C. renal papillae > minor calyx > major calyx > renal sinus > renal pelvis
D. renal papillae > minor calyx > major calyx > renal pelvis > ureter
E. renal papillae > renal sinus > major calyx > renal pelvis > ureter
D
During left nephrectomy on removal of a
diseased kidney, the renal vein must be ligated
as far as possible from its drainage site to avoid
compromising the venous drainage of the other
structures that drain into the renal vein. These
would include the following EXCEPT
A. diaphragm
B testis
C. spleen
D. suprarenal gland
C
Which anatomic structure is usually not visible on
a contrast film of the abdomen?
A. Stomach
B. Psoas
C. Ureter
D. Bowel
C
In a normal adult, the kidneys usually lie along
the length of which vertebral bodies?\
A. T11 to L3
B. T9 to T12
C.L1 to L4
D. T10 to L1
A
Which statement is not true of phleboliths?
A. They are vascular structures seen in the face.
B. They have a radiolucent central area
surrounded by a more radiodense periphery
C. They may be mistaken for calculi.
D. They are calcified arteries.
D
The outline of the renal shadows are visible on a
plain film of the abdomen because of the:
A. low density of perirenal fat
B. uptake of contrast by the kidneys
C. low soft density of the tissues of the psoas
D. presence of surrounding bowel gas
A
The following layers of tissue surround each
kidney EXCEPT
A. renal capsule
B. fibrous tissue
C. perirenal fat
D. perirenal fascia or Gerota’s fascia
B
Which statement is false regarding the normal
renal long axis orientation?
A. On the front plane the renal axis is oriented
downward and outward.
B. The kidneys are parallel to the lateral border of
the psoas muscle on either side.
C. In the lateral plane, the renal long axis is
oriented downward and anteriorly.
D. In the lateral plane, the lower renal pole is 2
– 3 cm posterior to the upper pole.
D
The isotope most common used for visualization
of the urinary tract on radiographic examination is
A. Calcium
B. Iodine
C. Strontium
D. Technicium
B
Stones tend to lodge and cause obstruction in the
following portions of the ureter EXCEPT in the:
A. ureteropelvic junction
B. ureterovesical junction
C. region of bifurcation of the illiac vessels
D. midportion of the ureter
D
Common findings on an intravenous spyelogram
in patients with hydronephrosis are the following
except:
A. flattening of the normal concavity of the calyx
B. reversal of the normal convexity of the papillae
C. atrophy of the renal pelvis
D. enlarged calyces
C
Which statement does not describe the perirenal
fascia?
A. It encloses the perirenal fat.
B. It is also known as Gerota’s fascia.
C. It anchors the kidney to its surrounding
structures and to the abdominal wall.
D. It is the innermost of the three tissue layers
that surround the kidney.
D
The functional unit of the kidney is the:
A. renal corpuscle
B collecting tubule
C. Uriniferous tubule
D. juxtamedullary nephron
C
The visceral layer of the Bowman’s capsule is
believed to originate from:
A. mesoderm
B. metanephros
C. endoderm
D. glomerular basement membrane
B
Which is/are true regarding mesangial cells?
A. contain actin and myosin
B. possess phagocytic functions
C. can contract and respond to angiotensin ll
D. all of the above
D
The glomerular endothelium is negatively
charged due to
A. podocalyxin
B. fibronectin
C. heparan sulphate
D. laminin
A
In minimal change disease, albumin is able to
pass through the glomerular filtration barrier. The
albumin passes through the glomeular filter in
this order:
A. podocyte > glomerular basement membrane > endothelium
B. endothelium > glomerular basement membrane > foot process
C. lamina rara externa > lamina densa > lamina rara interna
D. lamina rara interna > lamina densa > lamina rara externa
B
Which is not true regarding the renal caps
A. The parietal layer of Bowman’s capsule is
lined by simple squamous epithelium
B. The visceral layer of Bowman’s capsule is
lines by specialized stellate cells called
podocytes.
C. The efferent arteriorle has a wider diameter
than theafferent arteriole to allow a
pressure gradient to be maintained
across the glomerulos.
D. At the vascular pole, the podocyte layer of the
glomerular capillaries becomes continuos
with the parietal layerof the Bowman’s
capsule.
C
Which is true regarding the renal tubule?
A. It extends from the renal capsule to the papilla.
B. It is lined by transitional epithelium.
C. It is capable only of selective reabsorption of
water and solute.
D. It has four distinct histophysiological
zones each one which performs different
functions.
D
Which is not characteristic of proximal tubule cell?
A. simple cuboidal
B. clear cytoplasm
C. brush borders
D. basolateral interdigitations
B
Which specialized cells of the juxtaglomerular
apparatus respond to changes in luminal sodium
chloride concentration and glomerular filtrate
volume?
A. macula densa in the distal convoluted
tubule
B. lacis cells in the junction between DCT and
affrent arteriole
C. juxtaglomerular cells of the afferent arteriole
D. all of the above
A
What type of epithelium lines a distended urinary
bladder?
A. cuboidal
B. columnar
C. transitional
D. stratified squamous
C
What structures in transitional epithelium provide
an effective osmotic barrier between the urine in
the bladder and the underlying connective
tissue?
A. desmosomes
B. pedicels
C. lysosomes
D. pinocytic vesicle
A
The synctial arrangement of the detrusor muscle
is important for
A. maintaining compliance during the filling phase
B. sustained and complete emptying during
voiding
C. prevention of urine from going back to the
kidneys
D. prevention of urine leakage during the storage
phase
B
The behavior of the lower of the lower urinary
tract organs during normal voiding
A. Detrusor relaxation coupled with sphincter
relaxation
B. Detrusor contraction coupled with sphincter
contraction
C. Detrusor contraction coupled with
sphincter relaxation
D. Detrusor relaxation coupled with sphincter
contraction
C
Damage to the pudendal nerves often results in
A. difficulty in urination
B. leakage of urine during coughing
C. continuous urinary leakage
D. frequent urination
B
During the storage phase , the following event occurs
A. detrusor muscle contracts B. hyposgastric nerve stimulates the internal urethral sphincter C. the cerebral cortex sends inhibitory impulses to the pons D. trigonal muscle contracts
C
During the normal voiding phase, the following
events occur
A. pelvic floor muscles contracts
B. Pudendal nerve stimulates
rhabdomyosphincter
C. pelvic nerve sends signals to the detrusor
D. hypogastric nerve relaxes trigonal muscles
D
During the filling phase the inherent action of the
suprasacral spinal cord prevails manifesting as
A. Internal rethral sphincter is inhibited by the
hypogastric nerve
B. Detrusor contraction is inhibited
C.pudendal nerve stimulation of the pelvic
floor is inhibited
D. pelvic nerve stimulates the detrusor
C
The ability of the detrusor to maintain low
pressure as it fills up with urine is brought about
by
A. elastin content of the submucosal layer
B. fast conduction of its nerve impulses across its
gap junctions
C. syncitial arrangement of its fibers
D. constant inherent pelvic nerve stimulation
A
The earliest event during normal voiding is
A. Detrusor contraction
B. bladder neck relaxation
C. rhabdomyosphincter relaxation
D. pelvic floor muscle relaxation
B
The most important event occurring during stress
conditions to the bladder (e.g. coughing) which
prevents urinary leakage
A. detrusor relaxation
B. pelvic muscle floor relaxation
C. cortical inhibition of the pons
D. contraction of the rhabdomyopsphincter
D
The richly folded urethral epithelium and the
spongy tissue within the submucosa contribute to
this phenomenon that promotes continence
among women
A. reflex resting pressur of the urethra
B. urethrovesical angualtion
C. intrapelvic position of the urethra
D. urethral seal effect
D
The water content in the body is generally higher
in
A. females than males B. a two-year old baby than a newborn C. a lean than an obese person D. an eighteen year old than a twenty-five year old male
C
The interstitial fluid volume of a 70 kg male would
be about
A. 18 liters
B. 14.5 liters
C. 10.5 liters
D. 3.5 liters
C
Major difference between the composition of
interstitial fluid and that of plasma
A. higher sodium concentration in interstitial fluid
B. higher protein concentration in plasma
C. higher chloride concentration in plasma
D. higher calcium concentration in interstitial fluid
B
A patient has the following data:
Plasma [ Na+] 125 meq/L
[glucose] 108 mg/dl
BUN 140 mg/dl
What would be the above patient’s plasma
osmolality?
A. 250 mosm/kg
B. 256 mosm/kg
C. 300 mosm/kg
D. 306 mosm/kg
D
A patient has the following data:
Plasma [ Na+] 125 meq/L
[glucose] 108 mg/dl
BUN 140 mg/dl
Which of the following is true with regarding the
above patient?
A. There will be a shift of water from ICF to ECF.
B. There will be a shift of water from ECF to ICF.
C. ADH release is stimulated
D. Aldosterone release is inhibited
B
