patho review Flashcards
- Osteoporosis commonly occurs in patients with end-stage renal disease because of
Hyperparathyroidism.
- Which of the following categories doesn’t belong to the intrarenal disorders?
Belongs to Intrarenal Disorders:
* Congenital
* Neoplastic
* Infectious
* Obstructive
* Glomerular
- This test identifies gross abnormalities related to size, position, and shape (may show renal calculi).
KUB Xray ( Kidney, ureter and bladder)
- Which is incorrect about autosomal recessive forms of cystic kidney disease?
Cystic kidney diseases
Autosomal recessive forms
Ø Evident at birth
Ø Kidneys enlarged
Ø Respiratory distress or palpable kidneys on physical examination
Ø Severe systemic hypertension
Ø Liver problems
Ø Diagnosis: inheritance pattern with liver biopsy
- Which is false about Nephroblastoma (Wilms’ tumor)?
Nephroblastoma (Wilms’ tumor)
* Most common kidney cancer in children
* Clinical manifestations: identified by palpable abdominal mass; may also have abdominal pain, hypertension, and/or hematuria
* Treatment: nephrectomy, radiation therapy, and chemotherapy
* Excellent cure rate
- The following are normal protective mechanisms against infection in the Urinary tract, except.
Normal protective mechanisms against infection
Ø Acidic pH
Ø Presence of urea in the urine
Ø Men: bacteriostatic prostatic secretions
Ø Women: glands in the distal urethra secrete mucus
Ø Micturition: wash out pathogens
Ø Unidirectional urine flow, prevents reflux
- Which is incorrect about Acute pyelonephritis?
Acute pyelonephritis
* Infection of renal pelvis/parenchyma usually from ascending UTI
* Major risk factor: pregnancy
* Clinical manifestations: CVA tenderness (classic sign) accompanied by fever, chills, N/V, anorexia, which increases fever-induced dehydration
* Urosepsis: organisms in the bloodstream originating from a UTI
* Diagnosis: presence of WBC casts indicative of upper UTI
* Treatment: promptly managed with antimicrobials to avoid decreased renal function
- Which is incorrect about the consequences of complete obstruction in the Kidney?
Consequences:
Ø Hydronephrosis
Ø Decreased GFR
Ø Ischemic kidney damage because of increased intraluminal pressure
Ø Acute tubular necrosis (intrarenal acute renal failure)
Ø Chronic kidney disease
- Which is false about IgA nephropathy (Berger disease)
TRUE:
Ø Most commonly diagnosed
Ø Common in adults
Ø Upper respiratory or gastrointestinal viral infections
Ø Hematuria presents in 1 to 2 days
Ø Prognosis: variable, may progress to end-stage renal disease
- Which is false about Chronic glomerulonephritis?
TRUE:
* Assumes a progressive course ultimately developing into end-stage renal disease
o Sclerosis and fibrosis of kidney
* Present with persistent proteinuria, with or without hematuria, and slowly declining renal function
* Dialysis or kidney transplantation necessary
- Which is false about Nephrotic syndrome?
- Occurs because of increased glomerular permeability to proteins
- Urinary loss of 3 to 3.5 g of protein per day
- Proteinuria leads to hypoalbuminemia and generalized edema; decreased blood colloid oncotic pressure.
- Increase in liver activity can cause hyperlipidemia and hypercoagulability.
- Most common finding: edema
- Treatment: conservative symptom management
- Lipid-lowering agents
- Steroids
- Antihypertensives
- Management of underlying process when identified
- May resolve spontaneously, others progress to end-stage renal disease
- Which is false about Minimal change disease (MCD)?
- Previously called lipoid nephrosis
- Alteration in glomerular podocytes
- Sudden onset of edema, nephrotic levels of protein loss, and hypoalbuminemia
- Responds well to corticosteroids
- Concerning the Stages of chronic kidney disease, which is false?
- The most frequent initial symptom of bladder cancer is
Hematuria
- A ureterocele is
a cystic dilation of a ureter
- Urinary retention with consistent or intermittent dribbling of urine is called
Overflowing Incontinence
- A patient who has difficulty walking without assistance is incontinent of urine when help doesn’t get to her quickly enough. The term for this type of incontinence is
Functional
- Which group is at the highest risk for urinary tract infection?
Active sexually woman
- The difference between stress incontinence and urge incontinence is that stress incontinence
is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.
- The direct cause of stress incontinence is
Pelvic Muscle Weakness
- A patient has ureteral colic. The manifestation that requires immediate notification of the physician is
chills and fever.
- The following are complications of Chronic Kidney Disease, except;
Complications:
* Hypertension and cardiovascular disease
* Uremic syndrome
* Metabolic acidosis
* Electrolyte imbalances
* Bone and mineral disorders
* Malnutrition
* Anemia
* Pain
* Depression
- The normal post-void residual urine in the bladder is
less than 100 mL.
- About the management of Malnutrition in Chronic kidney disease, which of the following is incorrect?
Ø Calories, vitamins, calcium increased
Ø Sufficient carbohydrate and fat to meet energy requirements
Ø Limit dietary phosphorus, protein, sodium, potassium, and water/fluids depending on laboratory values and other clinical manifestations
Ø Limit diet factors that could increase cardiovascular risk
Ø Involving a dietitian is crucial.
- Which is incorrect about Peritoneal dyalisis?
Correct:
Ø Peritoneum serves as the dialyzing membrane
Ø Access: dialysis catheter surgically placed in abdomen
Ø Types: continuous ambulatory peritoneal dialysis (CAPD) and continuous cycling peritoneal dialysis (CCPD)
* CAPD: exchanges performed by patients in their homes and without machines; instills in abdomen
* CCPD: can also be done at home; uses a special machine (cycler); exchanges occur while sleeping
- Absence of menstruation is called
Amenorrhea
- Dysfunctional uterine bleeding (DUB) is due to
absent or diminished levels of progesterone.
- It is true that fibrocystic breast disease
may be exacerbated by methylxanthines
- A breast lump that is painless, hard, and unmoving is most likely
Carcinoma
- The HPV vaccine is recommended for 11- to 12-year-old girls but can be administered to girls as young as _____ years of age.
9
- The most common types of uterine tumors are known as
Leiomyomas (benign fibroid tumors)
- About Transplantation related to chronic kidney disease, which is false?
TRUE:
Ø Potential option for patients with ESRD
Ø Associated with a high degree of success
Ø Allows for increased independence
Ø Return to normal activities of daily living
Ø Normal renal function
Ø Antirejection drug therapy required: immunosuppressants
- Which is false about Chronic kidney disease in older adults?
TRUE:
* Majority of patients diagnosed with CKD are older adults.
* Rates of treated ESRD among the elderly (>80 years) have risen by more than 50% in the last decade.
* Dialysis for elderly is becoming worldwide.
* Comorbid conditions of this population require complex care.
- Which is false about the diagnosis of Micropenis?
Ø Evaluate endocrine abnormalities
Ø Measure serum testosterone, luteinizing hormone, and follicle-stimulating hormone
Ø Prader-Willi syndrome and Kallmann syndrome (hypothalamic-pituitary axis)
Ø Klinefelter syndrome (testicular disorder)
- Which is false about the Urethral Valve Abnormalities?
- Majority of abnormalities occur posteriorly and in distal prostatic urethra.
- Common cause of urinary obstruction in male newborns and infants
- Valves are mucosal folds that resemble thin membranes.
- Valves cause obstruction when child attempts to void.
- The Clinical manifestations of Urethral Valve Abnormalities include all the following except ;
Ø Intrauterine renal failure causing:
* Oligohydramnios (decreased amniotic fluid)
* Pulmonary hypoplasia (incomplete lung development)
* Stillbirth or extreme distress at the time of birth
* Inability to void (normally void within 24 hours of birth)
* Abdominal masses, such as palpable bladder or hydronephrotic kidneys
* Varying degrees of azotemia or renal failure
* Urinary ascites (extravasated urine in the peritoneum)
* Floating bowel on x-ray
- All are secondary causes of erectile dysfunction, except
- Peripheral vascular disease: arterial insufficiency from obstruction, atherosclerosis, stenosis of arteries, vascular endothelial damage
- Endocrine problems: diabetes, pituitary dysfunction (↓ luteinizing hormone, ↓ testosterone, ↑ prolactin)
- Medications: antihypertensives, antihistamines, phenothiazines, some antidepressants
- Trauma: penile fractures, pelvic fractures
- Iatrogenic causes: aortoiliac vascular surgery, radical pelvic cancer surgery
- Psychological causes
- Which false about the etiology of neoplasms of the Penis?
- Rare in the United States: <0.2% cancer cases
- Phimosis resulting from chronic inflammation most common cause
- Extremely low incidence in circumcised men
- 97% squamous cell CA of the glans or inner surface of the foreskin
- Metastasis occurs by lymphatic dissemination.
- Four stages progressing in severity
- Which is false about Hypogonadism
- Incidence: 4 to 5 million
- Cause: primary testicular failure
- Androgen deficiency in the aging male (ADAM) or andropause
o Causes erectile dysfunction (ED), loss of muscle tone, osteoporosis, and lipid metabolism changes - Diagnosis: serum testosterone level
- Treatment: replace testosterone
- The ________ Inflammation of testis from trauma, reflux of sterile urine up the vas deferens or secondary to a bacterial infection
Epididymitis
