Urina 3.3

Question 1

Secondary glomerular diseases include which types of disorders?
A Immunologic
B Metabolic
C Systemic
D Hereditary

Answer 1

C Systemic

Question 2

What type of morphologic change results in the accumulation of a homogeneous eosinophilic extracellular material in the glomeruli?
A Cellular proliferation
B Leukocyte infiltration
C Hyalinization of glomeruli
D Glomerular basement membrane thickening

Answer 2

C Hyalinization of glomeruli

Question 3

The pathogenesis of glomerular damage marked by immune-mediated processes involves
A) B and C
B) antibodies reacting directly with glomerular tissue antigens.
C) antigen-antibody complexes.
D) nong omerular antigens that reside in the glomeru.

Answer 3

C) antigen-antibody complexes

Question 4

Glomerular damage characterized by hematuria, proteinuria, oliguria, azotemia, edema, and hypertension is referred to as
A acute nephritic syndrome.
B nephrotic syndrome.
C IgA nephropathy.
D chronic glomerulonephritis.

Answer 4

A acute nephritic syndrome

Question 5

Glomerular disease associated with lipiduria is known as
A rapidly progressive glomerulonephritis (RPGN).
B nephrotic syndrome.
C chronic glomerulonephritis.
D acute nephritic syndrome.

Answer 5

B nephrotic syndrome

Question 6

The pathogenesis of all of the following forms of primary glomerulonephritis is antibody mediated except
A rapidly progressive glomerulonephritis.
B minimal change disease.
C acute glomerulonephritis.
D membranous glomerulonephritis

Answer 6

B minimal change disease.

Question 7

Her blood pressure is mildly elevated. The creatinine clearance is decreased, with an elevated blood urea nitrogen to creatinine ratio. The clinical history reveals that the child had strep throat several weeks ago and that she appeared to have recovered without incident.

The clinical diagnosis for this patient, based on the history and laboratory results, is
A acute glomerulonephritis.
B nephrotic syndrome.
C IgA nephropathy.
D minimal change disease.

Answer 7

A acute glomerulonephritis.

Question 8

The causative agent of the clinical diagnosis in question 7 is
A) B-hemolytic streptococci.
B) vaccination.
C) allergic reaction.
D) T-cell dysfunction.

Answer 8

A) B-hemolytic streptococci.

Question 9

Which type of glomerulonephritis may develop as a result of a systemic disease, such as systemic lupus erythematosus, or after an infection?
A) Acute glomerulonephritis
B) Membranous glomerulonephritis
C) Focal segmental glomerulosclerosis
D) Rapidly progressive glomerulonephritis

Answer 9

D) Rapidly progressive glomerulonephritis

Question 10

A 50-year-old male presents to his physician, complaining of having had edema, general malaise, fatigue, and anorexia for the past several weeks. The physical examination reveals no other abnormal presentations, except a reported weight gain of 20 pounds in the past 3 days. The clinical history reports no previously existing pathologic conditions. The blood pressure, pulse, and temperature are normal. Blood work and a UA are ordered. The findings include an elevated blood urea nitrogen to creatinine ratio, a decreased creatinine clearance, and a decreased serum protein.

Based on the test results, this clinical presentation and UA report are typical for which of the following conditions?
A) Chronic glomerulonephritis
B) Membranous glomerulonephritis
C) Rapidly progressive glomerulonephritis
D) Acute glomerulonephritis

Answer 10

B) Membranous glomerulonephritis

Question 11

Based on your answer to question 10, the patient is most likely suffering from idiopathic onset of
A) glomerulosclerosis.
B) nephrotic syndrome.
C) nephritic syndrome.
D) IgA nephropathy.

Answer 11

B) nephrotic syndrome

Question 12

The pathogenesis of which systemic disorder involves deposition of a pathologic proteinaceous substance between cells in numerous tissues and organs?
A) Systemic lupus erythematosus
B) Amyloidosis
C) Diabetes mellitus
D) IgA nephropathy

Answer 12

B) Amyloidosis

Question 13

Ischemic acute tubular necrosis (ATN) may result from all of the following conditions except
A crush injuries.
B bacterial infection.
C renal glycosuria.
D severe burns.

Answer 13

C renal glycosuria

Question 14

The four types of renal tubular acidosis involve all of the following pathogeneses except
A increased secretion of calcium carbonate, resulting in hypocalciuria.
B decreased proximal tubular reabsorption of bicarbonate.
C inability to maintain the hydrogen ion gradient and inability to increase tubular ammonia secretion.
D impaired ability to exchange sodium for potassium and hydrogen.

Answer 14

A increased secretion of calcium carbonate, resulting in hypocalciuria.

Question 15

A 65-year-old male is admitted to the hospital suffering from azotemia, hyperkalemia, metabolic acidosis, and oliguria. The patient is currently being treated with an aminoglycoside for a urinary tract infection. The physician suspects toxic tubular necrosis and expects to see which of the following listed on the urinalysis report?
• Low specific gravity
• Proximal renal tubular cell
• Broad casts
• Bacteria

Answer 15

• Proximal renal tubular cell

Question 16

One of the most common causes of Fanconi’s syndrome is
• cystinosis.
• nephrotoxins.
• rhabdomyolysis.
• glycosuria.

Answer 16

• cystinosis.

Question 17

Which of the following is another name for the inherited dominant sex-linked disorder, vitamin D-resistant rickets?
Renal phosphaturia
Renal cystinosis
Renal glycosuria
Renal tubular acidosis (RTA)

Answer 17

Renal phosphaturia

Question 18

An active, vibrant, 85-year-old female is brought to the clinic by her daughter, who states that her mother has been experiencing mental confusion and distress. No other signs or symptoms are reported. The physical examination notes no abnormalities; temperature, pulse, and blood pressure all are normal. A urinalysis is ordered, which produces the following results

Based on these results, the patient’s confused mental state and anxiety most likely are due to

A) age-related dementia.
B pyelonephritis.
C cystitis.
D glomerulonephritis.

Answer 18

C cystitis.

Question 19

The most common pathogen in UTIs is
• Escherichia coli.
• Pseudomonas sp.
• Enterococci.
• Enterobacter sp.

Answer 19

• Escherichia coli

Question 20

23-year-old female presents to the ED with sudden onset of flank and back pain, dysuria, and urgency. She is febrile and has chills, nausea, and headache. She reports no illnesses in the preceding weeks, and she currently is not taking any

Based on the clinical signs and symptoms and the UA results, the most likely diagnosis is
A acute pyelonephritis.
B acute cystitis.
C renal calcull.
D acute glomerulonephritis.

Answer 20

A acute pyelonephritis

Question 21

The progressive loss of the GFR in chronic renal failure clinically presents when the patient shows which of the following?

A Decreased renal perfusion
B Atherosclerosis of intrarenal arteries
C Increased frequency of UTIs
D Loss of 80% to 85% of normal renal function

Answer 21

D Loss of 80% to 85% of normal renal function

Question 22

Which of the following plays an important role in the formation of renal calculi?
A Isosthenuria
B Hypotonicity of urine
C Decreased nucleation
D Isohydruria

Answer 22

D Isohydruria

Question 23

Which of the following inherited diseases gives the urine a characteristic mousy or musty odor?
A Maple syrup urine disease
B Cystinosis
C Alkaptonuria
D Phenylketonuria

Answer 23

D Phenylketonuria

Question 24

A 35-year-old man presents to his physician with complaints of pain in his spine and large joints that has been progressively worsening over the past 6 months. He also points out that his ears are getting darker in color. He sheepishly reveals that, to conserve water, he does not always flush the toilet after urination, and he has noticed that when he voids, the urine is yellow, but when he comes back later, it has changed to a much darker color. The physician orders a gas chromatography-mass spectrometry analysis on the patient’s urine. The results are positive for
A tyrosine.
B melanin.
C catecholamines.
D homogentisic acid.

Answer 24

D homogentisic acid.

Question 25

Which condition produces a pale urine with a high specific gravity?
A Porphyria
B Diabetes mellitus
C Galactosuria
D Diabetes insipidus

Answer 25

B Diabetes mellitus

Question 26

Neonatal screening tests are routinely performed for which condition to prevent mental retardation through dietary restrictions?
1. Galactosemia
2. Maple syrup disease
3. Phenylketonuria
4. Cystinosis
A 1, 2, and 4
B 2, 3, and 4
C 1 and 3
D 2 and 4

Answer 26

C 1 and 3

Question 27

A 21-year-old female presents at the university clinic with complaints of increased thirst, urination, and hunger. She says that she eats constantly, yet she has lost about 10 pounds and her weight is down to 100 pounds. She is tired all the time, and her vision is a little blurry. She also reports that her urine smells “sort of fruity.” Her blood pressure, temperature, and pulse all are normal at the time of examination. The patient’s past clinical history reveals no previous disease conditions. Urinalysis and blood work are ordered. Her blood glucose level is 600 mg/dL, and the UA results are as follows

Based on the clinical symptoms and laboratory results, the most likely diagnosis is
A diabetes insipidus.
B) renal tubular acidosis.
C type 2 diabetes.
D type 1 diabetes.

Answer 27

D type 1 diabetes.

Question 28

What is the distinguishing clinical feature of the type of porphyria that results in the accumulation of porphyrins?
A Nephropathy
B Photosensitivity
C Neurologic symptoms
D Mental retardation

Answer 28

B Photosensitivity

Question 29

Reflux nephropathies can result in
A renal tubular acidosis.
B acute tubular necrosis.
C acute glomerulonephritis.
D chronic pyelonephritis.

Answer 29

D chronic pyelonephritis