P21b Likely 10

1. Cystitis is more common in females due to:

A. the mucosa in the urinary tract is continuous

B. the urethra is short, wide, and adjacent to areas with resident flora

C. the pH of urine is more acidic in females

D. females have a higher incidence of congenital anomalies

2. Which of the following is a significant indicator of renal insufficiency?

A. urine with pH of 5

B. increased serum urea and creatinine

C. urine with high specific gravity

D. increased blood pressure

3. The normal pH of urine is:

A. 7.35-7.45

B. 4.5- 8.0

C. 1.5-7.5

D. 1.0-7.0

4. Reduced urine output resulting from inflammation and necrosis of the tubules is called:

A. oliguria

B. anuria

C. pyuria

D. polyuria

5. Which of the following relates to polycystic kidney disease?

A. It affects only one of the kidneys.

B. It results in gradual degeneration and chronic renal failure.

C. The kidneys are displaced and the ureters are twisted.

D. The prognosis is good because there is adequate reserve for normal life.

6. What is a cause of acute tubule necrosis and acute renal failure?

A. prolonged circulatory shock

B. sudden significant exposure to nephrotoxins

C. crush injuries or burns

D. all of the above

7. Choose the basic cause of osteodystrophy associated with chronic renal failure.

A. development of hypercalcemia

B. deficit of parathyroid hormone

C. failure of the kidney to activate vitamin D

D. excessive loss of phosphate ion

8. Uncontrolled essential hypertension may cause chronic renal failure because of:

A. predisposition to recurrent urinary tract infections

B. damage to afferent arterioles and renal ischemia

C. failure of tubules to respond to hormonal controls

D. glomerular congestion causes damaged capillaries

9. Uremic signs of renal failure include all of the following EXCEPT:

A. encephalopathy

B. congestive heart failure

C. osteodystrophy

D. azotemia and acidosis

10. In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from:

A. the antecedent infection

B. type III hypersensitivity reaction

C. ascending infection from the bladder

D. spread of infection from the tubules

11. Which of the following would likely cause chronic renal failure?

A. cystitis with pyelonephritis in the right kidney

B. circulatory shock

C. persistent bilateral glomerulonephritis

D. obstruction of a ureter by a renal calculus

12. The reabsorption of water and electrolytes by the kidneys is directly controlled by: 1. atrial natriuretic hormone 2. antidiuretic hormone 3. angiotensin 4. the levels of bicarbonate ion

A. 2 only

B. 3 only

C. 1, 2

D. 2, 4

E. 1, 3, 4

13. Which of the following indicate a decreased GFR?

A. increased serum urea and decreased serum bicarbonate

B. urine with low specific gravity and dark color

C. albuminuria and hematuria

D. hyponatremia and hypokalemia

14. What causes polyuria during the stage of renal insufficiency?

A. loss of tubule function

B. increased blood pressure

C. decreased aldosterone secretion

D. increased GFR

15. Which of the following does NOT usually result from nephrosclerosis?

A. secondary hypertension

B. chronic renal failure

C. acute renal failure

D. increased renin and aldosterone secretions

16. Which factor contributes to severe anemia in individuals with chronic renal failure?

A. increased erythropoietin secretion

B. limited protein intake

C. compensatory increase in bone marrow activity

D. inability to absorb Vitamin B12 and iron

17. When acidosis becomes decompensated in renal failure, a key indicator is:

A. increased PCO2

B. increased bicarbonate ion

C. serum pH dropping below 7.35

D. serum buffer ratio of 20 bicarbonate ion to 1 carbonic acid

18. What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?

A. decreased parathyroid hormone secretion

B. insufficient calcium in the diet

C. excessive excretion of calcium ions in the urine

D. a deficit of activated vitamin D and hyperphosphatemia

19. Autoregulation in the kidneys refers to:

A. control of blood flow by the sympathetic nervous system

B. the secretion of renin and activation of angiotensin

C. local minor reflex adjustments in the arterioles to maintain normal blood flow

D. the control of systemic blood pressure by the kidneys

20. Which of the following results from decreased blood flow into the kidneys?

A. decreasing blood pressure

B. dilation of the afferent arterioles

C. decreased aldosterone secretion

D. increased angiotensin and systemic vasoconstriction

21. Which of the following causes acute renal failure?

A. polycystic kidney disease

B. pyelonephritis in the right kidney

C. nephrosclerosis

D. bilateral acute glomerulonephritis

22. In acute post-streptococcal glomerulonephritis, the inflammation causes:

A. increased permeability of the glomerular capillaries

B. glomerular congestion and decreased GFR

C. decreased blood pressure and edema

D. a, b

E. a, c

23. Which of the following is NOT likely to lead to hydronephrosis?

A. renal calculi

B. pyelonephritis

C. nephrosclerosis

D. benign prostatic hypertrophy

24. Which of the following congenital defects is a common cause of cystitis in young children?

A. polycystic kidney

B. horseshoe kidney

C. hypoplasia of the kidney

D. vesicoureteral reflux

25. Agenesis is often not diagnosed because:

A. the kidney is displaced from its normal position

B. it is a genetic defect and asymptomatic until mid-life

C. the two functioning kidneys are fused together

D. one kidney provides more than adequate function

26. Which of the following indicates the early stage of acute renal failure?

A. polyuria with urine a fixed, low specific gravity

B. hypotension and increased urine output

C. development of decompensated acidosis

D. very low GFR and increased serum urea