Term 4, CPC 1 Quiz

14 Questions | Total Attempts: 131

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Term 4, CPC 1 Quiz - Quiz

Questions and Answers
  • 1. 
    A 72 year old man has been feeling tired and lethargic for 5 months. He has noted increasing hesitancy with urination. On physical examination his prostate is diffusely enlarged. Laboratory studies show sodium 139 mmol/L, potassium 4.0 mmol/L, chloride 104 mmol/L, creatinine 1.9 mg/dL, and glucose 81 mg/dL. Which of the following renal abnormalities is most likely to be present in this man?
    • A. 

      Cortical atrophy

    • B. 

      Glomerulonephritis

    • C. 

      Papillary necrosis

    • D. 

      Polycystic change

    • E. 

      Renal cell carcinoma

  • 2. 
    A 35 year old woman has experienced urinary frequency with dysuria for the past 4 days. On physical examination she has no flank pain or tenderness. A urinalysis reveals sp. gr. 1.014, pH 7.5, no glucose, no protein, no casts, no blood, nitrite positive, and many WBC's. She has a serum creatinine of 0.9 mg/dL. Which of the following is the most likely diagnosis?
    • A. 

      Lupus nephritis

    • B. 

      Urinary tract lithiasis

    • C. 

      Acute bacterial cystitis

    • D. 

      Malakoplakia

    • E. 

      Urothelial carcinoma

  • 3. 
    A clinical study is performed with paediatric subjects who had minimal change disease. These patients are observed to have prominent periorbital oedema. Laboratory test findings from serum and urine tests are analysed. Which of the following laboratory test findings is most likely to be consistently present in these subjects?
    • A. 

      Nitrite positive urinalysis specimen

    • B. 

      Proteinuria >3.5 gm/24 hours

    • C. 

      Hematuria with >10 RBC/hpf

    • D. 

      Lipiduria in association with hypercholesterolemia

    • E. 

      Renal tubular epithelial cells and casts

  • 4. 
    A 12 year old boy is a member of a family with a history of renal disease, with males more severely affected than females. He is found to have auditory nerve deafness, corneal dystrophy, and ocular lens dislocation. A urinalysis shows microscopic haematuria. A renal biopsy is performed. Microscopically, the glomeruli show glomerular capillaries with irregular basement membrane thickening and attenuation with splitting of the lamina densa. The mesangial matrix is increased and epithelial cells may appear foamy. Which of the following is the most likely diagnosis?
    • A. 

      Goodpasture’s syndrome

    • B. 

      IgA nephropathy

    • C. 

      Alport syndrome

    • D. 

      Dominant polycystic kidney disease

    • E. 

      Diabetes mellitus, type I

  • 5. 
    A clinical study is performed of laboratory findings in subjects with renal diseases. Loss of physiologic function accompanies many diseases. Loss of which of the following renal functions is most likely to be identified by laboratory measurement of the urine specific gravity?
    • A. 

      Filtration

    • B. 

      Reabsorption

    • C. 

      Secretion

    • D. 

      Concentration

    • E. 

      Blood flow

  • 6. 
    A 5 year old boy is noted to have increased puffiness around his eyes for the past week and he has been less active than normal. On physical examination he has periorbital oedema. His BP is 140/90 mm Hg. A urinalysis reveals sp. gr. 1.010, pH 6.5, no glucose, 4+ protein, no blood, no casts, and no ketones. Microscopic urinalysis reveals oval fat bodies, but no WBCs or RBCs. He improves following a course of corticosteroid therapy. Which of the following renal lesions is most likely to have been present in this boy?
    • A. 

      Glomerular crescents

    • B. 

      Fusion of podocyte foot processes

    • C. 

      Patchy tubular necrosis

    • D. 

      Hyperplastic arteriolosclerosis

    • E. 

      Mesangial immune complex deposition

  • 7. 
    A clinical study is performed involving subjects with glomerulonephritis. One group of subjects has a diagnosis of crescentic glomerulonephritis and another group has membranous glomerulonephritis. Which of the following laboratory findings is most likely to be found in the absence of other findings in subjects with membranous glomerulonephritis?
    • A. 

      Rapid onset

    • B. 

      Red blood cell casts

    • C. 

      Oliguria

    • D. 

      Albuminuria

    • E. 

      Hypertension

  • 8. 
    A 50 year old man is hospitalised for acute myocardial infarction. He has decreased cardiac output with hypotension requiring multiple pressor agents. His urine output drops over the next 3 days. His serum urea nitrogen increases to 55 mg/dL, with creatinine of 2.9 mg/dL. Urinalysis reveals no protein or glucose, a trace blood, and numerous hyaline casts. Five days later, he develops polyuria and his serum urea nitrogen declines. Which of the following pathologic findings in his kidneys is most likely to have caused his azotemia?
    • A. 

      Patchy tubular necrosis

    • B. 

      Fusion of podocyte foot processes

    • C. 

      Glomerular crescents

    • D. 

      Hyperplastic arteriolosclerosis

    • E. 

      Mesangial immune complex deposition

  • 9. 
    A clinical study is performed to determine the value of percutaneous renal biopsy. The medical records of subjects with renal diseases are analysed to determine the circumstances in which the results of a renal biopsy facilitated determination of therapy that improved prognosis. In which of the following situations is a percutaneous needle biopsy of the kidney most useful?
    • A. 

      Fever with suspected acute pyelonephritis

    • B. 

      Prostatic hyperplasia with suspected hydronephrosis

    • C. 

      Premature neonate with suspected polycystic kidney; disease

    • D. 

      Suspected renal cyst

    • E. 

      Systemic lupus erythematosus and acute renal failure

  • 10. 
    A 20 year old previously healthy man has been feeling tired for the past 5 days. He goes to his physician when he passes dark-coloured urine. On physical examination his blood pressure is 155/110 mm Hg. Labortory studies show his serum creatinine is 4.4 mg/dL. A urinalysis reveals 3+ blood, 1+ protein, no glucose, and no ketones. On urine microscopic examination there are numerous RBC casts. His condition worsens even with therapy. Which of the following pathologic findings on renal biopsy is most likely to be present in this man?
    • A. 

      Glomerular crescents

    • B. 

      Widened proximal tubules

    • C. 

      Polymorphonuclear infiltrates

    • D. 

      Lipiduria

    • E. 

      IgA deposited in glomerular capillaries

  • 11. 
    A 12 year old boy presents with tiredness, oliguria with dark colour urine. He had just recovered from a sore throat last month and was treated with antibiotic (tetracycline) and antipyretics. His kidney biopsy image is shown for your interpretation. What is the most likely diagnosis?  
    • A. 

      Minimal change disease

    • B. 

      Crescentic glomerulonephritis

    • C. 

      Diffuse proliferative glomerulonephritis

    • D. 

      Membranous glomerulonephritis

    • E. 

      Membranoproliferative glomerulonephritis

  • 12. 
    A 78 year old man with chronic hypertension and diabetes on treatment died following progressive loss of kidney function. His kidney specimen is shown for your interpretation. What is the most likely gross diagnosis?
    • A. 

      Chronic glomerulonephritis

    • B. 

      Benign nephrosclerosis

    • C. 

      Renal Infarction

    • D. 

      Hypertensive haemorrhages

    • E. 

      Malignant hypertension

  • 13. 
    A 25 year old male complains of haematuria after an episode of URTI. He has a history of celiac disease for the past 4 years. Haematuria clears after 3 days only to return again after one month. No remarkable findings on physical examination. Urine analysis shows a ph 6.5, specific gravity 1.018, hematuria 3+, proteinuria1+, no glucose or ketone bodies. Microscopic examination shows Only RBC, no WBC, casts or crystals. A 24 hr urine protein level is 200 mg. What do you expect in renal biopsy from this patient?
    • A. 

      Subepithelial electron dense deposits

    • B. 

      Granular staining of basement membrane

    • C. 

      Mesangial IgA staining by immunofluorescence

    • D. 

      Diffuse proliferation and basement membrane thickening

    • E. 

      Thrombosis in the glomerular capillaries

  • 14. 
    A 54 year old male is having recurrent infections in urinary tract along with polyuria and nocturia. His kidnet biopsy shows the following picture. What is the most likely diagnosis? 
    • A. 

      Diffuse proliferative GN

    • B. 

      Membranous GN

    • C. 

      Minimal change GN

    • D. 

      Rapidly progressive GN

    • E. 

      Nodular glomerulo sclerosis

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