Alterations of Renal, Urinary Tract, and Digestive Function – Flashcards
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how does progressive nephrons injury affect angiotensin 2 activity
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it is elevated
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which mineral accounts for the most common type of renal stone
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calcium oxalate
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regarding the formation of renal calculi, what fx does pyrophosphate, potassium citrate, and magnesium perform
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they inhibit crystal growth
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hypercalciuria is primarily attributable to which alteration
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intestinal hyperabsorption of dietary calcium
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detrusor hyperreflexia develops from neurologic disorders that orginate where
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above the pontine micturition center
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considering the inneravtion of the circular muscles of the bladder neck, which classifications of drug is used to treat bladder neck obstruction
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alpha adrenergic blocking medications
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renal cell carcinoma, classified as clear cell tumors, arises from epithelial cells in which structure
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proximal tubule
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bladder cancer is associated with the gene mutation of which gene
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TP53
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what is the most common cause of uncomplicated UTI's
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E. coli
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which differentiating sign is required to make the diagnosis of pyelonephritis from that of cystitis
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urinalysis confirmation of white blood cell casts
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considering host defense mechanisms, which element in the urine is bacteriostatic
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high urea
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which clinical manifestations of a UTI may be demonstrated in an 85 year old individual
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confusion and poorly localized abdominal discomfort
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pyelonephritis is usually caused by which type of organism
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bacteria
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which abnormal lab value is found in glomerular disorders
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elevated creatinine concentration
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which glomerular lesion is characterized by thickening of the glomerular capillary wall with immune deposition of IgG and C3
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membranous
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goodpasture syndrome is an example of which of the following
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antiglomerular basement mmebrane disease
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a pt. exhibits symptoms including hematuria with red blood cell casts and proteinuria exceeding 3 to 5 grams/day, with albumin as the major protein. these data suggests the presence of which disorder
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glomerulonephritis
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18. Hypothyroidism, edema, hyperlipidemia, and lipiduria characterize which kidney disorder?
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nephrotic syndrome
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Which antibiotics are considered "major culprits" in causing nephrotoxic acute tubular necrosis (ATN)?
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gentamicin and tobramycin
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Which urine characteristics are indicative of acute tubular necrosis (ATN) caused by intrinsic (intrarenal) failure?
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urine sodium > 30 mEq/L
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How are glucose and insulin used to treat hyperkalemia associated with acute renal failure?
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when insulin transports glucose into the cell, it also carries potassium with it
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Creatinine is primarily excreted by glomerular filtration after being constantly released from what type of tissue?
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Muscle
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Which statement is false concerning the skeletal alterations caused by chronic renal failure when the glomerular filtration rate (GFR) declines to 25% of normal?
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The parathyroid gland is no longer able to secrete sufficient parathyroid hormone.
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Anemia of chronic renal failure can be successfully treated with which element?
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Erythropoietin
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When the right kidney is obstructed, how will the glomeruli and tubules in the left kidney compensate?
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increase in size
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What medical term is used to identify a functional urinary tract obstruction caused by an interruption of the nerve supply to the bladder?
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neurogenic bladder
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Where in the brain is the vomiting center located?
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medulla oblongata
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2. Antiemetic agents, such as domperidone and haloperidol, are antagonists for which receptors?
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dopamine
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What type of vomiting is caused by the direct stimulation of the vomiting center by neurologic lesions involving the brainstem?
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projectile
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Considering the normal frequency of bowel evacuation, how infrequently can evacuation occur and still be considered within normal range?
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once a week
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5. How many stools per day are considered the upper limits of normal?
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three
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6. The adult intestine processes approximately how many liters of luminal content per day?
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9
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7. A person who has cholera would be expected to have which type of diarrhea?
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secretory
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8. What type of diarrhea is a result of lactase deficiency?
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osmotic
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9. Which statement is false concerning how abdominal pain is produced?
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Low concentrations of anaerobes, such as Streptococci, Lactobacilli, Staphylococci, Enterobacteria, and Bacteroides, produce abdominal pain.
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10. How can abdominal pain that is visceral in nature best be described?
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Abdominal pain that is visceral in nature is diffused, vague, poorly localized, and dull.
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11. What is the cause of gastroesophageal reflux disease?
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Zone of low pressure of the lower esophageal sphincter
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12. What term is used to identify frank bleeding of the rectum?
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Hematochezia
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13. What is the cause of functional dysphagia?
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neural or muscular disorders
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14. What is the cause of reflux esophagitis?
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delayed gastric emptying
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15. By what mechanism does intussusception cause an intestinal obstruction?
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Telescoping of part of the intestine into another section of intestine, usually causing strangulation of the blood supply
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16. What is the most immediate result of a small intestinal obstruction?
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distention
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An intestinal obstruction at the pylorus or high in the small intestine causes metabolic alkalosis by causing which outcome?
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Excessive loss of hydrogen ions normally absorbed from gastric juices
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what are the cardinal symptoms of small intestinal obstruction?
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Colicky pain caused by distention, followed by vomiting
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19. What is a cause of chronic antral gastritis?
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Helicobacter pylori bacteria
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20. What is the primary cause of peptic ulcers?
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helicobacter pylori
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21. A peptic ulcer may occur in all of the following areas except the:
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jejunum
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22. Which statement is false regarding the contributing factors of duodenal ulcers?
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gastric emptying is slowed, causing greater exposure of the mucosa to acid
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After a partial gastrectomy or pyloroplasty, clinical manifestations that include increased pulse, hypotension, weakness, pallor, sweating, and dizziness are the results of which mechanism?
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Rapid gastric emptying and the creation of a high osmotic gradient in the small intestine, causing a sudden shift of fluid from the blood vessels to the intestinal lumen
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24. Which statement is consistent with dumping syndrome?
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Dumping syndrome usually responds well to dietary management.
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25. What stimulates the desire to eat?
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Agouti-related protein (AgRP)
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26. Which structure regulates eating behavior and energy metabolism?
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Hypothalamus
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27. Which symptom is characteristic of bulimia nervosa?
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recurrent episodes of binge eating with fears of not being able to stop eating
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28. The most common clinical manifestation of portal hypertension is what type of bleeding?
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Esophageal
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29. What is the most common manifestation of portal hypertension-induced splenomegaly?
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Thrombocytopenia
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30. Which statement is false concerning the accumulation of fluid in the peritoneal cavity?
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Circulating nitric oxide causes vasoconstriction, which forces fluid from the capillaries into the peritoneal cavity.
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Which statement is false regarding the sources of increased ammonia that contribute to hepatic encephalopathy?
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Accumulation of short-chain fatty acids that is attached to ammonia is a source of increased ammonia.
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32. Hepatic fat accumulation is observed in which form of cirrhosis?
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Alcoholic
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33. Which statement is false concerning the pathophysiologic process of alcoholic cirrhosis?
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Inflammation and damage leading to cirrhosis begin in the bile canaliculi.
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34. Which statement is false regarding the pathophysiologic process of acute pancreatitis?
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Acute pancreatitis is an autoimmune disease in which immunoglobulin G (IgG) coats the pancreatic acinar cells; consequently, the pancreatic enzymes destroy the cells.
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The mutation of which gene is an early event associated with the pathogenetic origin of esophageal cancer?
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TP53
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36. Obesity is defined as a body mass index (BMI) greater than what measurement?
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30
