Ch. 12 Fitzgerald Renal Disorders 4th edition – Flashcards
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All of the following electrolyte disorders are commonly found in a person with chronic renal failure except: A. hypernatremia B. hypercalcemia C. hyperkalemia D. hypophosphatemia (Ch. 12 Fitzgerald)
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D
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All of the following are common precipitating factors in acute renal failure except: A. anaphylaxis B. infection C. myocardial infarction D. type 1 diabetes (Ch. 12 Fitzgerald)
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D
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Common causes of chronic renal failure include all of the following except: A. type 2 diabetes B. recurrent pyelonephritis C. hypotension D. polycystic kidney disease (Ch. 12 Fitzgerald)
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C
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The use of which of the following medications can precipitate acute renal failure in a patient with bilateral renal artery stenosis? A. corticosteroids B. angiotensin II receptor antagonists C. beta-adrenergic antagonists D. cephalosporins (Ch. 12 Fitzgerald)
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B
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A 78 year old man presents with fatigue and difficulty with bladder emptying. Examination reveals a distended bladder but is otherwise nremarkable. The blood urea nitrogen (BUN) is 88mg/dL (3.14 mmol/L); the creatininge is 2.8 mg/dL (247.5 umol/L). This clinical assessment is most consistent with A. prerenal azotemia B. acute glomerulonephritis C. acute tubular necrosis D. postrenal azotemia (Ch. 12 Fitzgerald)
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D
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A 68 year old woman with heart failure presents with tachycardia, S3 heard sound and basilar crackles bilaterally. Blood pressure is 90/68 mm Hg; BUN is 58 mg/dL (20.7 mmol/L); creatinine is 2.4 mg/dL (212.1 umol/L). This clinical presentation is most consistent with A. prerenal azotemia B. acute glomerulonephritis C. acute tubular necrosis D. postrenal azotemia (Ch. 12 Fitzgerald)
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A
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Which of the following is found early in the development of chronic renal railure? A. persistent proteinuria B. elevated creatinine level C. acute uremia D. hyperkalemia (Ch. 12 Fitzgerald)
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A
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You see a 63 year old man with a suspected upper gastrointestinal bleed. Expected laboratory findings would include: A. elevated BUN; elevated serum creatinine B. normal BUN; elevated serum creatinine C. elevated BUN; normal serum creatinine D. lowered BUN; elevated serum creatinine (Ch. 12 Fitzgerald)
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C
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Angiotensin-converting enzyme inhibitors can limit the progression of some forms of renal disease by: A. increasing intraglomerular pressure B. reducing efferent arteriolar resistance C. enhancing afferent arteriolar tone D. increasing urinary protein excretion (Ch. 12 Fitzgerald)
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B
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Objective findings in patients with glomerulonephritis include all of the following except: A. edema B. urinary red blood cell (RBC) casts C. proteinuria D. hypotension (Ch. 12 Fitzgerald)
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D
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An inrease in creatinine from 1 to 2 mg/dL is typically seen with a _ loss in renal function A. 25% B. 50% C. 75% D. 100% (Ch. 12 Fitzgerald)
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B
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Creatinine clearance usually: A. approximates glomerular filtration rate (GFR) B. does not change as part of normative aging C. is greater in women compared with men D. increases with hypotension (Ch. 12 Fitzgerald)
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A
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Creatinine is best described as A. a substance produced by the kidney. B. a product related to skeletal muscle metabolism C. produced by the liver and filtered by the kidney D. a by-product of protein metabolism (Ch. 12 Fitzgerald)
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B
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Guidelines recommend considering initiating treatment with an erythropoiesis-stimulating agent (ESA) for patients with chronic renal failure and a hemoglobin (Hg) level: A. less than 8.5 mg/dL B. less than 9.0 mg/dL C. less than 10 mg/dL D. less than 11.5 mg/dL (Ch. 12 Fitzgerald)
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C
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Which of the following hemograms would be expected for a 75 year old woman with anemia and chronic renal failure? A. Hg=9.7 g/dL (12 to 14 g/dL); MCV=69 fL (80 to 98 fL); reticulocytes = 0.8% (1% to 2%) B. Hg=10.2 g/dL (12 to 14 g/dL); MCV=104 fL (80 to 98 fL); reticulocytes = 1.2% (1% to 2%) C. Hg=9.4 g/dL (12 to 14 g/dL); MCV=683 fL (80 to 98 fL); reticulocytes = 0.7% (1% to 2%) D. Hg=10.4g/dL (12 to 14 g/dL); MCV=94 fL (80 to 98 fL); reticulocytes = 2.6% (1% to 2%) (Ch. 12 Fitzgerald)
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C
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Which of the following is the most likely candidate to initiate dialysis due to chronic kidney disease (CKD)? A. a 46 year old man with hypertension and GFR=42 mL/min B. A 64 year old woman with type 2 diabetes and GFR=28mL/min C. A 76 year old man with anemia and GFR=55mL/min D. A 58 year old woman with heart disease and GFR=46 mL/min (Ch. 12 Fitzgerald)
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B
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Risk factors for acute glomerulonephritis include all of the following except: A. bacterial endocarditis B. Goodpasture's syndrome C. Crohn's disease D. polyarteritis (Ch. 12 Fitzgerald)
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D
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Poststreptococcal glomerulonephritis typically occurs how long following a bacterial pharyngitis infection? A. 4 to 6 days B. 1 to 2 weeks C. 3 to 4 weeks D. 2 month (Ch. 12 Fitzgerald)
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B
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Diagnostic confirmation of glomerulonephritis typically requires: A. urinalysis plus a CBC with diff B. abdominal CT scan C. kidney ultrasound D. kidney biopsy (Ch. 12 Fitzgerald)
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D
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A 35 year old man presents with edema of the face, hands, and ankles along with hypertension (175/115). He reports urine that is darkly colored and foamy. You suspect acute glomerulonephritis and would expect urinalysis results to include all of the following findings except: A. elevated level of protein B. presence of red blood cells C. presence of renal casts. D. abnormally high glucose levels (Ch. 12 Fitzgerald)
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D
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A 47 year old woman with lupus erythematosus is diagnosed with acute glomerulonephritis. Treatment options include all of the following except: A. systemic corticosteroids B. systemic antimicrobials C. immune suppressors D. plasmapheresis (Ch. 12 Fitzgerald)
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B
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A complication of glomerulonephritis is: A. type 2 diabetes B. nephrotic syndrome C. pyelonephritis D. bladder cancer (Ch. 12 Fitzgerald)
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B
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Which of the following is most likely to be apart of the clinical presentation of an otherwise healthy 27 year old woman with uncomplicated lower urinary tract infection (UTI)? A. urinary frequency B. fever C. suprapubic tenderness D. lower gastrointestinal (GI)upset (Ch. 12 Fitzgerald)
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A
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Compared to younger women, uncomplicated UTI in an elderly woman is more likely to be associated with each of the following signs and symptoms except: A. new onset urinary incontinence B. delirium C. weakness D. hematuria (Ch. 12 Fitzgerald)
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D
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A 36 year old afebrile woman with no health problems presents with dysuria and frequency of urination. Her urinalysis findings include results positive for nitrites and leukocyte esterase. You evaluate these results and consider that she likely has: A. purulent vulvovaginitis B. a gram-negative UTI C. cystitis caused by Staphylococcus saprophyticus D. urethral syndrome (Ch. 12 Fitzgerald)
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B
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The most likely causative organism in community acquired UTI in women during the reproductive years is A. Klebsiella species B. Proteus mirabilit C. Escherichia coli D. Staphylococcus saprophyticus (Ch. 12 Fitzgerald)
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C
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Which urine culture result is needed to confirm a UTI in an asymptomatic woman who has not had recent use of a urinary catheter? A. 10 squared cfu/mL or more B. 10 cubed cfu/mL or more C. 10 to the 4th cfu/mL or more D. 10 to the fifth cfu/mL or more (Ch. 12 Fitzgerald)
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D
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You see a 34 year old woman with an uncomplicated UTI. She is otherwise healthy but reports having a sulfa allergy. Appropriate therapy would include: A. TMP-SMX B. amoxicillin C. Azithromycin D. Ciprofloxacin (Ch. 12 Fitzgerald)
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D
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The notation of alkaline urine in a patient with a UTI may point to infection caused by: A. Klebsiella apecies B. P. mirabilis C. E. coli D. S. saprophyticus (Ch. 12 Fitzgerald)
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B
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Which of the following is the most accurate information in the caring for a 40 year old man with cystitis? A. This is a common condition in men of this age B. A gram-positive organism is the likely causative pathogen C. A urological evaluation should be considered D. Pyuria is rarely found (Ch. 12 Fitzgerald)
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C
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Evidence-based factors that prevent or minimized the risk of UTIs include all of the following except: A. male gender B. longer urethra-to-anus length in women C. timed voiding schedule D. zinc-rich prostatic secretion (Ch. 12 Fitzgerald)
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C
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Hemorrhagic cystitis is characterized by: A. irritative voiding symptoms B. persistent microscopic hematuria C. the presence of hypertension D. elevated creatinine and BUN levels (Ch. 12 Fitzgerald)
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A
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A 44 year old woman presents with pyelonephritis. The report of her urinalysis is least likely to include: A. WBC casts B. positive nitrites C. 3+ protein D. rare RBCs (Ch. 12 Fitzgerald)
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C
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An example of a first-line therapeutic agent for the treatment of pyelonephritis is: A. amoxicillin with clavulanate B. trimethoprim-sulfamethoxazole C. ciprofloxacin D. nitrofurantoin (Ch. 12 Fitzgerald)
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C
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With fluoroquinolone use, length of antimicrobial therapy during uncomplicated pyelonephritis is typically: A. 5 days B. 1 week C. 2 weeks D. 3 weeks (Ch. 12 Fitzgerald)
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B
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Risk factors for UTI in women include: A. post-void wiping back to front B. low peri-vaginal loactobacilli colonization C. hot tub use D. wearing snug-fitting pantyhose (Ch. 12 Fitzgerald)
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B
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All of the following can negatively impact perivaginal lactobacilli colonization except: A. recent antimicrobial use B. exposure to the spermicide nonoxynol-9 C. estrogen deficiency D. postcoital voiding (Ch. 12 Fitzgerald)
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D
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In children and the elderly, which of the following conditions can contribute to bladder instability and increase the risk of a UTI? A. constipation B. upper respiratory tract infection C. chronic diarrhea D. efficient bladder emptying (Ch. 12 Fitzgerald)
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A
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Which of the following is not a gram-negative organism A. E coli B. k pneumoniae C. P. mirabilis D. saprophyticus (Ch. 12 Fitzgerald)
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D
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You see a 70 year old woman in a walk-in center with a chief complaint of increased urinary frequency and dysuria. Urinalysis reveals pyuria and positive nitrites. She mentions she has a "bit of kidney trouble, not too bad." Recent evaluation of renal status is unavailable. In considering antimicrobial therapy for this patient, you prescribe: A. nitrofurantoin B. fosfomycin C. ciprofloxacin D. doxycycline (Ch. 12 Fitzgerald)
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C
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Long-term use of which medication has been possibly associated with increased risk for bladder cancer? A. pioglitazone B. saxagliptin C. rosuvastatin D. clopidogrel (Ch. 12 Fitzgerald)
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A
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Which of the following is not a risk factor for bladder cancer? A. occupational exposure to textile dyes B. cigarette smoking C. occupational exposure to heavy metals D. long-term aspirin use (Ch. 12 Fitzgerald)
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D
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A 68-year old man presents with suspected bladder cancer. You consider that its most common presenting sign or symptoms is: A. painful urination B. fever and flank pain C. painless gross hematuria D. palpable abdominal mass (Ch. 12 Fitzgerald)
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C
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In a person diagnosed with superficial bladder cancer without evidence of metastases, you realize that: A. The prognosis for 2 year survival is poor B. a cystectomy is indicated C. despite successful initial therapy, local recurrence is common D. systemic chemotherapy is the treatment of choice (Ch. 12 Fitzgerald)
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C
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Persistent microscopic hematuria would be the primary finding in about ___% of individuals with bladder cancer. A. 10 B. 20 C. 30 D. 40 (Ch. 12 Fitzgerald)
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B
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Preferred therapy for nonmuscle-invasive bladder cancer without evidence of metastases is: A. cystectomy. B. intravesical chemotherapy only C. transurethral resection with intravesical chemotherapy D. systemic chemotherapy (Ch. 12 Fitzgerald)
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C
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Patients with urge incontinence often report urine loss: A. with exercise B. at night C. associated with a strong sensation of needing to void D. as dribbling after voiding (Ch. 12 Fitzgerald)
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C
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Patients with urethral stricture often report urine loss: A. with exercise B. during the day C. associated with urgency D. as dribbling after voiding (Ch. 12 Fitzgerald)
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D
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Patients with stress incontinence often report urine loss: A. with lifting B. at night C. associated with a strong sensation of needing to void D. as dribbling after voiding (Ch. 12 Fitzgerald)
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A
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Factors that contribute to stress incontinence include: A. detrusor overactivity B. pelic floor weakness C. urethral stricture D. urinary tract infection (UTI) (Ch. 12 Fitzgerald)
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B
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Factors that contribute to urge incontinence include: A. detrusor overactivity B. pelic floor weakness C. urethral stricture D. urinary tract infection (UTI) (Ch. 12 Fitzgerald)
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A
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Pharmacological intervention for patients with urge incontinence includes: A. doxazosin (Cardura) B. tolterodine (Detrol) C. finasteride (Proscar) D. pseudoephedrine (Ch. 12 Fitzgerald)
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B
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The most appropriate behavioral intervention for a patient with urge incontinence would be A. having an assistant who is aware of voiding cues and helps with toileting activities B. establishing a voiding schedule and gentle bladder stretching C. Kegel exercises and pelvic floor rehabilitation with biofeedback (Ch. 12 Fitzgerald)
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B
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The most appropriate behavioral intervention for a patient with stress incontinence would be A. having an assistant who is aware of voiding cues and helps with toileting activities B. establishing a voiding schedule and gentle bladder stretching C. Kegel exercises and pelvic floor rehabilitation with biofeedback (Ch. 12 Fitzgerald)
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C
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The most appropriate behavioral intervention for a patient with functional incontinence would be A. having an assistant who is aware of voiding cues and helps with toileting activities B. establishing a voiding schedule and gentle ladder stretching C. Kegel exercises and pelvic floor rehabilitation with biofeedback (Ch. 12 Fitzgerald)
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A
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Which form of urinary incontinence is most common in elderly persons? A. stress B. urge C. iatogenic D. overflow (Ch. 12 Fitzgerald)
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B
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Common adverse effects of musculotropic relaxants used in the treatment of urinary incontinence include: A. dry mouth and constipation B. nausea C. headaches D. syncope (Ch. 12 Fitzgerald)
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A
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You see an 82 year old woman with early onset dementia and urge incontinence. Which of he following medications is least likely to contribute to worsening mental status? A. oxybutynin (Ditropan) B. tolterodine (Detrol) C. darifenacin (Enablex) D. solifenacin (Vesicare) (Ch. 12 Fitzgerald)
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C
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A 64 year old woman presents with urge incontinence and has not been able to tolerate treatment with anticholinergic agents. You recommend the use of which of the following? More than one can apply. A. botulinum toxin injections B. fesoterodine fumarate (Toviaz) C. mirabegron (Myrbetriq) D. finasteride (Proscar) (Ch. 12 Fitzgerald)
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A, C
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Risk factors for renal stones include all of the follwoing except: A. male gender B. vegetarian diet C. family history of renal stones D. obesity (Ch. 12 Fitzgerald)
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B
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Medications known to increase the risk of renal stones include all of the following except: A. hydrochlorothiazide B. moxifloxiacin C. topiramate D. indinair (Ch. 12 Fitzgerald)
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B
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The most common renal stones are composed of A. Calcium B. Uric acid C. sodium D. iron (Ch. 12 Fitzgerald)
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A
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Sturvite stones are typically found in people: A. with type 2 diabetes B. who live in colder climates C. who abuse alcohol D. with a history of kidney infections (Ch. 12 Fitzgerald)
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D
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Common symptoms of renal stones include all of the following except: A. pink, red, or brown urine B. shart pain in the back or lower abdomen C. marked febrile response D. pain while urinating (Ch. 12 Fitzgerald)
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C
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The preferred method to identify the location of small renal stones is A. x-ray B. abdominal ultrasound C. CT scan D. radionuclide scan (Ch. 12 Fitzgerald)
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C
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You see a 58 year old man diagnosed with a kidney stone who reports pain primarily during urination. You consider all of the following except: A. improved hydration B. alpha blocker use C. prescribing a diuretic D. analgesia use (Ch. 12 Fitzgerald)
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C
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A 63 year old man presents with abdominal pain, pain during urination, and red urine. Imaging reveals a renal stone in the ureter. An appropriate treatment option would be: A. percutaneous nephrolithotomy B. shock wave lithotripsy C. insertion of a nephrostomy tube D. insertion of a catheter (Ch. 12 Fitzgerald)
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B
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The most effective strategy for preventing renal stones is: A. daily exercise B. adequate hydration C. limiting coffee consumption D. smoking cessation (Ch. 12 Fitzgerald)
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B
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You see a 58 year old woman who is being treated for a renal stone. Analysis of a stone passed in the urine reveals that it is composed of calcium oxalate In counseling the patient about preventing future stones, you consider all of the following except: A. reducing sodium in her diet B. limiting consumption of beets, rhubarb, nuts, and chocolate C. encouraging getting her daily calcium requirement from food D. if calcium supplements are needed, this medication should be taken on an empty stomach (Ch. 12 Fitzgerald)
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D
