Chapter 18: Urinary Systems Disorders

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Which of the following structures is most likely to be located in the renal medulla?
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Loop of Henle
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Which of the following is NOT a function of the kidney?
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Production of albumin
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Which of the following describes the correct flow of blood in the kidney?
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Afferent arteriole to the glomerular capillaries to the efferent arteriole
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Which of the following describes the flow of filtrate in the kidney?
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Bowman’s capsule to the proximal convoluted tubule to the loop of Henle
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Which of the following describes the normal flow of urine?
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Collecting duct to the renal pelvis to the ureter to the bladder
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Which statement about the bladder is TRUE?
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Three openings from the urinary bladder form the trigone.
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Which of the following increases glomerular filtration rate?
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Increased hydrostatic pressure in the glomerular capillaries
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By what process is water reabsorbed from the filtrate?
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Osmosis
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Which substance directly controls the reabsorption of water from the collecting ducts?
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Antidiuretic hormone
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Under what circumstances do cells in the kidneys secrete renin?
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Blood flow in the afferent arteriole decreases.
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Which of the following should be present in the filtrate in the proximal convoluted tubule?
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Sodium ions
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From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.
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Albumin
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Involuntary urination by a child after age 4 or 5, when bladder control is expected, is referred to as:
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enuresis.
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When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids?
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Secrete more acids and reabsorb more bicarbonate ions.
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When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?
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Active transport
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What is the cause of most cases of pyelonephritis?
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An ascending infection by E. coli
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Which disease is manifested by dysuria and pyuria?
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Cystitis
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Why may acute pyelonephritis and cystitis follow untreated prostatitis?
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There is a continuous mucosa along the involved structures.
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Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:
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urinary casts and flank pain.
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In a case of acute pyelonephritis, what is the cause of flank pain?
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Inflammation, stretching the renal capsule
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Which pathophysiological process applies to acute post-streptococcal glomerulonephritis?
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Immune complexes deposit in glomerular tissue, causing inflammation
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What causes the dark urine associated with acute post-streptococcal glomerulonephritis?
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Blood and protein leaking through the capillary into the filtrate
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Renal disease frequently causes hypertension because:
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congestion and ischemia stimulate release of renin.
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Urinary casts are present with acute post-streptococcal glomerulonephritis because:
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inflamed tubules compress red blood cells (RBCs) and protein into a typical mass.
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Which disease would cause an increased ASO titer and elevated serum ASK?
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Acute post-streptococcal glomerulonephritis
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Why does metabolic acidosis develop with bilateral kidney disease?
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Tubule exchanges are impaired.
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What is the first indicator in the arterial blood gases of acidosis caused by glomerulonephritis?
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Decreased bicarbonate ion
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What would be the long-term effects of chronic infection or inflammation of the kidneys?
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Gradual necrosis, fibrosis, and development of uremia
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What factors contribute to headache, anorexia, and lethargy with kidney disease? 1. Increased blood pressure 2. Elevated serum urea 3. Anemia 4. Acidosis
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1, 2, 3, 4
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What are the significant signs of nephrotic syndrome?
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Hyperlipidemia and lipiduria
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Why does blood pressure often remain near normal in patients with nephrotic syndrome?
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Hypovolemia results from fluid shift to the interstitial compartment.
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Common causes of urolithiasis include all of the following EXCEPT:
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hyperlipidemia.
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Which of the following results from obstruction of the left ureter by a renal calculus?
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An attack of renal colic
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What does hydronephrosis lead to?
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Ischemia and necrosis in the compressed area
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Which of the following is a predisposing factor to bladder cancer?
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Exposure to chemicals and cigarette smoke
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What is the common initial sign of adenocarcinoma of the kidney?
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Microscopic hematuria
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Which of the following does NOT usually result from nephrosclerosis?
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Acute renal failure
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Which of the following relates to polycystic kidney disease?
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It results in gradual degeneration and chronic renal failure.
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Which of the following is related to Wilms’ tumor?
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A genetic defect
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With severe kidney disease, either hypokalemia or hyperkalemia may occur and cause:
answer

cardiac arrhythmias.
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Which of the following indicates the early stage of acute renal failure?
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Very low GFR and increased serum urea
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What is/are a cause(s) of acute tubule necrosis and acute renal failure? Prolonged circulatory shock, Sudden significant exposure to nephrotoxins, Crush injuries or burns
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All of the above
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Which of the following would likely cause chronic renal failure?
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Diabetes
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What causes polyuria during the stage of renal insufficiency?
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Loss of tubule function
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What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?
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A deficit of activated vitamin D and hyperphosphatemia
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Cystitis is more common in females because:
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the urethra is short, wide, and adjacent to areas with resident flora.
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Which of the following indicate a decreased GFR?
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Increased serum urea and decreased serum bicarbonate
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Which of the following is NOT likely to lead to hydronephrosis?
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Nephrosclerosis
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Which of the following congenital defects is a common cause of cystitis in young children?
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Vesicoureteral reflux
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Which factor contributes to severe anemia in individuals with chronic renal failure?
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Limited protein intake
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When acidosis becomes decompensated in renal failure, a key indicator is:
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serum pH dropping below 7.35.
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What is the primary action of the diuretic furosemide?
answer

Decreased reabsorption of sodium and water
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Which of the following causes acute renal failure?
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Bilateral acute glomerulonephritis
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Which of the following is a significant indicator of renal insufficiency?
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Increased serum urea and creatinine
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Uremic signs of renal failure include all of the following EXCEPT:
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high blood pressure.
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Choose the basic cause of osteodystrophy associated with chronic renal failure.
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Failure of the kidney to activate vitamin D
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Agenesis is often not diagnosed because:
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it is usually asymptomatic as one kidney provides adequate function.
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The normal pH of urine is:
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4.5- 8.0.
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Wilms’ tumor is:
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an encapsulated mass in one kidney.
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Reduced urine output resulting from inflammation and necrosis of the tubules is called:
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oliguria.
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The micturition reflex is initiated by:
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increased pressure distending the bladder.
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Which of the following results from decreased blood flow into the kidneys?
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Increased angiotensin and systemic vasoconstriction
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In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from:
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a type III hypersensitivity reaction.
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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.
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A and B
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Circulatory shock causes:
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decreased GFR and increased renin secretion.
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Autoregulation in the kidneys refers to:
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local minor reflex adjustments in the arterioles to maintain normal blood flow.
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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.
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1, 2
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Uncontrolled essential hypertension may cause chronic renal failure because of:
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damage to afferent arterioles and renal ischemia.
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Urine with a low specific gravity is usually related to:
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renal failure due to tubule damage.
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Excess urea and other nitrogen wastes in the blood is referred to as:
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azotemia.

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