patho quiz week 7 uro/renal

Generally, children voluntary control of urination is expected to be fully established at approximately what age? 7 5 4 3

7 (>6) ...see chart in feedback

Many situation put a patient at risk for development of AKI, Select all the patient situations below that indicate a common risk for AKI. An 80 year-old otherwise healthy individual who likes to use a sauna. A 25 year-old otherwise healthy long distance runner A diabetic patient who is having abdominal surgery A patient with an eGFR <60 mL/min

An 80 year-old otherwise healthy individual who likes to use a sauna. A diabetic patient who is having abdominal surgery A patient with an eGFR <60 mL/min As long as the distance runner stays properly hydrated, there is no additional risk for AKI. All the other situations require careful monitoring as they are at risk by definition

Which of the following sign or symptom indicates an ascending infection in the urinary tract? urinary incontinence suprapubic pain foul smelling urine fever

Clinical signs UTI: •Burning •Frequency/urgency •Dysuria •Suprapubic, flank or abdominal pain •Incontinence •Foul smelling urine •Infants/Elders may present with high fever, "chills", vomiting, diarrhea or irritability •Fever, nausea, vomiting with dysuria and flank pain: red flag for ascended infection and pyelonephritis

Pyelonephritis causes damage to glomeruli and most patients have long term renal insufficiency after resolution. True False

False

Urine is formed in a three-step process: which of the following gives the correct order in which these steps take place in the nephron? Glomerular filtration, tubular reabsorption, tubular secretion tubular secretion, glomerular filtration tubular reabsorption tubular reabsorption, tubular secretion, glomerular filtration Glomerular filtration, tubular secretion, tubular reabsorption

Glomerular filtration, tubular reabsorption, tubular secretion

Which of the following conditions causes prerenal acute kidney injury? Bilateral nephrolithiasis Drug-induced nephrotoxicity Glomerulonephritis Severe hypotension

Severe hypotension Severe hypotension is prerenal; decreased blood pressure leads to decreased or even no flow to kidneys Glomerulonephritis is an intrarenal inflammation of glomeruli Bilateral nephrolithiasis could cause obstructive uropathy, and would be postrenal Drug-induced nephrotoxicity would indicate damage to glomerulus, and would be Intrarenal,

Select the zone of the prostate gland that is most effected by hypertrophy in older men. transition anterior central peripheral

The area of the prostate that is most effected by benign hyperplasia is that inner "transitional" zone, right up against the urethra

In a patient complaining of urinary urgency and frequency, an urinalysis dipstick confirms lower urinary tract infection? (LUTI) Which of the following would exclude this patient from an uncomplicated LUTI? Select all that apply Urine analysis showing blood and positive nitrites The patient has well-controlled diabetes type 2 A pregnant female Nausea and vomiting Intermittent mild supra-pubic pain

The patient has well-controlled diabetes type 2 A pregnant female Nausea and vomiting

Obstruction by renal stone, especially the staghorn and pelvic types, as associated with pyelonephritis because of more significant urine stagnation True False

True 75% cal oxalate, 15% cal hydroxyl phosphate

Which of the following describes the defect in this picture? (look up the pic in quiz) Uretero-pelvic junction obstruction vesicoureteral reflux posterior urethral valve defect

Uretero-pelvic junction obstruction

The pathophysiologic cause of acute post streptococcal glomerulonephritis (APSGN) is: renal ischemia an antigen-antibody complex bacterial invasion of the glomerulus an anaphylactic reaction

an antigen-antibody complex Strep antigen-antibody complex in the glomeruli, coming from systemic blood, causes APSGN Renal ischemia would cause lack of oxygenation or blood flow which is not the cause of APSGN Bacterial invasion of the glomeruli causes infection, and not the cause of APSGN An anaphylactic reactions can be responsible for renl damage, but not directly related to APSGN

Which of the following individuals are a greatest risk for developing infectious cystitis (LUTI) ? females males children elders

females

Presence of which of the following in the urine, even in small amounts, is indicative of a possible problem in a patient? glucose creatinine potassium urea

glucose Glucose should not be found in urine. The others are substances that are filtered out, though amounts may indicate a problem, the question says "even in small amounts."

Of the following, which is is most characteristic of intra-renal disorders oliguria diuresis hematuria proteinuria

proteinuria Proteinuria is likely in either nephritic or nephrotic syndromes, more so in nephrotic syndromes. Oligoria can be caused by pre-renal problems like significant reduction in cardiac output. The kidney may initally be functional, but is not getting much blood to filter. Eventually this is an equally bad situation. Hematuria may have intra-renal or post-renal causes Diuresis may be due to fluid overload, medications, or returning renal function after AKI

Which of the following is the most common cause of acute kindey injury (AKI)? post-renal obstruction renal hypertension renal hypoperfusion nephrotoxic medications

renal hypoperfusion

Mr. Day has declining kidney function due to hypertension. The nurse knows the physiologic principle causing hypertension is believed to be increased production of renin anti-diuretic hormone (ADH) Brain naturiuretic hormone (BNP) glucocorticoids

renin Renin activates the angiotensin-aldosterone system. This in turn causes peripheral vasoconstriction, which increases blood pressure. Persisting vasoconstriction can result in renal dysfunction

The most helpful laboratory value in monitoring the progression of declining renal function is serum creatinine. serum potassium. hematocrit. blood urea nitrogen.

serum creatinine. This question identifies the most critical laboratory value to determine renal function. The creatinine is the most useful and accurate laboratory measure of renal function. The BUN is subject to fluid artifact (false positive/false negative). Potassium may rise with renal disease, but it may also elevate for other disorders so it is not specific to renal disease. Finally, hematocrit may decrease due to a lack of erythropoeitin, but it may also decline due to other disease processes. It is also not specific to renal disease.

Which type of Urinary Incontinence is characterized by loss of small amounts of urine when intra-abdominal pressure increases? (sneezing, laughing, lifting) urge reflexive stress overflow

stress

Urosepsis develops most often as a consequence of ascending E Coli cystitis. True False

true

Which of the followingis a major contributor to developing chronic and/or reoccurring pyelonephritis benign prostatic hypertrophy re-occurring LUTI chronically poor hydration status vesicoureteral reflux

vesicoureteral reflux