NSG5003 UROLOGY Qbank
At what age does the pediatric glomerular filtration rate reach adult levels? A) 3 years B) 8 years C) 12 years D) 18 years
3 years Glomerular filtration rate (GFR) increases with age and is calculated differently from the GFR in adults. Adjusted for body surface area, the GFR reaches adult levels at 2-3 years. Aspects of pediatric kidney function and the measure of creatinine are important in the treatment of patients of all ages.
A 50% rise in plasma creatinine represent a nephron mass loss of: A) 25% B) 50% C) 75% D) 100%
50%
In the absence of disease, the glomerular filtration rate at age 70 years should be approximately: A) 30 mL/min B) 50 mL/min C) 70 mL/min D) 90 mL/min
70 mL/min
In which of the following patient is pyelonephritis most likely? A) A 10 year old premenstrual girl B) An 18 year old woman with amenorrhea C) A 32 year old pregnant woman D) A 55 year old woman with urge incontience
A 32 year old pregnant woman. Physiologic changes in pregnancy make a pregnant woman the most likely choices to experience pyelonephritis. The organisms that cause bacteriuria and UTIs in pregnant women are of the Sam species and have similar virulence factors as those in non pregnant women.
Patients with chronic kidney disease are not likely to develop hyperkalemia as long as they secrete adequate levels of: A) antidiuretic hormone B) Renin C) Aldosterone D) Natriuretic peptide
Aldosterone
The mineralocorticoid that is produced by the adrenal cortex and helps to regulate blood pressure is: A) vasopressin B) angiotensin C) aldosterone D) renin
Aldosterone. Aldosterone is the principle regulator of salt and water and helps regulate blood pressure
The hormone that helps control the kidney's role in fluid balance is: A) vasopressin B) epinephrine C) oxytocin D) antidiuretic
Antidiuretic
Medications associated with acute urinary retention include: A) proton pump inhibitors B) antihyperglycemics C) beta blocker D) antihistamines
Antihistamines (Tricyclic antidepressants, antispasmodics, antiparkinsonian, antipsychotics, vertigo treatment, bronchodilators, and over active bladder drugs).
Metabolic acidosis results from a reduction in: A) carbonic acid B) oxygen C) carbon dioxide D) bicarbonate
Bicarbonate. Metabolic acidosis results from a reduction in bicarbonate (HCO3-), typically accompanied by a reduction in carbon dioxide partial pressure (pCO@).
In children, the glomerular filtration rate is adjusted for: A) temperature B) body surface area C) age D) creatinine level
Body surface are In children the GFR increases with age and is calculated differently from the GFR in adults. Adjusted for body surface area, the GFR reaches adult levels by age 2-3 years.
Renal stones are most likely composed of: A) calcium oxalate B) potassium chloride C) magnesium sulfate D) thiamine
Calcium oxalate. Account for 80% of all stones. Uric acid (UA) accounts fo 9%, struvite (magnesium ammonium phosphate hexahydrate) from infection by bacterial account for 10% only 1% are cystine.
Which one of the following statements is NOT true about calcium phosphate involvement in renal stone production? A) Calcium phosphate precipitates the membrane of the loop of Henle B) Calcium phosphate erodes into the interstitium C) Calcium phosphate accumulates in the sub epithelial space of the renal papilla D) Calcium phosphate builders up in the water
Calcium phosphate builds up in the ureter.
The most common type of renal calculator is formed by an increased concentration of: A) Calcium B) Magnesium C) Phosphate D) Cystine
Calcium. Calcium sones associated with increased calcium in the blood and urine. Excess bone resorption caused by immobility, bone disease, hyperparathyroidism, and renal tubular acidosis are contributing factors in stone formation. High o slate concentration in the blood and urine predispose to the formation of calcium oxalate stones.
The most common cause of death in patients with chronic kidney disease who receive dialysis treatment is: A) electrolyte imbalance B) respiratory failure C) Cardiovascular disease D) opportunistic infections
Cardiovascular disease CKD is associated with an increased risk of cardiovascular disease and chronic renal failure. Kidney disease in the 9th leading cause of death in the US. The most common cause of sudden death in patients with ESRD (end stage renal disease) is hyperkalemia, which often follows missed dialysis or dietary indiscretion. The most common OVERALL cause of death in the dialysis population is cardiovascular disease: cardiovascular mortality is 10-20 times higher in dialysis patients.
Which of the following is NOT a contributor to detrusor under activity (Bladder retention)? A) Childbirth B) Medications C) Diabetes D) Aging
Childbirth. Detrusor function may be affected by multiple factors including bladder outlet obstruction, local neuropathy, central nervous system disorder, ischemic changes, and bladder wall muscle changes. THE COMMON CAUSES OF DETRUSOR UNDER-ACTIVITY INCLUDE: AGING, DIABETES, NEUROLOGICAL DISEASE AND MEDICATIONS.
Nephrons in the kidney: A) are insignificant to the ability of the kidney to clear plasma solutes B) are only found in the distal convoluted tubule C) contribute to the total glomerular filtration rate D) are ill equipped to maintain glomerular filtration rate
Contribute to the total glomerular filtration rate
A factor that is NOT associated with progressive renal injury is: A) smoking B) Proteinuria C) Hyperlipidemia D) controlled diabetes
Controlled diabetes- Aside from underlying disease process and glomerular hypertension, factors that may cause progressive renal injury include: systemic hypertension, nephrologies, (NSAIDS, intravenous contrast media); decreased perfusion (Due to severe dehydration or episodes of shock); proteinuria (in addition to being a marker of chronic kidney disease); Hyperlipidemia, hyperphosphatemia with calcium phosphate deposition; smoking and uncontrolled diabetes
Which of the following is not a function of the kidney? A) secretion of hydrogen ions B) conversion of vitamin D to its active form C) conversion of ammonia into urea D) production of uromodulin
Conversion of ammonia into urea
Which of the following assessment finding is common in pyelonephritis? A) Suprapubic tenderness B) Cervical motion tenderness C) Rebound umbilical tenderness D) Costovertebral angle tenderness
Costovertebral angle tenderness is a common sign of acute pyelonephritis.
Which of the following laboratory values is an amino acid breakdown that represents the glomerular filtration rate and metabolism in muscles? A) uric acid B) creatinine C) nitrate D) phosphate
Creatinine
The volume of blood that the kidneys can clear of creatinine in 1 minutes is: A) tubular reabsorption B) tubular secretion C) glomerular filtration rate D) creatinine clearance
Creatinine clearance
Patients with history of renal stones secrete: A) magnesium phosphate B) leukocytes C) crystalluria D) nitrates
Crystalluria
The failure to achieve complete bladder emptying within a normal time span is due to the under activity of which muscle? A) Detrusor B) Visceral C) Rectus a dominos D) Oblique
Detrusor. Detrusor underactivity (DU) is a contraction of reduced strength and/or duration that results in prolonged bladder emptying and/or a failure to achieve complete bladder emptying within a normal time span.
The cafeteria that is most commonly responsible for acute pyleonephritis is A) Klebisella pneumonia B) E. Coli C) Staphyloccus aureus D) Proteus mirabilis
E. Coli. E. Coli is most commonly identified pathogen due to its unique ability to adhere to and colonize the urinary tract and kidneys. It can lead to an acute inflammatory response that can cause scarring of the renal parenchyma.
The definition and criteria used to diagnosis chronic kidney disease is the: A) serum creatinine B) glomerular filtration rate C) blood urea nitrogen to creatinine ration D) serum albumin levels
Glomerular filtration rate
Protein passes into the urine instead of being reabsorbed when the: A) glomeruli are damaged B) distal convoluted tubules are inflamed C) loop of Henle is overstimulated D) collecting tubule releases urine to quickly
Glomeruli are damaged. When the glomeruli are damaged, protein appears in the urine (proteinuria) because the large protein molecules pass into the urine instead of being reabsorbed. The amount of a substance reabsorbed or secreted depends on the maximum tubular transport capacity of the substance. The maximum tubular transport capacity is the maximum amount of a substance that can be reabsorbed or secreted in 1 minute without saturating the renal system.
The glomerular filtration rate is the rate at which: A) filtrates pass through the tubules to the collecting tubules and ducts B) the troubles reabsorb filtered fluids C) glomeruli filter blood D) a substance is completely removed from the blood
Glomeruli filter blood
What is the primary risk factor for calcium phosphate renal stones? A) low urine volume B) High urine calcium C) Low urine specific gravity D) High urine pH
High urine pH Is observed in half of patients who develop idiopathic calcium phosphate renal sones.
Which of the following is NOT associated with renal stone development? A) high urine protein B) low urine citrate C) high urine calcium D) low urine volume
High urine protein
When antidiuretic hormone (ADH) is elevated in the serum, the collecting tubules int eh kidney become more permeable to H2), meaning the urine will have a: A) high specific gravity B) low specific gravity C) higher pH D) lower pH
Higher specific gravity. The ADH alters the collection tubules' permeability to water. When ADH concentration in serum is high, the tubules are more permeable to water. This cause more water to be absorbed, creating a highly concentrated but small volume of urine that has a high specific gravity.
Dysregulation of antidiuretic hormone and aldosterone in the kidneys may lead to: A) renal stones B) Anura C) hypertension D) edema
Hypertension Antidiuretic hormones and aldosterone are partially responsible for helping the kidneys maintain fluid balance. ADH (vasopressin) promotes reabsorption of water by collecting ducts in the kidney and is produced by the pituitary gland. Aldosterone is produced by the adrenal cortex and promotes absorption of sodium by the kidneys. In concert with ADH, water and fluid balance is maintained. Altered ADH and aldosterone concentration may cause fluctuations in sodium and potassium concentration, and these may lead to hypertension
The decreased glomerular filtration rate in a patient with acute glomerulonephritis is due to which pathophysiologic process? A) Decreased renal-induced constriction of the renal arteries B) Immune complex deposition, increased capillary permeability, and cellular proliferation C) Necrosis of 70% or more of the nephrons secondary to increased kidney interstitial hydrostatic pressure D) Scar tissue formation throughout the proximal convoluted tubule secondary to toxin-induced collagen synthesis
Immune complex deposition, increased capillary permeability, and cellular proliferation
Progression of chronic kidney disease is thought to occur as a result of: A) hypofiltration with accumulation of toxic chemicals and decreased urine output B) prevention of water and solutes crossing the capillary membrane and large molecules allowed to cross C) Intraglomerular hypertension and glomerular hypertrophy D) tubulointerstital constriction with decreased blood flow
Intraglomerular hypertension and glomerular hypertrophy
The nurse practitioner is interpreting the results of a urinalysis and concludes that the specimen was contaminated. The presence of which organism would lead her to reach that conclusion? A) Lactobacillus B) Escherichia Coli C) Staphylococcus D) Klebsiella
Lactobacillus. Isolation of more than one species, or the presence of Lactobacillus or Cutibacterium, indicate that the specimen was contaminated by vaginal or skin flora. Echerichia coli is the most common pathogen in UTI's. Less common are Staphylococcus and Klebsiella
The most common cause of urethritis is: A) Haemophilus influenza B) Staphylococcus aureus C) Neisseria gonorrhoea D) Candida albicans
Neisseria gonorrhea. The most common cause of urethritis is infection via sexual transition of N. Gonorrhoeae which is a gram negative diplodocus that interacts with noncillated epithelia cells.
Which urinalysis finding is highly specific for urinary tract infection? A) Ketones B) Nitrates C) Blood D) Protein
Nitrites. The finding of nitrates on a urinalysis is highly specific for UTI. Nitrate test detect products of nitrate reductive, an enzyme produced by many bacterial species.
A patient has a serum creatinine level of 2.5 mg/dl, a serum potassium level of 6 mEq/L, an arterial pH of 7.32, and a urine output of 250 ml/day. Which phase of acute kidney injury is the patient experiencing? A) Intrarenal B) Postrenal C) Oliguric D) Recovery
Oliguric
Continuous urinary leaking or dribbling in the setting of incomplete bladder emptying is referred to as: A) Stress incontinence B) Over incontinence C) Urge incontinence D) Functional incontience
Over incontinence
Which of the following is a clinical manifestation in a patient with renal impairment associated with polysystic kidney disease? A) Suprapubic pain B) Periorbital edema C) Low serum creatinine level D) Palpable kidneys
Palpable kidneys
Bone disease secondary to chronic kidney disease is due to alteration in levels of: A) Potassium B) Phosphorus C) Sodium D) Magnesium
Phosphorous. Renal bone disease is a common complication of chronic kidney disease. Chronic kidney disease mineral and bone disorder (CKD-MBD) involves biochemical abnormalities related to bone metabolism. CKD-MBD may result from alteration in levels of phosphorus, parathyroid hormone, vitamin D, and alkaline phosphates.
A 58 year old man is experiencing possible urinary retention. Which diagnostic test should be performed to confirm this finding? A) Maximum urine flow rate B) Ultrasound of the prostate C) Postvoid residual D) Urethrocystoscopy
Postvoid residual. The measurement of Postvoid residual volume is an appropriates first step in diagnosing the cause of urinary retention in a midlife man. The bladder scanner, which can be used in an office setting, has made the measurement of Postvoid residual simple to obtain because it does not require catheterization or radioglogic
With nephritis syndrome in comparison to nephrotic syndrome, there is: A) higher amounts of albuminuria B) negligible hematuria or absence of hematuria C) presence of red blood cell casts in the urine D) hypoalbuminemia
Presence of red blood cell casts in the urine
The kidneys help regulate acid-base balance by: A) secreting carbon dioxide B) producing ammonia C) reabsorbing phosphates D) secreting sodium chloride
Producing ammonia
In a normal functioning kidney, the majority of glucose is reabsorbed in the: A) renal corpuscle B) glomerulus C) proximal convoluted tubule D) loop of Henle
Proximal convoluted tubule is a small tubular structure within the nephron of the kidney. The PCT connects Bowman's capsule with the proximal straight tubule, and it is essential for the reabsorption of water and solutes from filtrate within the nephrons.
Infection of the upper urinary tract and renal parenchyma is called: A) pyelonephritis B) cystitis C) nephrolithiasis D) urinary retention
Pyelonephritis. Acute pyelonephritis is an infection of the upper urinary tract and renal parenchyma. It is usually uncomplicated, but if it is not managed appropriately, it can lead to bacteremia, scarring, and death. The primary source of infection, accounting form 75% of cases, is E. Coli.
Bacterial invasion if the renal parenchyma is termed: A) urinary tract infection B) bacterial vaginosis C) pyleonephritis D) epididymitis
Pyelonephritis. Acute pyelonephritis results from bacterial invasion of the renal parenchyma. Bacterial usually reach the kidney by ascending from the lower urinary tract.
The juxtoglomerular complex is the site of the production of which enzyme and hormone involved in blood pressure and fluid balance? A) renin B) angiotensin C) nitric oxidase D) antidiuretic hormone
Renin
The kidneys help regulate blood pressure by producing angiotensin, which is formed from the enzyme: A) Urease B) trypsin C) creating kinase D) renin
Renin
Aldosterone helps regulate water reabsorption by regulating which one of the following electrolyte? A) Phosphate B) Chloride C) Calcium D) Sodium
Sodium. Aldosterone regulates water reabsorption by the distal tubules and changes urine concentration by increasing sodium reabsorption . A high plasma aldosterone concentration increases sodium and water reabsorption by the tubules and decreases sodium and water excretion in the urine . A low plasma aldosterone concentration promotes sodium and water excretion.
A man had a radical prostatectomy from prostate cancer. When teaching him about urine function, what would be one of the complications of this surgery that he may developed? A) Kidney stones B) Stress incontinence C) Overactive bladder D) Urinary obstruction
Stress incontinence
The involuntary loss of urine during coughing or sneezing is: A) stress incontinence B) urge incontinence C) overflow incontinence D) spastic bladder
Stress incontinence. Stress incontince occur during coughing, laughing, sneezing or lifting . It occurs as a result of increased abdominal pressure on the bladder. Reduced muscle tone associated with aging, childbirth, or surgical procedure can cause weakness in the pelvic floor muscles and result in stress incontinence by damaging the posterior urethrovesical angle.
Which of the following is NOT a vital function of the kidney? A) Erythropoiesis B) Regulation of calcium formation C) Acid base balance D) Temerature regulation
Temperature regulation ( Vital functions of the kidney include: Maintaining fluid and acid base balance; regulating electrolyte concentration; removing wastes and excess fluid; regulating blood pressure; aiding red blood cel production (erythropoiesis); and regulating Vitamin D and calcium formation
Which enzyme is formed in the liver as a byproduct of protein metabolism and in eliminated entirely by the kidney? A) Creatinine B) Uric acid C) Urea D) Phosphate
Urea. Urea is eliminated entirely by the kidneys. Blood urea nitrate (BUN) is related to the glomerular filtration rate, and it is influenced by protein intake and hydration status. In a state of dehydration, BUN levels rise as a results of urea concentration. Two thirds of renal function is lost before a significant rise in the BUN level occurs.
Which one of the following is NOT affected when urinary retention is present? A) The urethra B) The hypogastric nerve C) The urethral sphincter D) The pelvic floor
Urethra. Urinary retention is not related to urethral function. Normal voiding requires coordinated urethral and pelvic floor muscle relaxation followed by bladder contraction.
Mycoplasma genitalium is associated with which disease presentation in men? A) Benign prostatic hyperplasia B) Urethritis C) Epididymitis D) Urinary tract infection
Urethritis. M. Genitalium infection is common in men with persistent or recurrent urethritis. A specialized terminal tip like structure allows M. genitalium to attach to and adhere to the surface of, and enter cells. Upon entry into the epithelia cell, M. genitalium evades the host immune response through modulation of the immune system, including suppression and stimulation of lymphocytes and up regulation of cytokine expression.
A woman is complaining that she often gets a strong need to urinate and then she sometimes "wets herself" because she cannot make it to the bathroom in time. The type of incontinence she is describing is: A) transient B) mixed C) stress D) urge
Urge
A 45 year old man with peripheral neuropathy reports being awakened frequently at night by the urge to urinate. Which type of incontinence is usually associated with this presentation? A) Functional incontinence B) Overflow incontinence C) Urge incontinence D) Idiopathic incontinence
Urge incontinence. (Bladder dysfunction can develop as a result of several neurological conditions, including peripheral neuropathy) Dysfunction can result from debris or over activity or bladder outlet obstruction and result in urge urinary incontinence or stress incontinence. Diabetic neuropathy is the most common cause of peripheral neuropathy associated bladder dysfunction. Overflow incontinence results from impaired detrusor contractility . Functional incontinence is a results of a physical or mental impairment preventing successful voiding Idiopathic incontinence develops suddenly as a result of disease.
A 65 year old woman who cannot make it to the bathroom in time to urinate into the toilet is experiencing: A) stress incontinence B) urge incontinence C) overactive bladder D) functional incontinence
Urge incontinence. Urge incontinence is a sponge an sudden urge to urinate by involuntary leakage of urine.
Which one of the following is found in acidic urine and has a pH of approximately 5.5? A) calcium stone B) Struvitte stone C) Uric acid stone D) Cristina
Uric acid stone. They are crystalline structures and pH between 5.1 and 5.9). The most common cause for their formation is supersaturation of urine by substance such as cystine, calcium and oxalate. A high prevalence of obesity, diabetes and hypertension is company associated with urine acid nephrolithiasis (Stones). These are conditions that increase the risk of gout. Gout is a well established factor for kidney stone formation.
What is the primary predisposing factor for renal stones in patients with gout? A) Urine pH of 5.5 B) Specific gravity of 1.015 C) Calcium 210 mg/dl D) Creatinine 0.9
Urine pH of 5.5 In patients with gout, the primary predisposing factor that causes a renal stone is persistently acidic urine (urine pH of 5 to 5.5) A low urine pH also occurs in patients with gout who overproduce urine acid an d therefore have hyperuricosuria: the combination of an acidic urine and high urine acid concentration leads to an increased risk for urine acid nephrolithiasis.
In the Randall's plaque pathway for kidney stone formation, the stone is: A) attached to plugs protruding from the opening of Bellini ducts B) fixed to the surface of a renal papilla at sites of interstitial apatite plaque C) formed in free solution in the renal system collection D) formed in the interstitial or tubular compartment of the renal medulla
fixed to the surface of a renal papilla at sites of interstitial apatite plaque
The most common type of anemia in patients with chronic kidney disease is: A) normochromic microcytic B) hyperchromic macrocytic C) hypochromic microcytic D) normochromic normocytic
normochromic normocytic
