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Module 13: Alterations of Renal and Urinary Tract Function

STUDY
PLAY
Which of the following changes will result in a decreased glomerular filtration rate?

A) Increased hydrostatic pressure in Bowman's capsule
B) Decreased plasma colloid oncotic pressure
C) Increased arterial blood pressure
D) All of the above
A) Increased hydrostatic pressure in Bowman's capsule
Which of the following renal structures is not a component of the nephron?

A) Loop of Henle
B) Renal capsule
C) Proximal convoluted tubule
D) Collecting duct
B) Renal capsule
The renal structure that drains urine directly into the ureter is the:

A) major calyx.
B) urethra.
C) collecting duct.
D) renal pelvis.
D) renal pelvis.
Which of the following substances does not normally get filtered in the kidneys?

A) Plasma proteins
B) Glucose
C) Sodium
D) Creatinine
A) Plasma proteins
Which of the following capillaries surround the proximal and distal convoluted tubules and are involved in reabsorbing filtered substances back into the blood?

A) Glomerular capillaries
B) Renal papillae
C) Peritubular capillaries
D) Vasa recta
C) Peritubular capillaries
Activation of the renin-angiotensin system stimulates the secretion of:

A) antidiuretic hormone.
B) aldosterone.
C) atrial natriuretic peptide.
D) cortisol.
B) aldosterone.
The transport maximum for glucose refers to the maximum rate of glucose:

A) filtration.
B) reabsorption.
C) secretion.
D) excretion.
B) reabsorption.
Increased levels of aldosterone stimulate the reabsorption of which of the following molecules?

A) Sodium and water
B) Potassium and sodium
C) Glucose and sodium
D) Protein and water
A) Sodium and water
If the posterior pituitary is damaged, which of the following hormones is affected?

A) Renin
B) Antidiuretic hormone
C) Erythropoietin
D) Aldosterone
B) Antidiuretic hormone
Which of the following substances are actively secreted by the renal tubules?

A) Hydrogen and potassium
B) Sodium and chlorine
C) Bicarbonate and carbonic acid
D) Phosphate and calcium
A) Hydrogen and potassium
Which of the following hormones stimulates the production of red blood cells in the bone marrow?

A) Aldosterone
B) Renin
C) Creatinine
D) Erythropoietin
D) Erythropoietin
Which of the following statements correctly describes a direct end-effect of the renin-angiotensin-aldosterone system?

A) Angiotensin II causes systemic vasoconstriction.
B) Aldosterone promotes the excretion of sodium and water in the renal tubules.
C) Renin promotes sodium and water reabsorption in the collecting tubules.
D) Aldosterone increases the permeability of the collecting tubules to water only.
A) Angiotensin II causes systemic vasoconstriction.
What percentage of filtered creatinine is excreted in the urine?

A) 0%
B) 20%
C) 50%
D) 100%
D) 100%
Which of the following hormones is produced and secreted by the juxtaglomerular apparatus in response to low blood pressure?

A) Renin
B) Aldosterone
C) Antidiuretic hormone
D) Natriuretic peptide
A) Renin
After passing through the proximal convoluted tubule, the urine filtrate flows into the:

A) loop of Henle.
B) minor calyx.
C) collecting tubule.
D) distal tubule.
A) loop of Henle.
Which of the following sexually transmitted diseases is associated with urinary tract infections?

A) Herpes simplex virus
B) Candida albicans
C) Human papillomavirus
D) Trichomoniasis
B) Candida albicans
What is the consequence of an upper urinary tract obstruction in a single ureter?

A) Renal stone formation
B) Hydronephrosis
C) Dilation of the urethra
D) Anuria
B) Hydronephrosis
A major modifiable risk factor for the development of renal calculi in the general population is:

A) obesity.
B) dehydration.
C) smoking.
D) drinking alcohol.
B) dehydration.
Which of the following procedures uses ultrasound waves to break large renal calculi into smaller stones that can be passed through the urinary tract?

A) Lithotripsy
B) Pyelography
C) Renal biopsy
D) Enterocystoplasty
A) Lithotripsy
Which of the following disorders is characterized by a lesion of the central or peripheral nervous system that affects bladder control?

A) Neurogenic bladder
B) Bladder dyssynergia
C) Bladder prolapse
D) Cystitis
A) Neurogenic bladder
Problems associated with a lower urinary tract obstruction include all of the following except:

A) urinary retention.
B) flank pain.
C) increased voiding frequency.
D) intermittent urinary stream.
B) flank pain.
A major risk factor for developing bladder cancer is:

A) exposure to asbestos.
B) urethral obstruction.
C) cystitis.
D) smoking.
D) smoking.
In addition to urinary tract infection, which of the following is a risk factor in the development of pyelonephritis?

A) Urinary retention and reflux
B) Nephrotic syndrome
C) Respiratory disease
D) Glomerulonephritis
A) Urinary retention and reflux
Which of the following symptoms manifests with both urinary tract infection and pyelonephritis?

A) Costovertebral (CVA) tenderness
B) Chills
C) Dysuria
D) Fever
C) Dysuria
What would urinalysis show in a patient who is developing glomerular disease?

A) Increased urine creatinine
B) Proteinuria
C) Low urine sodium
D) Presence of white blood cells
B) Proteinuria
Nephrotic syndrome occurs when there is loss of _____ in the urine.

A) red blood cells
B) sodium
C) glucose
D) protein
D) protein
In renal failure, the kidneys will continue to adapt until renal function reaches what percent of normal?

A) 75%
B) 50%
C) 25%
D) 10%
C) 25%
The primary manifestation of acute renal failure is:

A) proteinuria.
B) oliguria.
C) hematuria.
D) diuresis.
B) oliguria.
What is a primary laboratory finding in chronic renal failure?

A) Decreased blood urea nitrogen (BUN)
B) Decreased serum sodium
C) Metabolic alkalosis
D) Increased serum creatinine
D) Increased serum creatinine
Which of the following dietary nutrients must be restricted in individuals with advanced chronic renal failure?

A) Fats
B) Carbohydrates
C) Protein
D) All of the above
C) Protein
Which of the following complications associated with renal failure creates the greatest need for immediate dialysis?

A) Uremia
B) Increased creatinine
C) Hypertension
D) Hyperkalemia
D) Hyperkalemia
Which of the following is not a known cause of chronic renal failure?

A) Hypertension
B) Systemic lupus erythematosus
C) Diabetes
D) Angiotensin converting enzyme inhibitors
D) Angiotensin converting enzyme inhibitors
Which of the following systems are affected by uremia in renal failure?

A) Skin
B) Central nervous system
C) Reproductive system
D) All of the above
D) All of the above
Loss of one kidney results in ______ of the remaining kidney.

A) hyperplasia
B) hypertrophy
C) atrophy
D) dysplasia
B) hypertrophy
Obstruction of the lower urinary tract in males is often caused by:

A) congenital stricture of a calyx.
B) prostate enlargement.
C) pelvic organ prolapse.
D) urinary tract infection.
B) prostate enlargement.
Which of the following factors has a major influence on the development of renal calculi?

A) Urine sodium levels
B) Serum lactate levels
C) Urine pH
D) Urine creatinine levels
C) Urine pH
The main clinical manifestation of a kidney stone obstructing the ureter is:

A) pyuria.
B) renal colic.
C) urge incontinence.
D) an abdominal mass.
B) renal colic.
Which of the following are risk factors for the development of renal cell carcinoma?

A) Male gender
B) Tobacco use
C) Obesity
D) All of the above
D) All of the above
Which one of the following microorganisms causes the vast majority of urinary tract infections (UTIs)?

A) Klebsiella
B) Escherichia coli
C) Herpes simplex virus
D) Candida albicans
B) Escherichia coli
An important cause of bacterial persistence resulting in recurring urinary tract infections includes:

A) poor hygiene.
B) increased mucus secretion by the urinary tract.
C) microbial resistance to antibiotics.
D) acidic urine pH.
C) microbial resistance to antibiotics.
Which of the following diseases is a glomerular disorder?

A) Pyelonephritis
B) Obstructive uropathy
C) Interstitial cystitis
D) Nephrotic syndrome
D) Nephrotic syndrome
The cause of glomerulonephritis is:

A) infection of the glomerular capsule secondary to a urinary tract infection.
B) antigen-antibody complexes that deposit on the glomerular membrane.
C) hydronephrosis from kidney stones.
D) viral infection in the blood stream that migrates to the glomerulus.
B) antigen-antibody complexes that deposit on the glomerular membrane.
Which of the following infections is most commonly associated with the development of acute poststreptococcal glomerulonephritis?

A) Skin and wound infections
B) Throat infections
C) Endocarditis
D) Urinary tract infections
B) Throat infections
What is the cause of the peripheral edema that often manifests with glomerulonephritis and nephrotic syndrome?

A) Systemic inflammation
B) Right heart failure
C) Loss of plasma proteins in urine
D) Sodium retention
C) Loss of plasma proteins in urine
What is the cause of rapidly progressive glomerulonephritis in Goodpasture syndrome?

A) Autoimmune destruction of the glomerular membrane
B) Glomerular injury from drug toxicity
C) Viral infection of the glomerular membrane
D) Abnormal clotting in the glomerular capillaries
A) Autoimmune destruction of the glomerular membrane
Secondary forms of nephrotic syndrome are associated with all of the following conditions except:

A) diabetes.
B) hyperthyroidism.
C) renal disease.
D) systemic lupus erythematosus.
B) hyperthyroidism.
Renal insufficiency refers to a decline in renal function to ____ of normal.

A) 75%
B) 50%
C) 25%
D) 5%
C) 25%
Which of the following are symptoms of uremia and azotemia?

A) Pruritus
B) Fatigue
C) Nausea
D) All of the above
D) All of the above
Prerenal causes of acute renal failure include:

A) severe hypotension.
B) glomerulonephritis.
C) kidney stones.
D) acute tubular necrosis.
A) severe hypotension.
Acute tubular necrosis leading to acute renal failure can result from all of the following problems except:

A) increased ammonia levels from liver failure.
B) contrast dyes used for radiologic studies.
C) ischemia occurring after major surgery.
D) antibiotics that are nephrotoxic.
A) increased ammonia levels from liver failure.
Individuals with chronic renal failure are at risk for osteomalacia and spontaneous bone fractures because:

A) excess potassium leaches calcium from the bone.
B) erythropoietin secretion is impaired.
C) urea causes demineralization of the bone tissue.
D) of a vitamin D deficiency.
D) of a vitamin D deficiency.
In chronic renal failure, which of the following hormones often needs to be therapeutically replaced?

A) Antidiuretic hormone (ADH)
B) Cortisol
C) Erythropoietin
D) Aldosterone
C) Erythropoietin
Renal calculi are formed from all of the following substances except:

A) Struvite
B) Calcium oxalate
C) Uric acid
D) Urobilirubin
D) Urobilirubin