An Introduction to Human Disease 8th Edition Crowley Test Bank
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File: chap19, Chapter 19
- Which of the following does NOT occur as a complication of a kidney stone?
- Renal colic caused by passage of stone from kidney into ureter
- Kidney infection
- Hydronephrosis caused by obstruction of urinary drainage by stone impacted in the ureter
- Pyelonephritis results from which of the following?
- Formation of immune complexes that damage the glomeruli
- Bacterial infection of the kidney
- Formation of autoantibodies directed against the glomerular basement membrane
- Inadequate renal blood flow
- Which of the following statements regarding acute glomerulonephritis developing after a streptococcal infection is correct?
- It results from a bacterial infection of the glomeruli.
- Antigen-antibody complexes are filtered from the blood and accumulate within the walls of the glomerular capillaries where they incite an acute inflammation.
- The glomerular filtration rate is increased, leading to excess loss of fluid and electrolytes in the urine.
- It is usually associated with coexisting streptococcal infection of the bladder (cystitis).
- Which of the following statements regarding the nephrotic syndrome is correct?
- Production of plasma proteins by the liver is impaired as a result of kidney disease.
- Protein is lost in the urine more rapidly than it can be produced by the liver and blood protein falls, which is responsible for the edema.
- It is usually caused by a bacterial infection of the glomeruli, which impairs glomerular filtration.
- It is usually caused by renal tubular disease, which prevents reabsorption of protein filtered by the glomeruli.
- Which of the following statements regarding congenital polycystic kidney disease is INCORRECT?
- It is transmitted as a mendelian dominant trait.
- Enlarging cysts within the kidneys eventually destroy kidney function.
- The kidneys become greatly enlarged.
- Manifestations of kidney failure usually occur in late childhood or adolescence.
- It may be complicated by infection or bleeding in kidney cysts.
- A young woman experiences frequent urination with a burning sensation. Her urine contains many white blood cells and bacteria. There is no glucose or protein in the urine. What is the most likely cause of these manifestations?
- Congenital polycystic kidney disease
- Urinary tract infection
- Chronic glomerulonephritis
- Nephrotic syndrome
- Which of the following statements regarding urea is INCORRECT?
- It is a nitrogen-containing compound formed as a byproduct of protein metabolism.
- It is a toxic compound.
- It is a waste product excreted by the kidney.
- The concentration of urea in the blood is elevated in patients with renal failure.
Page: 480, 502
- All of the following diseases may damage the kidneys EXCEPT:
- lupus erythematosus.
- diabetes mellitus.
- infectious mononucleosis.
Page: 488-489, 490-491, 493
- The region of the kidney where the blood vessels enter and leave and where the ureter exits to descend to the bladder is called the __________.
- inner medulla
- renal pelvis
- hilus of the kidney
- What is the site where the afferent arteriole enters the glomerulus and the efferent arteriole exits?
- The Bowman’s capsule
- The vascular pole
- Glomerular arteriole
- Capsular epithelium
- What powerful vasoconstrictor raises the blood pressure by causing the peripheral arterioles to constrict?
- Angiotensin I
- Angiotensin II
- Angiotensin-converting enzyme
- Which of the following is NOT a condition that must be satisfied for the nephron to function normally?
- There must be free flow of blood through the glomerular capillaries.
- An adequate volume of filtrate must be produced, and the filter should not restrict passage of blood cells and proteins.
- The tubules must be able to reabsorb important substances from the filtrate to excrete other constituents into the filtrate.
- The urine formed must be able to flow freely from the kidney into the bladder and out of the urethra.
- Renal agenesis can best be described as which of the following?
- Fusion of the two kidneys
- Formation of extra ureters and renal pelves
- Improper positioning of one or both kidneys
- Failure of one or both kidneys to develop
- Which of the following statements regarding nephrotic syndrome is INCORRECT?
- The syndrome refers to a group of abnormalities characterized by an excess of protein in the urine.
- It may be produced by a number of different types of renal diseases.
- Patients have marked leg edema.
- It most frequently occurs in children.
- All of the following protect against cystitis and pyelonephritis EXCEPT:
- infrequent urination.
- large urine volume.
- complete emptying of the bladder.
- an acid urine.
- If a patient complains of burning pain on urination and a desire to urinate frequently, this person should be checked for which of the following conditions?
Ans: A and B
- Which of the following statements about vesicoureteral reflux is INCORRECT?
- This condition predisposes to urinary tract infection.
- Bacteria may also be carried into the upper urinary tract by the reflux of urine.
- This condition predisposes to gout.
- Residual urine remains in the bladder.
- Which of the following does not predispose to kidney stone formation?
- Increased concentration of salts in the urine
- Infection of the urinary tract
- Increased concentration of protein in the urine
- Urinary tract obstruction
- Which of the following statements about polycystic kidney disease is INCORRECT?
- It is a very common hereditary disease that affects as many as 1 in 400 persons.
- About 85% of cases result from a mutation of PKD2.
- Two different genes, PKD1 and PKD2, are involved.
- The disease is characterized by disturbed proliferation of tubular epithelial cells, which leads to the formation of cysts.
- A urinalysis can include all of the following EXCEPT which of the following?
- Determinations of urine PH
- Tests for glucose and protein
- Tests for fecal material
- Determinations of specific gravity
- Tests for acetone
- Approximately 50-75% of all cases of chronic renal failure result from which of the following?
- Chronic pyelonephritis
- Polycystic renal disease
- Diabetes and hypertension
- Chronic glomerulonephritis
- Autoimmune diseases
- Which of the following is NOT a symptom of renal failure?
- Retention of water weight
- Increase in blood volume
- Which of the following statements about hemodialysis is INCORRECT?
- Waste products diffuse from the blood into the dialysate because of differences in blood volume on the two sides of the membrane.
- It is usually performed in an outpatient dialysis center 3 times a week for 3-4 hours.
- This procedure substitutes for the functions of the kidneys.
- The dialysate flows on the other side of the membrane in a direction opposite to the blood flow.
- Which of the following does NOT describe creatine clearance?
- Higher in women
- Measures the ability of the kidneys to clear the blood of creatinine
- Creatinine is the breakdown product of phosphocreatine in the muscle.
- Expressed in milliliters of blood cleared of creatinine per minute
- Results represent the glomerular filtration rate
- Which of the following does NOT characterize Wilm’s tumor?
- It is a highly malignant tumor of primitive cells.
- It arises in the kidneys of infants and young children.
- It can metastasize widely.
- It is a type of a renal cortical adenoma.
- Treatment is by surgical resection with radiation and chemotherapy.
- Almost all tumors arising from the transitional epithelium of the urinary tract are malignant.
- Renal cortical adenomas are usually small and of no clinical significance.
- The procedure called extracorporeal shock wave lithotripsy is a method used to eliminate kidney stones using shock waves.
- Cystitis most commonly affects children. However, with corticosteroid therapy, most children can recover completely.
- Patients with arteriolar nephrosclerosis have marked leg edema, and often fluid collects in the abdominal cavity and sometimes in the pleural cavities.
- One of the less common ways for glomerulonephritis to develop is from an autoantibody directed against the basement membranes of the glomerular capillaries.
- Immune-complex glomerulonephritis is characterized by a relatively uniform layer of antibody and complement deposited along the inner surface of the glomerular basement membranes.
- The kidneys begin their development in the pelvis. As the embryo grows, the kidneys and their excretory ducts occupy a higher position, and eventually ascend to reach their final positions in the upper lumbar region.
- The backflow of urine into the ureters during urination is primarily prevented by the angle of each ureter entering the bladder.
- Urine is discharged into the bladder in part by gravity.
- A patient who has had a kidney transplant must continue to take immunosuppressive drugs indefinitely to prevent rejection of the new kidney.
- The ureteral openings in the bladder are partially covered by folds of mucosa to prevent the retrograde flow of urine.
- The signs and symptoms of uremia begin to appear when 50% of renal function is lost.
- Peristalsis of the muscular walls of the ureters prevents discharge of urine.
- Conversion of angiotensin I to angiotensin II is catalyzed by the angiotensin-converting enzyme from the renal endothelium.
- Match the disease with its characteristic feature.
___ Polycystic kidney disease
___ IgA nephropathy
- Kidney infection
- Mendelian dominant trait
- Nodular and diffuse basement membrane thickening
- Urate crystals plug tubules
- Immune complexes in mesangial cells
Ans: B, D, A, E, C
Page: 488, 490-491,
42 Name and describe the parts that comprise the juxtaglomerular apparatus.
Ans: 1. The juxtaglomerular apparatus is composed of the macula densa, a condensation of cells in the distal part of the renal tubule, where it is in contact with the vascular pole of the glomerulus. 2. The juxtaglomerular cells are specialized renin-containing smooth muscle cells located in the wall of the afferent glomerular arteriole at the vascular pole of the glomerulus. 3. A group of cells interposed between the vascular pole of the glomerulus and the macula densa.
- Provide the formula for the clearance test and define its parts.
Ans: Clearance = UV/P, where U is the concentration of the substance excreted in milligrams per milliliter of urine; V is the volume of urine excreted, expressed in millimeters per minute; and P is the concentration of the substance in the plasma expressed in milligrams per milliliter.
- Name and briefly explain the three basic types of dialyzers.
Ans: 1. The three basic types of dialyzers are coil dialyzers, plate dialyzers, and hollow fiber dialyzers. In a coil dialyzer, the blood flows through a tube made of synthetic, semipermeable membrane material. The tube is wrapped around a mesh screen to form a coil, and the dialysate flows around the coil. 2. In a plate dialyzer, blood flows within a synthetic, semipermeable membrane between two plates, and the dialysate flows in the opposite direction outside the membrane. 3. A hollow fiber dialyzer consists of a bundle of hollow synthetic fibers through which the blood passes. The dialysate circulates around the outside of the fibers in the opposite direction.
- What two mechanisms prevent the backflow of urine into the ureters?
Ans: Ureters enter the bladder at an angle such that as the bladder contracts, the muscles of the bladder compress the ureters like a one-way valve. Second, the ureteral openings in the bladder are partially covered by folds of mucosa that also help prevent the retrograde flow of urine.
- What is the trigone of the bladder?
Ans: The triangular area bounded by the urethral orifice anteriorly and by the ureteral openings posteriorly.
- What are the three main parts of the renal tubules and its main action?
Proximal convoluted tubule: greatly coiled first part of the tubule located close to the glomerulus
Loop of Henle: U-shaped segment composed of descending and ascending limbs (thin and thick segments of the loop of Henle)
Distal convoluted tubule: shorter than the proximal tubule and empties into the collecting tubule
Action: selective reabsorption of water, minerals, and other substances; excretion of waste; urine formation
- What are the requirements for normal renal function?
Free flow of blood through the glomerular capillaries
Normal glomerular filter function
Selective tubular reabsorption of important substances from the filtrate
Free flow of urine formed by the nephron in the kidneys into the bladder and the urethra
- Compare and contrast immune complex glomerulonephritis versus diabetic glomerulosclerosis.
Immune complex glomerulonephritis: antigen-antibody complexes are filtered from the blood and accumulate within the walls of the glomerular capillaries where they incite an acute inflammation. Injury to the tissues results from the action of complements and leukocytes; these block the glomeruli, resulting in less blood filtered, less urine output with retention of waste products in the blood, and leakage of proteins
Poststreptococcal infection: formation of immune complexes comprised of antistreptococcal antibodies and soluble streptococcal antigens; larger complexes become trapped into the glomerular capillaries inducing an inflammatory reaction
SLE: deposition of autoantibody-containing immune complexes in the glomeruli
IgA nephropathy: accumulation of immune complexes containing IgA with proliferation of mesangial cells, achromic and slowly progressive disease
Diabetic glomerulosclerosis: progressive renal damage in diabetes with nodular and diffuse thickening of the glomerular basement membrane and severe sclerosis of the glomerular arterioles Results in reduced glomerular blood flow, reduced urine formed, and leakage of protein
Page: 488, 490-491
- Describe three common developmental abnormalities of the kidneys.
Ans: Renal agenesis: failure of one or both kidneys to develop; bilateral agenesis is uncommon
Duplications of the urinary tract: formation of extra ureters and renal pelves secondary to the abnormal prenatal development of ureteric buds; may unilateral or bilateral; when there is an extra renal pelvis present, it is known as a complete duplication. Partial duplication is union of both ureters to form a single ureter that enters the bladder.
Abnormalities of position and fusion: kidneys either remain in the pelvis or ascend part way; most common fusion is the union of the lower poles of the two kidneys to form a U-shaped mass of renal tissue or a horseshoe-shaped kidney