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A 45-year-old woman begins hemodialysis for end-stage renal disease associated with diabetes mellitus. Which of the following is the most likely eventual cause of her death? A. Dementia B. Major bleeding episode C. Myocardial infarction D. Progressive uremia E. Sepsis - -- <> ---C. Myocardial infarction Which of the following acute kidney injury patients is most likely to have evidence of hydronephrosis on ultrasound evaluation of the kidneys? A. A 19-year-old man with purpura fulminans associated with gonococcal sepsis B. A 37-year-old woman undergoing chemotherapy and radiation for advanced cervical cancer C. A 53-year-old man with E. coli 0157:H7 associated thrombotic thrombocytopenic purpura
D. An 85-year-old nursing home resident with pyelonephritis and sepsis - -- <> ---B. A 37-year-old woman undergoing chemotherapy and radiation for advanced cervical cancer Which of the following is a potential etiology for ischemic acute renal failure? A. Apoptosis and necrosis of tubular cells B. Decreased glomerular vasodilation in response to nitric oxide C. Increased glomerular vasoconstriction in response to elevated endothelin levels D. Increased leukocyte adhesion within the glomerulus E. All of the above - -- <> ---E. All of the above A 48-year-old man with diabetes mellitus and hyperlipidemia presents to the emergency department for evaluation of right flank pain and groin pain that has been severe and present for approximately 3 hours. He is diagnosed with a kidney stone. Which of the following is most likely to be found as the constituent of his stone? A. Calcium B. Cysteine C. Oxalic acid D. Struvite E. Uric acid - -- <> ---A. Calcium 40 some year old man complaining of dull left sided scrotal pain and swelling. Swelling goes away when he lies down. He isnt sure when symptoms started. Slowly progressive for years. Further questioning reveals he is infertile. What
A: ensures adequate energy for the adrenal glands to operate efficiently B: stabilizes the position of the kidneys by holding them in their normal position C: is necessary as a barrier between the adrenal glands and the kidneys D: produces Vitamin D - -- <> ---B: stabilizes the position of the kidneys by holding them in their normal position The function of angiotensin II is to: A: constrict arterioles and increase blood pressure B: decrease the production of aldosterone C: Increases secretion of ADH D: inhibits the release of ADH - -- <> ---A: constrict arterioles and increase blood pressure Urine passes through the: A: renal hilum to the bladder to the ureter B: pelvis of the kidney to ureter to bladder to urethra C: glomerulus to ureter to renal tubule D: hilum to urethra to bladder - -- <> ---B: pelvis of the kidney to ureter to bladder to urethra The juxtaglomerular apparatus is responsible for ________. A. the secretion of drugs B. the secretion of acids and ammonia C. reabsorption of organic molecules, vitamins, and water
D. regulating the rate of filtrate formation and controlling systemic blood pressure
- -- <> ---D. regulating the rate of filtrate formation and controlling systemic blood pressure Which of the hormones below is responsible for facultative water reabsorption? A. ADH B. thyroxine C. aldosterone D. atrial natriuretic peptide - -- <> ---A. ADH Which of the choices below are the most important hormone regulators of electrolyte reabsorption and secretion? A. angiotensin II and ADH B. angiotensin II and aldosterone C. angiotensin I and epinephrine D. angiotensin I and atrial natriuretic peptide - -- <> ---B. angiotensin II and aldosterone Which of the following conditions can cause frothy or sudsy urine? A. High concentrations of urinary protein B. Myoglobinuria C. Porphyrinuria D. Porphobilinuria - -- <> ---A. High concentrations of urinary protein
D. diuretics - -- <> ---A. ACE inhibitors Isolated hematuria is urinary RBCs without other urine abnormalities (eg. Proteinuria, casts). The most common causes in adults are UTI, prostatitis, and which of the following? A. vigorous exercise B. urinary calculi C. polycystic kidney disease D. glomerular disorders - -- <> ---B. urinary calculi A history of travel to the Middle East should suggest which of the following as a possible cause of hematuria? A. mixed cryoglobinemia B. schistosomiasis C. Group A B-hemolytic streptococcal infections D. IgA nephropathy - -- <> ---B. schistosomiasis Excruciating colicky pain indicates which of the following causes of isolated hematuria? A. cancer B. glomerulonephritis C. calculi D. polycystic kidney disease - -- <> ---C. calculi
The presence of which of the following essentially rules out a glomerular disorder as the cause of isolated hematuria? A. blood clots in the urine B. hypertension C. infection preceding symptoms D. edema - -- <> ---A. blood clots in the urine In men with urethritis, which of the following symptoms is usually present: A: scrotal pain B: profuse urine C: urethral dc D: flank pain - -- <> ---C: urethral dc A 35-year-old woman just back from her honeymoon has urinary frequency, urgency, painful voiding of small volumes of urine and lower abdominal pain. What is the most likely diagnosis? A: uncomplicated UTI B: UTI due to urinary tract obstruction C: asymptomatic bacteriuria D: early pregnancy - -- <> ---A: uncomplicated UTI In men, urethritis occurs when organisms that gain access to the urethra acutely or chronically colonize the structures of the urethra. This infection can be associated with sexually transmitted pathogens. Which of the following pathogens is most common in this scenario?
Asymptomatic candiduria rarely requires therapy. Candiduria should be treated in all EXCEPT which of the following patients? A. Patients who are undergoing urologic manipulation B. Patients with catheters colonized by fungi C. Neutropenic patients D. Patients with renal allografts - -- <> ---B. Patients with catheters colonized by fungi Renal candidiasis commonly originates from which of the following? A. The circulatory system B. A nephrostomy tube C. The GI tract D. The urinary tract - -- <> ---C. The GI tract Which of the following complications of candidal UTI is rare? A. Severe renal failure B. Pyelonephritis C. Intrarenal abscess D. Papillary necrosis - -- <> ---A. Severe renal failure Most patients with candiduria are asymptomatic. However, among the symptoms of lower UTIs, which of the following may be more characteristic of candidal infection? A. Urinary frequency and urgency
B. Urethral obstruction C. Suprapubic pain D. Hematuria - -- <> ---B. Urethral obstruction For symptomatic candidal cystitis, treatment is with fluconazole. Which drug may help eradicate candiduria due to non-albicans species of Candida? A. Voriconazole B. Flucytosine C. Amphotericin B D. Fluconazole - -- <> ---B. Flucytosine Which of the following is the most likely underlying cause of acute kidney injury in a patient with an elevated serum creatine kinase level? A. Goodpasture syndrome B. Systemic lupus erythematosis C. Rhabdomyolysis D. Multiple myeloma - -- <> ---C. Rhabdomyolysis Patients with trauma, burns, or severe hemorrhage are at increased risk for developing AKI. This risk can be minimized by observing which of the following preventive actions? A. Maintaining normal fluid balance, blood volume, and blood pressure B. Maintaining normal levels of BUN and creatinine C. Restricting protein, sodium and potassium intake
In patients with chronic kidney disease (CKD), a loss of 75% of renal tissue causes a fall in GFR to A: 75% of normal B: 50% of normal C: 25% of normal D: 5% of normal - -- <> ---B: 50% of normal In distinguishing acute from chronic renal failure, which of the following is the most reliable evidence of CKD? A: History of increased serum creatinine B: History of increased BUN C: Above-normal plasma sodium D: Above-normal serum calcium - -- <> ---A: History of increased serum creatinine Which of the following are often the earliest manifestations of uremia? A. Lassitude, fatigue, and decreased mental acuity B. Nocturia, excessive thirst, and hunger C. Muscle cramps, hyperreflexia, and restless legs syndrome D. Anorexia, nausea, and vomiting - -- <> ---A. Lassitude, fatigue, and decreased mental acuity In determining prognosis for a patient with CKD, progression of the disease is predicted in most cases by a) Kidney size on an ultrasound
b) Abnormalities in sodium-water balance c) Chronically elevated hemoglobin A1C levels d) The degree of proteinuria - -- <> ---d) The degree of proteinuria In prescribing nutritional therapy for patients with CKD, which of the following parameters should be used to guide vitamin D dosage levels? a) Serum vitamin D levels b) Levels of dietary vitamin D c) Parathyroid hormone concentrations d) Serum calcium levels - -- <> ---c) Parathyroid hormone concentrations You have a Hispanic woman with urinary frequency, urgency, and burning at urination. Suspicion of cystitis. What would be the most likely causative agent of this? - -- <> ---- E. coli, Klebsiella, Proteus mirabilis, pseudomonas aeruginosa 10 yr old boy with sx. Of frequency, urgency, and dysuria in the past 5 days. He has a mild fever and has just finished tx. For a UTI that occurred a month ago. In the past 2 years, he has 5-6 episodes of these sx. At this point, what would you consider doing for this pt.? - -- <> ---Treat him with oral antibiotics and schedule him for a cystoscopy. A body's response to decrease ECV that would cause sodium retention is/area: a. Increase aldosterone b. Increase ADH
d. Bactrin DS - -- <> ---•B. Amoxicillin Of the following diuretics which one is potassium sparing diuretic? a. Lasix b. Triamterene c. Zaroxylin d. Mannitol - -- <> ---B. Triamterene You want to confirm that a pt. has renal parenchymal disease, what test would you order to confirm this? - -- <> ---radionuclide scanning? A person was admitted in a coma. Analysis of the arterial blood gave the following values: PCO2 16 mm Hg, HCO3- 5 mmol/l and pH 7.1. What is the underlying acid- base disorder? a) Metabolic Acidosis b) Metabolic Alkalosis c) Respiratory Acidosis d) Respiratory Alkalosis - -- <> ---a) Metabolic Acidosis In patients who are suffering from a recurrent infection of the GU tract the most common relapse or re-infection is due to? a. Cystitis b. Prostatitis c. Pyelonephritis
d. Urethritis - -- <> ---B. prostatitis UA and you notice that uric acid crystals in the sediment. Of the following, what would be true concerning uric acid crystals? - -- <> ----increased urine acidity What is the leading cause of death in patients with chronic kidney disease? A. Cardiovascular disease B. Hyperkalemia C. Infection D. Malignancy E. Uremia - -- <> ---A. Cardiovascular disease A 47-year-old man with a history of diabetes mellitus, hyperlipidemia, tobacco abuse, and coronary artery disease undergoes emergency appendectomy. Which of the following conditions predisposes this patient to postoperative acute kidney injury? A. Abdominal procedure, emergency surgery, and hyperlipidemia B. Age greater than 40, abdominal procedure, and emergency surgery C. Age greater than 40, emergency surgery, and diabetes mellitus D. Coronary artery disease, tobacco abuse, and abdominal procedure E. Diabetes mellitus and emergency procedure - -- <> ---C. Age greater than 40, emergency surgery, and diabetes mellitus
E. Sepsis - -- <> ---C. Myocardial infarction Which of the following acute kidney injury patients is most likely to have evidence of hydronephrosis on ultrasound evaluation of the kidneys? A. A 19-year-old man with purpura fulminans associated with gonococcal sepsis B. A 37-year-old woman undergoing chemotherapy and radiation for advanced cervical cancer C. A 53-year-old man with E. coli 0157:H7 associated thrombotic thrombocytopenic purpura D. An 85-year-old nursing home resident with pyelonephritis and sepsis - -- <> ---B. A 37-year-old woman undergoing chemotherapy and radiation for advanced cervical cancer Which of the following is a potential etiology for ischemic acute renal failure? A. Apoptosis and necrosis of tubular cells B. Decreased glomerular vasodilation in response to nitric oxide C. Increased glomerular vasoconstriction in response to elevated endothelin levels D. Increased leukocyte adhesion within the glomerulus E. All of the above - -- <> ---E. All of the above A 48-year-old man with diabetes mellitus and hyperlipidemia presents to the emergency department for evaluation of right flank pain and groin pain that has been severe and present for approximately 3 hours. He is diagnosed with a kidney stone. Which of the following is most likely to be found as the constituent of his stone? A. Calcium
B. Cysteine C. Oxalic acid D. Struvite E. Uric acid - -- <> ---A. Calcium 40 some year old man complaining of dull left sided scrotal pain and swelling. Swelling goes away when he lies down. He isnt sure when symptoms started. Slowly progressive for years. Further questioning reveals he is infertile. What would be the most likely diagnosis? - -- <> ---Varicocele - enlargement of the veins w/in the scrotum The maximum size of the conduit or pipe shall NOT exceed _______ of the thickness of the concrete. - -- <> ---1/ Which of the following tests for concrete is conducted at the site/field? - -- <> ---Color Test Explanation: Rest of the above are laboratory tests. If the concrete compressive strength specified is less than 3600 psi, it has the option of being tested at 28 days and is able to accept the concrete if it attains ___________ percentage of the minimum required strength. - -- <> --- 85
