PATHOPHYSIOLOGY
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Homework for Chapter 29 - Alterations of Renal and Urinary Tract Function
Instructions:
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Use your lecture notes and textbook to find the answers to these questions.
When finished, enter your answers on the electronic version of the homework posted on
Canvas.
You may do this as many times as you want until you are happy with your grade.
1. 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
2. Loss of one kidney results in ______ of the remaining kidney.
A) hypertrophy
B) hyperplasia
C) atrophy
D) dysplasia
3. Renal calculi are formed from all of the following substances except:
A) Struvite
B) Calcium oxalate
C) Uric acid
D) Urobilirubin
4. 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
5. 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.
6. The main clinical manifestation of a kidney stone obstructing the ureter is:
A) pyuria.
B) renal colic.
C) urge incontinence.
D) an abdominal mass.
7. 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
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8. 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
9. 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.
10. 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.
11. Which of the following are risk factors for the development of renal cell carcinoma?
A) Long-term analgesic use
B) Tobacco use
C) Obesity
D) All of the above
12. A major risk factor for developing bladder cancer is:
A) exposure to asbestos.
B) urethral obstruction.
C) cystitis.
D) smoking.
13. 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
14. 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
15. 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) vesicoureteral reflux.
D) acidic urine pH.
16. In addition to urinary tract infection, which of these is a risk factor in the development of pyelonephritis?
A) Urinary retention and reflux
B) Nephrotic syndrome
C) Respiratory disease
D) Glomerulonephritis
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17. Which of the following symptoms manifests with both acute cystitis and acute pyelonephritis?
A) Costovertebral (CVA) tenderness
B) Chills
C) Dysuria
D) Fever
18. 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
19. Which of the following diseases is a glomerular disorder?
A) Pyelonephritis
B) Obstructive uropathy
C) Interstitial cystitis
D) Nephrotic syndrome
20. 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.
21. Nephrotic syndrome occurs when there is loss of _____ in the urine.
A) red blood cells
B) sodium
C) glucose
D) protein
22. 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
23. 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%
24. The primary manifestation of acute renal failure is:
A) proteinuria.
B) oliguria.
C) hematuria.
D) diuresis.
25. Prerenal causes of acute renal failure include:
A) severe hypotension.
B) glomerulonephritis.
C) kidney stones.
D) acute tubular necrosis.
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26. What is a primary laboratory finding in chronic renal failure?
A) Decreased blood urea nitrogen (BUN)
B) Increased serum sodium
C) Metabolic alkalosis
D) Increased serum creatinine
27. Which of the following are symptoms of chronic renal failure?
A) Pruritus
B) Edema
C) Nausea
D) All of the above
28. Which of the following is NOT a known cause of chronic renal failure?
A) Hypertension
B) Systemic lupus erythematosus
C) Angiotensin converting enzyme inhibitors
D) Diabetes
29. 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
30. 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
31. 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
Critical Thinking Questions
32. A patient is diagnosed with renal calculi. All of the following are possible sequelae EXCEPT:
A) upper urinary tract obstruction
B) lower urinary tract obstruction
C) glomerulonephritis
D) pyelonephritis
33. Diminished urine flow could lead to:
A) increased risk of bladder infection.
B) formation of renal calculi.
C) vesicoureteral reflux.
D) hydronephrosis.
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34. A six-year-old girl is brought to her pediatrician because she has blood in her urine. Two weeks
earlier she had strep throat. Which of the following problems is most likely?
A) nephrotic syndrome
B) Goodpasture syndrome
C) acute pyelonephritis
D) acute glomerulonephritis
35. The underlying pathophysiology of acute poststreptococcal glomerulonephritis is most similar to
which of the following?
A) Raynaud syndrome
B) atherosclerosis
C) rheumatic heart disease
D) acute respiratory distress syndrome
36. Which of the following typically occurs in acute renal failure but NOT chronic renal failure?
A) Need for kidney transplant
B) Recovery of function
C) End-stage renal failure
D) Development of azotemia