Quiz 18: Urinary System Disorders

Pathophysiology for the Health Professions

Nursing
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Questions

Q1
Free

Which of the following structures is most likely to be located in the renal medulla?

Multiple Choice
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A) Proximal convoluted tubule
B) Glomerulus
C) Loop of Henle
D) Afferent arteriole
Answer:
C) Loop of Henle
Q2
Free

Which of the following is NOT a function of the kidney?

Multiple Choice
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A) Regulation of body fluid concentrations
B) Removal of nitrogenous and acidic wastes
C) Activation of vitamin D
D) Production of albumin
Answer:
D) Production of albumin
Q3
Free

Which of the following describes the correct flow of blood in the kidney?

Multiple Choice
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A) Afferent arteriole to the peritubular capillaries to the venule
B) Efferent arteriole to the glomerular capillaries to the peritubular capillaries
C) Peritubular capillaries to the glomerular capillaries to the venule
D) Afferent arteriole to the glomerular capillaries to the efferent arteriole
Answer:
D) Afferent arteriole to the glomerular capillaries to the efferent arteriole
Q4

Which of the following describes the flow of filtrate in the kidney?

Multiple Choice
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A) The collecting duct to the distal convoluted tubule to the renal pelvis
B) Bowmans capsule to the proximal convoluted tubule to the loop of Henle
C) The loop of Henle to the collecting duct to Bowmans capsule
D) The distal convoluted tubule to the loop of Henle to the collecting duct
Answer:

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Q5

Which of the following describes the normal flow of urine?

Multiple Choice
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A) Collecting duct to the renal pelvis to the ureter to the bladder
B) Renal pelvis to the urethra to the bladder to the ureter
C) Ureter to the renal pelvis to the urethra to the bladder
D) Collecting duct to the ureter to the urethra
Answer:

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Q6

Which statement about the bladder is TRUE?

Multiple Choice
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A) The bladder wall lacks rugae.
B) Three openings from the urinary bladder form the trigone.
C) It contracts when stimulated by the sympathetic nervous system.
D) Continuous peristalsis in the bladder wall promotes urine flow.
Answer:

A) You need to subscribe to get the answer.

Q7

Which of the following increases glomerular filtration rate?

Multiple Choice
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A) Increased plasma osmotic pressure
B) Dilation of the efferent arteriole
C) Increased hydrostatic pressure in the glomerular capillaries
D) Constriction of the afferent arteriole
Answer:

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Q8

By what process is water reabsorbed from the filtrate?

Multiple Choice
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A) Osmosis
B) Active transport
C) Cotransport
D) Capillary action
Answer:

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Q9

Which substance directly controls the reabsorption of water from the collecting ducts?

Multiple Choice
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A) Renin
B) Aldosterone
C) Angiotensin
D) Antidiuretic hormone
Answer:

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Q10

Under what circumstances do cells in the kidneys secrete renin?

Multiple Choice
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A) The urine pH decreases.
B) Blood flow in the afferent arteriole decreases.
C) Serum potassium levels are high.
D) Serum osmotic pressure increases.
Answer:

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Q11

Which of the following should be present in the filtrate in the proximal convoluted tubule?

Multiple Choice
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A) Plasma proteins
B) Erythrocytes
C) Sodium ions
D) Leukocytes
Answer:

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Q12

From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.

Multiple Choice
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A) Albumin
B) Urea
C) Sodium
D) Creatinine
Answer:

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Q13

Involuntary urination by a child after age 4 or 5, when bladder control is expected, is referred to as:

Multiple Choice
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A) enuresis.
B) stress incontinence.
C) micturition.
D) overflow incontinence.
Answer:

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Q14

When a respiratory infection with high fever is present in the body, how would the kidney tubules maintain normal pH of body fluids?

Multiple Choice
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A) Increase the flow of filtrate.
B) Secrete more acids and reabsorb more bicarbonate ions.
C) Excrete a larger volume of more dilute urine.
D) Retain more potassium ions in exchange for sodium ions.
Answer:

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Q15

When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?

Multiple Choice
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A) Diffusion
B) Osmosis
C) Ultrafiltration
D) Active transport
Answer:

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Q16

What is the cause of most cases of pyelonephritis?

Multiple Choice
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A) An ascending infection by E. coli
B) Abnormal immune response, causing inflammation
C) Dialysis or other invasive procedure
D) Severe pH imbalance of urine
Answer:

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Q17

Which disease is manifested by dysuria and pyuria?

Multiple Choice
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A) Nephrotic syndrome
B) Cystitis
C) Glomerulonephritis
D) Urolithiasis
Answer:

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Q18

Why may acute pyelonephritis and cystitis follow untreated prostatitis?

Multiple Choice
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A) Microbes spread through the circulation.
B) Antibodies have not yet formed.
C) There is no effective treatment.
D) There is a continuous mucosa along the involved structures.
Answer:

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Q19

Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:

Multiple Choice
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A) microbes, leukocytes, and pus in the urine.
B) painful micturition.
C) urgency and frequency.
D) urinary casts and flank pain.
Answer:

A) You need to subscribe to get the answer.

Q20

In a case of acute pyelonephritis, what is the cause of flank pain?

Multiple Choice
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A) Inflammation, causing ischemia in the tubules
B) Inflammation, stretching the renal capsule
C) Increasing glomerular permeability, creating an increased volume of filtrate in the kidney
D) Microbes irritating the tissues
Answer:

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Q21

Which pathophysiological process applies to acute post-streptococcal glomerulonephritis?

Multiple Choice
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A) Streptococcal infection affects both the glomerular and tubule functions
B) Ischemic damage occurs in the tubules, causing obstruction and decreased glomerular filtration rate (GFR)
C) Immune complexes deposit in glomerular tissue, causing inflammation
D) Increased glomerular permeability for unknown reasons
Answer:

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Q22

What causes the dark urine associated with acute post-streptococcal glomerulonephritis?

Multiple Choice
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A) Blood and protein leaking through the capillary into the filtrate
B) Proteinuria and microscopic hematuria from the inflammation
C) Pyuria from inflammatory exudate
D) Bleeding from ulcerations in the kidneys
Answer:

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Q23

Renal disease frequently causes hypertension because:

Multiple Choice
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A) albuminuria increases vascular volume.
B) congestion and ischemia stimulate release of renin.
C) antidiuretic hormone (ADH) secretion is decreased.
D) damaged tubules absorb large amounts of filtrate.
Answer:

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Q24

Urinary casts are present with acute post-streptococcal glomerulonephritis because:

Multiple Choice
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A) large numbers of microbes and leukocytes enter the filtrate.
B) ruptured capillaries release debris into the tubules.
C) normal reabsorption of cells and proteins cannot take place.
D) inflamed tubules compress red blood cells (RBCs) and protein into a typical mass.
Answer:

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Q25

Which disease would cause an increased ASO titer and elevated serum ASK?

Multiple Choice
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A) Nephrotic syndrome
B) Acute post-streptococcal glomerulonephritis
C) Pyelonephritis
D) Polycystic kidney
Answer:

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Q26

Why does metabolic acidosis develop with bilateral kidney disease?

Multiple Choice
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A) Tubule exchanges are impaired.
B) GFR is increased.
C) Serum urea is increased.
D) More bicarbonate ion is produced.
Answer:

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Q27

What is the first indicator in the arterial blood gases of acidosis caused by glomerulonephritis?

Multiple Choice
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A) Increased carbonic acid
B) Increased bicarbonate ion
C) A pH less than 7.35
D) Decreased bicarbonate ion
Answer:

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Q28

What would be the long-term effects of chronic infection or inflammation of the kidneys?

Multiple Choice
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A) Dehydration and hypovolemia
B) Gradual necrosis, fibrosis, and development of uremia
C) Sudden anuria and azotemia
D) Severe back or flank pain
Answer:

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Q29

What factors contribute to headache, anorexia, and lethargy with kidney disease? 1. Increased blood pressure 2. Elevated serum urea 3. Anemia 4. Acidosis

Multiple Choice
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A) 1 only
B) 2, 4
C) 1, 3, 4
D) 1, 2, 3, 4
Answer:

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Q30

What are the significant signs of nephrotic syndrome?

Multiple Choice
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A) Hyperlipidemia and lipiduria
B) Pyuria and leucopenia
C) Hypertension and heart failure
D) Gross hematuria and pyuria
Answer:

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Q31

Why does blood pressure often remain near normal in patients with nephrotic syndrome?

Multiple Choice
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A) Massive amounts of fluid are lost from the body with polyuria.
B) Renin and aldosterone are no longer secreted.
C) Tubules do not respond to ADH and aldosterone.
D) Hypovolemia results from fluid shift to the interstitial compartment.
Answer:

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Q32

Common causes of urolithiasis include all of the following EXCEPT:

Multiple Choice
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A) hypercalcemia.
B) hyperlipidemia.
C) inadequate fluid intake.
D) hyperuricemia.
Answer:

A) You need to subscribe to get the answer.

Q33

Which of the following results from obstruction of the left ureter by a renal calculus?

Multiple Choice
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A) Mild flank pain on the affected side
B) Hydronephrosis in both kidneys
C) Immediate cessation of urine production
D) An attack of renal colic
Answer:

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Q34

What does hydronephrosis lead to?

Multiple Choice
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A) Ischemia and necrosis in the compressed area
B) Multiple hemorrhages in the kidney
C) Severe colicky pain radiating into the groin
D) Increased GFR
Answer:

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Q35

Which of the following is a predisposing factor to bladder cancer?

Multiple Choice
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A) Prostatic cancer
B) Hormonal abnormalities
C) Exposure to chemicals and cigarette smoke
D) Presence of embryonic tissue
Answer:

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Q36

What is the common initial sign of adenocarcinoma of the kidney?

Multiple Choice
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A) Gross hematuria
B) Microscopic hematuria
C) Sharp flank pain
D) Oliguria
Answer:

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Q37

Which of the following does NOT usually result from nephrosclerosis?

Multiple Choice
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A) Secondary hypertension
B) Chronic renal failure
C) Acute renal failure
D) Increased renin and aldosterone secretions
Answer:

A) You need to subscribe to get the answer.

Q38

Which of the following relates to polycystic kidney disease?

Multiple Choice
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A) It affects only one of the kidneys.
B) It results in gradual degeneration and chronic renal failure.
C) The kidneys are displaced and the ureters are twisted.
D) The prognosis is good because there is adequate reserve for normal life.
Answer:

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Q39

Which of the following is related to Wilms tumor?

Multiple Choice
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A) Direct exposure to carcinogens
B) Hormonal imbalance
C) Repeated infections
D) A genetic defect
Answer:

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Q40

With severe kidney disease, either hypokalemia or hyperkalemia may occur and cause:

Multiple Choice
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A) cardiac arrhythmias.
B) encephalopathy.
C) hypervolemia.
D) skeletal muscle twitch or spasm.
Answer:

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Q41

Which of the following indicates the early stage of acute renal failure?

Multiple Choice
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A) Polyuria with urine of fixed and low specific gravity
B) Hypotension and increased urine output
C) Development of decompensated acidosis
D) Very low GFR and increased serum urea
Answer:

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Q42

What is/are a cause(s) of acute tubule necrosis and acute renal failure?

Multiple Choice
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A) Prolonged circulatory shock
B) Sudden significant exposure to nephrotoxins
C) Crush injuries or burns
D) All of the above
Answer:

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Q43

Which of the following would likely cause chronic renal failure?

Multiple Choice
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A) Cystitis with pyelonephritis in the right kidney
B) Circulatory shock
C) Diabetes
D) Obstruction of a ureter by a renal calculus
Answer:

A) You need to subscribe to get the answer.

Q44

What causes polyuria during the stage of renal insufficiency?

Multiple Choice
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A) Loss of tubule function
B) Increased blood pressure
C) Decreased aldosterone secretion
D) Increased GFR
Answer:

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Q45

What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?

Multiple Choice
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A) Decreased parathyroid hormone secretion
B) Insufficient calcium in the diet
C) Excessive excretion of calcium ions in the urine
D) A deficit of activated vitamin D and hyperphosphatemia
Answer:

A) You need to subscribe to get the answer.

Q46

Cystitis is more common in females because:

Multiple Choice
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A) the mucosa in the urinary tract is continuous.
B) the urethra is short, wide, and adjacent to areas with resident flora.
C) the pH of urine is more acidic in females.
D) females have a higher incidence of congenital anomalies.
Answer:

A) You need to subscribe to get the answer.

Q47

Which of the following indicate a decreased GFR?

Multiple Choice
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A) Increased serum urea and decreased serum bicarbonate
B) Urine with low specific gravity and dark color
C) Albuminuria and hematuria
D) Hyponatremia and hypokalemia
Answer:

A) You need to subscribe to get the answer.

Q48

Which of the following is NOT likely to lead to hydronephrosis?

Multiple Choice
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A) Renal calculi
B) Pyelonephritis
C) Nephrosclerosis
D) Benign prostatic hypertrophy
Answer:

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Q49

Which of the following congenital defects is a common cause of cystitis in young children?

Multiple Choice
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A) Polycystic kidney
B) Horseshoe kidney
C) Hypoplasia of the kidney
D) Vesicoureteral reflux
Answer:

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Q50

Which factor contributes to severe anemia in individuals with chronic renal failure?

Multiple Choice
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A) Increased erythropoietin secretion
B) Limited protein intake
C) Compensatory increase in bone marrow activity
D) Inability to absorb vitamin B12 and iron
Answer:

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Q51

When acidosis becomes decompensated in renal failure, a key indicator is:

Multiple Choice
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A) increased PCO2.
B) increased bicarbonate ion.
C) serum pH dropping below 7.35.
D) serum buffer ratio of 20 bicarbonate ions to 1 carbonic acid.
Answer:

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Q52

What is the primary action of the diuretic furosemide?

Multiple Choice
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A) Decreased reabsorption of sodium and water
B) Decreased reabsorption of H+ in the tubules
C) Increased secretion of antidiuretic hormone
D) Inhibition of renin
Answer:

A) You need to subscribe to get the answer.

Q53

Which of the following causes acute renal failure?

Multiple Choice
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A) Polycystic kidney disease
B) Pyelonephritis in the right kidney
C) Nephrosclerosis
D) Bilateral acute glomerulonephritis
Answer:

A) You need to subscribe to get the answer.

Q54

Which of the following is a significant indicator of renal insufficiency?

Multiple Choice
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A) Urine with pH of 5
B) Increased serum urea and creatinine
C) Urine with high specific gravity
D) Decreased blood pressure
Answer:

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Q55

Uremic signs of renal failure include all of the following EXCEPT:

Multiple Choice
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A) encephalopathy.
B) high blood pressure.
C) osteodystrophy.
D) azotemia and acidosis.
Answer:

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Q56

Choose the basic cause of osteodystrophy associated with chronic renal failure.

Multiple Choice
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A) Development of hypercalcemia
B) Deficit of parathyroid hormone
C) Failure of the kidney to activate vitamin D
D) Excessive loss of phosphate ion
Answer:

A) You need to subscribe to get the answer.

Q57

Agenesis is often not diagnosed because:

Multiple Choice
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A) the kidney is displaced from its normal position.
B) it is a genetic defect and asymptomatic until mid-life.
C) the two functioning kidneys are fused together.
D) it is usually asymptomatic as one kidney provides adequate function.
Answer:

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Q58

The normal pH of urine is:

Multiple Choice
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A) 7.35-7.45.
B) 4.5- 8.0.
C) 1.5-7.5.
D) 1.0-7.0.
Answer:

A) You need to subscribe to get the answer.

Q59

Wilms tumor is:

Multiple Choice
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A) a malignant tumor in the bladder.
B) an encapsulated mass in one kidney.
C) not considered to have a genetic origin.
D) manifested in adulthood.
Answer:

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Q60

Reduced urine output resulting from inflammation and necrosis of the tubules is called:

Multiple Choice
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A) oliguria.
B) anuria.
C) pyuria.
D) polyuria.
Answer:

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Q61

The micturition reflex is initiated by:

Multiple Choice
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A) sympathetic nerves in the sacral spinal cord.
B) relaxation of the internal sphincter of the bladder.
C) increased pressure distending the bladder.
D) contraction of the bladder.
Answer:

A) You need to subscribe to get the answer.

Q62

Which of the following results from decreased blood flow into the kidneys?

Multiple Choice
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A) Decreasing blood pressure
B) Dilation of the afferent arterioles
C) Decreased aldosterone secretion
D) Increased angiotensin and systemic vasoconstriction
Answer:

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Q63

In acute post-streptococcal glomerulonephritis, the glomerular inflammation results from:

Multiple Choice
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A) toxins produced by the bacteria.
B) a type III hypersensitivity reaction.
C) an ascending infection from the bladder.
D) spread of infection from the tubules.
Answer:

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Q64

In acute post-streptococcal glomerulonephritis, the inflammation causes:

Multiple Choice
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A) increased permeability of the glomerular capillaries.
B) glomerular congestion and decreased GFR.
C) decreased blood pressure and edema.
D) A and B
Answer:

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Q65

Circulatory shock causes:

Multiple Choice
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A) decreased GFR and increased renin secretion.
B) increased ADH and decreased aldosterone secretion.
C) immediate tubule necrosis and obstruction.
D) sympathetic nervous system (SNS) stimulation and vasodilation of afferent and efferent arterioles.
Answer:

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Q66

Autoregulation in the kidneys refers to:

Multiple Choice
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A) control of blood flow by the SNS.
B) the secretion of renin and activation of angiotensin.
C) local minor reflex adjustments in the arterioles to maintain normal blood flow.
D) the control of systemic blood pressure by the kidneys.
Answer:

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Q67

The reabsorption of water and electrolytes by the kidneys is directly controlled by: 1. atrial natriuretic hormone. 2. antidiuretic hormone. 3. angiotensin. 4. the levels of bicarbonate ion.

Multiple Choice
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A) 2 only
B) 3 only
C) 1, 2
D) 2, 4
Answer:

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Q68

Uncontrolled essential hypertension may cause chronic renal failure because of:

Multiple Choice
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A) predisposition to recurrent urinary tract infections.
B) damage to afferent arterioles and renal ischemia.
C) failure of tubules to respond to hormonal controls.
D) glomerular congestion causes damaged capillaries.
Answer:

A) You need to subscribe to get the answer.

Q69

Urine with a low specific gravity is usually related to:

Multiple Choice
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A) an infection of the gallbladder.
B) renal failure due to tubule damage.
C) lack of sufficient fluid intake.
D) presence of numerous renal calculi.
Answer:

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Q70

Excess urea and other nitrogen wastes in the blood is referred to as:

Multiple Choice
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A) dysuria.
B) azotemia.
C) bacteremia.
D) hematuria.
Answer:

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