Quiz 4 - Renal and Electrolyte Disorders

Question 1

Infants are at a higher risk for developing dehydration because they have:

a. a lower total body water volume.
b. a greater body surface area to volume ratio.
c. a decreased intravascular volume.
d. an increased tendency towards developing oedema.

Answer 1

b. a greater body surface area to volume ratio.

Question 2

A 10-year-old male is brought to the Emergency Department because he is incoherent and semiconscious. CT scan reveals he is suffering from cerebral oedema. This type of oedema is referred to as:

a. localised oedema.
b. generalised oedema.
c. pitting oedema.
d. lymphoedema.

Answer 2

a. localised oedema.

Question 3

Causes of acute renal injury include:

a. cholecystitis.
b. stones and strictures to kidneys or ureters.
c. heart failure leading to poor renal perfusion.
d. a., b. and c are correct.

Answer 3

d. a., b. and c are correct.

Question 4

A 60-year-old male is diagnosed with acute renal injury. Which of the following data is most indicative of acute renal injury?

a. alterations in blood pH accompanied by peripheral oedema
b. elevated plasma creatinine and decreased glomerular filtration rate
c. decreased plasma creatinine, potassium ions and calcium ions
d. decreased urine output, haematuria and increased glomerular filtration rate

Answer 4

b. elevated plasma creatinine and decreased glomerular filtration rate

Question 5

Chronic compensation for respiratory alkalosis includes:

a. increased renal excretion of H+.
b. decreased renal reabsorption of HCO3-.
c. prolonged exhalations to blow off CO2.
d. protein buffering.

Answer 5

b. decreased renal reabsorption of HCO3-.

Question 6

Kussmaul’s respirations (deep, rapid and sustained breaths) leading to a decreased PaCO2 are a compensatory mechanism for which acid-base imbalance:

a. respiratory alkalosis.
b. respiratory acidosis.
c. metabolic alkalosis.
d. metabolic acidosis.

Answer 6

d. metabolic acidosis.

Question 7

Nephrotic syndrome is associated with ________________ to plasma____________.

a. increased glomerular permeability; urea
b. decreased glomerular permeability; proteins
c. decreased glomerular permeability; tubular filtrate
d. increased glomerular permeability; proteins

Answer 7

d. increased glomerular permeability; proteins

Question 8

The presence of albumin in the urine would indicate probable damage to:

a. glomeruli.
b. loops of Henle.
c. proximal convoluted tubules.
d. none of the above.

Answer 8

a. glomeruli.

Question 9

Hypovolaemia is associated with all the following, EXCEPT:

a. severe vomiting.
b. severe diarrhea.
c. hypersecretion of aldosterone.
d. haemorrhage.

Answer 9

c. hypersecretion of aldosterone.

Question 10

Hypervolaemia is associated with all the following, EXCEPT:

a. excess IV fluid therapy.
b. increased blood volume.
c. hypersecretion of aldosterone.
d. haemorrhage.

Answer 10

d. haemorrhage

Question 11

One cause of metabolic alkalosis is:

a. retention of metabolic acids.
b. excessive diarrhoea.
c. excessive vomiting.
d. hyperventilation.

Answer 11

c. excessive vomiting.

Question 12

Acute compensation for metabolic acidosis includes:

a. increased kidney excretion of H+.
b. hyperventilation.
c. hypoventilation.
d. aldosterone secretion.

Answer 12

b. hyperventilation.

Question 13

Plasma is referred to as:

a. intracellular fluid.
b. extracellular fluid.
c. interstitial fluid.
d. intravascular fluid.

Answer 13

d. intravascular

Question 14

Which of the following conditions would decrease oncotic pressure in the capillaries?

a. high-protein diet
b. liver failure
c. low blood pressure
d. high blood-glucose

Answer 14

b. liver failure

Question 15

A 54-year-old female is diagnosed with nephrotic syndrome. Which of the following is a common symptom of this disease?

a. haematuria
b. dysuria
c. oliguria
d. proteinuria

Answer 15

d. proteinuria

Question 16

Which substance is an abnormal constituent of urine?

a. urea
b. glucose
c. sodium chloride
d. creatinine

Answer 16

b. glucose

Question 17

A 56-year-old male presents with flank pain and polyuria. Tests reveal that he has an enlarged prostate. Which of the following types of acute renal injury is most likely to occur?

a. prerenal
b. intrarenal
c. extrarenal
d. postrenal

Answer 17

d. postrenal

Question 18

A patient has a plasma sodium level of 130 mmol/L. What is this condition called?

a. hypernatraemia
b. hyponatraemia
c. hyperkalaemia
d. hypokalaemia

Answer 18

b. hyponatraemia

Question 19

Long-term regulation of acid-base balance through removal or retention of acids is accomplished by the:

a. buffer systems.
b. kidneys.
c. lungs.
d. liver.

Answer 19

c. lungs.

Question 20

A 10-year-old male was diagnosed with glomerulonephritis. History reveals that he had an infection 3 weeks before the onset of this condition. The infection was most likely located in the:

a. external ear.
b. bowel.
c. pharynx.
d. stomach.

Answer 20

c. pharynx.

Question 21

A 25-year-old male has a severe kidney obstruction leading to removal of the affected kidney. Which of the following would be expected to occur?

a. atrophy of the remaining kidney
b. compensatory hypertrophy of the remaining kidney
c. dysplasia in the remaining kidney
d. renal failure

Answer 21

b. compensatory hypertrophy of the remaining kidney

Question 22

The most common type of renal stone is composed of:

a. magnesium.
b. struvite.
c. calcium.
d. phosphate.

Answer 22

c. calcium.

Question 23

Acid-base imbalance causing metabolic acidosis is associated with the following conditions except:

a. chronic diabetes.
b. chronic alcoholism.
c. emphysema.
d. diarrhoea.

Answer 23

c. emphysema.

Question 24

A 42-year-old male is involved in a motor vehicle accident during which he loses a lot of blood. He develops acute kidney injury caused by:

a. kidney stones.
b. immune complex deposition in the glomerulus.
c. inadequate renal blood flow.
d. obstruction of the proximal tubule.

Answer 24

c. inadequate renal blood flow.

Question 25

A 45-year-old female presents with hypertension, anorexia, nausea and vomiting, and anaemia. She is diagnosed with chronic kidney disease. Anaemia in this patient is caused by: a. red blood cells being lost in the urine. b. inadequate production of erythropoietin. c. inadequate iron absorption in the gut. d. red blood cells being injured as they pass through the glomerulus.

Answer 25

b. inadequate production of erythropoietin.

Question 26

Which of the patients below is considered hypernatraemic? a. a patient with a plasma sodium level of 155 mmol/L b. a patient with a plasma sodium level of 136 mmol/L c. a patient with a plasma sodium level of 120 mmol/L d. a patient with a plasma sodium level of 145 mmol/L

Answer 26

a. a patient with a plasma sodium level of 155 mmol/L Hypernatraemic = >145 mmol/L

Question 27

A 19-year-old male presents to his primary care provider reporting restlessness, muscle cramping, and diarrhea. Lab tests reveal that he is hyperkalemic. Which of the following could have caused his condition? a. Primary hyperaldosteronism b. Acidosis c. Insulin secretion d. Diuretic use

Answer 27

B. Acidosis During acute acidosis, hydrogen ions accumulate in the ICF and potassium shifts out of the cell to the ECF, causing hyperkalemia. Primary hyperaldosteronism is associated with hypokalemia, not hyperkalemia. Insulin secretion helps reduce potassium levels in the cell, not cause it. Diuretics would cause hypokalemia, not hyperkalemia.

Question 28

Which of the following patients would be considered to have a significant risk of developing postrenal acute renal injury? a. A 78-year old male with diagnoses of poorly controlled diabetes mellitus and heart failure. b. A 20-year old male who is admitted for treatment of an overdose of a nephrotoxic drug. c. A 41-year old female who is admitted for intravenous antibiotic treatment of pyelonephritis. d. A 68-year old male with a diagnosis of benign prostatic hyperplasia.

Answer 28

d. A 68-year old male with a diagnosis of benign prostatic hyperplasia.

Question 29

The blood pH is maintained near 7.4 by buffering systems. The sequence from the fastest acting to the slowest acting buffering system is: a. lungs, kidneys, blood buffers. b. blood buffers, lungs, kidneys. c. blood buffers, kidneys, lungs. d. lungs, blood buffers, kidneys.

Answer 29

b. blood buffers, lungs, kidneys. (BLK)

Question 30

Which of the following alterations would result in fluid movement into the interstitial space? a. increased capillary oncotic pressure b. increased interstitial hydrostatic pressure c. decreased capillary hydrostatic pressure d. decreased capillary oncotic pressure

Answer 30

d. decreased capillary oncotic pressure

Question 31

Hyperkalaemia may cause: a. an increase in resting membrane potential of cardiac muscle cells. b. a decrease in resting membrane potential of cardiac muscle cells c. no change in the resting membrane potential of cardiac muscle cells.

Answer 31

a. an increase in resting membrane potential of cardiac muscle cells.

Question 32

A 54-year-old male with a long history of smoking complains of excessive tiredness and shortness of breath. Laboratory blood results reveal decreased pH, increased CO2 and normal bicarbonate ion. The most likely diagnosis is: a. respiratory alkalosis. b. metabolic acidosis. c. respiratory acidosis. d. metabolic alkalosis.

Answer 32

c. respiratory acidosis.

Question 33

A 70-year-old male with chronic renal failure presents with oedema. Which of the following is the most likely cause of this condition? a. increased capillary oncotic pressure b. decreased interstitial oncotic pressure c. increased capillary hydrostatic pressure d. increased interstitial hydrostatic pressure

Answer 33

c. increased capillary hydrostatic pressure