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Flashcards in Rein (Biochimie) Deck (183)
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1

A physician calls in the laboratory and asks what lab tests should be requested to assess the regulatory function of a patient's renal system. Your response is serum

  1. creatinine, serum urea, serum uric acid, and creatinine clearance
  2. bilirubin and urine urobilinogen
  3. renin and erythropoietin
  4. and urine sodium and potassium, arterial blood pH, and sodium bicarbonate

 

4 - serum and urine sodiam and potassium, arterial blood pH, and sodium bicarbonate

 

2

Which of the following laboratory results would point to a diagnosis of acute nephritic syndrome:

  1. increased serum protein, increased GFR, and hematuria
  2. increased WBCs in the urine, bacteria in the urine, decrease GFR, and proteinuria
  3. hematuria, sodium retention, decreased GFR, and proteinuria
  4. normal serum urea and creatinine, increased GFR, and massive proteinuria

 

3 - hematuria, sodium retention, decreased GFR, and proteinuria

 

3

A 4 year old girl has edema that is most obvious around her ankles and face, and a rash. Her laboratory findings reveal: serum protein 4.8 g/dL (low), serum cholesterol 450 mg/dL (high), serum urea 20 mg/dL (high), heavy urine protein (high), and negative urine blood (normal). All other values were normal. These findings are most consistent with a diagnosis of:

  1. nephrotic syndrome
  2. acute pyelonephritis
  3. IgA nephropathy
  4. acute poststreptococcal glomerulonephritis

 

1 - nephrotic syndrome

 

4

A toxic condition involving a very high serum level of urea and creatinine accompanied by failure of the three main functions of the renal system is referred to as:

  1. uremic syndrome
  2. acute renal failure
  3. azotemia
  4. acute glomerulonephritis

 

1 - uremic syndrome

 

5

The functional unit of the kidney is the:

  1. lobule
  2. bladder
  3. glomerulus
  4. nephron

 

4 - nephron

6

If a physician orders a creatinine clearance of an individual, what is he or she attempting to determine:

  1. glomerular filtration rate (GFR)
  2. 24 hour urine output volume
  3. serum creatinine level
  4. urine creatinine level

 

1 - glomerular filtration rate

 

7

The major function of the loops of Henle in the kidney is to

  1. secrete ions under hormonal control
  2. eliminate urea
  3. adjust urine osmolality
  4. conserve protein

 

3 - adjust urine osmolality

8

Which one of the following statements regarding creatinine is correct:

  1. serum creatinine levels are elevated early in all renal disease
  2. normal plasma creatinine does not always indicate normal kidney function
  3. creatinine levels fluctuate in a diurnal manner
  4. creatinine is completely reabsorbed by the renal tubules

 

2 - normal plasma creatinine does not always indicated normal kidney function

 

9

Secretion of renin and antidiuretic hormone (ADH) is induced by low blood pressure and volume. Renin is synthesized in the ______ and ADH is made in the ________.

  1. brain; adrenal gland
  2. kidney; brain
  3. adrenal gland; brain
  4. adrenal gland; kidney

 

2 - kidney; brain

 

10

Secretion of renin and antidiuretic hormone (ADH) is induced by low blood pressure and volume. What other hormone would be released in the event of low blood pressure and volume:

  1. 1,25 (OH2) vitamin D3
  2. growth hormone
  3. erythropoietin
  4. aldosterone

 

4 - aldosterone

 

11

Where is aldosterone synthesized:

  1. kidney juxtaglomerular cells
  2. brain
  3. adrenal gland
  4. kidney proximal tubular epithelial cells

 

3 - adrenal gland

 

12

Upon microscopic examination, a patient's urine exhibits many bacteria, white blood cells, and cellular casts composed of polymorphonuclear leukocytes. It is likely that this individual has:

  1. pyelonephritis
  2. rapidly progressing glomerulonephritis
  3. urinary tract infection
  4. end-stage renal disease

 

1 - pyelonephritis

 

13

If a freshly voided morning urine specimen has a pH of 6.0 in the absence of any other systemic disease, what is the likely cause:

  1. it is increased above the reference interval due to the conversion of urea to ammonia
  2. this pH is within the healthy reference interval for this speciman
  3. it has decreased below the reference interval due to the urea content
  4. there is likely the onset of distal renal tubular acidosis

 

2 - this pH is within the healthy reference interval for this specimen

 

14

Damage to the glomerulus would be suspected when the urine sediment contains:

  1. proteinaceous casts
  2. red blood cell casts
  3. visible proteins
  4. crystals

 

2 - red blood cell casts

 

15

An individual is admitted to the emergency department of the hospital with possible carbon monoxide intoxication. What kidney hormone might be relased in this case:

  1. ADH
  2. aldosterone
  3. erythropoietin
  4. renin

 

3 - erythropoietin

 

16

The portion of a nephron that is most important in maintaning plasma electrolyte balance is the:

  1. glomerulus
  2. proximal tubule
  3. loop of Henle
  4. distal tubule

 

4 - distal tubule

 

17

Renal colic is:

  1. a consequence of urinary obstruction usually above the bladder with dilation of the renal pelvis
  2. associated with chronic pyelonephritis
  3. caused by elevated blood renin due to a tumor of the kidney
  4. severe flank pain observed in an individual with renal calculi

 

4 - severe flank pain observed in an individual with renal calculi

18

The most common glomerular disease woldwide is

  1. acute proliferative glomerulonephritis
  2. acute pyelonephritis
  3. IgA nephropathy
  4. minimal change disease

 

3 - IgA nephropathy

 

 

19

A female patient visits her physician with a complaint of blood in her urine and oliguria. She states that these symptoms have gotten worse over the past 2 to 3 months. Urine and blood samples are collected. Urine GFR is calculated to be 40 ml/min/1.73m2 and hemoglobin is 8 g/dL. Urine protein was elevated. Upon review of her health history, it was noted that she was a cigarette smoker with hypertension. The most likely diagnosis in this case would be:

  1. nephrotic syndrome
  2. chronic kidney disease
  3. end stage renal disease
  4. chronic pyelophritis

 

2 - chronic kidney disease

 

20

What might be the predominant cause of the low hemoglobin value noted in the preceding question and based on the correctly identified disease:

  1. decreased EPO synthesis
  2. decreased iron absorption
  3. bone loss from decreased 1, 25 (OH2) vitamin D3 synthesis
  4. folate deficiency

 

1 - decreased EPO synthesis

 

21

A man comes to his physician with generalized weakness and fatigue. Blood is collected and an elevated WBC count with lymphocytosis is noted. Serum protein is moderately decreased, but the urine reagent dipstick does not indicate proteinuria. Upon confirmatory testing with a precipitation test, the urine protien is 4+. Based on other symptoms, the physician suspects multiple myeloma. What might be the cause of the discrepency in urine protein values:

  1. increased WBC will interfere with urine protein dipstick values
  2. the urine reagent dipsticks are outdated and must be discarded
  3. the precipitation tests was performed without controls
  4. reagent dipstick respond mostly to urine albumin and not other proteins

 

4 - reagent dipstick respond mostly to urine albumin and not other proteins

 

 

22

In regard to the preceding question, what protein is likely causing the elevated value in the urine protein confirmatory test:

  1. tamm-Horsfall protein
  2. bence jones protein
  3. haptoglobin
  4. mucoprotein

 

2 - Bence Jones protein

 

 

23

A patient visits his physician with complaints of insatiable thirst, sudden onset of fatigue, polydipsia, and polyuria. Laboratory results indicate a normal fasting blood sugar. Serum sodium was slightly elevated. Urine was hypotonic. The most likely cause of these symptoms and lab results would be:

  1. diabetes mellitus due to hormonal deficiency
  2. secondary hypothyroidism
  3. pituitary adenoma
  4. diabetes insipidus

 

4 - diabetes insipidus

 

24

In homeostatic regulation of plasma acid-base concentrations, sodium is both actively and passively exchanged in the tubules for which one of the following ions:

  1. bicarbonate
  2. carbon dioxide
  3. hydrogen
  4. potassium

3 - hydrogen

 

 

25

Destruction of a kidney stone and removal of the fragments is referred to as nephrolithiasis:

  1. true
  2. false

 

2 - false

 

26

High doses of amoxicillin can lead to interstitial nephritis:

  1. true
  2. false

 

1 - true

 

27

Which one of the following statements regarding creatinine is correct:

  1. most intraindividual variation in serum creatinine is due to muscle mass
  2. serum creatinine levels are not affected by renal disease
  3. creatinine production increases when serum creatinine is elevated
  4. creatinine is completely reabsorbed by the renal tubules

 

1 - most intraindividual variation in serum creatinine is due to muscle mass

 

28

Urea

  1. biosynthesis is carried out exclusively in the renal system
  2. is 100% reabsorbed by the kidney
  3. is decreased in plasma by a variety of renal diseases
  4. concentration in plasma is increased by a high protein diet

 

4 - concentration in plasma is increased by a high protein diet

 

29

A pateint's urea value is 32 mg/dL (high) and serum creatinine level is 1.1 mg/dL (limit high). These results suggest:

  1. laboratory error measuring the urea
  2. renal dysfunction
  3. possible heart failure
  4. a healthy reference ratio value

 

3 - possible heart failure

 

30

Creatinine clearance is a measure of the _____ of a patient:

  1. glomerular filtration rate
  2. creatine concentration
  3. renal threshhold
  4. renin function

1 - glomerular filtration rate