Renal path review questions.ppt

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Renal path review questions.ppt

  1. 1. A significant rise in serum creatinine will occur when (A) the patient is on a high protein diet (B) the patient is suffering from dehydration (C) 75% of the functioning nephrons are destroyed (D) severe muscle damage has occurred
  2. 2. Dialysis removes waste products of metabolism from the bloodstream mostly by (A) absorption (B) active transport (C) diffusion (D) excretion (E) ultrafiltration
  3. 3. The most common pathogenetic defect resulting in acute renal failure is (A) defect in peripheral wall of glomerular capillaries (B) intravascular hemolysis (C) obstruction of lower urinary tract (D) renal cortical ischemia (E) toxic injury to peripheral tubular epithelia
  4. 4. A patient undergoing an experimental protocol to examine renal function using inulin clearance method had the following lab data: urine excreted over 6 hours = 360 ml; urine inulin concentration = 100 mg%; plasma inulin concentration = 1.0 mg%; What is the glomerular filtration rate of this patient? (A) 10 ml/min (B) 50 ml/min (C) 100 ml/min (D) 125 ml/min (E) 130 ml/min
  5. 5. A 12-year-old girl is found to have proteinuria and mild edema but no evidence of hypertension or hematuria. A renal biopsy is taken. There is no discernable abnormalities except for visceral epithelial cell foot process "fusion" by electron microscopy. Which of the following is the most likely diagnosis? (A) focal segmental glomerulosclerosis (B) IgA nephropathy (C) membranous glomerulopathy (D) minimal change disease (E) post-infectious glomerulonephritis
  6. 6. A renal disease characterized by the presence of antiglomerular basement membrane (anti-GBM) antibodies is (A) Goodpasture syndrome (B) acute proliferative glomerulonephritis (C) focal segmental glomerulosclerosis (D) malignant hypertension and glomerulosclerosis (E) minimal change disease
  7. 7. A 35-year-old man has an episode of hemoptysis following an upper respiratory infection. He has 30-pack year history of smoking. Physical examination demonstrates edema and hypertension. Urinalysis reveals hematuria and red cell casts as well as proteinuria. A renal biopsy demonstrates crescentic glomerulonephritis. These findings are most consistent with the diagnosis of (A) acute post-streptococcal glomerulonephritis (B) Goodpasture syndrome (C) lupus nephritis (D) systemic lupus erythematosus (E) Wegener granulomatosis
  8. 8. Nephrotic syndrome is characterized by (A) hematuria, proteinuria, hypertension (B) pyuria, oliguria, hematuria (C) hematuria, azotemia, hypertension (D) proteinuria, edema, hyperlipidemia (E) bacteriuria, azotemia, hypertension
  9. 9. A patient with hemoptysis and renal failure has a renal biopsy which reveals crescentic proliferative glomerulonephritis. Immunofluorescence reveals linear deposits of IgG. The diagnosis is (A) acute post-infectious glomerulonephritis (B) IgA nephropathy (C) Goodpasture syndrome (D) Henoch-Schönlein syndrome (E) membranous glomerulonephritis
  10. 10. The most consistent finding in glomeruli of patients with the nephrotic syndrome is (A) crescent formation (B) electron-dense deposits (C) enlargement of the mesangium (D) obliteration of epithelial cell foot processes (E) scarring in parts of glomeruli
  11. 11. The histologic finding that correlates with the most destructive and irreversible form of glomerular injury is (A) basement membrane spikes (B) crescents (C) mesangeal hypercellularity (D) red cell casts (E) reduplication of basement membranes
  12. 12. A 30-year-old patient presents with nephrotic syndrome. Subsequently a renal biopsy demonstrates uniformly thickened peripheral capillary basement membranes without electron dense deposits. This combination of findings suggests (A) amyloidosis (B) diabetes mellitus (C) focal sclerosing glomerulopathy (D) membranous glomerulonephritis (E) minimal change disease
  13. 13. Hematuria is an expected finding in (A) acute proliferative glomerulonephritis (B) amyloidosis (C) diabetic glomerulosclerosis (D) lipid nephrosis (E) membranous glomerulonephritis
  14. 14. In glomerulonephritis, the one histologic finding which best correlates with a poor prognosis is (A) polymorphonuclear exudation in glomerular capillaries (B) increase in numbers of endothelial and mesangial cells (C) increase in epithelial cells with epithelial crescents (D) subepithelial electron dense deposits (E) glomerular deposits of IgG and C3
  15. 15. Renal disease associated with edema, hematuria, proteinuria, and recent history of a sore throat is most likely to be associated with (A) antigen-antibody complexes in glomeruli (B) rapidly fatal course (C) necrosis of renal tubules (D) urine culture positive for beta-hemolytic streptococci
  16. 16. The nephrotic syndrome results in edema due to (A) altered plasma osmotic pressure (B) impaired venous drainage (C) increased capillary hydrostatic pressure (D) increased vascular permeability
  17. 17. A 6-year-old boy has peripheral edema and massive proteinuria. He has no hematuria or hypertension. On a renal biopsy, the glomeruli appear normal. Electron microscopy demonstrates foot process "fusion". What conclusion can be best made? (A) hearing loss likely (B) initiated by streptococcal infection (C) rapid response to steroids probable (D) transformation to membranous glomerulonephritis common

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