Question 1

During times of increasing blood volume such as in heart failure, a compensatory renal response is:

Accepted Answer

Urodilatin is released by the kidneys and acts to inhibit sodium and water reabsorption, promoting diuresis to help reduce blood volume.

Question 2

A 70-year-old woman with severe rheumatoid arthritis has difficulty with activities of daily living such as eating and dressing herself. She also states that she sometimes is incontinent of urine because she has trouble walking to the bathroom because of pain and getting her underwear off quickly enough. The type of incontinence she is describing is:

Accepted Answer

Functional incontinence occurs when a person is unable to reach the bathroom in time due to physical limitations, such as severe arthritis, rather than a problem with the urinary system itself.

Question 3

A mother is concerned about her 5-year-old son wetting his bed at night. She says he has rarely had a "dry" night and during the day he does not have accidents. What is the most likely cause of this enuresis?

Accepted Answer

Bedwetting (nocturnal enuresis) in a 5-year-old is often due to a normal delay in the maturation of voiding control, which is common at this age.

Question 4

Which of the following is an accurate description of a flaccid bladder?

Accepted Answer

A flaccid bladder, also known as an atonic bladder, is characterized by detrusor areflexia, which is a lack of bladder muscle contraction due to damage to the nerves connecting the bladder to the spinal cord.

Question 5

Escherichia coli is a common organism implicated in uncomplicated urinary tract infections because:

Accepted Answer

Escherichia coli is commonly found in the gastrointestinal tract and around the anus. Its proximity to the urethra allows it to easily access and colonize the urinary tract, leading to infections.

Question 6

Which of the following diagnostic findings is present in pyelonephritis but not in acute cystitis?

Accepted Answer

White blood cell casts are typically found in pyelonephritis, indicating kidney involvement, whereas they are not present in acute cystitis, which affects the bladder.

Question 7

A man has hematuria and colicky flank pain. A kidney stone is suspected. Which diagnostic test is best to order to evaluate the stone size, location, and hydronephrosis?

Accepted Answer

A CT scan of the abdomen and pelvis is the best test for evaluating kidney stones as it provides detailed images of the stone's size, location, and any associated hydronephrosis.

Question 8

Stones form in the kidney as a result of:

Accepted Answer

Kidney stones form when there is an increased concentration of insoluble salts, such as calcium oxalate or uric acid, in the urine, leading to crystallization and stone formation.

Question 9

A mother brings in her 4-year-old daughter because she felt a "lump" on her abdomen and she feels her daughter's belly is swollen. The mother states her daughter is pretty healthy but has been stating that her stomach hurts on and off. Physical exam reveals a nontender abdominal mass that is firm and does not cross the midline. Based on this presentation, a possible diagnosis is:

Accepted Answer

The presentation of a firm, nontender abdominal mass in a child that does not cross the midline is characteristic of a nephroblastoma, also known as Wilms' tumor.

Question 10

Which of the following is the most common risk factor associated with the development of bladder cancer?

Accepted Answer

Smoking is the most common risk factor for bladder cancer, as it introduces carcinogenic chemicals into the bladder through urine.

Question 11

Causes of painless, asymptomatic hematuria include:

Accepted Answer

Both urothelial cell carcinoma and renal cell carcinoma can cause painless, asymptomatic hematuria.

Question 12

Discharge teaching is done for the patient after a nephrectomy for renal carcinoma. Which statement by the patient indicates that teaching has been effective?

Accepted Answer

The remaining kidney typically compensates for the loss of one kidney, allowing for normal renal function.

Question 13

Finasteride, a 5α reductase inhibitor, is used for benign prostatic hypertrophy, because the medication:

Accepted Answer

Finasteride works by inhibiting the enzyme 5α-reductase, which is responsible for converting testosterone to dihydrotestosterone (DHT). By reducing DHT levels, it helps decrease prostate size and alleviate symptoms of benign prostatic hypertrophy.

Question 14

A man with benign prostatic hypertrophy is complaining that his urine stream is slower than in the past and sometimes his stream sprays. He also reports dribbling when he is almost done urinating. These symptoms are known as:

Accepted Answer

These symptoms are known as voiding symptoms, which include a slow stream, spraying, and dribbling, commonly associated with benign prostatic hypertrophy.

Question 15

The cause of a decreased glomerular filtration rate in rapidly progressive glomerulonephritis is due to the development of:

Accepted Answer

In rapidly progressive glomerulonephritis, the decreased glomerular filtration rate is primarily due to the formation of crescents, which are composed of collagen and fibrin deposits in Bowman's space, leading to compression and dysfunction of the glomeruli.

Question 16

A patient has stage V chronic kidney disease, and his family explains he is becoming progressively confused. Uremic encephalopathy is suspected. What other manifestations would support this complication?

Accepted Answer

Uremic encephalopathy is associated with neurological symptoms such as asterixis (a type of tremor) and hyperreflexia due to the accumulation of toxins in the blood that affect the nervous system.

Question 17

A patient with end-stage renal disease (ESRD) has tall, peaked T waves on his electrocardiogram (ECG). Which of the following is the best action?

Accepted Answer

Tall, peaked T waves on an ECG are indicative of hyperkalemia, which is common in patients with ESRD. Checking the serum potassium level is essential to confirm hyperkalemia and guide further treatment.

Question 18

Patients with chronic kidney disease may require:

Accepted Answer

Patients with chronic kidney disease may require lower levels of insulin because the kidneys are less able to clear insulin from the blood, leading to prolonged insulin action and increased risk of hypoglycemia.

Quiz 7: Urinary Function