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AUBF: RENAL DISEASES

A 14-year-old boy who has recently recovered from a sore throat develops edema and hematuria. Significant laboratory results include a BUN of 30 mg/dL (normal 8 to 23 mg/dL) and a positive group A streptococcal antibody test. Results of a urinalysis are as follows:
Color: Red                      Ketones: Negative
Clarity: Cloudy                Blood: Large
SG: 1.020                      Bilirubin: Negative
pH: 5.0                          Urobilinogen: Normal
Protein: 3+                    Nitrite: Negative
Glucose: Negative           Leukocyte: Trace
Microscopic:
    100 RBCs/hpf—many dysmorphic forms
    5–8 WBCs/hpf
    0–2 granular casts/lpf
    0–1 RBC casts/lpf
 
What disorder do these results and history indicate?
Acute glomerulonephritis
Chronic glomerulonephritis
Acute pyelonephritis
Chronic pyelonephritis
What is the significance of the dysmorphic RBCs?
Irregularly shaped RBCs
Indication of glomerular damage
It is not significant
Indication of the thickening of glomerular basement membrane
The highest levels of proteinuria are seen with:
IgA nephropathy
NS
GPA
Nil disease
Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen in patients with:
IgA nephropathy
Nephrotic syndrome
Goodpasture syndrome
Acute renal tubular necrosis
MATCHING TYPE
Binding of antineutrophilic cytoplasmic antibody to the neutrophils in the vascular walls produce inflammation of the small blood vessels in the kidneys and respiratory system.
GRANULOMATOSIS WITH POLYANGIITIS
Marked decrease in renal function resulting from prolonged glomerular damage.
CHRONIC GLOMERULONEPHRITIS
Thickening of the glomerular basement membrane resulting from IgG deposition.
MEMBRANOUS GLOMERULONEPHRITIS
Sudden loss of renal function.
ACUTE RENAL FAILURE
Deposition of immune complexes in the glomerulus and produces crescentic formations that causes permanent damage to the capillary tufts.
RAPIDLY PROGRESSIVE GLOMERULONEPHRITIS
Attachment of cytotoxic autoantibody to the basement membrane, followed by complement activation, produces the capillary destruction.
GOODPASTURE SYNDROME
MATCHING TYPE
Most common cause of primary glomerular disease.
FOCAL SEGMENTAL GLOMERULOSCLEROSIS
Most common cause of ESRD (End stage renal disease)
MINIMAL CHANGE DISEASE
Most common cause of glomerulonephritis
IgA NEPHROPATHY
Most common cause of NS in children.
DIABETIC NEPHROPATHY
MATCHING TYPE
Appearance of raised, red patches on the skin and occurs primarily in children after upper respiratory infections.
UROMODULIN-ASSOCIATED KIDNEY DISEASE
A disorder of T cells characterized by damage to the podocytes and shield of negativity, allowing for increased protein filtration.
NEPHROGENIC DIABETES INSIPIDUS
Disrupted action of ADH caused either by the inability of renal tubules to respond to ADH or failure of hypothalamus to produce ADH.
FOCAL SEGMENTAL GLOMERULOSCLEROSIS
Glucose reabsorption is affected.
MINIMAL CHANGE DISEASE
Autosomal mutation in the gene that produces uromodulin which causes a decrease in the production of normal uromodulin.
RENAL GLUCOSURIA
Disruption of podocytes in certain areas of glomeruli associated with heroin and analgesics abuse and with HIV and hepatitis virus.
HENOCH-SCHONLEIN PURPURA
The presence of fatty casts is associated with all of the following except:
Nephrotic syndrome
FSGS
Nephrogenic DI
MCD
The presence of WBCs and WBC casts with no bacteria is indicative of:
Chronic pyelonephritis
ATN
AIN
AOTA
ESRD is characterized by all of the following except:
Hypersthenuria
Isosthenuria
Azotemia
Electrolyte imbalance
Dysmorphic RBC casts would be a significant finding with all of the following except:
Goodpasture syndrome
AGN
Chronic pyelonephritis
Henoch-Schönlein purpura
The only protein produced by the kidney is:
Albumin
Uromodulin
Globulin
AOTA
Match each hallmarks/markers to their associated diseases.
Presence of WBCs and WBC casts with bacteria.
ACUTE TUBULAR NECROSIS
Presence of RTE cells and casts.
ACUTE PYELONEPHRITIS
ANCA
RENAL GLUCOSURIA
Marked by massive protenuria.
NEPHROTIC SYNDROME
Increase urine glucose concentration.
UROMODULIN-ASSOCIATED KIDNEY DISEASE
Increase in serum uric acid.
Nephrogenic DI
Antiglomerular basement membrane antibody
GOODPASTURE SYNDROME
Low SG, pale yellow urine.
WEGENER'S GRANULOMATOSIS
Presence of broad casts can be seen in all of the following except:
Chronic glomerulonephritis
Acute renal failure
Acute glomerulonephritis
NOTA
Generalized failure of tubular reabsorption in the PCT
Alport syndrome
Fanconi syndrome
Cystitis
ATN
A disorder associated with polyuria and low specific gravity is:
Renal glucosuria
Nephrogenic DI
MCD
FSGS
Most common component of renal calculi
Calcium phosphate
Calcium oxalate
NOTA
AOTA
Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:
Heavy proteinuria
Microscopic hematuria
Low specific gravity
Uric acid crystals
A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for:
Fanconi syndrome
Alport syndrome
Uromodulin-associated kidney disease
Acute tubular necrosis
Ischemia frequently produces:
Acute renal tubular necrosis
MCD
Renal glycosuria
Goodpasture syndrome
Differentiation between cystitis and pyelonephritis is aided by the presence of:
WBC casts
RBC casts
Bacteria
Granular casts
A 45-year-old woman is recovering from injuries received in an automobile accident that resulted in her being taken to the emergency department with severe hypotension. She develops massive edema. Significant laboratory results include a BUN of 30 mg/dL (normal 8 to 23 mg/dL), cholesterol of 400 mg/dL (normal 150 to 240 mg/dL), triglycerides of 840 mg/dL (normal 10 to 190 mg/dL), serum protein of 4.5 mg/dL (normal 6.0 to 7.8 mg/dL), albumin of 2.0 mg/dL (normal 3.2 to 4.5 mg/dL), and a total urine protein of 3.8 g/d (normal 100 mg/d). Urinalysis results are as follows:
Color: Yellow                   Ketones: Negative
Clarity: Cloudy                Blood: Moderate
SG: 1.015                      Bilirubin: Negative
pH: 6.0                          Urobilinogen: Normal
Protein: 4+                    Nitrite: Negative
Glucose: Negative          Leukocyte: Negative
Microscopic:
  15–20 RBCs/hpf            Moderate free fat droplets
  0–5 WBCs/hpf               Moderate cholesterol
  0–2 granular casts/lpf    crystals
  0–2 fatty casts/lpf         0–2 oval fat bodies/hpf

What renal disorder do these results suggest?
Nephrogenic DI
Nephrotic syndrome
MCD
FSGS
Respiratory and renal symptoms are associated with all of the following except:
IgA nephropathy
GPA
Henoch-Schönlein purpura
Goodpasture syndrome
A routinely active 4-year-old boy becomes increasingly less active after receiving several preschool immunizations. His pediatrician observes noticeable puffiness around the eyes. A blood test shows normal BUN and creatinine results and markedly decreased total protein and albumin values. Urinalysis results are as follows:
Color: Yellow                   Ketones: Negative
Clarity: Hazy                   Blood: Small
SG: 1.020                       Bilirubin: Negative
pH: 6.5                           Urobilinogen: Normal
Protein: 4+                     Nitrite: Negative
Glucose: Negative           Leukocyte: Negative
Microscopic:
    10–15 RBCs/hpf          0–1 hyaline casts/lpf
    0–4 WBCs/hpf             0–2 granular casts/lpf
    Moderate fat droplets   0–1 oval fat bodies/hpf
 
What disorder do the patient history, physical appearance, and laboratory results suggest?
Minimal change disease
Nephrotic syndrome
Focal segmental glomerulosclerosis
NOTA
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