The tendency to involuntarily pass urine, usually in small amounts, when abdominal pressure is raised during coughing, for example, is termed:
urge incontinence
neurological incontinence
stress incontinence
overflow incontinence
Which diuretics promote the greatest diuresis?
Thiazides.
Potassium-sparing diuretics.
Aldosterone inhibitors.
Loop diurectics.
Turbid urine normally indicates:
kidney stones
diabetes
infection
dehydration
Which is most likely to contribute to overflow incontinence?
kidney stones lodged in the renal calyxes
glomerulonephritis
prostate enlargement
urethritis
Azotaemia describes increased concentrations of:
nitrogen waste compounds in blood
urea in urine
potassium and sodium levels in blood
azotaemia is, in fact, an alternative term for uraemic frost
From the following, choose the substance likely to appear in the urine when the glomerulus is inflamed.
Creatinine
Urea
Sodium
Albumin
When comparing normal kidney function with dialysis, which of the following mechanisms is not possible in dialysis?
Diffusion
Active transport
Ultrafiltration
Osmosis
Which of the following should be present in the filtrate in the proximal convoluted tubule?
Erythrocytes
Leukocytes
Glucose molecules
Plasma proteins
Common causes of urolithiasis include all of the following EXCEPT:
hypercalcemia.
hyperlipidemia.
inadequate fluid intake.
hyperuricemia.
Which of the following increases glomerular filtration rate?
Constriction of the afferent arteriole
Increased hydrostatic pressure in the glomerular capillaries
Dilation of the efferent arteriole
Increased plasma osmotic pressure
Reducing fluid intake is non-pharmacological advice designed to decrease the incidence of urinary tract infections.
Infection and inflammation of the bladder is termed:
cystitis
pyelonephritis
any of the above, depending on the origin of the infection
The incidence of urinary tract infections is about the same in women and in men, but treatment is more frequently sought by women.
Requesting patients to produce a mid-stream urine sample is designed to ensure the sample is not diluted by urine that has accumulated at the base of the bladder and in the urethra.
Under normal circumstances urine in the bladder is sterile, but it may be contaminated with bacteria upon exiting the urethra.
What is the cause of most cases of pyelonephritis?
Severe pH imbalance of urine
Dialysis or other invasive procedure
An ascending infection by E. coli
Abnormal immune response, causing inflammation
What is the first indicator in the arterial blood gases of acidosis caused by glomerulonephritis?
Increased carbonic acid
Increased bicarbonate ion
Decreased bicarbonate ion
A pH less than 7.35
Which of the following would be considered normal serum pH?
7.0
7.4
8
4.5 - 8
In a case of acute pyelonephritis, what is the cause of flank pain?
Increasing glomerular permeability, creating an increased volume of filtrate in the kidney
Inflammation, causing ischemia in the tubules
Inflammation, stretching the renal capsule
Microbes irritating the tissues
Pyelonephritis may be distinguished from cystitis by the presence in pyelonephritis of:
urinary casts and flank pain.
painful micturition.
microbes, leukocytes, and pus in the urine.
urgency and frequency.
An elderly male patient produced only 25 mL of urine in the past 24 hours. The urologist discovers that prostatic hypertrophy is the cause. Which one of the following best describes this patient's acute renal failure?
Postrenal oliguric
Prerenal anuric
Postrenal anuric
Intrinsic nonoliguric
Which one of the following electrolytes usually must be restricted in patients with acute renal failure?
Potassium
Bicarbonate
Calcium
Chloride
Intrinsic acute kidney injury can be identified/caused by?
decreased creatinine
a blockage of the renal artery
haemorrhage
What is the definition of acute kidney injury?
A drop in serum creatinine to less than or equal to 26 umol/L within 48 hours.
An increase in urine output to greater than 0.5 mL/kg/hr for 6 consecutive hours.
A rise in serum creatinine to greater than or equal to 26 umol/L within 48 hours.
An decrease in urine output to greater than 0.5 mL/kg/hr for 6 consecutive hours.
Which of the following indicates the early stage of acute renal failure?
Very low GFR and increased serum urea
Hypotension and increased urine output
Development of decompensated acidosis
Polyuria with urine of fixed and low specific gravity
What is/are a cause(s) of acute tubule necrosis and acute renal failure?
Sudden significant exposure to nephrotoxins
Prolonged circulatory shock
Crush injuries or burns
All of the above
What is the primary reason for hypocalcemia developing during end-stage renal failure or uremia?
Insufficient calcium in the diet
A deficit of activated vitamin D and hyperphosphatemia
Excessive excretion of calcium ions in the urine
Decreased parathyroid hormone secretion
Which of the following would likely cause chronic renal failure?
Circulatory shock
Diabetes mellitus
Cystitis with pyelonephritis in the right kidney
Obstruction of a ureter by a renal calculus
What causes polyuria during the stage of renal insufficiency?
Loss of tubule function
Increased GFR
Increased blood pressure
Decreased aldosterone secretion
Insensible water loss occurs from ________, and ________.
irregular incidents, such as vomiting as output can vary greatly
faeces; accounts for approximately 15% of normal daily output
kidneys; accounts for approximately 35% of normal daily output
lungs and skin; accounts for approximately 30% of normal daily output
Fluid load in patients may be increased, inadvertently or purposely, by:
rectal solutions
enteral feeding
peritoneal dialysis
all of the above
Which condition will induce cell shrinking?
when interstitial fluid is hypertonic
when interstitial fluid is hypotonic
when interstitial fluid is isotonic
An athlete who has lost a litre or more of fluid via sweating is best advised to replace this with a solution that contains both salts and water, and a total osmolarity of approximately:
5.8 mOsmols
90 mOsmols
280 mOsmols
560 mOsmols
A clinical use of a hypertonic solution is:
To correct whole blood loss with mild hypvolaemia
Dehydrated patients with severe hypernatremia
Treat severe intracellular dehydration
Treating cerebral oedema and intracranial hypertension
Which of the following is an example of an isotonic solution?
0.45% sodium chloride.
4% glucose with 0.18% sodium chloride.
10% glucose.
25% mannitol.
Which of the following is an example of an hypotonic solution?
0.9% sodium chloride
25% mannitol
Water
Whole blood
A 70-year-old male with chronic renal failure presents with oedema. Which of the following is the most likely cause of this condition?
increased interstitial oncotic pressure
decreased capillary oncotic pressure
increased capillary oncotic pressure
decreased capillary hydrostatic pressure
A 10-year-old male is brought to the ED because he is incoherent and semiconscious. CT scan reveals he is suffering from cerebral oedema. This type of oedema is referred to as:
pitting oedema
localised oedema
generalised oedema
pulmonary oedema
Insensible fluid loss refers to water lost through:
faeces only
perspiration only
urine and faeces
perspiration and expiration
A 35-year-old male weighs 70 kg. Approximately how much of this weight is intracellular fluid?
5 L
10 L
28 L
42 L
A 5-year-old male presents to the ED with delirium and sunken eyes. After diagnosing him with severe dehydration, the doctor orders fluid replacement. The nurse administers a hypertonic IV solution. Which of the following would be expected?
his symptoms would subside quickly
decreased extracellular fluid volume
intracellular dehydration
increased intracellular fluid volume
Which of the following is a common cause of hyponatraemia?
Prolonged period of rapid, deep respirations
Excessive sweating
Loss of the thirst mechanism
Excessive aldosterone secretion
Which of the following ions is most closely related to water movement?
Which of the following is the primary cation in the extracellular fluid?
Which compartment contains the greatest amount of body water
Intracellular
Interstital
Plasma
Transcellular
When a patient is being treated with thiazide diuretics, there is a danger of ________, an unwanted and potentially dangerous side effect.
hypocalcaemia
hypokalaemia
hypophosphataemia
hyponatraemia
Hyperkalaemia causes:
a decrease in resting membrane potential with increased excitability of cardiac muscle.
a decrease in resting membrane potential with decreased excitability of cardiac muscle.
an increase in resting membrane potential with decreased excitability of cardiac muscle.
an increase in resting membrane potential with increased excitability of cardiac muscle.
Which of the following would most likely cause hypochloraemia?
hypernataemia
elevated bicarbonate
hypercalcaemia
A 42-year-old female presents to her GP complaining of muscle weakness and cardiac abnormalities. Laboratory tests indicate that she is hypokalaemic. Which of the following could be the cause of her condition?
hypoglycaemia
respiratory acidosis
constipation
frusemide therapy
Secretion of aldosterone results in:
decreased plasma osmolality.
increased blood volume.
increased serum potassium levels.
localised oedema.
Metabolic acidosis may be associated with
Increased chloride levels
Decreased bicarbonate
Increased metabolic acids
All answers are correct
Chronic compensation for respiratory acidosis includes:
kidney excretion of HCO3-
kidney excretion of H+
protein buffering
prolonged exhalations to blow off CO2
Which of the following is a strong acid?
Phosphorus
Sodium chloride
Lactate
Long-term regulation of acid-base balance through removal or retention of acids is accomplished by the:
lungs
kidneys
liver
protein buffer systems
Which of the following buffer pairs is considered the major plasma buffering system?
NH3/NH4
NaCl/KPO4
HCO3-/H2CO3
HPO4/H2PO4
Autoregulation in the kidneys refers to:
the control of systemic blood pressure by the kidneys.
control of blood flow by the SNS.
the secretion of renin and activation of angiotensin.
local minor reflex adjustments in the arterioles to maintain normal blood flow.
Place the following events in the correct sequence of events when ketoacids increase in the blood of a diabetic patient. Not all options are used in the answers. 1. Serum pH decreases 2. Serum bicarbonate decreases 3. PCO2 decreases 4. Respiration decreases 5. Respiration increases 6. Serum pH increases 7. Serum bicarbonate increases
7, 6, 5, 3, 6
2, 6, 5, 3, 7
7, 6, 4, 3, 1
2, 1, 5, 3, 6
Which condition is likely to cause metabolic acidosis?
Slow, shallow respirations
Excessive fluid in the body
Prolonged diarrhoea
Mild vomiting
A 55-year-old female presents to her GP complaining of dizziness, confusion and tingling in the extremities. Blood tests reveal an elevated pH, decreased PCO2 and slightly decreased HCO3-. Which of the following is the most likely diagnosis?
respiratory alkalosis with renal compensation
respiratory acidosis with renal compensation
metabolic alkalosis with respiratory compensation
metabolic acidosis with respiratory compensation
Which serum value indicates decompensated metabolic acidosis?
Bicarbonate level increases
Bicarbonate level decreases
pH is above normal range
pH is below normal range
Acute compensation for metabolic acidosis includes:
CO2 retention.
kidney excretion of H+.
hyperventilation.
hypoventilation.
A 52-year-old male with diabetes presents to the ED with lethargy, confusion and depressed reflexes. His wife indicates that he does not follow the prescribed diet and takes his medication sporadically. Which of the following is most likely to occur?
diabetes insipidus
decreased extracellular fluid osmolality
decreased urine formation
Uncontrolled essential hypertension may cause chronic renal failure because of:
damage to afferent arterioles and renal ischemia.
failure of tubules to respond to hormonal controls.
glomerular congestion causes damaged capillaries.
predisposition to recurrent urinary tract infections.
In chronic renal failure, which of the following is the most immediately dangerous?
acidosis
phosphataemia
haematuria
anaemia
Which of the following causes acute renal failure?
Nephrosclerosis
Bilateral acute glomerulonephritis
Polycystic kidney disease
Pyelonephritis in the right kidney
Which of the following is a typical sign of dehydration?
Rapid, strong pulse
Low haematocrit
Increased urine output
Decreased tissue turgor
The normal pH of urine is:
1.5-5.5.
4.5- 8.0.
7.35-7.45.
7.0-10.
Which of the following conditions would decrease oncotic pressure in the capillaries?
low blood pressure
high-protein diet
liver failure
high blood-glucose
Chronic renal failure adversely affects which body system?
the cardiovascular system
the respiratory system
the CNS
Infants are at a higher risk for developing dehydration because they have:
a lower total body water volume.
a decreased intravascular volume.
a greater body surface area.
an increased tendency towards developing oedema.
Which of the following would result in hyperkalaemia?
insulin
excess aldosterone
acute acidosis
alkalosis
Which of the following results from decreased blood flow into the kidneys?
Systemic blood pressure drop
Dilation of the afferent arterioles
Increased angiotensin and systemic vasoconstriction
Which of the following alterations would result in fluid movement into the interstitial space?
increased interstitial hydrostatic pressure
Causes of respiratory acidosis include:
an increase in noncarbonic acids.
pneumonia.
vomiting.
Crush injuries associated with a massive degree of cell rupture are likely to increase levels of extracellular:
potassium
calcium
sodium
phosphate
Choose the basic cause of bone remodelling disorders associated with chronic renal failure.
Excessive loss of phosphate ion
Deficit of parathyroid hormone
Failure of the kidney to activate vitamin D
Development of hypercalcemia