Kidney Quiz - Path Exam 3

March 27, 2018 | Author: tatti999 | Category: Kidney, Urinary System, Nephrology, Organ (Anatomy), Medical Specialties


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1. An adult patient has a serum urea nitrogen of 50 mg/dL with creatinine 5.8 mg/dL.The presence of which of the following urinalysis findings is most indicative of glomerulonephritis as a cause for these findings: A. Oval fat bodies B. Proteinuria C. Red blood cell casts D. Broad waxy casts E. White blood cell casts Her chest x-ray shows bilateral interstitial markings but no areas of consolidation and no masses. but she has antineutrophil cytoplasmic autoantibodies. A renal biopsy shows a necrotizing glomerulonephritis without immune deposition. These findings are most characteristic for which of the following diseases: : A. Diffuse scleroderma B. A urinalysis reveals microscopic hematuria and proteinuria. Post-infectious glomerulonephritis D. Microscopic polyarteritis E.2. Hemolytic-uremic syndrome . There are no significant findings on physical examination. She is surprised by the appearance of a small amount of red-tinged sputum. Over the next day she notes some small nodular purple lesions beneath the skin of her lower extremities. A 32-year-old woman has had a cough for several days along with increasing weakness. Systemic lupus erythematosus C. Her antinuclear antibody test is negative. 3. A 40-year-old man has the sudden onset of severe lower abdominal pain one evening. Cystinosis . Physical examination reveals no abdominal tenderness or masses. The underlying cause for these findings is most likely to be: A. He notes the presence of bloody urine. An abdominal CT scan reveals a small bright rounded object in the region of the left ureter. Hyperparathyroidism C. Hypercalciuria B. and bowel sounds are active. Urinary tract infection D. Gout E. Which of the following is the most likely pathologic finding in this patient A. Diffuse glomerulosclerosis E. He now has chronic renal failure. A 57-year-old man has been bothered by arthritis.4. Transitional cell carcinoma C. Urinary tract lithiasis . Chronic interstitial nephritis D. As a consequence. he has consumed large quantities (greater than 3 gm per year) of analgesics (aspirin. Acute tubular necrosis B. without reading the labels on over-the-counter medications. phenacitin. acetaminophen) for the past 10 years. If the foot processes are effaced in minimal change disease. E. B. The anionic charge barrier is lost. . C. The basement membrane is attenuated. Type IV collagen is lost.5. then why do serum proteins leak into the urine more readily: A. Glomerular filtration pressure is increased. Fenestrations in endothelial cells are enlarged. D. Multiple 1 to 2 cm cortical and medullary cysts within small kidneys bilaterally . Normal left kidney but enlarged right right kidney with variably-sized cysts C. During that time he has continued working and has had no major illnesses. Markedly enlarged kidneys with multiple cysts along with a polycystic liver D. Multiple cystic dilations of medullary collecting ducts B. A 61-year-old man with a history of diabetes mellitus has been on hemodialysis for the past 12 years.6. Which of the following findings most likely would be present in his kidneys as a consequence of the chronic hemodialysis A. Bilaterally enlarged cystic kidneys along with congenital hepatic fibrosis E. Benign nephrosclerosis E. Malignant nephrosclerosis C. The microscopic findings at autopsy of slightly small kidneys with a granular surface and the microscopic appearance of scattered hyalinized glomeruli. Nodular glomerulosclerosis B.7. Chronic pyelonephritis . interstitial fibrosis with focal tubular atrophy. and arteriolar thickening in a 75-year-old woman with normal renal function most strongly suggests: A. Analgesic abuse nephropathy D. Which of the following findings is LEAST likely to be present: A. Heamaturia C. Reduced viscosity of blood D. 3% Hgb A2. Papillary necrosis . and 1% Hgb F. A 26-year-old African-American man has had a history of painful abdominal crises. He has a hemoglobin electrophoresis performed that shows 96% Hgb S. Renal infarcts E.8. Decreased renal concentrating ability B. Focal segmental glomerulosclerosis D. There is granular deposition of C3 and IgG on immunofluoresence. with reduplication of basal lamina seen by electron microscopy.9. He notes a lot of foam in the toilet when he urinates. A renal biopsy is performed and shows increased mesangial cells and matrix. Rapidly progressive glomerulonephritis C. Nodular and diffuse glomerulosclerosis B. Minimal change disease . He is developing peripheral edema. 4+ protein.012. A 28-year-old man has increasing malaise with myalgias and arthralgias for the past month. pH 6. He receives a course of corticosteroid therapy and does not improve. A urinalysis shows: sp gr 1. he has a positive antinuclear antibody and negative antineutrophil cytoplasmic autoantibody. and no glucose or ketones. Which of the following diseases is he most likely to have: : A. 1+ blood. Membranoproliferative glomerulonephritis E. 10. Voiding cystourethrography reveals obstruction on the right at the level of the bladder. or glucosuria. Schistosomiasis D. Transitional cell carcinoma B. but that there is mild hydroureter on the right. proteinuria. Ureteritis cystica E. There are no abnormal findings on physical examination. Abnormal ureteral insertion (Vesicoureteral reflex) C. Ureteral calculus . An abdominal ultrasound reveals that the kidneys are of normal size and consistency. A urinalysis reveals increased WBCs but no hematuria. Which of the following conditions is most likely to be present: A. A 6-year-old girl has had dysuria with multiple bacterial urinary tract infections diagnosed over the past 2 years. The most likely diagnosis is A.5 g/dL.11. and albumin 3. Diabetes mellitus E. A 60-year-old woman has anemia. total protein 8. amorphous.9 g/dL. Metastatic breast carcinoma D. A renal biopsy shows pink. Chronic lymphocytic leukemia . She has a serum urea nitrogen of 48 mg/dL.8 mg/dL. vertebral bone pain. irregular glomerular deposits which by immunohistochemical staining contain only irregular fibrils in a beta-pleated sheet. Systemic lupus erythematosus C. and sudden onset of renal failure. creatinine 2. Multiple myeloma B. An intravenous urogram and voiding cystourethrogram have shown no evidence for obstruction. including Streptococcus. A physical examination reveals no abnormal findings. Proteus. She does not have any other significant medical problems. and Escherichia have been cultured. Polycystic change B. A 51-year-old woman has had multiple urinary tract infections for most of her adult life. Which of the following long-term renal complications is most likely to develop in this patient: A.12. and the infections have responded to antibiotic therapy. Transitional cell carcinoma D. Acute pyelonephritis C. Benign nephrosclerosis . A variety of bacterial organisms. Obstructive nephropathy E. Membranoproliferative glomerulonephritis . His serum complement C3 and C4 were normal. The most likely diagnosis is: A. found to be due to both albumin and transferrins. The child did improve by corticosteroid therapy. Focal segmental glomerulosclerosis E. Membranous glomerulonephritis B.13. His antinuclear antibody test was negative.1 gm. An 11-year-old boy was seen by the family physician because of increasing lethargy. but no glucosuria or blood was present. Urinalysis revealed 3+ proteinuria. Systemic lupus erythematosus D. A 24 hour urine protein was 2. Minimal change disease (MCD) C. A urinalysis reveals hematuria. glucosuria. but no proteinuria. The most likely underlying problem in this setting is: A. The pain has come in waves for several hours. Gout with uric acid stone .14. Idiopathic hypercalciuria with calcium oxalate stone D. A 40-year-old man comes to the emergency room early in the morning because of excruciating pain in the lower abdomen. Transitional cell carcinoma of the bladder B. or WBCs. Acute pyelonephritis with staghorn calculus E. Prostatic hyperplasia with obstructive uropathy C. A linear pattern of glomerular capillary IgG deposition by immunofluorescence D. and the medical examiner investigated. Fibromuscular dysplasia B.15. A 46-year-old African-American man died suddenly. Nodular glomerulosclerosis . Vasculitis with mononuclear cell infiltrates C. She found a large right basal ganglia hemorrhage that resulted from arteriosclerosis of small cerebral arterial branches. Arteriolar fibrinoid necrosis with microhemorrhages E. Which of the following findings was most likely to have been present in his kidneys: A.
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