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| 1 |
A 23 year old male presents to the
emergency room complaining of severe sharp pain in the left side and back. The pain was of
sudden onset. He reports that he also feels nauseated. His urine is positive for blood.
Based upon his history and symptoms you would suspect: |
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Glomerulonephritis. |
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A kidney stone. |
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A urinary tract infection. |
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Early renal failure. |
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| 2 |
What is the pathophysiologic reason
for his nausea? |
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Neurologic response to severe pain. |
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Associated gastrointestinal inflammation. |
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Deferred gall bladder disease. |
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Metabolic alkalosis. |
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| 3 |
A staghorn calculi: |
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Forms in the kidney pelvis and may extend into the calyces. |
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Are the smallest of renal stones and are usually passed in the urine. |
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Is another name for the calcium-based kidney stone that is caused by
gout. |
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B & C |
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| 4 |
Frances Jenkins, 63 year old female
with a 15 year diagnosis of Diabetes, presents in the clinic. She also has a 10 year
history of hypertension. Her diabetes and hypertension has been only moderately
controlled. Today she reports edema in her hands, face, and feet. She reports that she is
tired and "just doesn't seem to have any energy". Her blood sugar is within
acceptable limits. Her urine is positive for blood and protein. What complication of
diabetes might you suspect? |
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Ureteral Epispadias. |
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Wilms Tumor. |
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Chronic kidney failure related to diabetic nephropathy. |
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Acute renal failure related to a severe urinary tract infection. |
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| 5 |
What is generally the first sign of
renal dysfunction in the diabetic patient? |
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High sugar content of the urine. |
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Proteinuria |
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DKKA |
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Neurogenic bladder. |
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| 6 |
Jacob Rollins, 69 year old male,
presents in his physician's office for a post-surgery check up. He was diagnosed with
benign prostatic hypertrophy several years ago and had surgery 6 weeks ago. His
catheter was removed four weeks ago. He reports that he hasn't felt as well the past week.
He has had some back, side and groin pain and noticed an increased urgency and burning
with urination. He noticed that his urine has a pink tinge yesterday. His vital
signs reveal fever and an increased heart rate. His urine test reveals bacteria and casts.
What do you suspect? |
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Prostatic cancer. |
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UTI related to recent indwelling catheter. |
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Kidney stone. |
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Nothing, this is normal in the post-operative period. |
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| 7 |
What is a cast? |
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Accumulation of cellular precipitates from the renal
tubules. |
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Another name for white blood cells in the urine. |
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Urine with a very low specific gravity. |
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Normal urine cells found upon microscopic examination. |
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| 8 |
A distraught young mother brings her
4 year old daughter into the clinic. The mother reports that the child keeps needing to go
to the bathroom and cries when urinating and complains of lower abdominal pain. She only a
produces small amount of urine each time she attempts to urinate. The mother also reports
that the urine has a different smell than normal. The child has no other remarkable
history. What do you suspect? |
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Wilms Tumor. |
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Nephrotic Syndrome. |
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Exostrophy of the bladder. |
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Urinary tract infection. |
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| 9 |
Sean Morgan, a 19 year old student,
was badly injured in a MVA a few days ago in a rural location. He was trapped in the
vehicle for over an hour and transported to the ER approximately 2 hours after he
sustained injuries. He is in intensive care with a fractured pelvis, femur, ribs, and
shoulder. He also suffered a tension pneumothorax and a head injury. He was in shock when
he arrived in the ER. His BP has remained somewhat low despite fluids and medication. His
hourly urinary output has gradually declined. What pathophysiological process should you
be concerned about at this point? |
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Neurotoxicity of medications. |
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Liver failure. |
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Acute renal failure. |
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Renal calculi. |
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| 10 |
Sean's BUN is rapidly elevating, he
is hyperkalemic and becoming edematous. He begins to show signs of early congestive heart
failure. What additional complication will Sean be prone to developing? |
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Diatrophy of the renal tubules. |
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Pneumonia and delayed wound healing. |
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Malignant hypertension. |
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Iatrogenic bladder. |
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| 11 |
Deana Lewis, a 43 year old
housewife, complains of "not feeling well", edematous hands and feet, and
smoky-colored urine. She reports that she had strep throat 3 weeks ago. Her vitals are
within normal limits except that her blood pressure is 142/100. She states that her BP
generally runs around 130/80. What renal problem do you suspect? |
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Pyelonephritis. |
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Cystitis. |
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Acute glomerulonephritis |
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Nephrotic syndrome |
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| 12 |
What component of her history and
presenting symptoms is most indicative of this disorder? |
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Elevated blood pressure. |
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Edema. |
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General Malaise. |
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Recent strep infection. |
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