Question

A patient with a history of chronic kidney disease sustains a stress fracture of the vertebra. Her increased risk of this kind of event is most likely due to dehydration from postrenal AKI osteoporosis from decreased activation of vitamin D. osteoporosis from decreased phosphate anemia due to lack of erythropoietin. 1. a. b. c. d. 2. Over a 30 hour period a patient develops oliguria. Blood work is done & he is found to have a BUN of 26 and serum creatinine of 1.1. What type of problem is most likely? prerenal acute kidney injury acute tubular necrosis a. norm BUN 7 to 25 mg/d: norm serum creatinine 0.6-1.2 mg/d (we will use these male levels- women's normal levels are usually lower; you dont have to memorize these number ranges anyway-they will be provided on the test) b. postrenal chronic kidney injury glomerulonephritis c. d. 3. Findings consistent with the above problem would be all of the following EXCEPT poor skin turgor. a urinalysis (UA) that shows an increased urine specific gravity. a urinalysis (UA) that shows decreased urine specific gravity. hypovolemia a. b. C. d. should not be used in chronic renal failure (CKD) Drugs that enhance potassium secretion in the distal convoluted tubule (DCT) enhance potassium reabsorption in the DCT decrease pruritis. enhance diuresis. 4. a. b. C. d. The reason for the answer above is 5. pruritis is caused by increased urea levels in the blood. in CKD aldosterone pathologically increases K+ excretion into the DCT diuresis would increase the risk of hypokalemia. in CKD, K+ excretion into the DCT is decreased because of pathologic unresponsiveness to a. b. C. d. aldosterone. The parents of a 12-year-old boy who is having surgery to remove a testis that didn't descend before birth asks the nurse why the surgery is necessary since his other testis is fine and in the scrotal sac. The nurse's explanation is based on the understanding that 6. the retained testis can lead to a urinary obstruction later in life. the retained testis can lead to a cancerous condition called cryptorchidism cryptorchidism is a risk factor for testicular cancer. having both testes in the scrotal sac is of acute life-threatening importance. a. b. C. d. A 70 year old man with emphysema develops postrenal AKI. What is the most likely cause? dehydration from chronic hyperventilation. a positive PSA benign prostatic hyperplasia. a UTI 7. a. b. c. d. un

Answer 1

ANSWER.

1) Stress fracture of vertebra in a Chronic kidney disease patient is due to

    b) Osteoporosis from decreased activation of vitamin D.

2) Oliguria over a 30 hr period,BUN level 26 and creatinine 1.1 indicate

    a) Prerenal acute kidney injury.

3) Findings consistent with prerenal acute kidney injury include all of the

    following ( poor skin turgor,UA shows increased specific gravity,hypovolemia)

   except c) Urine analysis shows decreased specific gravity.

4) Drugs that b) enhance potassium reabsorption from DCT should not be used in

    CKD.

5) The reason for the above answer is d) in CKD K+ excretion into the DCT is decreased

    because of pathologic unresponsiveness to aldosterone.

6) The nurses explanation based on the understanding that c) Cryptorchidism is a risk factor

    for testicular cancer.

7) Cause of a 70 yr old man with emphysema develops postrenal AKI is c) Benign prostatic

    hyperplasia (BPH).