Chapter 38: Alterations of Renal and Urinary Tract Function
MULTIPLE CHOICE
1. How does progressive nephrons injury affect angiotensin II activity?
a. Angiotensin II activity is decreased.
b. It is elevated.
c. Angiotensin II activity is totally suppressed.
d. It is not affected.
ANS: B
Angiotensin II activity is elevated with progressive nephron injury. This selection is the only
accurate identification of the effect of progressive nephron injury on angiotensin II activity.
PTS: 1 REF: Page 1364 | Page 1366
2. Which mineral accounts for the most common type of renal stone?
a. Magnesium-ammonium-phosphate c. Calcium oxalate
b. Uric acid d. Magnesium phosphate
ANS: C
Calcium stones (calcium phosphate or calcium oxalate) account for 70% to 80% of all stones
requiring treatment.
PTS: 1 REF: Page 1343
3. Regarding the formation of renal calculi, what function does pyrophosphate, potassium cit-
rate, and magnesium perform?
a. They inhibit crystal growth.
b. Pyrophosphate, potassium citrate, and magnesium stimulate the supersaturation of
salt.
c. They facilitate the precipitation of salts from a liquid to a solid state.
d. Pyrophosphate, potassium citrate, and magnesium enhance crystallization of salt
crystals to form stones.
ANS: A
Stone or crystal growth inhibiting substances, including potassium citrate, pyrophosphate, and
magnesium, are capable of crystal growth inhibition. They are not capable of the functions
stated by the other options.
PTS: 1 REF: Page 1343
4. Hypercalciuria is primarily attributable to which alteration?
a. Defective renal calcium reabsorption
b. Intestinal hyperabsorption of dietary calcium
c. Bone demineralization caused by prolonged immobilization
d. Hyperparathyroidism
ANS: B
, Hypercalciuria is usually attributable to intestinal hyperabsorption of dietary calcium and less
commonly to a defect in renal calcium reabsorption. Hyperparathyroidism and bone deminer-
alization associated with prolonged immobilization are also known to cause hypercalciuria but
too a much lesser degree.
PTS: 1 REF: Page 1343
5. Detrusor hyperreflexia develops from neurologic disorders that originate where?
a. Spinal cord between C2 and S1 c. Above the pontine micturition center
b. Spinal cord between S2 and S4 d. Below the cauda equina
ANS: C
Neurologic disorders that develop above the pontine micturition center result in detrusor hy-
perreflexia, also known as an uninhibited or reflex bladder. This selection is the only option
responsible for detrusor hyperreflexia.
PTS: 1 REF: Page 1345
6. Considering the innervation of the circular muscles of the bladder neck, which classification
of drug is used to treat bladder neck obstruction?
a. b-Adrenergic blocking medications c. Parasympathomimetic medications
b. a-Adrenergic blocking medications d. Anticholinesterase medications
ANS: B
Because the bladder neck consists of circular smooth muscle with adrenergic innervation, de-
trusor sphincter dyssynergia may be managed by a-adrenergic blocking (antimuscarinic) med-
ications. This selection is the only option capable of this specific function.
PTS: 1 REF: Page 1346
7. Renal cell carcinoma, classified as clear cell tumors, arises from epithelial cells in which
structure?
a. Proximal tubule c. Nephron
b. Distal tubule d. Glomerulus
ANS: A
Renal cell carcinoma, classified as clear cell tumors according to cell type and extent of
metastasis, arises from the proximal tubular epithelium. These tumors are not associated with
the other options.
PTS: 1 REF: Page 1347
8. Bladder cancer is associated with the gene mutation of which gene?
a. c-erbB2
b. Human epidermal growth factor receptor 2 (HER2)
c. TP53
d. myc
ANS: C
Oncogenes of the ras gene family and tumor-suppressor genes including TP53 mutations and
the inactivation of the retinoblastoma gene (pRb) are implicated in bladder cancer. This
process is not associated with the other options.
MULTIPLE CHOICE
1. How does progressive nephrons injury affect angiotensin II activity?
a. Angiotensin II activity is decreased.
b. It is elevated.
c. Angiotensin II activity is totally suppressed.
d. It is not affected.
ANS: B
Angiotensin II activity is elevated with progressive nephron injury. This selection is the only
accurate identification of the effect of progressive nephron injury on angiotensin II activity.
PTS: 1 REF: Page 1364 | Page 1366
2. Which mineral accounts for the most common type of renal stone?
a. Magnesium-ammonium-phosphate c. Calcium oxalate
b. Uric acid d. Magnesium phosphate
ANS: C
Calcium stones (calcium phosphate or calcium oxalate) account for 70% to 80% of all stones
requiring treatment.
PTS: 1 REF: Page 1343
3. Regarding the formation of renal calculi, what function does pyrophosphate, potassium cit-
rate, and magnesium perform?
a. They inhibit crystal growth.
b. Pyrophosphate, potassium citrate, and magnesium stimulate the supersaturation of
salt.
c. They facilitate the precipitation of salts from a liquid to a solid state.
d. Pyrophosphate, potassium citrate, and magnesium enhance crystallization of salt
crystals to form stones.
ANS: A
Stone or crystal growth inhibiting substances, including potassium citrate, pyrophosphate, and
magnesium, are capable of crystal growth inhibition. They are not capable of the functions
stated by the other options.
PTS: 1 REF: Page 1343
4. Hypercalciuria is primarily attributable to which alteration?
a. Defective renal calcium reabsorption
b. Intestinal hyperabsorption of dietary calcium
c. Bone demineralization caused by prolonged immobilization
d. Hyperparathyroidism
ANS: B
, Hypercalciuria is usually attributable to intestinal hyperabsorption of dietary calcium and less
commonly to a defect in renal calcium reabsorption. Hyperparathyroidism and bone deminer-
alization associated with prolonged immobilization are also known to cause hypercalciuria but
too a much lesser degree.
PTS: 1 REF: Page 1343
5. Detrusor hyperreflexia develops from neurologic disorders that originate where?
a. Spinal cord between C2 and S1 c. Above the pontine micturition center
b. Spinal cord between S2 and S4 d. Below the cauda equina
ANS: C
Neurologic disorders that develop above the pontine micturition center result in detrusor hy-
perreflexia, also known as an uninhibited or reflex bladder. This selection is the only option
responsible for detrusor hyperreflexia.
PTS: 1 REF: Page 1345
6. Considering the innervation of the circular muscles of the bladder neck, which classification
of drug is used to treat bladder neck obstruction?
a. b-Adrenergic blocking medications c. Parasympathomimetic medications
b. a-Adrenergic blocking medications d. Anticholinesterase medications
ANS: B
Because the bladder neck consists of circular smooth muscle with adrenergic innervation, de-
trusor sphincter dyssynergia may be managed by a-adrenergic blocking (antimuscarinic) med-
ications. This selection is the only option capable of this specific function.
PTS: 1 REF: Page 1346
7. Renal cell carcinoma, classified as clear cell tumors, arises from epithelial cells in which
structure?
a. Proximal tubule c. Nephron
b. Distal tubule d. Glomerulus
ANS: A
Renal cell carcinoma, classified as clear cell tumors according to cell type and extent of
metastasis, arises from the proximal tubular epithelium. These tumors are not associated with
the other options.
PTS: 1 REF: Page 1347
8. Bladder cancer is associated with the gene mutation of which gene?
a. c-erbB2
b. Human epidermal growth factor receptor 2 (HER2)
c. TP53
d. myc
ANS: C
Oncogenes of the ras gene family and tumor-suppressor genes including TP53 mutations and
the inactivation of the retinoblastoma gene (pRb) are implicated in bladder cancer. This
process is not associated with the other options.
