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Pathophysiology of the kidneys



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Pathophysiology of the kidneys

#A patient, 35 years old, complains of pain in the lumber region, edemas under the eyes, weakness. Erythrocytes and proteins were found in urine of the patient. Arterial pressure is 160/110 mm Hg. What pathology can most probably be suspected in this case? -Urethritis

-Pyelitis

-Cystitis

+Glomerulonephritis

-Pyelonephritis

#Nephrocytotoxic serum was injected to a guinea pig. What pathology of the kidneys has been modelled in this experiment?

+Acute diffuse glomerulonephritis

-Nephrotic syndrome

-Acute pyelonephritis

-Chronic renal failure

-Chronic pyelonephritis

#Solution of mercury bichloride in dose of 5 mg per 1 kg of body weight was injected subcutaneously to the white rat. In 24 h concentration of kreatinine in blood plasma has increased several times. What is the mechanism of retentional azotemia in this case?

-Increased glomerular filtration

-Increased formation of kreatinine in the muscles

-Increased reabsorption of kreatinine

+Decrease of glomerular filtration

-Increased secretion of kreatinine in kidney’s tubules

#Examination of the patient established, that the clearance of endogenic kreatinine compounds as 50 ml / min (normal - 110-150 ml / min). The decreas what function it testify?

-Ions removing from the organism

-Tubular reabsorption

-Incretory of function of the kidneys

+Glomerular filtration

-Tubular secretion

#During 17 years the man has chronic glomerulonephritis. Pulse - 82, arterial pressure - 190/120 mm Hg. What is the initial mechanism of increase of arterial pressure?

-Increased minute volume of the blood.- -Decreased volume of circulating blood.-

-Increased tone of the venous vessels.-

-Hyperkinemia.-

+Increased general peripheric resistance.+

#The man, 32 years old, has chronic glomerulonephritis for 4 years. Edemas of the face, legs, and the trunk, and high proteinuria are observed. What may cause edemas in this patient?

+Decreased oncotical pressure of blood

-Increased hydrostatic pressure of blood in capillaries

-Increased oncotical pressure of intracellular lymph

-Difficulty of lymph drainage

-Increased permeability of capillaries

#Due to overdose of vasodilatator the arterial pressure of the patient has decreased up to 60/40 mm Hg. Collapse has developed. What kind of pathology can occur in this case?

-Myocardial infarction

+Acute renal failure

-Cholemic syndrome

-Insult (stroke)

-Acute respiratory failure

#The patient with hemorrhage into the region of supraoptical and paraventricular nucleus of the hypothalamus developed polyuria. Level of vasopressin in blood decreased. What is the main mechanism of development of polyuria in this case?

-Decreased reabsorption of sodium in channels

-Increased filtration of water in glomeruli

-Increased reabsorption of sodium in channels

+Decreased reabsorption of water in channels

-Increased excretion of potassium

#Chronic glomerulonephritis was reproduced in a rabbit by injection of high dose of antikidneys serum of guinea pig .What is the underlying cause of chronic development glomerulonephritis? -Toxic necrosis of channel’s epithelium

+Allergic process

-Infection

-Amyloidosis of the kidneys

-Ischemic damage of the tubules

#Chronic glomerulonephritis was diagnosed in the patient. Due to significant sclerotic changes, the mass of functioning nephrons has decreased up to 10% and the signs of uremic syndrome increrased. What is the cause of uremia?

-Arterial hypertension

-Water dysbalance

-Osmotic dysbalance

-Renal osteodystrophy

+Asotemia

#In the patient, oliguria resulted from acute renal failure. What 24-houres diuresis corresponds to such symptom?

-50-100 ml

+100-500 ml

-500-1000 ml

-1000-1500 ml

-1500-2000 ml

#The patient with of the kidney pathology revealed proteinuria, edemas, hypoproteinemia, lipidemia. What pathology of the kidneys is it typical of?

-Thrombosis of renal arteria

+Nephrotic syndrome

-Chronic diffuse glomerulonephritis

-Chronic pyelonephritis

-Acute diffuse glomerulonephritis

#In the patient with chronic pathology of the kidneys, urinal analysis by Zimnitskiy revealed hyposthenuria. What changes of uroemission are most probable in this case? -Anuria

-Nicturia

+Polyuria

-Hematuria

-Cylindoruria

#The level of general blood protein in the patient with initial nephrotic syndrome is 40 g/L. What is the cause of hypoproteinemia in this case?

-Decreased synthesis of protein in the liver

-Exudation of protein from vessels into the tissue

+Proteinuria

-Increased proteolysis

-Disorder of protein absorption in the intestines

#The patient has chronic glomerulonephritis. The glomerular filtration reduced to 20% of normal one. What causes decrease of glomerular filtration in case ofchronic renal failure? -Obturation of urinary trackt

-Tubulopathy

+Decreased amount of active nephrons

-Ischemia of the kidneys

-Thrombosis of renal arterias

#In the patient, 58 years old, with acute cardiac failure, decreased 24-h diuresis was observed. What is the mechanism of oliguria in this case?

-Decreased amount of functioning glomeruli

+Decreased glomerular filtration rate

-Decreased oncotical blood pressure

-Increased reabsorption of water.-

-Decreased permeability of the glomerular membrane

#The patient, 30 years old, was hospitalized with the diagnosis of acute glomerulonephritis. Proteinuria was observed. What is the mechanism of its onset?

-Decreased oncotical blood pressure

-Delayed removal of nitrogen metabolism products

+Rising permeability of glomerular membrane

-Rising hydrostatic pressure in capillaries

-Decreased amount of functioning nephrons

#One kidney of the experimental animal was removed and the ligature narrowing the artery of the other kidney was applied. What model of hypertension was reproduced in this case? -Neurogenic

-Renoprival

-Endocrine

+Renovascular

-Saline

#The woman, 55 years old, developed pain in the kidneys region. Ultrasonic examination revealed the presence of renal stones. High concentration of wich substance is the most probable cause of formation of stones in this case?

-Cholesterin

-Urea


-Bilirubin

+Urates


-Cystine

#In the patient with diabetes mellitus, diabetic nephropathy with development of uremia occured. Glomerular filtration rate is 9 ml / min. What is the possible mechanism of decreased glomerular filtration and development of chronic renal failure?

+Lack of working nephrons

-Decrease of systemic arterial pressure

-Occlusion of nephrone tubules by hyaline cylinders

-Development of metabolic acidosis

-Spasm of afferent arterioles

#Leached Erythrocytes were found in 24-h urine of the patient. What pathology of the kidneys is it most typical of?

-Nephrotic syndrome +Diffuse glomerulonephritis

-Nephrolithiasis

-Pyelonephritis

-Acute renal failure

#Changes in composition of urine in the experimental animal, with the model of acute diffuse glomerulonephritis. What symptom results from rising permeability of glomerular membrane? -Aminoaciduria

-Glucosuria

+Proteinuria -Alcaptonuria

-Phosphaturia

#The patient with chronic diffuse glomerulonephritis developed chronic renal failure. In its terminal stage oliguria occurred. What is the cause of this oliguria?

-Disseminated intravascular coagulation of blood

-Ischemia of kidney’s cortex due to vasospasm

-Decreased filtration pressure in the glomeruli

-Increased reabsorption of water in the distal tubules

+Decreased mass of working nephrons

#Normochromal normocytic anemia develops in the patient with chronic glomerulonephritis. What is the mechanism of its onset?

-Loss of iron

+Decreased secretion of erythropoietins

-Decreased secretion of erythropoietin’s inhibitor

-Streptococcal intoxication

-Damaging action of immune complexes

#A serious infection was followed by the signs of diabete insipidus have: increased up to 10L a day diuresis. What is the main mechanism of dehydration development?

-Decreased oncotical pressure of plasma

-Rising osmolarity of the ultrafiltrate

-Decreased reabsorbtion of water in the intestine

-Decreased reabsorption of sodium in the kidneys

+Decreased reabsorption of water in the kidneys

#Urine analysis reveled in the patient with chronic pyelonephritis decreased density of urine up to 1010 and increased diuresis. What function of the kidneys is broken?

-Tubules secretion

-Glomerular filtration

+Tubules reabsorption

-Incretion

-Metabolic

#The patient, 55 years old, has chronic glomerulonephritis for 15 years. What changes of blood composition or urine composition is most clearly testify the depression of excretory function of the kidneys?

-Proteinuria

-Hyperglycemia

-Hypoproteinemia

+Hyperazotemia

-Hypo-, isosthenuria

#The patient with acute renal failure developed polyuria on the 6-th day of the treatment. What is the cause of increasing diuresis at the beginning of the polyuria stage of acute renal failure?

-Decreased level of aldosteron in plasma

-Increased volume of circulating blood

-Increased level of natriiurical factor

+Restorance of filtration in nephrons

-Decreased level of vasopressinum in plasma

#The woman, 30 years old, developed edemas. Analyse reveled - proteinuria (5.87 g/L), hypoproteinemia, disproteinemia, hyper lipidemia. What pathology of the kidneys such as syndrome characterize?

-Glomerulonephritis

+Nephrotic syndrome

-Chronic pyelonephritis

-Acute renal failure

-Chronic renal failure





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