,NSG3850/NSG 3850 Exam 3 | Advanced
1. A patient with nephrotic syndrome typically presents with which triad of clinical findings?
A) Hematuria, hypertension, and oliguria
B) Proteinuria, hypoalbuminemia, and generalized edema
C) Pyuria, bacteriuria, and fever
D) Polyuria, polydipsia, and hyperglycemia
Correct Answer: B) Proteinuria, hypoalbuminemia, and generalized edema
Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) due to increased
glomerular permeability from podocyte damage. This leads to hypoalbuminemia and subsequent
generalized edema. Hematuria and hypertension (A) are characteristic of nephritic syndromes, not
nephrotic. Pyuria (C) suggests infection, and polyuria/polydipsia (D) suggests diabetes.
2. Red blood cell casts in the urinalysis are most suggestive of which renal condition?
A) Nephrotic syndrome
B) Glomerulonephritis
C) Pyelonephritis
D) Acute tubular necrosis
Correct Answer: B) Glomerulonephritis
Rationale: Red blood cell casts indicate glomerular bleeding and are characteristic of glomerulonephritis.
Nephrotic syndrome (A) typically shows fatty casts and oval fat bodies without significant hematuria.
Pyelonephritis (C) presents with white blood cell casts. Acute tubular necrosis (D) is associated with
muddy brown casts.
3. White blood cell casts in the urine are most indicative of which condition?
A) Glomerulonephritis
B) Nephrotic syndrome
,C) Acute pyelonephritis
D) Nephrolithiasis
Correct Answer: C) Acute pyelonephritis
Rationale: White blood cell casts indicate inflammation and infection within the renal parenchyma,
characteristic of acute pyelonephritis. Glomerulonephritis (A) presents with red blood cell casts.
Nephrotic syndrome (B) presents with fatty casts. Nephrolithiasis (D) is not typically associated with
cellular casts.
4. The pathophysiologic basis of acute glomerulonephritis is most commonly which of the following?
A) Renal ischemia
B) Bacterial invasion of the glomerulus
C) An anaphylactic reaction
D) An immune complex reaction
Correct Answer: D) An immune complex reaction
Rationale: Acute glomerulonephritis is most often caused by immune complex deposition in the
glomerular basement membrane, triggering inflammation. Renal ischemia (A) is associated with prerenal
AKI. Bacterial invasion (B) describes pyelonephritis. Anaphylactic reactions (C) are Type I
hypersensitivity, not the mechanism of glomerulonephritis.
5. Which of the following findings is consistent with a diagnosis of glomerulonephritis?
A) Anuria
B) Proteinuria
C) Red blood cell casts in urine
D) Foul-smelling urine
Correct Answer: C) Red blood cell casts in urine
, Rationale: Red blood cell casts are a hallmark of glomerulonephritis, indicating glomerular bleeding.
Anuria (A) may occur in severe cases but is not a consistent finding. Proteinuria (B) can occur but is more
prominent in nephrotic syndrome. Foul-smelling urine (D) suggests infection.
6. In nephrotic syndrome, the primary pathophysiologic mechanism for proteinuria is which of the
following?
A) Damage to podocytes increasing glomerular membrane permeability
B) Excessive protein synthesis by the liver
C) Tubular obstruction by cellular debris
D) Decreased renal blood flow
Correct Answer: A) Damage to podocytes increasing glomerular membrane permeability
Rationale: In nephrotic syndrome, damage to podocytes increases glomerular membrane permeability,
allowing massive protein to escape into the urine. Excessive liver protein synthesis (B) is a compensatory
response, not the cause. Tubular obstruction (C) and decreased renal blood flow (D) are not the primary
mechanisms.
7. Nephrotic syndrome does NOT usually cause which of the following?
A) Hyperlipidemia
B) Proteinuria
C) Hematuria
D) Generalized edema
Correct Answer: C) Hematuria
Rationale: Hematuria is characteristic of nephritic syndrome, not nephrotic syndrome. Nephrotic
syndrome is characterized by proteinuria (B), hypoalbuminemia leading to generalized edema (D), and
hyperlipidemia (A) as the liver compensates by synthesizing excess lipids.
8. A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely
which of the following?
1. A patient with nephrotic syndrome typically presents with which triad of clinical findings?
A) Hematuria, hypertension, and oliguria
B) Proteinuria, hypoalbuminemia, and generalized edema
C) Pyuria, bacteriuria, and fever
D) Polyuria, polydipsia, and hyperglycemia
Correct Answer: B) Proteinuria, hypoalbuminemia, and generalized edema
Rationale: Nephrotic syndrome is defined by massive proteinuria (>3.5 g/day) due to increased
glomerular permeability from podocyte damage. This leads to hypoalbuminemia and subsequent
generalized edema. Hematuria and hypertension (A) are characteristic of nephritic syndromes, not
nephrotic. Pyuria (C) suggests infection, and polyuria/polydipsia (D) suggests diabetes.
2. Red blood cell casts in the urinalysis are most suggestive of which renal condition?
A) Nephrotic syndrome
B) Glomerulonephritis
C) Pyelonephritis
D) Acute tubular necrosis
Correct Answer: B) Glomerulonephritis
Rationale: Red blood cell casts indicate glomerular bleeding and are characteristic of glomerulonephritis.
Nephrotic syndrome (A) typically shows fatty casts and oval fat bodies without significant hematuria.
Pyelonephritis (C) presents with white blood cell casts. Acute tubular necrosis (D) is associated with
muddy brown casts.
3. White blood cell casts in the urine are most indicative of which condition?
A) Glomerulonephritis
B) Nephrotic syndrome
,C) Acute pyelonephritis
D) Nephrolithiasis
Correct Answer: C) Acute pyelonephritis
Rationale: White blood cell casts indicate inflammation and infection within the renal parenchyma,
characteristic of acute pyelonephritis. Glomerulonephritis (A) presents with red blood cell casts.
Nephrotic syndrome (B) presents with fatty casts. Nephrolithiasis (D) is not typically associated with
cellular casts.
4. The pathophysiologic basis of acute glomerulonephritis is most commonly which of the following?
A) Renal ischemia
B) Bacterial invasion of the glomerulus
C) An anaphylactic reaction
D) An immune complex reaction
Correct Answer: D) An immune complex reaction
Rationale: Acute glomerulonephritis is most often caused by immune complex deposition in the
glomerular basement membrane, triggering inflammation. Renal ischemia (A) is associated with prerenal
AKI. Bacterial invasion (B) describes pyelonephritis. Anaphylactic reactions (C) are Type I
hypersensitivity, not the mechanism of glomerulonephritis.
5. Which of the following findings is consistent with a diagnosis of glomerulonephritis?
A) Anuria
B) Proteinuria
C) Red blood cell casts in urine
D) Foul-smelling urine
Correct Answer: C) Red blood cell casts in urine
, Rationale: Red blood cell casts are a hallmark of glomerulonephritis, indicating glomerular bleeding.
Anuria (A) may occur in severe cases but is not a consistent finding. Proteinuria (B) can occur but is more
prominent in nephrotic syndrome. Foul-smelling urine (D) suggests infection.
6. In nephrotic syndrome, the primary pathophysiologic mechanism for proteinuria is which of the
following?
A) Damage to podocytes increasing glomerular membrane permeability
B) Excessive protein synthesis by the liver
C) Tubular obstruction by cellular debris
D) Decreased renal blood flow
Correct Answer: A) Damage to podocytes increasing glomerular membrane permeability
Rationale: In nephrotic syndrome, damage to podocytes increases glomerular membrane permeability,
allowing massive protein to escape into the urine. Excessive liver protein synthesis (B) is a compensatory
response, not the cause. Tubular obstruction (C) and decreased renal blood flow (D) are not the primary
mechanisms.
7. Nephrotic syndrome does NOT usually cause which of the following?
A) Hyperlipidemia
B) Proteinuria
C) Hematuria
D) Generalized edema
Correct Answer: C) Hematuria
Rationale: Hematuria is characteristic of nephritic syndrome, not nephrotic syndrome. Nephrotic
syndrome is characterized by proteinuria (B), hypoalbuminemia leading to generalized edema (D), and
hyperlipidemia (A) as the liver compensates by synthesizing excess lipids.
8. A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely
which of the following?
