NSG 530 – Exam 3
Advanced Pathophysiology |
Wilkes University | 2026 update
100 Questions with Answers &
Rationales
1. Apatient is diagnosed with a kidney stone composed of
magnesium, ammonium, and phosphate. What type of urinary
calculus is this?
A) Calcium oxalate
B) Struvite
C) Uric
acid
D) Cystine
Correct Answer: B) Struvite
RATIONALE:Struvite stones (infection stones) form in alkaline urine and are
composed of magnesium ammonium phosphate. They are associated with
urease-producing bacteria such as Proteus mirabilis.
2. What renal tissue is primarily affected by pyelonephritis?
A) Renalcortex only
B) Renal pelvis and kidney interstitium
C) Glomeruli only
D) Renal tubules only
Correct Answer: B) Renal pelvis and kidney interstitium
RATIONALE:Pyelonephritis is an ascending infection that affects the renal
pelvis and the interstitial tissue of the kidney, typically resulting from
, untreated lower urinary tract infections.
3. A7-year-old child presents with sudden onset of hematuria,
periorbital edema, hypertension, and oliguria following a streptococcal
throat infection. What is the most likely diagnosis?
A) Nephrotic
syndrome
B) Acute post-streptococcal glomerulonephritis
C) Pyelonephritis
D) Wilms tumor
Correct Answer: B) Acute post-streptococcal glomerulonephritis
RATIONALE:Post-streptococcal glomerulonephritis is an immune-complex
mediated disease that occurs 1-3 weeks after a streptococcal infection,
presenting with the classic triad of hematuria, edema, and hypertension.
4. What is the most common symptom seen in nephrotic syndrome?
A) Gross hematuria
B) Severe edema around eyes, ankles, and feet
C) Flank pain
D) Fever
, Correct Answer: B) Severe edema around eyes, ankles, and feet
RATIONALE:Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, hyperlipidemia, and edema. The edema
results from decreased oncotic pressure due to albumin loss.
5. Which laboratory value is the most consistent indicator of renal failure?
A) ElevatedAST/ALT
B) Decreased platelet count
C) Decreased GFR
D) Elevated serum calcium
Correct Answer: C) Decreased GFR
RATIONALE:The glomerular filtration rate (GFR) is the gold standard for
assessing renal function. A GFR <60 mL/min/1.73m² for 3 months indicates
chronic kidney disease.
6. Where would you expect to find a Wilms tumor?
A) Liver
B) Kidney
C) Adrenal gland
D) Ovary
Correct Answer: B) Kidney
RATIONALE:Wilms tumor (nephroblastoma) is the most common renal
malignancy in children, typically presenting as an asymptomatic abdominal
mass in children aged 2-5 years.
7. Apatient with chronic kidney disease develops anemia. What is
the primary underlying mechanism?
A) Iron
deficiency
B) Decreased erythropoietin production
C) Folate deficiency
D) Hemolysis
Correct Answer: B) Decreased erythropoietin production
RATIONALE:Erythropoietin (EPO) is produced by peritubular cells in the
kidney. In CKD, reduced EPO production leads to normocytic, normochromic
anemia.
, 8. Which type of renal stone is radiolucent and not visible on plain abdominal X-
ray?
A) Calcium oxalate
B) Struvite
C) Uric
acid
D) Calcium phosphate
Correct Answer: C) Uric acid
RATIONALE:Uric acid stones are radiolucent because they do not contain
calcium. They require CT or ultrasound for visualization and form in acidic
urine (pH <5.5).
9. A65-year-old male with benign prostatic hyperplasia presents with
urinary retention and fever. Which complication is most likely?
A) Nephrotic syndrome
B) Acute pyelonephritis
Advanced Pathophysiology |
Wilkes University | 2026 update
100 Questions with Answers &
Rationales
1. Apatient is diagnosed with a kidney stone composed of
magnesium, ammonium, and phosphate. What type of urinary
calculus is this?
A) Calcium oxalate
B) Struvite
C) Uric
acid
D) Cystine
Correct Answer: B) Struvite
RATIONALE:Struvite stones (infection stones) form in alkaline urine and are
composed of magnesium ammonium phosphate. They are associated with
urease-producing bacteria such as Proteus mirabilis.
2. What renal tissue is primarily affected by pyelonephritis?
A) Renalcortex only
B) Renal pelvis and kidney interstitium
C) Glomeruli only
D) Renal tubules only
Correct Answer: B) Renal pelvis and kidney interstitium
RATIONALE:Pyelonephritis is an ascending infection that affects the renal
pelvis and the interstitial tissue of the kidney, typically resulting from
, untreated lower urinary tract infections.
3. A7-year-old child presents with sudden onset of hematuria,
periorbital edema, hypertension, and oliguria following a streptococcal
throat infection. What is the most likely diagnosis?
A) Nephrotic
syndrome
B) Acute post-streptococcal glomerulonephritis
C) Pyelonephritis
D) Wilms tumor
Correct Answer: B) Acute post-streptococcal glomerulonephritis
RATIONALE:Post-streptococcal glomerulonephritis is an immune-complex
mediated disease that occurs 1-3 weeks after a streptococcal infection,
presenting with the classic triad of hematuria, edema, and hypertension.
4. What is the most common symptom seen in nephrotic syndrome?
A) Gross hematuria
B) Severe edema around eyes, ankles, and feet
C) Flank pain
D) Fever
, Correct Answer: B) Severe edema around eyes, ankles, and feet
RATIONALE:Nephrotic syndrome is characterized by massive proteinuria
(>3.5g/day), hypoalbuminemia, hyperlipidemia, and edema. The edema
results from decreased oncotic pressure due to albumin loss.
5. Which laboratory value is the most consistent indicator of renal failure?
A) ElevatedAST/ALT
B) Decreased platelet count
C) Decreased GFR
D) Elevated serum calcium
Correct Answer: C) Decreased GFR
RATIONALE:The glomerular filtration rate (GFR) is the gold standard for
assessing renal function. A GFR <60 mL/min/1.73m² for 3 months indicates
chronic kidney disease.
6. Where would you expect to find a Wilms tumor?
A) Liver
B) Kidney
C) Adrenal gland
D) Ovary
Correct Answer: B) Kidney
RATIONALE:Wilms tumor (nephroblastoma) is the most common renal
malignancy in children, typically presenting as an asymptomatic abdominal
mass in children aged 2-5 years.
7. Apatient with chronic kidney disease develops anemia. What is
the primary underlying mechanism?
A) Iron
deficiency
B) Decreased erythropoietin production
C) Folate deficiency
D) Hemolysis
Correct Answer: B) Decreased erythropoietin production
RATIONALE:Erythropoietin (EPO) is produced by peritubular cells in the
kidney. In CKD, reduced EPO production leads to normocytic, normochromic
anemia.
, 8. Which type of renal stone is radiolucent and not visible on plain abdominal X-
ray?
A) Calcium oxalate
B) Struvite
C) Uric
acid
D) Calcium phosphate
Correct Answer: C) Uric acid
RATIONALE:Uric acid stones are radiolucent because they do not contain
calcium. They require CT or ultrasound for visualization and form in acidic
urine (pH <5.5).
9. A65-year-old male with benign prostatic hyperplasia presents with
urinary retention and fever. Which complication is most likely?
A) Nephrotic syndrome
B) Acute pyelonephritis
