MARYVILLE NURS 611 COMPREHENSIVE EXAM 2025/2026
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Why do we think of E. coli, especially for women with pyelonephritis? - ✔✔Because
of proximity of the anus to the urinary tract
✔✔On urinalysis what would you see with pyelonephritis - ✔✔WBC casts, because they
are only formed in the renal tubules
✔✔Urine should always go (----) and when there is an obstruction urine goes (----) -
✔✔Forward, backward
✔✔When the urine flows backward from an obstruction, where does it flow back into -
✔✔The renal pelvis
✔✔What is the renal pelvis? - ✔✔is the funnel-like dilated part of the ureter in the
kidney, The renal pelvis functions as a funnel for urine flowing to the ureter.
✔✔When the urine flows backward from an obstruction into the renal pelvis, what
happens? - ✔✔it causes inflammation, which is caused by bacteria
✔✔A condition that includes non bacterial infectious cystitis and noninfectious cystitis is
called what? - ✔✔Painful bladder syndrome or interstitial cystitis
✔✔Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ✔✔UTI, but is non
bacterial. Patients present with UTI and are treated with multiple rounds of abx and do
not improve is the clue it is PBS/IC
✔✔Cause of PBS/IC - ✔✔Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
✔✔Which patients do we generally think about when we think about PBS/IC? -
✔✔Diabetics because they are prone to infection, but when they have gotten what we
think is a UTI and we keep giving antibiotics again and again, and here it is the third
, time, we need to think that they probably have PBS (painful bladder syndrome or also
known as interstitial cystitis).
✔✔Because it is difficult to differentiate between pyelonephritis and cystitis by clinical
manifestations alone, what diagnostic testing should be performed? - ✔✔Urine culture,
urinalysis, and clinical manifestations
✔✔Gold standard indicator of kidney function - ✔✔GFR
✔✔Normal GFR - ✔✔60-120 mL/min
✔✔What does a GFR of 15-60 indicate? - ✔✔Kidney disease
✔✔What does a GFR of less than 15 indicate? - ✔✔Kidney Failure
✔✔What is a reduced GFR during glomerular disease evidenced by? - ✔✔Elevated
plasma urea, creatinine concentration, or reduced renal creatinine clearance
✔✔Includes renal diseases in which glomerular inflammation is caused by immune
mechanisms that damage the glomerular capillary filtration membrane. - ✔✔Acute
glomerulonephritis
✔✔What are some symptoms of acute glomerulonephritis? - ✔✔Hematuria and mild
proteinuria
✔✔Severe symptoms of glomerulonephritis - ✔✔Edema (due to protein loss in urine) ,
HTN, Impaired renal function
✔✔Normally, the glomerular capillary filtration membranes are very close to each other,
but with acute glomerulonephritis, what happens is that those membranes become
spaced apart due to what? - ✔✔Inflammation, infection, and damage so that proteins
(which are huge molecules) can go through when normally they should not be able to
filtrate through such a small opening.
✔✔What is the main difference between acute glomerulonephritis and nephrotic
syndrome? - ✔✔Acute glomerulonephritis involves mild proteinuria. Nephrotic syndrome
involves massive proteinuria up to 3 grams or more excreted per day as well as
hypoalbuminemia (less than 3.0 g/dl) as well as peripheral edema. But the MAIN
difference is nephrotic syndrome involves MASSIVE PROTEINURIA!
✔✔Causes of nephrotic syndrome - ✔✔Glomerulonephritis, Genetic defects that alter
the glomerular membrane, Systemic diseases (diabetes, Lupus)**, Drug/toxin injury,
Infections (especially chronic and/or recurrent)
QUESTIONS WITH SOLUTIONS GRADED A+
✔✔Why do we think of E. coli, especially for women with pyelonephritis? - ✔✔Because
of proximity of the anus to the urinary tract
✔✔On urinalysis what would you see with pyelonephritis - ✔✔WBC casts, because they
are only formed in the renal tubules
✔✔Urine should always go (----) and when there is an obstruction urine goes (----) -
✔✔Forward, backward
✔✔When the urine flows backward from an obstruction, where does it flow back into -
✔✔The renal pelvis
✔✔What is the renal pelvis? - ✔✔is the funnel-like dilated part of the ureter in the
kidney, The renal pelvis functions as a funnel for urine flowing to the ureter.
✔✔When the urine flows backward from an obstruction into the renal pelvis, what
happens? - ✔✔it causes inflammation, which is caused by bacteria
✔✔A condition that includes non bacterial infectious cystitis and noninfectious cystitis is
called what? - ✔✔Painful bladder syndrome or interstitial cystitis
✔✔Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics - ✔✔UTI, but is non
bacterial. Patients present with UTI and are treated with multiple rounds of abx and do
not improve is the clue it is PBS/IC
✔✔Cause of PBS/IC - ✔✔Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation
- Chemical
- Autoimmune
- Hypersensitivity
✔✔Which patients do we generally think about when we think about PBS/IC? -
✔✔Diabetics because they are prone to infection, but when they have gotten what we
think is a UTI and we keep giving antibiotics again and again, and here it is the third
, time, we need to think that they probably have PBS (painful bladder syndrome or also
known as interstitial cystitis).
✔✔Because it is difficult to differentiate between pyelonephritis and cystitis by clinical
manifestations alone, what diagnostic testing should be performed? - ✔✔Urine culture,
urinalysis, and clinical manifestations
✔✔Gold standard indicator of kidney function - ✔✔GFR
✔✔Normal GFR - ✔✔60-120 mL/min
✔✔What does a GFR of 15-60 indicate? - ✔✔Kidney disease
✔✔What does a GFR of less than 15 indicate? - ✔✔Kidney Failure
✔✔What is a reduced GFR during glomerular disease evidenced by? - ✔✔Elevated
plasma urea, creatinine concentration, or reduced renal creatinine clearance
✔✔Includes renal diseases in which glomerular inflammation is caused by immune
mechanisms that damage the glomerular capillary filtration membrane. - ✔✔Acute
glomerulonephritis
✔✔What are some symptoms of acute glomerulonephritis? - ✔✔Hematuria and mild
proteinuria
✔✔Severe symptoms of glomerulonephritis - ✔✔Edema (due to protein loss in urine) ,
HTN, Impaired renal function
✔✔Normally, the glomerular capillary filtration membranes are very close to each other,
but with acute glomerulonephritis, what happens is that those membranes become
spaced apart due to what? - ✔✔Inflammation, infection, and damage so that proteins
(which are huge molecules) can go through when normally they should not be able to
filtrate through such a small opening.
✔✔What is the main difference between acute glomerulonephritis and nephrotic
syndrome? - ✔✔Acute glomerulonephritis involves mild proteinuria. Nephrotic syndrome
involves massive proteinuria up to 3 grams or more excreted per day as well as
hypoalbuminemia (less than 3.0 g/dl) as well as peripheral edema. But the MAIN
difference is nephrotic syndrome involves MASSIVE PROTEINURIA!
✔✔Causes of nephrotic syndrome - ✔✔Glomerulonephritis, Genetic defects that alter
the glomerular membrane, Systemic diseases (diabetes, Lupus)**, Drug/toxin injury,
Infections (especially chronic and/or recurrent)
