NUR 612 - EXAM 5 Questions with Correct Answers 100% Verified By Experts| Latest Update
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Describe the pathophysiology of membraneous GN Chronic immune-complex disorder,
insidious onset
Seen in SLE, chronic hepatitis B, DM
Which person would be most likely to have focal segmental glomerulosclerosis cause their
nephrotic syndrome?
a. 55 y/o Black male w/ hx of SCD
b. 13 y/o Asian female w/ hx of recurrent cystine renal calculi
c. 43 y/o caucasian female w/ hx of polycystic kidney disease
d. 67 y/o Native american male with hx of chronic hepatitis B a. 55 y/o Black male w/ hx of
SCD
This disease is common in Hispanic and African Americans
- idiopathic but seen in conditions that decrease oxygenation like SCD, cyanotic heart conditions
Buerger's Dz is aka.... Immunoglobulin A nephropathy
A 28 y/o male presents c/o lots of urine in the blood. Of note, you recently treated the patient
for the flu. Lab work reveals elevated IgA levels. What do you as the NP deduce could be cause
of his issues? Buerger's Disease (Immunoglobulin A nephropathy)
What glomerular disorder would produce purple rashes on BLE? Henoch-Schönlein Purpura
Nephritis (HSP)
A mother brings her 5 y/o son into the clinic concerned about this purple rash on his legs.
Mother also notes that he has been grasping his belly and not moving as much as he used to.
Further, the patient is seeing blood when wiping. What do you as the NP deduce as the cause?
Henoch-Schönlein Purpura Nephritis (HSP)
,How is Henoch-Schönlein Purpura Nephritis (HSP) treated? Steroids! Most people fully
recover
Which glomerular disorder can lead to sensorial hearing loss at adolescence or eye problems?
a. Henoch-Schönlein Purpura Nephritis (HSP)
b. Buerger's Disease
c. Alport syndrome
d. Chronic glomerulonephriitis c. Alport syndrome
[T/F]: Alport syndrome is majority Y-linked recessive False! It is 85% X-linked dominant (Boys
are more severely effected)
A 27 y/o Black female presents with decreased GFR. Of note, her history includes SLE. What do
you as the NP suspect could be the cause? SLE GN
40-80% of SLE patients will have kidney involvement
[T/F]: Diabetic glomerulosclerosis is the most common cause of renal failure True!
Diabetic glomerulosclerosis is more common in which populations? African Americans,
Asians and Native Americans
Microalbuminuria + HTN are common manifestations of what glomerular lesions associated
with systemic dz? diabetic glomerulosclerosis
How does HTN lead to glomerular dz? HTN --> sclerotic changes in renal arterioles -->
nephrosclerosis
These manifestations describe what glomerular disorder associated w/ systemic dz:
,kidneys SMALLER
BILATERAL dz
thickening and SCARING of vessels --> RBF -->tubular atrophy, interstitial fibrosis, changes in
glomerular function Hypertensive glomerular dz
[PROXIMAL/ DISTAL] tubular acidosis affects bicarb reabsorption Proximal
[PROXIMAL/ DISTAL] tubular acidosis affects fixed metabolism acid secretion Distal
Describe the pathophysiology proximal renal tubular acidosis HCO3 lost --> Na+ loss -->
volume contraction --> incr aldosterone secretion --> decr serum K+
Distal tubule continues to secrete fixed acids --> decr pH + reabsorb HCO3 --> incr serum HCO3 -
-> cascade REPEATS
Fanconi syndrome can cause [PROXIMAL/ DISTAL] tubular acidosis Proximal
Impaired reabsorption of glucose, amino acids, phosphate and uric acids combined with growth
retardation, rickets, osteomalacia, abn vitamin D metabolism could be...? Fanconi syndrome
A distal tubular defect in H+ secretion w/ net loss of NAHCO3 is characteristic of what type of
renal tubular acidosis? Distal renal tubular acidosis (DRTA)
These manifestations are characteristic of which type of renal tubular acidosis:
Hypokalemia, hyperchloremic METABOLIC ACIDOSIS
Nephrocalcinosis
Nephrolithiasis
Osteomalacia/ rickets (acidosis requires Ca+ and PO4 buffering from bone) Distal renal
tubular acidosis (DRTA)
, [T/F]: Pyelonephritis is an infection of the LOWER tract False! Particularly the renal
parenchyma and renal pelvis
[T/F]: Pylonephritis is an ascending infection True! Except S. aureus that is usually blood
borne
If a person has unexplained sepsis, what should you consider as the origin? Urinary tract
[T/F]: Chronic pyelonephritis has pain at the costovertebral angle False! ACUTE
pyelonephritis has pain at costovertebral able
Explain the complications of chronic pyelonephritis Chronic renal insufficiency --> loss of
tubular fx --> proteinuria, polyuria, nocturia
Severe chronic HTN (JG complex)
Explain the pathophysiology of chronic pyelonephritis Upper urinary tract infx + reflux* or
obstruction
*most common - unilateral or bilateral
How are the kidneys affected by nephrotoxic drugs? Damages RBF --> damage to
tubulointerstitial structures or produces hypersensitivity rxn
List common drugs that cause drug related nephropathy diuretics, contrast media, NSAIDs,
aminoglycosides
Which is the most common primary neoplasm of children? Wilm's tumor
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Describe the pathophysiology of membraneous GN Chronic immune-complex disorder,
insidious onset
Seen in SLE, chronic hepatitis B, DM
Which person would be most likely to have focal segmental glomerulosclerosis cause their
nephrotic syndrome?
a. 55 y/o Black male w/ hx of SCD
b. 13 y/o Asian female w/ hx of recurrent cystine renal calculi
c. 43 y/o caucasian female w/ hx of polycystic kidney disease
d. 67 y/o Native american male with hx of chronic hepatitis B a. 55 y/o Black male w/ hx of
SCD
This disease is common in Hispanic and African Americans
- idiopathic but seen in conditions that decrease oxygenation like SCD, cyanotic heart conditions
Buerger's Dz is aka.... Immunoglobulin A nephropathy
A 28 y/o male presents c/o lots of urine in the blood. Of note, you recently treated the patient
for the flu. Lab work reveals elevated IgA levels. What do you as the NP deduce could be cause
of his issues? Buerger's Disease (Immunoglobulin A nephropathy)
What glomerular disorder would produce purple rashes on BLE? Henoch-Schönlein Purpura
Nephritis (HSP)
A mother brings her 5 y/o son into the clinic concerned about this purple rash on his legs.
Mother also notes that he has been grasping his belly and not moving as much as he used to.
Further, the patient is seeing blood when wiping. What do you as the NP deduce as the cause?
Henoch-Schönlein Purpura Nephritis (HSP)
,How is Henoch-Schönlein Purpura Nephritis (HSP) treated? Steroids! Most people fully
recover
Which glomerular disorder can lead to sensorial hearing loss at adolescence or eye problems?
a. Henoch-Schönlein Purpura Nephritis (HSP)
b. Buerger's Disease
c. Alport syndrome
d. Chronic glomerulonephriitis c. Alport syndrome
[T/F]: Alport syndrome is majority Y-linked recessive False! It is 85% X-linked dominant (Boys
are more severely effected)
A 27 y/o Black female presents with decreased GFR. Of note, her history includes SLE. What do
you as the NP suspect could be the cause? SLE GN
40-80% of SLE patients will have kidney involvement
[T/F]: Diabetic glomerulosclerosis is the most common cause of renal failure True!
Diabetic glomerulosclerosis is more common in which populations? African Americans,
Asians and Native Americans
Microalbuminuria + HTN are common manifestations of what glomerular lesions associated
with systemic dz? diabetic glomerulosclerosis
How does HTN lead to glomerular dz? HTN --> sclerotic changes in renal arterioles -->
nephrosclerosis
These manifestations describe what glomerular disorder associated w/ systemic dz:
,kidneys SMALLER
BILATERAL dz
thickening and SCARING of vessels --> RBF -->tubular atrophy, interstitial fibrosis, changes in
glomerular function Hypertensive glomerular dz
[PROXIMAL/ DISTAL] tubular acidosis affects bicarb reabsorption Proximal
[PROXIMAL/ DISTAL] tubular acidosis affects fixed metabolism acid secretion Distal
Describe the pathophysiology proximal renal tubular acidosis HCO3 lost --> Na+ loss -->
volume contraction --> incr aldosterone secretion --> decr serum K+
Distal tubule continues to secrete fixed acids --> decr pH + reabsorb HCO3 --> incr serum HCO3 -
-> cascade REPEATS
Fanconi syndrome can cause [PROXIMAL/ DISTAL] tubular acidosis Proximal
Impaired reabsorption of glucose, amino acids, phosphate and uric acids combined with growth
retardation, rickets, osteomalacia, abn vitamin D metabolism could be...? Fanconi syndrome
A distal tubular defect in H+ secretion w/ net loss of NAHCO3 is characteristic of what type of
renal tubular acidosis? Distal renal tubular acidosis (DRTA)
These manifestations are characteristic of which type of renal tubular acidosis:
Hypokalemia, hyperchloremic METABOLIC ACIDOSIS
Nephrocalcinosis
Nephrolithiasis
Osteomalacia/ rickets (acidosis requires Ca+ and PO4 buffering from bone) Distal renal
tubular acidosis (DRTA)
, [T/F]: Pyelonephritis is an infection of the LOWER tract False! Particularly the renal
parenchyma and renal pelvis
[T/F]: Pylonephritis is an ascending infection True! Except S. aureus that is usually blood
borne
If a person has unexplained sepsis, what should you consider as the origin? Urinary tract
[T/F]: Chronic pyelonephritis has pain at the costovertebral angle False! ACUTE
pyelonephritis has pain at costovertebral able
Explain the complications of chronic pyelonephritis Chronic renal insufficiency --> loss of
tubular fx --> proteinuria, polyuria, nocturia
Severe chronic HTN (JG complex)
Explain the pathophysiology of chronic pyelonephritis Upper urinary tract infx + reflux* or
obstruction
*most common - unilateral or bilateral
How are the kidneys affected by nephrotoxic drugs? Damages RBF --> damage to
tubulointerstitial structures or produces hypersensitivity rxn
List common drugs that cause drug related nephropathy diuretics, contrast media, NSAIDs,
aminoglycosides
Which is the most common primary neoplasm of children? Wilm's tumor
