NR 507 Patho Final Exam
Renal System
Urinary Tract pre-quiz Q's
1. What are the two main functions of the kidney Review diagram for anatomical structures ANS: 1.
Filtration and collection
Women are at a higher risk for the development of a UTI because of having a shorter urethra. True/False
ANS: True
Which of the following can help to prevent a UTI?
Increase water consumption
Use spermicides during sexual intercourse
Taking more Vitamin D
Douching to prevent the growth of bacteria ANS: Increase water consumption
A symptom of a lower urinary tract infection includes:
Fever
Flank pain
Urgency
Decreased Urination ANS: Urgency
Which of the following is true regarding a complicated urinary tract infection?
It is usually asymptomatic
,Can be caused by a structural urinary tract disorder
Bacteria are located mostly in the lower urinary tract
Is associated with young adults ANS: Can be caused by a structural urinary tract disorder
Which of the following is a risk factor for the development of a urinary tract infection (UTI)?
Perimenopause
Frequent showering
Marathon running
Pregnancy ANS: Pregnancy
1. Where do bacteria commonly come from in UTI's
2. Where can a UTI occur?
3. It is more common for women to develop a UTI especially when ANS: 1. Bacteria from the gut can
invade the urinary epithelium to cause inflammation and infection
2. anywhere along the urinary tract such as the urethra, bladder, ureter, or kidney
3. pregnant, sexually active, during post-menopause with estrogen-deficiency and when being treated
with antibiotics where the normal bacteria flora is diminished
1. Escherichia coli can bind to cells in the lower urinary tract and hide from the immune cells. The
bacteria can form biofilms-what is this?
2. Describe the pathophysiology of a UTI that can lead to septic shock or bacterimia
Note the diagram btw a male & female urinary tracts (who's is much shorter) ANS: 1. A biofilm is any
group of microorganisms that allow them to stick to one another and adhere to surfaces that help them
survive.
2. First, bacteria enter and contaminate the lower urinary tract. This causes the colonization of bacteria
in the urethra and the bladder. If the UTI progresses the bacteria can ascend to the kidneys and colonize
there. At this point, the infection becomes an upper UTI. From there, if left untreated, the bacteria can
spread into the circulation via the renal veins causing bacteremia
,UTI risk factors
1. For women, pregnancy is a risk factor. why?
2. The female ureter is shorter and
3. Post-menopausal women are also at risk because
4. Sexual intercourse is a risk factor especially if women use
5. Indwelling urinary catheterization is also a major cause of a UTI ANS: 1. During pregnancy,
progesterone relaxes smooth muscle that causes stasis of urine, allowing the bacteria to colonize
2. allows for the entrance of bacteria into the urethra.
3. lack of estrogen results in vaginal and urethral dryness promoting an environment for bacteria
growth.
4. spermicides
5. Fibrinogen accumulates on the catheter which provides an ideal environment for the attachment of
uropathogens that then form biofilms. This results in epithelial damage
Lower vs. Upper Tract Disorders
1. Lower UTI's include what parts of the urinary tract
2. In a lower urinary tract disorder, the individual experiences (blank) Other common symptoms include
3. initially, a urine dipstick can be performed to identify hematuria, proteinuria, and the presence of
nitrites. The presence of nitrites
4. an individual can have a negative urine dipstick but still have a UTI. If this is the case, then the NP can
send the urine for a
5. On microscopic exam of the urine, a patient with cystitis will have ANS: 1. urethra (urethritis) or
bladder (cystitis). In males, the cystitis may be associated with prostatitis.
2. urgency associated with burning on urination. frequency, dysuria, and suprapubic pain. The urine may
also appear cloudy and have an odor.
3. is highly specific for bacterial infection
4. culture and sensitivity (C&S) test and microscopy
5. a white blood cell (WBC) count of greater than 5000 high power field (hpf) and hematuria
, 1. An infection of the lower urinary tract can progress to an upper urinary tract infection if the bacteria
ascends from the bladder to the kidney. The condition is
2. The signs and symptoms of pyelonephritis include
3. Think of the symptoms of pyelonephritis in a classic triad:
4. if the infection has entered the circulation from the kidney via the renal vein
5. For the patient with pyelonephritis, the urine will present with ANS: 1. pyelonephritis.
2. all the symptoms associated with cystitis plus fever, flank pain, costovertebral angle (CVA) tenderness,
nausea, and vomiting. Malaise is also a common complaint
3. vomiting, flank pain and fever
4. there can also be signs of shock
5. WBC casts
Uncomplicated vs. Complicated Urinary Tract Infections (UTI)
1. A UTI may be classified as complicated or uncomplicated in terms of its severity. An uncomplicated
UTI indicates that
2. In a complicated UTI, there is decreased ANS: 1. renal function is normal, urine results may confirm a
UTI, but the patient denies symptoms, no antibiotic is prescribed
2. renal function and an abnormality in the renal tract
Un-Complicated UTI
1. Occurs in the normal urinary tract
2. Responds well to
3. Ie: Simple cystitis in
Complicated UTI
4. A UTI that extends beyond
5. Caused by
Renal System
Urinary Tract pre-quiz Q's
1. What are the two main functions of the kidney Review diagram for anatomical structures ANS: 1.
Filtration and collection
Women are at a higher risk for the development of a UTI because of having a shorter urethra. True/False
ANS: True
Which of the following can help to prevent a UTI?
Increase water consumption
Use spermicides during sexual intercourse
Taking more Vitamin D
Douching to prevent the growth of bacteria ANS: Increase water consumption
A symptom of a lower urinary tract infection includes:
Fever
Flank pain
Urgency
Decreased Urination ANS: Urgency
Which of the following is true regarding a complicated urinary tract infection?
It is usually asymptomatic
,Can be caused by a structural urinary tract disorder
Bacteria are located mostly in the lower urinary tract
Is associated with young adults ANS: Can be caused by a structural urinary tract disorder
Which of the following is a risk factor for the development of a urinary tract infection (UTI)?
Perimenopause
Frequent showering
Marathon running
Pregnancy ANS: Pregnancy
1. Where do bacteria commonly come from in UTI's
2. Where can a UTI occur?
3. It is more common for women to develop a UTI especially when ANS: 1. Bacteria from the gut can
invade the urinary epithelium to cause inflammation and infection
2. anywhere along the urinary tract such as the urethra, bladder, ureter, or kidney
3. pregnant, sexually active, during post-menopause with estrogen-deficiency and when being treated
with antibiotics where the normal bacteria flora is diminished
1. Escherichia coli can bind to cells in the lower urinary tract and hide from the immune cells. The
bacteria can form biofilms-what is this?
2. Describe the pathophysiology of a UTI that can lead to septic shock or bacterimia
Note the diagram btw a male & female urinary tracts (who's is much shorter) ANS: 1. A biofilm is any
group of microorganisms that allow them to stick to one another and adhere to surfaces that help them
survive.
2. First, bacteria enter and contaminate the lower urinary tract. This causes the colonization of bacteria
in the urethra and the bladder. If the UTI progresses the bacteria can ascend to the kidneys and colonize
there. At this point, the infection becomes an upper UTI. From there, if left untreated, the bacteria can
spread into the circulation via the renal veins causing bacteremia
,UTI risk factors
1. For women, pregnancy is a risk factor. why?
2. The female ureter is shorter and
3. Post-menopausal women are also at risk because
4. Sexual intercourse is a risk factor especially if women use
5. Indwelling urinary catheterization is also a major cause of a UTI ANS: 1. During pregnancy,
progesterone relaxes smooth muscle that causes stasis of urine, allowing the bacteria to colonize
2. allows for the entrance of bacteria into the urethra.
3. lack of estrogen results in vaginal and urethral dryness promoting an environment for bacteria
growth.
4. spermicides
5. Fibrinogen accumulates on the catheter which provides an ideal environment for the attachment of
uropathogens that then form biofilms. This results in epithelial damage
Lower vs. Upper Tract Disorders
1. Lower UTI's include what parts of the urinary tract
2. In a lower urinary tract disorder, the individual experiences (blank) Other common symptoms include
3. initially, a urine dipstick can be performed to identify hematuria, proteinuria, and the presence of
nitrites. The presence of nitrites
4. an individual can have a negative urine dipstick but still have a UTI. If this is the case, then the NP can
send the urine for a
5. On microscopic exam of the urine, a patient with cystitis will have ANS: 1. urethra (urethritis) or
bladder (cystitis). In males, the cystitis may be associated with prostatitis.
2. urgency associated with burning on urination. frequency, dysuria, and suprapubic pain. The urine may
also appear cloudy and have an odor.
3. is highly specific for bacterial infection
4. culture and sensitivity (C&S) test and microscopy
5. a white blood cell (WBC) count of greater than 5000 high power field (hpf) and hematuria
, 1. An infection of the lower urinary tract can progress to an upper urinary tract infection if the bacteria
ascends from the bladder to the kidney. The condition is
2. The signs and symptoms of pyelonephritis include
3. Think of the symptoms of pyelonephritis in a classic triad:
4. if the infection has entered the circulation from the kidney via the renal vein
5. For the patient with pyelonephritis, the urine will present with ANS: 1. pyelonephritis.
2. all the symptoms associated with cystitis plus fever, flank pain, costovertebral angle (CVA) tenderness,
nausea, and vomiting. Malaise is also a common complaint
3. vomiting, flank pain and fever
4. there can also be signs of shock
5. WBC casts
Uncomplicated vs. Complicated Urinary Tract Infections (UTI)
1. A UTI may be classified as complicated or uncomplicated in terms of its severity. An uncomplicated
UTI indicates that
2. In a complicated UTI, there is decreased ANS: 1. renal function is normal, urine results may confirm a
UTI, but the patient denies symptoms, no antibiotic is prescribed
2. renal function and an abnormality in the renal tract
Un-Complicated UTI
1. Occurs in the normal urinary tract
2. Responds well to
3. Ie: Simple cystitis in
Complicated UTI
4. A UTI that extends beyond
5. Caused by
