Multiple Choice Questions (MCQ)

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Category: Urology--->Renal Pathophysiology
Page: 2

Question 6#Print Question

Regarding post-obstructive diuresis, which of the following is FALSE?

A. Although this occurs mainly after relief of BUO or obstruction of a solitary kidney, it can rarely occur when there is a normal contralateral kidney
B. The normal physiologic diuretic response is due to the volume expansion and solute accumulation occurring during obstruction
C. A pathological postobstructive diuresis, characterised by inappropriate renal handling of water or solutes occurs due to a derangement of the medullary solute gradient and downregulation of sodium transporters with subsequent impaired sodium reabsorption in the distal convoluted tubule
D. There is no role for gradual bladder decompression, because this has not been demonstrated to limit hematuria or reduce the risk of postobstructive diuresis
E. Pathologic postobstructive diuresis is also marked by poor responsiveness of the collecting duct to antidiuretic hormone (ADH)

Question 7#Print Question

Regarding retroperitoneal fibrosis (RPF), which of the following is FALSE?

A. One possible pathogenesis could be the development of vasculitis in the adventitial vessels of the aorta and periaortic small vessels
B. Inflammatory bowel disease (IBD) is reported to be a cause of RPF
C. The classic radiologic findings include medial deviation of extrinsically compressed ureters with hydronephrosis
D. CT typically reveals a well demarcated retroperitoneal mass, isodense to muscle on unenhanced studies
E. . Tamoxifen, a steroidal anti-oestrogen, has also been used for primary treatment at a dose of 20 mg per day with a reported response rate of 80%

Question 8#Print Question

Which of the following is TRUE in hydronephrosis of pregnancy?

A. The reported occurrence varies between 5% and 15%
B. The right kidney becomes hydronephrotic two to three times more commonly than the left
C. Approximately one half of patients have persistent hydronephrosis during the first postpartum week, but it resolves within 2 weeks of delivery in the majority
D. The use of MRI is advocated in the first trimester of pregnancy but gadolinium contrast should be avoided because it crosses the placental barrier
E. The majority of patients with symptomatic hydronephrosis of pregnancy can be managed with placement of ureteral stents or nephrostomy (especially if associated with pyonephrosis)

Question 9#Print Question

Which of the following is FALSE regarding biochemical pathology of urine in patients with kidney stones?

A. A solution containing ions or molecules of a sparingly soluble salt is described by the concentration product, which is a mathematic expression of the product of the concentrations of the pure chemical components (ions or molecules) of the salt
B. The concentration product, the point at which the dissolved and crystalline components are in equilibrium for a specific set of conditions, at the point of saturation is called the stability product, Ksp
C. The Ksp value and the formation product (Kf) differentiate the three major states of saturation in urine: undersaturated, metastable, and unstable
D. The concentration product at the point where the crystals can no longer be held in solution is called the formation product, Kf
E. Inhibitors can generally prevent the process of crystal growth or aggregation above the formation product, Kf

Question 10#Print Question

Which of the following is TRUE regarding biochemical pathology of urine?

A. Tamm-Horsfall protein is secreted by renal epithelial cells in the loop of Henle and the proximal convoluted tubule as a membrane-anchored protein
B. Nephrocalcin is an acidic glycoprotein containing predominantly acidic amino acids that is synthesised in the thick ascending limb and distal tubule
C. Uropontin is an acidic phosphorylated glycoprotein expressed in bone matrix and renal epithelial cells of the ascending limb of the loop of Henle and the distal tubule
D. Polyanions including glycosaminoglycans, acid mucopolysaccharides and RNA have been shown to inhibit crystal growth but not nucleation
E. Among the glycosaminoglycans, heparan sulfate interacts most strongly with calcium phosphate crystals

Category: Urology--->Renal Pathophysiology
Page: 2 of 4