RASMUSSEN PATHOPHYSIOLOGY EXAM
1.WITH VERIFIED QUESTIONS AND
ANSWERS.A+ GRADED.2024/2025.
Reduced glomerular filtration rate during glomerular disease is evidenced by elevated plasma
_______, ______ concentration, or reduced ______ clearance. ------CORRECT ANSWER-----urea,
creatinine, renal creatinine
____ includes renal diseases in which glomerular inflammation is caused by immune
mechanisms that damage the glomerular capillary filtration membrane including the
endothelium, basement membrane, and epithelium (podocytes). ------CORRECT ANSWER-----
acute glomerulonephritis
The classic symptoms of ______ include sudden onset of hematuria including red blood cell
casts and proteinuria (milder than nephrotic syndrome), and in more severe cases, these
symptoms are also accompanied by edema, hypertension, and impaired renal function. ------
CORRECT ANSWER-----acute glomerulonephritis
Nephrotic syndrome is the excretion of _____g or more of protein in the urine per day. ------
CORRECT ANSWER-----3.0
_____ is the excretion of less than 3.0g/dl of albumin per day. ------CORRECT ANSWER-----
hypoalbuniemia
______ is the excretion of massive proteinuria in the urine each day, hypoalbuminemia,
hyperlipidemia, and peripheral edema. ------CORRECT ANSWER-----nephrotic syndrome
Nephrotic syndrome is characteristic of ____ injury. ------CORRECT ANSWER-----glomerular
____ causes of nephrotic syndrome include minimal change disease, membranous
glomerulonephritis, and focal segmental glomerulosclerosis. ------CORRECT ANSWER-----primary
______ forms of nephrotic syndrome occur in systemic diseases including diabetes mellitus,
amyloidosis, and systemic lupus erythematosus. ------CORRECT ANSWER-----secondary
True/false: acute kidney injury may be reversible. ------CORRECT ANSWER-----true
Renal insufficiency refers to a decline in renal function to about ___ % of normal or an eGFR of
____ml/minute. ------CORRECT ANSWER-----25, 25-30
,2|Pa ge
_____ is extremely useful in determining improvement or decline in kidney function. ------
CORRECT ANSWER-----eGFR
Levels of serum creatinine and urea are mildly _____ in acute kidney injury. ------CORRECT
ANSWER-----elevated
Changes in serum creatinine level only occur if more than ___% of glomerular filtration is lost
and are often delayed more than ____ hours. ------CORRECT ANSWER-----50, 24
What prevents the implementation of early therapy during acute kidney injury? ------CORRECT
ANSWER-----diagnostic delays
Patients with acute kidney injury are prone to develop ______ and metabolic ______. ------
CORRECT ANSWER-----hyperkalemia, acidosis
Acute kidney injury can lead to decreased renal phosphate excretion (AKA _______). ------
CORRECT ANSWER-----hyperphosphatemia
Fluid retention causes _____ in cases of acute kidney injury. ------CORRECT ANSWER-----edema
Symptoms of ______ develop in persons with cardiac disease when acute kidney injury occurs. -
-----CORRECT ANSWER-----congestive heart failure
Acute kidney injury commonly results from intracellular/extracellular volume depletion,
increased/decreased renal blood flow, or toxic and inflammatory injury to kidney cells that
result in alterations in renal function that may be minimal or severe. ------CORRECT ANSWER-----
extracellular, decreased
Renal hypoperfusion is referred to as ______ acute kidney injury. ------CORRECT ANSWER-----
prerenal
disorders involving renal parenchymal or interstitial tissue ------CORRECT ANSWER-----intrarenal
disorders associated with acute urinary tract obstruction ------CORRECT ANSWER-----postrenal
____ is the presence of waste products in the blood. ------CORRECT ANSWER-----uremia
Causes of ______ AKI include hypovolemia, hemorrhagic blood loss, loss of plasma volume due
to burns and peritonitis, water and electrolyte losses, systemic hypotension or hypoperfusion,
and cardiac failure or shock (AKA LOSS OF VOLUME) ------CORRECT ANSWER-----prerenal
Causes of _____ AKI include tubular necrosis, glomerulopathies, tumors in interstitium, vascular
damage, malignant hypertension, coagulation defects, renal artery/vein occlusion, and acute
pyelonephritis. ------CORRECT ANSWER-----intrarenal
,3|Pa ge
______ causes of AKI include obstructive uropathies, ureteral destruction, bladder neck
obstruction, and neurogenic bladder (THINK URETERS). ------CORRECT ANSWER-----postrenal
Acute/chronic kidney failure is complex and involves the interaction of cells, cytokines, and
structural alterations. ------CORRECT ANSWER-----chronic
Two factors that have consistently been recognized to advance renal disease are ______ and
_____ activity. ------CORRECT ANSWER-----proteinuria, angiotensin II
Glomerular _____ and increased glomerular capillary ____ lead to proteinuria. ------CORRECT
ANSWER-----hyperfiltration, permeability
_____ contributes to tubulointerstitial injury by accumulating in the interstitial space and
activating complement proteins and other mediators and cells, such as macrophages, that
promote inflammation and progressive fibrosis. ------CORRECT ANSWER-----proteinuria
_____ activity is elevated with progressive nephron injury, which promotes glomerular
hypertension and hyperfiltration caused by efferent arteriolar vasoconstriction and also
promotes systemic hypertension. ------CORRECT ANSWER-----angiotensin II
Angiotensin II can promote the activity of _____ cells and growth factors that participate in
tubulointerstitial fibrosis and scarring. ------CORRECT ANSWER-----inflammatory
GERD is the reflux of ___ and ____ from the stomach to the esophagus that causes esophagitis.
------CORRECT ANSWER-----acid, pepsin
_____ (type I) is the most common type of hiatal hernia, and it occurs when the proximal
portion of the stomach moves into the thoracic cavity through the esophageal hiatus. ------
CORRECT ANSWER-----sliding
The _____ is an opening in the diaphragm for the esophagus and vagus nerves. ------CORRECT
ANSWER-----esophageal hiatus
A person that has a sliding hiatal hernia will experience symptoms when in the ____ position,
because the lower esophagus and stomach are pulled into the thorax. ------CORRECT ANSWER---
--supine
Drugs that can relax the lower esophageal sphincter: a______, n______, c________, and
n_______. ------CORRECT ANSWER-----anticholinergics, nitrates, calcium channel blockers,
nicotine
Clinical manifestations of ____ include heartburn, chronic cough, asthma attacks, and laryngitis.
------CORRECT ANSWER-----reflux esophagitis
, 4|Pa ge
____ may be a trigger for asthma or chronic cough. ------CORRECT ANSWER-----GERD
Upper ____ pain accompanies GERD and usually occurs within 1 hour of eating. It can be
relapsing or remitting. ------CORRECT ANSWER-----abdominal
Symptoms of GERD worsen if an individual _____ or if intra-abdominal ____ increases as a
result of coughing, vomiting, or straining on the toilet. ------CORRECT ANSWER-----lies down,
pressure
the most common occurring small bowel obstruction is related to _______ and account for 50-
70% of small bowel obstructions. ------CORRECT ANSWER-----adhesions
Small bowel obstructions usually present early with _____. ------CORRECT ANSWER-----
abdominal distention
If the obstruction is at the pylorus or high in the small intestine, metabolic acidosis/alkalosis
develops initially as a result of excessive loss of hydrogen ions that normally would be
reabsorbed from the gastric juice. ------CORRECT ANSWER-----alkalosis
In short/prolonged intestinal obstruction, the lack of circulation produces lactic acid. ------
CORRECT ANSWER-----prolonged
In prolonged intestinal obstruction, the lack of circulation produces lactic acid because of
decreased tissue perfusion, thus causing metabolic acidosis/alkalosis. ------CORRECT ANSWER---
--acidosis
___ is the telescoping of part of the intestine into another, usually causing strangulation of the
blood supply. ------CORRECT ANSWER-----intussusception
Causes of intestinal obstructions: h_____, constriction from a______, v_____, and i______. -----
-CORRECT ANSWER-----hernia, adhesions, volvulus, intussusception
A _____ is a break, or ulceration, in the protective mucosal lining of the lower esophagus,
stomach, or duodenum. ------CORRECT ANSWER-----peptic ulcer
Risk factors for peptic ulcer disease include ____ predisposition, ____ infection of the gastric
mucosa, and habitual use of ______. ------CORRECT ANSWER-----genetic, H. pylori, NSAIDs
Chronic use of NSAIDs suppresses mucosal ______ synthesis, resulting in decreased
bicarbonate secretion and mucin (gut barrier component) production and increased secretion
of hydrochloric acid. ------CORRECT ANSWER-----prostaglandin
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