WorksheetsDisorders of the Genitourinary (GU) and Renal Systems
Total questions: 117
Worksheet time: 1hrs 25mins
Which of the following is a female-specific genitourinary disorder?
Testicular cancer
Ovarian cancer
Benign prostatic hyperplasia (BPH)
Prostate cancer
Which diagnostic test is used to evaluate and monitor renal function?
PSA
BUN
Creatinine clearance
All of the above
Fill in the blank: The kidneys have dozens of "______".
jobs
colors
wings
songs
Which of the following is NOT a male-specific genitourinary problem?
BPH
Prostate cancer
Menopause
Testicular cancer
Which of the following is a sign or symptom related to renal disorders?
UTI
Gonulonephritis
Ovarian cancer
PID
Fill in the blank: Maintenance of balance / homeostasis of fluid & solute status of body is a function of the ______.
kidneys
lungs
liver
pancreas
Which of the following is a urologic obstructive disorder?
STIs
PID
UTI
Urologic obstructions
Which of the following is a basic treatment modality for genitourinary and renal pathologies?
Diagnostic tests
Clinical manifestations
Treatment modalities
Pathophysiology
What is benign prostatic hyperplasia (BPH)?
Malignant neoplastic condition of the prostate gland
Enlargement of the prostate due to proliferation of glandular tissue
Malignant neoplastic condition of the testicle
Inflammation of the urethra
At what age does the proliferation of prostate glandular tissue commonly begin, leading to BPH?
20-30
40-45
55-60
65-70
Fill in the blank: By age 60, _____% of men have an enlarged prostate.
60
30
80
45
Which of the following is NOT a symptom of BPH?
Urgency
Delay in starting urine flow
Decrease in urine flow
Increased appetite
An enlarged prostate can be felt on digital rectal exam and should be checked yearly beginning at age 50.
True
False
What is the most common cancer in American males?
Testicular cancer
Prostate cancer
Bladder cancer
Kidney cancer
Which of the following is a risk factor for prostate cancer?
A) Age over 54
B) Family history
C) High fat diet
D) All of the above
Fill in the blank: Testicular cancer occurs most commonly in age range _____ and has a higher incidence in males with unresolved cryptorchidism.
15-35
35-55
5-15
55-75
What is the usual presenting sign of testicular cancer?
Painful testicular mass
Painless testicular mass
Testicular heaviness
Lower abdominal pain
Testicular self-exam has a cure rate of __% when caught early.
95%
60%
80%
40%
Urethritis is inflammation, discomfort in penis, sometimes dysuria, occasionally a discharge.
True
False
Both prostatitis and urethritis are most often caused by sexually transmitted infections (STIs) such as __ and __.
Chlamydia & gonorrhea
Syphilis & herpes
HIV & HPV
Trichomonas & hepatitis B
Dysmenorrhea is a general term for menstruation that is more painful, and/or larger in bleeding volume than is normal.
True
False
Amenorrhea is the absence of menses due to variety of causes (ex: anorexia, over-exercising); in later life can mean onset of __.
menopause
puberty
pregnancy
osteoporosis
Endometriosis affects __% of women of reproductive age and can cause chronic bleeding.
15%
5%
25%
40%
Classic symptom of ovarian cancer: "I feel bloated & my pants have gotten tight around the waist, despite diminished appetite and losing overall weight."
True
False
A PAP smear is a test for __ cancer, NOT ovarian.
cervical
lung
breast
colon
What does 'salpingo' refer to in medical terminology?
Ovary-related
Fallopian tube-related
Uterus-related
Inner lining-related
Fill in the blank: 'Oopher' refers to ______-related in medical terminology.
ovary
liver
kidney
lung
Fill in the blank: 'Hyster' refers to ______-related in medical terminology.
uterus
liver
heart
kidney
Fill in the blank: 'Endometr' refers to ______ lining-related in medical terminology.
inner
outer
muscle
bone
What is the most common organism causing urinary tract infection (UTI)?
Staphylococcus aureus
E. coli
Chlamydia
Gonorrhea
Which of the following is NOT a common symptom of urinary tract infection (UTI)?
Dysuria
Pyuria
Hematuria
Jaundice
Fill in the blank: The highest risk group for UTIs is ______, due to proximity of anus and vaginal opening to urethral meatus and much shorter urethra.
women
men
children
elderly
Men very rarely get UTIs unless they have structural defect, chronic disease, or indwelling catheter.
True
False
Match the following terms to their definitions:
Infection of fallopian tubes
Infection of fallopian tubes
Infection of ovaries
Infection of ovaries
Infection of fallopian tubes AND ovaries
Infection of fallopian tubes AND ovaries
Which of the following is the most common sexually transmitted infection (STI)?
Chlamydia
Gonorrhea
Syphilis
Herpes
Chlamydia is a bacterial infection caused by _________.
Chlamydia trachomatis
Neisseria gonorrhoeae
Treponema pallidum
Escherichia coli
Urethritis in men is a symptom of which STI?
Gonorrhea
Chlamydia
Syphilis
Herpes
Gonorrhea is caused by infection with _________?
Neisseria gonorrhea
Escherichia coli
Staphylococcus aureus
Treponema pallidum
Men with gonorrhea tend to have ________ discharge from the penis.
purulent
clear
bloody
watery
Syphilis is caused by which organism?
Neisseria gonorrhea
Chlamydia trachomatis
Treponema pallidum
Herpes simplex virus
The primary stage of syphilis is characterized by lesions called _________.
chancres
papules
vesicles
macules
Genital herpes is caused by which virus?
Human papillomavirus
Herpes simplex virus (HSV)
Treponema pallidum
Chlamydia trachomatis
HSV 2 is an STI that invades the genital area and can spread to the ________ and ________.
perineum and anus
lungs and heart
ears and nose
hands and feet
What is hydronephrosis?
Enlargement of & pressure in renal pelvis & calyces due to pathologic accumulation of fluid
Scarring of ureter
Tumor in bladder
Loss of bladder tone
Retrograde urinary flow is also known as "back-up" urinary flow that can't get past an obstruction in which of the following?
Ureters
Bladder
Urethra
All of the above
Within a short time, accumulation of urine can lead to infection and eventual fibrosis (scarring & stiffening of tissue), within the kidney & significant decline in function of ________.
nephrons
alveoli
hepatocytes
neurons
Which of the following is NOT a specific obstruction that can interfere with urine flow?
Tumors
Adhesions
Pelvic organ prolapse
Diabetes
A prolapse is a "falling-down" or intrusion of an organ due to deterioration of muscle tone holding it in place or other factors.
True
False
The best example of uterine prolapse is when the uterus drops from its normal mooring and puts pressure on bladder, urethra, or other structures—acts as obstruction to urine.
True
False
In males, BPH (Benign Prostatic Hyperplasia) causes urine to not get through a urethra narrowed by a large ________.
prostate
bladder
kidney
ureter
Neurogenic problems such as paraplegia and quadriplegia can cause neurogenic bladder dysfunction, where the bladder loses tone and acts as obstruction to urine flowing forward.
True
False
Which of the following is NOT a term for kidney stone?
Renal calculi
Ureteral calculus
Urethral calculus
Renal cyst
Kidney stones are a fairly common acute obstructive problem.
True
False
Which of the following increases the risk of getting a kidney stone?
Male gender
Having gout
Both A and B
None of the above
What is 'colic' or colicky pain? Fill in the blank: 'Colic is pain that comes and goes, a spasmodic type of pain; it is typical of a situation in which there is spasm of a ______ or other container in the body.'
tube
bone
muscle
nerve
Which of the following is NOT a cause of kidney stones?
Dehydration
Various dietary factors
Multiple myeloma
Excessive exercise
Fill in the blank: As urine is formed in the renal tubules, it becomes supersaturated with ______, uric acid, or other ions which eventually bond together and form stones in the kidney pelvis.
calcium
glucose
potassium
ammonia
Stones greater than 2mm in the kidney can get stuck in the ureter and cause obstruction, retrograde urine flow, and possible renal failure.
True
False
Which symptom is associated with kidney stones?
Excruciating flank and/or groin pain that comes and goes in spasms
Persistent cough
Skin rash
Blurred vision
Fill in the blank: The kidneys have dozens of jobs, which can be divided into two categories: maintenance of fluid & solute balance and maintenance of certain ______ functions.
metabolic
respiratory
digestive
skeletal
What percentage of urine is water?
50%
75%
95%
100%
Fill in the blank: The other 5% of urine contains ___ and other solutes.
urea, creatinine, Na, K, PO4
glucose, insulin, DNA, RNA, ATP
hemoglobin, myoglobin, collagen, elastin, keratin
amylase, lipase, pepsin, trypsin, maltase
Which two structures in the nephron are responsible for concentration decisions?
glomerulus and tubule
Bowman's capsule and collecting duct
proximal tubule and distal tubule
loop of Henle and renal artery
What is the function of the glomerular membrane in the kidney?
Reabsorption
Filtration
Secretion
Excretion
The glomerulus is the first 'decision' point of the kidneys. What does it decide?
What and how much to include as the beginning of urine
How much blood to circulate
How much water to reabsorb
How much creatinine to secrete
Fill in the blank: The volume of plasma filtered by all the functioning nephrons is called the ________ filtration rate (GFR).
glomerular
tubular
renal
hepatic
A decrease in GFR can be seen as decreased urine output clinically.
True
False
If kidneys aren’t working properly, a person would have ______ serum creatinine & urea nitrogen and ______ urine creatinine & urea nitrogen.
HIGH serum creatinine & urea nitrogen and LOW urine creatinine & urea nitrogen
LOW serum creatinine & urea nitrogen and HIGH urine creatinine & urea nitrogen
LOW serum creatinine & urea nitrogen and LOW urine creatinine & urea nitrogen
HIGH serum creatinine & urea nitrogen and HIGH urine creatinine & urea nitrogen
What is the minimum normal urine output that some kidney specialists consider should be present?
0.2 ml/kg/hr
0.5 ml/kg/hr
1.0 ml/kg/hr
2.0 ml/kg/hr
Tubular reabsorption refers to the movement of fluids and solutes from the tubular lumen into the ______ to join the vascular circulation.
peritubular capillaries
glomerulus
Bowman's capsule
collecting duct
Which of the following is an example of a waste that should be secreted appropriately into the urine?
Glucose
Creatinine
Sodium
Potassium
The decisions made by the glomeruli and tubules are assisted by substances created elsewhere in the body, such as ______, aldosterone, ADH, and natriuretic peptides.
angiotensin II
insulin
cortisol
thyroxine
What hormone is secreted by the kidneys in response to fluid deficit, and what does it ultimately stimulate?
Renin is secreted by the kidneys in response to fluid deficit, and it ultimately stimulates the creation of angiotensin II.
Aldosterone is secreted by the kidneys in response to fluid deficit, and it ultimately stimulates the breakdown of glucose.
Insulin is secreted by the kidneys in response to fluid deficit, and it ultimately stimulates the uptake of potassium.
Cortisol is secreted by the kidneys in response to fluid deficit, and it ultimately stimulates the release of calcium.
What is the effect of aldosterone secretion on sodium and potassium in the kidney tubules?
Aldosterone causes retention of Na+ into the blood and the kidney tubules excrete K+.
Aldosterone causes excretion of Na+ and retention of K+ in the blood.
Aldosterone causes both Na+ and K+ to be retained in the blood.
Aldosterone causes both Na+ and K+ to be excreted by the kidney tubules.
Which hormones are secreted by the heart in response to fluid overload, and what is their effect on the kidneys?
BNP and ANP are secreted by the heart in response to fluid overload, and they stimulate the kidneys to excrete more water into the urine.
Aldosterone and cortisol are secreted by the heart in response to fluid overload, and they stimulate the kidneys to retain more sodium.
Insulin and glucagon are secreted by the heart in response to fluid overload, and they stimulate the kidneys to reabsorb more glucose.
ADH and oxytocin are secreted by the heart in response to fluid overload, and they stimulate the kidneys to concentrate the urine.
Which of the following is NOT a metabolic function of the kidneys?
Making and regulating HCO3
Deciding how much H+ to excrete
Regulating calcium absorption
Producing insulin
The kidneys help to promote stable nutrition by minimizing non-appropriate substances such as proteins from entering urine.
True
False
How do the kidneys help regulate blood pressure?
The kidneys regulate blood pressure by increasing or decreasing renin secretion as needed, which regulates fluid volume and arterial pressure.
The kidneys regulate blood pressure by producing insulin to lower blood sugar levels.
The kidneys regulate blood pressure by directly pumping blood throughout the body.
The kidneys regulate blood pressure by absorbing excess oxygen from the bloodstream.
What hormone made by the kidneys helps with RBC birth and growth?
Erythropoietin
Insulin
Cortisol
Thyroxine
What does the term 'compromise' mean in the medical world, according to the worksheet?
In the medical world, 'compromise' means things are not as they should be, and it can describe acute or chronic situations.
It means a patient is always in perfect health.
It refers to a successful surgery outcome.
It means the patient has no symptoms at all.
The spectrum of renal compromise ranges from acute kidney injury (AKI) to chronic kidney disease (CKD).
True
False
What is the definition of acute kidney injury (AKI)? Fill in the blank: AKI is defined as an abrupt (occurs over <48 hrs) decrease in urine output (ie, GFR) and/or increase in serum creatinine, so typical patient has acute oliguria and/or _________?
acute jump in serum creatinine
acute drop in blood pressure
acute increase in urine pH
acute decrease in potassium levels
Which of the following is NOT a stage of kidney disease?
Stage 6: complete recovery
Stage 1: kidney damage with normal or increased GFR
Stage 2: mild reduction in GFR
Stage 4: severe reduction in GFR
Stage 3: moderate reduction in GFR
Match the following types of AKI with their main features:
Prerenal AKI
Something goes wrong with arterial flow BEFORE the kidneys
Intrarenal AKI
Something goes wrong IN any part of the kidney tissue (glomerulus or tubule)
Postrenal AKI
Something goes wrong with urine flow AFTER the kidneys
Acute kidney injury (AKI) can be completely resolved with normal renal function restored.
True
False
Fill in the blank: Chronic kidney disease (CKD) is also called ________ or CRF—chronic renal failure.
chronic renal insufficiency
chronic hepatic insufficiency
chronic pulmonary insufficiency
chronic cardiac insufficiency
Which stage of kidney disease is described as 'minimal or no GFR—sometimes called end-stage renal disease (ESRD)'?
Stage 1
Stage 2
Stage 3
Stage 4
Stage 5
What is the most common subtype of Acute Kidney Injury (AKI)?
Prerenal
Postrenal
Intrarenal
Chronic
Prerenal AKI is caused by acutely decreased arterial flow to the kidneys due to ________ or trauma to aorta and/or renal arteries.
acute vasoconstriction
chronic infection
renal calculi
autoimmune response
Prerenal AKI can be caused by hypotension or hypovolemia because of hemorrhage, dehydration, heart failure (HF), or hypotension from infection (sepsis).
True
False
Signs and symptoms (S&S) of prerenal AKI include:
Oliguria and increased serum creatinine (sCr.)
Polyuria and decreased serum creatinine
Hematuria and proteinuria
No symptoms
Treatment for prerenal AKI includes giving IV fluids/blood and/or fixing the basic problem (heart problem, infection, etc.).
True
False
If blood flow to the kidney is not quickly restored in prerenal AKI, the patient can go into ________ AKI from acute tubular necrosis (ATN), and then possibly CKD.
intrarenal
postrenal
extrarental
subrenal
Postrenal AKI occurs when there is an acute obstruction that occurs somewhere between kidneys & urethral meatus.
True
False
Which of the following is an example of a causative factor for postrenal AKI?
Urethral obstruction such as BPH in a man
Ureteral obstruction such as calculi
Uterine prolapse in a woman
All of the above
Prognosis for return to normal renal function in postrenal AKI is good if the obstruction is 'fixed' fairly quickly.
True
False
Intrarenal AKI happens when the kidneys have acutely diminished function from ________ tissue injury.
direct
chronic
systemic
external
Which of the following is a sign of glomerular damage?
Proteinuria
Hematuria
Both a and b
None of the above
Fill in the blank: Damage to either the kidney glomerulus or the kidney tubule will result in a ______ ability of the nephron to filter waste and water, reducing the GFR and causing the S&S of intrarenal AKI.
decreased
increased
unchanged
enhanced
Which of the following is NOT a result of tubular cell injury/death in acute tubular necrosis (ATN)?
Cast formation
Increased urine output
Tubular blockage
Decreased ability to excrete creatinine
Antidiuretic
pertaining to against urination
tumor of the kidney
non feeling
study of bladder
anuria
Absence of urine production, no urine
Little urine output
Evaluate the potential impact of chronic dehydration on kidney stones formation.
Chronic dehydration has no impact on kidney stone formation.
Chronic dehydration increases the risk of kidney stones by concentrating solutes in urine.
Chronic dehydration decreases the risk of kidney stones by reducing urine output.
Chronic dehydration increases urine pH, reducing stone formation.
The presence of pus in urine can be caused by
liver disease
diabetes mellitus
a urinary tract infection
all of the above
An indication that your body is in starvation mode is the presence of ___________________ in your urine
ketones
pus
red blood cells
bile
Renin is released from the ___ whereas angiotensinogen is released from the ___.
What is hydronephrosis?
Oliguria and fluid volume overload
GFR decreased
overactivation of RAAS/ no good response to it
kdney unable to remove water
volume overload
hypoosmolar state leads to movement of fluid/water from Bto T
edema
diuretics
encourages kidney to remove water
azotemia and uremia
kidney unable to remove waste in urine
leads to accumuation of waste(BUN and SCr) in blood (azotemia)
patient presents with N,V, puritis, and confusion (encephalopathy) known as uremia
leads to BUN formed from protein breakdown
low protein diet
dialysis if too dangerou
hyperkalemia
potassium, not able to be removed and increases in the blood
leads to hyperkalemia and hypopolarization
faster HR
diuretics to remove potassium
dialysis initiated if too dangerous
hyperphosphatemia
unable to remove phosphate and increases in the blood and can lead to problems
oral antacids will bind to phosphate in food nd prevent absorption
hypertension
over activation of RAAS leads to over production of renin to angiotensin II causes vasoconstrict
kidney unable to remove water
volume overload and over production of renin/angiotensin II
diuretics
anti-hypertensive meds
anemia
kidney not performing a metabolic function
no production of erythropoietin
less production of RBCs lead to anemia
administer erythropoietin hormone by injection
hypocalcemia and osteoporosis
no production of the substance that activates vitamin D
inability to absorb calcium from the foods causes hypocalcemia
hypocalcemia causes hypopolarization and osteoporosis
vitamin D+ calcium supplements
metabolic acidosis
kidney not producing HCO3
less HCO3 sends patient into a state of metabolic acidosis
admin HCO3 and antacids
Acute Kidney Injury
diminished arterial blood flow to kidney-from acute vasoconstriction/trauma to aorta
-or renal artery from low cardiac output/hypotension
dehydration, blood loss, heart failure, sepsis
S&S oliguria <30 cc/hr and high serum creatinine
kideny tissue injury to any part of nephron- glomerulus
S&S or glomerular injury- oliguria and high serum creatinine, proteinuria and hematuria
injury to nephron -tubule- direct injury from toxic substances leads to ATN
S&S of tubular injury ATN: oliguira casts in urine
urine flow obstruction from BPH, kidney stones, uterine prolapse
S&S oliguria, high serum creatinie, changes in uine flow
if the prerenal or postrenal damage occus and is not fixed it can lead to AKI from ATN
