Nokea
A 1mm renal calculi in the ureter will most likely impact at
- A. the pelvi-ureteric junction
- B. the vesico-ureteric junction
- C. the pelvic brim
- D. the bladder orifice
Correct Answer: A
Rationale: The correct answer is A: the pelvi-ureteric junction. A 1mm renal calculi is most likely to impact at this location because the pelvi-ureteric junction is the narrowest part of the ureter, making it more susceptible to blockages. The size of the calculi is small enough to get lodged at this site, causing obstruction and symptoms. The other choices are incorrect because the vesico-ureteric junction and bladder orifice are wider areas, less likely to be obstructed by a small calculi. The pelvic brim is not a common site for renal calculi obstruction.
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While caring for a 77-year-old woman who has a urinary catheter, the nurse monitors the patient for the development of a UTI. What clinical manifestations is the patient most likely to experience?
- A. Cloudy urine and fever
- B. Urethral burning and bloody urine
- C. Vague abdominal discomfort and disorientation
- D. Suprapubic pain and slight decline in body temperature
Correct Answer: A
Rationale: The correct answer is A: Cloudy urine and fever. UTI in a patient with a urinary catheter may present with cloudy urine due to pus or bacteria, and fever due to infection. Urethral burning and bloody urine (B) are more indicative of urethritis or bladder trauma. Vague abdominal discomfort and disorientation (C) are not specific to UTI. Suprapubic pain and slight decline in body temperature (D) are less likely with UTI.
Which is incorrect regarding the investigation of UTI?
- A. The sensitivity of dipstick for nitrites is 96%.
- B. A positive dipstick for leucocyte esterase is 96% specific for >10 wbc/mm .
- C. A bacterial culture with > 10 has 95% probability of representing infection.
- D. Use of blood cultures in does not change management when urine culture is taken.
Correct Answer: B
Rationale: The correct answer is B because a positive dipstick for leucocyte esterase is not 96% specific for >10 wbc/mm³. Leucocyte esterase can indicate the presence of white blood cells, but it does not quantitatively correlate with a specific wbc count. Therefore, it cannot be used to accurately determine the exact wbc count in the urine sample.
A: The sensitivity of dipstick for nitrites being 96% means it is good at detecting nitrites, which are a sign of bacterial infection in the urine.
C: A bacterial culture with >10^5 colony-forming units has a high probability of representing infection, typically around 95%.
D: Blood cultures are not routinely used for diagnosing UTIs; urine culture is the primary method. Blood cultures are more often used for systemic infections.
To minimize chances of renal calculi recurring, it is important for Mr. Reed to
- A. take prophylactic antibiotics on a daily basis
- B. increase fluid intake
- C. take megadoses of vitamin C daily
- D. get adequate rest to reduce stress and enhance resistance
Correct Answer: B
Rationale: The correct answer is B: increase fluid intake. Adequate hydration helps prevent the formation of kidney stones by diluting the substances in the urine that can lead to stone formation. Increasing fluid intake can also help flush out minerals and toxins from the kidneys.
A: Taking prophylactic antibiotics daily is not recommended for preventing renal calculi as it can lead to antibiotic resistance and potential side effects.
C: Taking megadoses of vitamin C daily can actually increase the risk of kidney stone formation as excess vitamin C can be converted into oxalate, a substance known to contribute to stone formation.
D: While adequate rest and stress reduction are important for overall health, they do not directly prevent the recurrence of renal calculi.
Which of the following statements about part of a nephron? antidiuretic hormone (ADH) is incorrect?
- A. renal pelvis
- B. ADH regulates the amount of water
- C. distal tubule reabsorbed by the kidneys
- D. collecting duct
Correct Answer:
Rationale: The correct answer is A: renal pelvis. The renal pelvis is not directly related to the action of antidiuretic hormone (ADH) in the nephron. ADH regulates water reabsorption in the collecting duct of the nephron to maintain water balance in the body. Choices B, C, and D are incorrect because they are all associated with the function of ADH in the nephron. ADH regulates the amount of water reabsorbed in the distal tubule and collecting duct, not the renal pelvis.
Which statement concerning the testes is true?
- A. The lymphatic vessels of the testes drain into the abdominal lymph nodes.
- B. The vas deferens is located along the inferior portion of each testis.
- C. The right testis is lower than the left because the right spermatic cord is longer.
- D. The cremaster muscle contracts in response to cold and draws the testicles closer to the body.
Correct Answer: D
Rationale: The correct answer is D: The cremaster muscle contracts in response to cold and draws the testicles closer to the body. This is true because the cremaster muscle is responsible for regulating the position of the testicles in response to temperature changes to maintain optimal conditions for sperm production. The other choices are incorrect because: A: The lymphatic vessels of the testes drain into the para-aortic lymph nodes, not the abdominal lymph nodes. B: The vas deferens is a duct that carries sperm from the testes to the urethra, not located along the inferior portion of each testis. C: The difference in height between the testes is due to differences in the descent of the testes during fetal development, not the length of the spermatic cord.