Nokea
A girl, age 5 1/2 years, has been sent to the school nurse for urinary incontinence three times in the past 2 days. The nurse should recommend to her parent that the first action is to have the child evaluated for what condition?
- A. School phobia
- B. Glomerulonephritis
- C. Urinary tract infection (UTI)
- D. Attention deficit hyperactivity disorder (ADHD)
Correct Answer: C
Rationale: Incontinence in a toilet-trained 5½-year-old girl suggests a UTI, common in this age group. UTI evaluation precedes psychosocial causes like school phobia or ADHD, and glomerulonephritis typically presents with reduced urine output and fluid retention, not incontinence.
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What pathologic process is believed to be responsible for the development of postinfectious glomerulonephritis?
- A. Infarction of renal vessels
- B. Immune complex formation and glomerular deposition
- C. Bacterial endotoxin deposition on and destruction of glomeruli
- D. Embolization of glomeruli by bacteria and fibrin from endocardial vegetation
Correct Answer: B
Rationale: Postinfectious glomerulonephritis results from immune complexes formed after streptococcal infection, depositing in glomerular capillaries. Renal vessel infarction occurs in sickle cell disease, bacterial endotoxins aren?t involved, and embolization is linked to bacterial endocarditis.
What diagnostic test allows visualization of renal parenchyma and renal pelvis without exposure to external-beam radiation or radioactive isotopes?
- A. Renal ultrasonography
- B. Computed tomography
- C. Intravenous pyelography
- D. Voiding cystourethrography
Correct Answer: A
Rationale: Renal ultrasonography uses ultrasonic waves to visualize renal structures without radiation or isotopes. CT and intravenous pyelography involve external radiation, often with contrast, and voiding cystourethrography uses radiation and contrast injected into the bladder.
What urine test result is considered abnormal?
- A. pH 4.0
- B. WBC 1 or 2 cells/ml
- C. Protein level absent
- D. Specific gravity 1.020
Correct Answer: A
Rationale: A urine pH of 4.0 is below the normal range (4.8-7.8) and may indicate urinary tract infection or metabolic imbalances. WBC of 1-2 cells/ml, absent protein, and specific gravity of 1.020 (within 1.001-1.030) are normal and not indicative of pathology.
Urinary tract anomalies are frequently associated with what irregularities in fetal development?
- A. Myelomeningocele
- B. Cardiovascular anomalies
- C. Malformed or low-set ears
- D. Defects in lower extremities
Correct Answer: C
Rationale: Malformed or low-set ears are frequently associated with urinary tract anomalies, prompting heightened suspicion during newborn exams. Myelomeningocele may impair urinary function due to neural defects, but it?s less directly linked. Cardiac and extremity defects have weaker associations with renal anomalies.
What name is given to inflammation of the bladder?
- A. Cystitis
- B. Urethritis
- C. Urosepsis
- D. Bacteriuria
Correct Answer: A
Rationale: Cystitis is inflammation of the bladder, often due to infection. Urethritis affects the urethra, urosepsis is a systemic infection from the urinary tract, and bacteriuria indicates bacteria in urine without necessarily implying inflammation.