Nokea
Where are the glomeruli and Bowman’s capsules found?
- A. Renal pelvis
- B. Ureter
- C. Renal cortex
- D. Renal column
Correct Answer: C
Rationale: The glomeruli and Bowman's capsules are found in the renal cortex. The renal cortex is the outer layer of the kidney where the initial stages of urine formation occur. Glomeruli are clusters of capillaries responsible for filtering blood, while Bowman's capsules surround the glomeruli and collect the filtrate. The renal pelvis (A) is the innermost part of the kidney where urine collects before entering the ureter (B). Renal columns (D) are extensions of the renal cortex that project into the renal medulla. Therefore, the correct answer is C as it accurately locates the structures involved in urine filtration.
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Which of the following is true of nephrons?
- A. they are the functional units of the kidneys
- B. the proximal convoluted tubules allow the kidney to concentrate or dilute urine
- C. there are about a million nephrons in each kidney
- D. both a and c are correct
Correct Answer: D
Rationale: Step 1: Identify key characteristics of nephrons - functional units of kidneys, responsible for urine formation.
Step 2: Confirm accuracy of statements - A: Nephrons are functional units. C: About a million nephrons in each kidney.
Step 3: Combine statements - A + C = D, confirming both are correct.
Step 4: Justify choice D - correct because nephrons are indeed functional units and there are approximately a million in each kidney.
Summary: B is incorrect as the proximal convoluted tubules are not solely responsible for urine concentration/dilution. Choice D is correct as it combines the accurate statements from A and C.
A patient with suprapubic pain and symptoms of urinary frequency and urgency has two negative urine cultures. What is one assessment finding that would indicate interstitial cystitis?
- A. Residual urine greater than 200 mL
- B. A large, atonic bladder on urodynamic testing
- C. A voiding pattern that indicates psychogenic urinary retention
- D. Pain with bladder filling that is transiently relieved by urination
Correct Answer: D
Rationale: The correct answer is D. Pain with bladder filling that is transiently relieved by urination is a classic symptom of interstitial cystitis. This pattern of pain is due to inflammation of the bladder lining, which worsens as the bladder fills with urine and improves temporarily after urination. This finding is specific to interstitial cystitis and not typically seen in other conditions.
Choices A, B, and C are incorrect:
A: Residual urine greater than 200 mL is more indicative of bladder outlet obstruction or neurogenic bladder dysfunction, not specifically interstitial cystitis.
B: A large, atonic bladder on urodynamic testing is suggestive of neurogenic bladder or bladder outlet obstruction, not interstitial cystitis.
C: A voiding pattern indicating psychogenic urinary retention is more likely related to psychological factors affecting bladder function, not interstitial cystitis.
Which antibiotic course is inappropriate for clinical scenario?
- A. Acute simple cystitis - trimethoprim for 3 days in otherwise well young women.
- B. Acute uncomplicated pyelonephritis - gentamycin + amoxicillin IV initially followed by 7 days of Augmentin orally.
- C. Pregnancy associated cystitis - nitrofurantoin 5 mg QID for 14 days.
- D. Acute simple cystitis in male patients - Augmentin or trimethoprim for 14 days.
Correct Answer: B
Rationale: The correct answer is B because the antibiotic regimen for acute uncomplicated pyelonephritis should not include gentamycin due to its potential toxicity and nephrotoxicity. The initial use of IV gentamycin is not recommended for uncomplicated pyelonephritis. The combination of gentamycin and amoxicillin is not the standard treatment for this condition. Gentamycin should be reserved for more serious infections. The choice of Augmentin for 7 days orally is also not the standard of care for pyelonephritis. The other choices (A, C, D) are appropriate antibiotic regimens for the corresponding clinical scenarios.
Which of the following viruses is most susceptible to acyclovir?: *
- A. Herpes simplex Type 1 virus
- B. Herpes simplex Type 2 virus
- C. Varicell
- D. zoster virus
Correct Answer: A
Rationale: Acyclovir is a nucleoside analog that inhibits viral DNA replication by targeting viral DNA polymerase. Herpes simplex Type 1 virus is most susceptible to acyclovir because it is a DNA virus that requires viral DNA polymerase for replication. The drug is selectively activated by viral thymidine kinase in infected cells, leading to its antiviral activity. Herpes simplex Type 2, Varicella zoster, and other viruses do not possess the same susceptibility to acyclovir due to differences in their replication mechanisms.
What does the dialysate for PD routinely contain?
- A. Calcium in a lower concentration than in the blood
- B. Sodium in a higher concentration than in the blood
- C. Dextrose in a higher concentration than in the blood
- D. Electrolytes in an equal concentration to that of the blood
Correct Answer: C
Rationale: Correct Answer: C - Dextrose in a higher concentration than in the blood
Rationale:
1. Dextrose in PD dialysate helps to create an osmotic gradient for fluid removal.
2. Higher dextrose concentration ensures effective ultrafiltration.
3. Dextrose is the main osmotic agent used in PD.
4. A higher concentration of dextrose in the dialysate aids in waste removal.
Summary:
A: Incorrect - Calcium concentration in dialysate is similar to blood to avoid imbalance.
B: Incorrect - Sodium concentration is lower in dialysate to prevent sodium loading.
D: Incorrect - Electrolyte concentration in dialysate is tailored to patient needs, not equal to blood.