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Robbins Review 2 Q's - rumrum
#1
A 30 year old female presents with recurrent urinary tract infections. A renal sonogram shows extensive scarring with pelvic and calyceal enlargement and cortical thinning. A renal biopsy reveals inflammatory infiltrates extending frommedulla to cortex, with tubular destruction and fibrosis. Lymphocytes, plasma cells and occasional neutrophils are present. These findings most likely resulted from..

A) Benign nephrosclerosis
B) Vesicoureteral reflux
C) Luppus nepthritis
D) Systemic amyloidosis
E) Congestive heart failure


A 19 year old female presents with fever and chills accompanied by right flank pain for the past three days. She is not diabetic, and her BP is 150/90. Urinalysis shows a pH of 6.5 specific gravity of 1.018 no protien, no blood, no glucose, and no ketones. Urine micorscopic examination shows many WBC's and WBC casts. which of the following factors is most important in the pathogenesis fo the renal disease affecting this patient?

A age
B sex
C Vesicoureteral reflex
D BP
E A focus of infection in the lungs
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#2
B...Hydronephrosis
B? or C?...C?more likely
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#3
I agree with the first answer : B
The second answer is B ( sex) as the mechanism for Ascending Pielonephritis. C is less likely here since is not said in the question that this patient has experience repetitive UTI.
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#4
b and b
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#5
1b
2b
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#6
sorry 1b
2c
same answer: B) Vesicoureteral reflux
my typing was worng
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#7
b
b
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#8
answer are B & C
always remember that vesicourteral reflux predominates in pat's with acute or chronic pylenophritis...

ans B These are changes of chronic pyelonephritis. UTI favors recurrent urniary tract infection. Vesicoureteral reflux propels infected urine from the urniary bladder to the ureters and renal pelvis and predispose to infection.

ans C This pat has acute pyelonephritis. VR acquired or congenital is extremely important in the pahtogenesis of ascending urinary tract infection.

kashmala hydronephrosis is not likely bc there is no urinary tract obstruction. it occurs when urinary ouflow is obstructed in the renal pelvis or in the ureter.

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