28 Jan Daniel has a large

QUESTION 1
Kelly is a 36-year-old female who has a history of type 2 diabetes, several respiratory infections as a child, and two full-term pregnancies (5 and 7 years ago). Two days ago, she began feeling a burning sensation when urinating. Her pain is progressively getting worse. Kelly assumes that she has a urinary tract infection (UTI) and makes an appointment at her primary clinic to seek relief.

A urinary tract infection could affect all of the following organs, except:

Spleen

Kidneys

Bladder

Urethra

QUESTION 2

Kelly’s physician orders a urinalysis. If she has a UTI, which of the following will most likely be abnormal?

pH

Hemoglobin

Nitrates

Leukocytes

QUESTION 3

Having female anatomy is a major risk factor for UTIs. Briefly describe, in your own words, why this is true.

QUESTION 4

Aside from being female, which other risk factor is mentioned in Kelly’s history?

QUESTION 5

Kelly’s physician determines that her infection has reached her bladder. What is this called?

Urethritis

Cystitis

Pyelonephritis

Ureteritis

QUESTION 6

Aside from Kelly’s complaint, which other symptoms are likely for her condition? (Select all that apply.)

Strong urge to urinate

Frequent urination in small amounts

Red, pink, or light brown colored urine

Right upper quadrant pain

Cloudy urine

Pelvic pain

QUESTION 7

Which of the following would be a sign that Kelly’s UTI has reached her kidneys?

upper back and flank pain

Headache/migraine

Pelvic pressure/pain

Incontinence

QUESTION 8

Which of the following choices is the most common cause of UTIs?

Viruses

Bacteria

Yeast

Fungi

QUESTION 9

Kelly will likely be prescribed short-course antibiotics for treatment. She may also be prescribed an analgesic. How would this help her, physiologically?

QUESTION 10

List and describe 3 steps Kelly can take to prevent UTIs in the future.

QUESTION 11

Daniel is a 52-year-old male with a history of obesity and diabetes. He had gastric bypass surgery 6 years ago and has been maintaining normal blood glucose levels and a BMI of 25 for the last 4 years. Daniel was able to stop taking medication for his diabetes, but still takes a daily multivitamin. He has had symptoms of Irritable Bowel Syndrome intermittently for 6 months, including abdominal pain and constipation. Within the last week, he has developed new symptoms that are more severe than the abdominal pain in the past. Daniel’s pain radiates into his groin and inferior to the ribs on his right side. The pain fluctuates in intensity, but is so severe that it’s debilitating at times. This morning, his pain was accompanied by nausea and vomiting, so he decided to seek emergency care.

The emergency department physician suspects that Daniel may have kidney stones. Where could the kidney stone be located?

Ureter

Bladder

Renal pelvis

All of these choices are possibilities

QUESTION 12

An x-ray confirms the presence of multiple kidney stones. If Daniel is not treated, what are possible complications? List and briefly describe 2 possible complications.

QUESTION 13

Why might Daniel’s doctor ask him about his diet? Briefly explain how his diet might be related to his condition.

QUESTION 14

Aside from the symptoms mentioned in Daniel’s history, which of the following are common symptoms of nephrolithiasis? (Select all that apply.)

Bright yellow urine

Pink or red urine

Frequent urination

Fever and/or chills

Urinating small quantities

QUESTION 15

Why might Daniel’s doctor recommend that he stop taking his daily multivitamin?

Calcium found in supplements may have an effect on his future risk of developing kidney stones.

The Vitamin C in his supplement may have contributed to his kidney stone development.

Potassium intake is closely related to the development of kidney stones.

The iron in his supplement is likely affecting his glomerular filtration rate.

QUESTION 16

Which parts of Daniel’s history contribute to his risk for kidney stones?

QUESTION 17

Kidney stones have many causes. The stones are commonly composed of all the following substances, except:

Calcium

Uric acid

Cystine

Bile

QUESTION 18

Daniel has small stones that are lodged in the left renal pelvis. His doctor recommends passing them naturally. Which of the following choices describes the path that these stones must take to exit the body?

Distal convoluted tubule- Ureter- Bladder

Loop of Henle- Proximal convoluted tubule- Urethra- Bladder

Urethra- Bladder- Ureter

Ureter- Bladder- Urethra

QUESTION 19

Daniel has a large stone lodged in his right ureter that requires treatment via a procedure called extracorporeal shockwave lithotripsy. Which of the following statements describes this procedure?

Surgical removal of a kidney stone via small scopes and instruments.

Removal of a kidney stone by passing a small tube through the urethra and bladder.

Using soundwaves to break up stones into smaller pieces that can then pass naturally.

Removal of the parathyroid glands which are allowing calcium buildup in the kidneys.

QUESTION 20

List and briefly describe 3 steps Daniel can take to prevent future renal lithiasis.