病理学（南开大学）章节测试课后答案2024春

第九章测试

1.A 35-year-old man is awakened at night because of severe lower abdominal pain that radiates to the groin. The pain is very intense and comes in waves. The next morning, he notices blood in his urine. On examination, there are no remarkable findings. Which of the following is the most likely diagnosis?
A:Ureteral lithiasis B:Acute cystitis  C:Renal cell carcinoma D:Hydronephrosis E:Autosomal dominant polycystic kidney disease
答案:A
2.A 3-year-old previously healthy boy has become increasingly lethargic for the past 3 weeks. On physical examination, his temperature 36.9℃，pulse 80/min, respirations 15/min, and blood pressure 140/90 mmHg. Periorbital edema is present. Urinalysis shows 4+ proteinuria, and no blood, ketones, or glucose. Which of the following is the best information to give the boy's parents about his disease? 
A:Rapid onset of renal failure is likely B:A course of antibiotic therapy is indicated C:Corticosteroid therapy should alleviate this problem  D:A relative should be found to provide a transplant E:Other family members are at risk for this disease 3.A 25-year-old man has a 5-year history of celiac sprue. Several days after a mild upper respiratory infection, he begins passing dark red-brown urine. The dark urine persists for the next 3days and then becomes clear and yellow, only to become red-brown again l month later. There are no remarkable findings on physical examination. Urinalysis shows a pH of 6.5, specific gravity 1.018, 3+hematuria, l+ proteinuria, and no glucose or ketones. Microscopic examination of the urine shows RBCs and no WBCs, casts, or crystals. A 24-hour urine protein level is 200mg. A renal biopsy specimen from the glomeruli of this patient is most likely to show which of the following alterations?
A:Granular staining of the basement membrane by anti-IgG antibodies B:Diffuse proliferation and basement membrane thickening  C:Mesangial lgA staining by immunofluorescence  D:Thrombosis in the glomerular capillaries E:Subepithelial electron-dense deposits 4.A 7-year-old boy is recovering from impetigo. Physical examination shows a few honey-colored crusts on his face. The crusts are removed, and a culture of the lesions grows group A Streptococcus pyogenes. He is treated with a course of antibiotics. One week later, he develops malaise with nausea and a slight fever and passes dark brown urine. Laboratory studies show a serum anti-streptolysin O (ASO) titer of l:1024. Which of the following is the most likely outcome? 
A:Lower urinary tract infection B:Chronic renal failure C:Progression to crescentic glomerulonephritis  D:Complete recovery without treatment E:Development of rheumatic heart disease 5.A 15-year-old boy has been passing dark-colored urine for the past month. On physical examination, he has bilateral sensorineural hearting loss and corneal erosins. Urinalysis shows a pH of 6.5, specific gravity 1.015, 1+hematuria, 1+proteinuria, and no ketones, glucose, or leukocytes. The serum creatinine level is 2.5 mg/dL, and the urea nitrogen level is 24 mg/dL. A renal biopsy specimen shows tubular epithelial foam cells by light microscopy. By electron microscopy, the glomerular basement membrane shows areas of attenuation, with splitting and lamination of lamina densa in other thickened areas. Which of the following is the most likely diagnosis? 
A:Acute tubular necrosis B:Alport syndrome C:Membranous glomerulonephritis D:Berger disease  E:Diabetic nephropathy 6.After eating a cheeseburger, French fries, and Ice cream for dinner one night, a 6-year-old girl develops nausea, mild abdominal cramping, and a slight fever. Three days later, her parents notice that she is passing dark stools and dark urine and appears fatigued and weak. On physical examination, she has a temperature of 37.9 , pulse 88/min, respirations 18/min, and blood pressure 140/90mmHg. Scattered petechiae are present ℃ on the extremities. Laboratory findings show a serum creatinine level of 2.2mg/dL and urea nitrogen level of 20 mg/dL. Urinalysis shows a pH of 6, specific gravity 1.016, 2+hematuria, and no protein or glucose. A renal biopsy specimen shows small thrombi within glomerular capillary loops. Which of the following diseases is most likely to produce these findings? 
A:Wegener granulomatosis B:Hemolytic-uremic syndrome C:Postinfectious glomerulonephritis D:IgA nephropathy E:Hereditary nephritis 7.A 26-year-old man is involved in a motor vehicle accident and sustains acute blood loss. He is hypotensive for several hours before paramedical personnel arrive. They stabilize the bleeding and transport him to a hospital, where he receives a transfusion of 3 units of packed RBCs. Over the next week, the serum urea nitrogen level increases to 48md/dL, the serum creatinine level increases to 5mg/dL, and the urine output decreases. He undergoes hemodialysis for the next 2 weeks and then develops marked polyuria, with urine output of 2 to 3L per day. His recovery is complicated by bronchopneumonia, but renal function gradually returns to normal. Which of the following histological features best characterizes the patient’s transient renal disease?
A:Interstitial lymphocytic infiltrates B:Rupture of the tubular basement membrane C:Nodular glomerulosclerosis D:Glomerular crescents in Bowman's space E:Arteriolar fibrinoid necrosis 8.A 50-year-old woman has had fever and flank pain for the past 2 days. On physical examination, her temperature is 38.2 , pulse 81/min, respirations 16/min,and blood pressure 130/80 mmHg. Urinalysis shows ℃ no protein, glucose, or ketones. The leukocyte esterase test is positive. Microscopic examination of the urine shows numerous polymorphonuclear leukocytes and occasional WBC casts. Which of the following organisms is most likely to be found in the urine culture? 
A:Mycobacterium tuberculosis B:Group A streptococcus  C:Mycoplasma hominis D:Cryptococcus neoformans E:Escherichia coli  9.A 29-year-old woman sees her physician because she has had a fever and sore throat for the past 3 days. On physical examination, her temperature is 38.0. The pharynx is erythematous, with yellowish tonsillar ℃ exudate. Group A Streptococcus pyogenes is cultured. She is treated with ampicillin and recovers fully in 7 days. Two weeks later; she develops fever and a rash and notices a slight decrease in urinary output. Her temperature is 37.7 , and there is a diffuse erythematous rash on the trunk and extremities. Urinalysis shows ℃ a pH of 6, specific gravity 1.022, l+ proteinuria, l+ hematuria, and no glucose or ketones. Microscopic examination of the urine shows RBCs and WBCs, including eosinophils, but no casts or crystals. Which of the following is not the most likely cause of her disease? 
A:Renal tubular cell necrosis caused by bacterial toxins B:Hematogenous dissemination of septic emboli  C:Hypersensitivity reaction to ampicillin  D:Formation of antibodies against glomerular basement membrane E:Deposition of immune complexes with streptococcal antigens 10.A 25-year-old woman experiences sudden onset of fever, malaise, nausea. On physical examination ,her temperature is 38.2 , pulse 85/min, respirations 18/min,and blood pressure 140/90mmHg. A routine ℃ urinalysis shows 1+ proteinuria, 4+ hematuria, and no ketones or glucose. RBC casts are seen on microscopic examination of the urine. A renal biopsy is performed, and light microscopic examination shows marked glomerular hypercellularity with neutrophils in glomerular capillary loops. immunofluorescence microscopy shows granular deposition of IgG and C3 in glomerular capillary basement membranes. Electron microscopyshows electron-dense subepithelial "humps”. Which of the following is the most likely diagnosis?   
A:Diabetes mellitus B:Postinfectious glomerulonephritis C:Membranous glomerulonephritis D:Systemic amyloidosis E:Goodpasture syndrome