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Renal and Urinary Tract Disorders

Which of the following is not a physiological change in pregnancy that contributes to the findings in the image below?

a. Vesicoureteral reflux

b. Glomerular hypertrophy

c. Distal ureteral compression by the uterus

d. Progesterone-induced relaxation of the muscularis

Which of the following statements regarding physiological changes in pregnancy is true?

a. Glomerular filtration decreases.

b. Effective renal plasma flow increases.

c. Serum creatinine concentration increases.

d. The number of glomerular cells increases.

A 35-year-old G5P3 presents at 24 weeks’ gestation. She has a history of chronic hypertension, but she is noncompliant with medication. You would like to do a baseline 24-hour urine collection. The patient is of low health literacy, and you are concerned she will not complete the collection as an outpatient, but she refuses to be admitted for it. You decide to do a urinary protein-to-creatinine ratio on a spot urine sample so you can gather additional information about the patient’s renal status. What is the cutoff for abnormal?

a. 0.1

b. 0.2

c. 0.3

d. 0.5

Which of the following is the threshold for proteinuria in pregnancy, above which levels are considered abnormal?

a. 100 mg/d

b. 250 mg/d

c. 300 mg/d

d. 1000 mg/d

Which of the following values is not a normal serum creatinine in pregnancy?

a. 0.4 mg/dL

b. 0.6 mg/dL

c. 0.8 mg/dL

d. 1.0 mg/dL

A pregnant patient who ...

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