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自测题9(第九章)肾功能不全

自测题9(第九章)肾功能不全
自测题9(第九章)肾功能不全

★★★单选题#尿毒症时不出现下述哪项变化()。

○●继发性甲状旁腺功能降低

○蛋白质代谢产物的潴留

○肾脏红细胞生成素分泌减少

○钾代谢紊乱

★★★单选题#慢性肾功能不全早期发生酸中毒的主要原因是()。

○醛固酮生成增加

○固定酸在体内蓄积

○高钾血症

○●肾小管上皮细胞分泌 H+、NH3障碍

★★★单选题#少尿是指每天尿量少于()。

○1000ml

○●400ml

○100ml

○600ml

★★★单选题#引起肾前性急性肾功能不全的病因是()。

○急性肾炎

○急性尿路梗阻

○●休克

○急性汞中毒

★★★单选题#慢性肾功能不全较早出现的症状是()。

○少尿

○高钾血症

○肾性骨营养不良

○●夜尿

★★★填空题#急性肾功能不全少尿期最危险的并发症是, 其对生命的主要危害是对功能的损害。

○高钾血症

○心脏

★★★填空题#少尿型急性肾功能不全的发病经过可以分为、和三期。

○少尿期

○多尿期

○恢复期

★★★填空题#慢性肾实质损害造成肾浓缩功能减退而稀释功能正常时,患者出现尿;随着病情发展,当肾浓缩功能和稀释功能均丧失时,患者出现尿。

○低渗

○等渗

★★★名词解释#什么是氮质血症?

指肾排泄功能障碍时, 血中非蛋白质含氮化合物大量增多。

★★★名词解释#什么是肾性高血压?

由肾实质原发病变引起的高血压。

★★★名词解释#什么是肾性骨营养不良?

是慢性肾功能衰竭尤其是尿毒症的严重而常见的并发症, 包括幼儿的佝偻病与成人的骨软化、纤维性骨炎、骨质疏松和骨硬化。其发病机制与慢性肾功能衰竭时出现的高磷血症、低钙血症、PTH分泌增多、1,25-(OH)2D3 形成减少及酸中毒有关。

★★★简答题#简述肾性高血压的机制。

肾性高血压的发生机制: ①肾素-血管紧张素系统活性增高, 引起血管收缩, 使外周阻力增加; ②肾脏对钠、水排出功能降低,钠、水在体内潴留, 导致血容量增加和心排血量增加; ③肾分泌的舒血管物质减少,使舒张血管降压作用减弱。

★★★简答题#肾性骨营养不良的发生机制。

慢性肾功能不全时常引起肾性骨营养不良, 其发生机制是: ①钙磷代谢障碍和继发性甲状旁腺功能亢进,分泌大量PTH致使骨质疏松; ②维生素代谢障碍, 肾生成

1,25-(OH)2D3减少, 使钙吸收减少; ③酸中毒可促进骨盐溶解, 并干扰 1,25-(OH)2D3 的合成。

★★★简答题#急性肾功能不全患者少尿期最严重的并发症是什么?简述其发生机制。

高钾血症是急性肾功能不全患者少尿期最严重的并发症,其发生机制主要是: ①GFR↓,肾排钾减少; ②组织损伤、坏死致分解代谢增强,钾释放↑; ③酸中毒时细胞内钾外移↑;④低钠血症时远端小管钾-钠交换↓。

★★★简答题#简述少尿型急性肾功能不全患者少尿期的主要功能代谢变化。

急性肾功能不全患者少尿期的功能代谢变化主要表现在: ①尿量与尿成分改变,发生少尿或无尿,出现血尿、管型尿、蛋白尿、低比重尿; ②水代谢障碍引起水中毒; ③电解质代谢障碍引起高钾血症和低钠血症,其中高钾血症是少尿期最严重的并发症;④代谢性酸中毒;⑤氮质血症。

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