2009 PPQs

Question 1

Which two hormones are affected by chronic renal failure? (2)

Answer 1

Erythropoietin (leads to anaemia)

Vitamin D not converted to active calcitriol (as kidney doesn’t make 1-a-hydroxylase -> renal osteodystrophy)

Question 2

At which GFR does the patient start to become symptomatic? Give units. (2)

Answer 2

80 ml/min

Question 3

What is value which oliguria? Give units. (2)

Answer 3

300-500 ml/min

Question 4

List three dietary restrictions for a patient with renal failure. (3)

Answer 4

Restrict levels of phosphate and potassium.
Restrict fluid intake and salt intake to <6g/day to help prevent thirst
If diabetic keep glycaemic control <53mmol/L.

Question 5

Give an example of a nephrotoxic agent. (1)

Answer 5

Gentamicin (aminoglycoside) Radiological contrast NSAIDs
ACEi
Lithium

Question 6

Streptococcus pneumoniae - Which gram stain? (1)



Answer 6

Gram positive
catalase negative
alpha haemolytic with optochin sensitivity

Question 7

Two infections caused by Streptococcus pneumoniae (2)

Answer 7

pneumonia
meningitis
septicaemia
bronchitis

Question 8

Give two host factors that stimulate opsonophagocytosis by binding to pathogens? (2)

Answer 8

complement (C3b) and antibody

mannose binding lectin

Question 9

List four conditions, excluding cardiac conditions, renal disease and age, where the host would be
immunocompromised. (4)

Answer 9

HIV
SLE (complement deficiency)
alcoholism (neutrophil deficiency)
malnourished/low BMI 
no spleen/ sickle cell anaemia

Question 10

Bug factors of S. pneumoniae (2)

Answer 10

Capsule prevents opsonophaocytosis

Pneumolysin penetrates tight junctions and forms pores