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ABIM > MKSAP STOCK4 > Flashcards

MKSAP STOCK4 Flashcards

1
Q

What is the pneumococcal immunization strategy in patients with chronic kidney disease

A

Vaccination with both the 13-valent pneumococcal conjugate AND the 23-valent pneumococcal polysaccharide vaccines

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2
Q

What is the diagnosis for abdominal pain, palpable purpura, athralgia, and glomerulonephritis with NORMAL complement levels

A

IgA vasculitis

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3
Q

What is the cancer risk in Balkan Endemic Nephropathy

A

Increased risk of transitional cell (urothelial) carcinoma of the renal pelvis, ureters, and bladders

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4
Q

This is the preferred drug class for CKD with proteinuria

A

ACE inhibitor or ARB

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5
Q

What is the syndrome involving fluid and electrolyte shifts resulting from nutritional rehabilitation of severely malnourished patients?

A

Refeeding Syndrome

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6
Q

Dx test of choice for evaluating suspected nephrolithiasis in pregnant pt

A

US

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7
Q

What is a cause of hypokalemia associated with hypovolemia, metabolic alkalosis, increased urine potassium excretion and DECREASED urine chloride excretion

A

Vomiting (losing Cl via gut so want to preserve in urine)

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8
Q

What are two imaging options for suspected nephrolithiasis?

A

Ultrasound; Non contrast CT

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9
Q

What are two metabolic complications commonly associated with immunosuppressive medications used in kidney transplantation?

A

Diabetes Mellitus; Dyslipidemia

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10
Q

What are the two most common causes of death in patients with ESRD?

A

Cardiovascular Dz, infection

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11
Q

What is the supposed chronic kidney disease associated with PPIs?

A

Chronic Tubulointerstitial Kidney Dz

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12
Q

What is the recommended monitoring of patients with isolated hematuria and a family history of hematuria?

A

Periodic measurement of kidney function and urine protein

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13
Q

What are two recommended mgmt interventions for DM nephropathy?

A

Adequate control of BP; Use of an ACE inhibitor or angiotensin receptor blocker

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14
Q

What are two distinguishing clinical features of membranous glomerulopathy?

A

Nephrotic Syndrome; Thromboembolic events (renal vein thrombosis)

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15
Q

What is the primary mgmt of drug-induced acute interstitial nephritis

A

Stop the offending medication

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16
Q

What is the clinical presentation, urine findings, and FENA associated with aminoglycoside-induced nephrotoxicity?

A

Nonoliguric acute tubular necrosis; granular casts in the urine sediment; and FENA >1

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17
Q

What acid base disorder is associated with opioid overdose

A

Primary Respiratory Acidosis

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18
Q

What are two characteristics of urine microscopic findings that are associated with glomerular hematuria?

A

Dysmprphic erythrocytes; erythrocyte casts

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19
Q

What is the initial fluid mgmt of chronic asymptomatic hyponatremia due to SIADH?

A

Fluid restriction without sodium restriction (liberalize salt in diet)

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20
Q

What is the mechanism of injury associated with anti-glomerular basement membrane disease?

A

Antibodies directed against the noncollagenous domain of type IV collagen

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21
Q

What is the diagnosis associated with hyperkalemia, a normal anion gap metabolic acidosis, and a urine pH <5.5

A

Type IV (Hyperkalemic Distal) renal tubular acidosis

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22
Q

What is the treatment for class III and class IV lupus nephritis?

A

Combination immunosuppression therapy (glucocorticoids and cyclophosphamide)

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23
Q

What obesity drug is associated with acute oxalate nephropathy?

A

Orlistat

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24
Q

What condition is associated with hypovolemia, metabolic alkalosis, and increased concentrations of urine sodium and chloride?

A

Diuretic Use

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25
Q

What is the characteristic urinalysis finding in renal amyloidosis?

A

Proteinuria; often nephrotic range (>5 g)

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26
Q

What are two screening tests for patients with risk for CKD?

A

Obtain eGFR (BMP); urine testing for protein/cr ratio or albumin/cr ratio

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27
Q

What is the recommended treatment approach for elderly patients with ESRD and a high burden of comorbid conditions and poor functional status

A

Nondialytic therapy (palliative care)

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28
Q

What is the BP goal for patients under 60 according to JNC 8?

A

BP <140/90

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29
Q

What is the renal syndrome associated with abnormal tubular handling of glucose, amino acids, uric acid, phosphate, and bicarbonate?

A

Fanconi Syndrome

30
Q

What are two vascular endothelial growth factor inhibitors linked to thrombotic microangiopathy?

A

Bevacizumab and Sunitinib

31
Q

What is the condition associated with bone pain, hypophosphatemia, low 1,25 vitamin D and normal 25 vitamin D

A

Oncogenic Osteomalacia

32
Q

Name 3 conditions that may cause abdominal compartment syndrome

A

Abdominal surgery, massive fluid resuscitation, liver or pancreatic disease with large volume ascites

33
Q

What is a common cause of decreased serum creatinine in the elderly in the absence of any change in kidney function

A

Low muscle mass

34
Q

What are the two highest cancer risks in kidney transplant patients?

A

Squamous Cell Carcinoma of the skin; Post-Transplant Lymphoproliferative Disorder (PTLD)

35
Q

What is the mechanism of serum creatinine elevation in patients taking trimethoprim?

A

Decreasd creatinine secretion (NO CHANGE IN GLOMERULAR FILTRATION RATE)

36
Q

What is the UA finding that distinguishes hemoglobinuria from hematuria?

A

Absence of erythrocytes (seen in myoglobinuria)

37
Q

What is the diuretic choice for resistent HTN in patients with stage >4 CKD?

A

Loop Diuretic

38
Q

What is the initial step in the mgmt of infection-related glomerulonephritis?

A

Treat the underlying infection

39
Q

What are THREE indications for mechanical kidney stone removal?

A

Large Stone >10 mm; Failed medical mgmt; or complicated nephrolithiasis (i.e. urosepsis, acute kidney injury, anuria, refractory pain)

40
Q

What is the ESSENTIAL drug class in the treatment of resistant hypertension?

A

Diuretics

41
Q

What makes a diagnosis of chronic HTN in a pregnant patient?

A

Development of HTN prior to the 20th week of gestation

42
Q

What is the JNC 8 HTN goal for HTN in CKD

A

BP <140/90 with an ACE or ARB

43
Q

What is the glomerular disease characteristically associated with HIV infection

A

Focal Segmental Glomerulosclerosis (Collapsing Variant)

44
Q

What condition is characterized by persistent hematuria, normal kidney function, and positive family history of hematuria WITHOUT renal failure?

A

Thin Glomerular Basement Membrane Disease

45
Q

What are three findings associated with infection-related glomerulonephritis?

A

Nephritic Syndrome; Low C3 levels; Normal C4 levels

46
Q

What is the reduction of serum sodium for every 100 mg/dL increase in plasma glucose above 100?

A

1.6 (So if glucose is 300, the Na is actually about 3 higher)

47
Q

What is the condition characterized by impaired excretion of hydrogen ions in the DCT

A

Type I (Hypokalemic Distal) Renal Tubular Acidosis

48
Q

What are three interventions for chronic mgmt of uric acid nephrolithiasis?

A

Increase urine output (fluids); Alkalinization of urine; Xanthine oxidase inhibitors (allopurinol)

49
Q

What is the necessary study to diagnose type of glomerulonephritis?

A

Kidney Bx

50
Q

Cause of diarrhea, MAHA, thrombocytopenia, and kidney failure

A

Shiga Toxin related HUS

51
Q

What are three conditions that predispose to alcoholic ketoacidosis

A

Chronic Alcohol abuse, liver disease, and acute intoxication

52
Q

What are two drug classes that are recommended by JNC 8 for treating HTN in patients with CKD and DM

A

Either an ACE inhibitor or an ARB

53
Q

What are two electrolyte changes associated with NSAID use?

A

Sodium Retention, Hyperkalemia

54
Q

What Acid-Base abnormality may occur in patients with short-bowel syndrome?

A

D-lactic acidosis

55
Q

This is the management of prehypertension

A

Lifestyle modification and annual blood pressure determinations

56
Q

What is the recommended kidney imaging modality in patients with CKD

A

Ultrasound

57
Q

What is the strongest nonmodifiable predictor of the development of acute kidney injury after cardiac surgery?

A

Pre-existing chronic kidney disease

58
Q

What are two types of kidney disease associated with elevated IgG4 levels

A

IgG4 related interstitial nephritis; Retroperitoneal fibrosis

59
Q

Tx for patients with enteric hyperoxaluria and calcium oxalate stones?

A

Bile Salt Binders

60
Q

What ambulatory blood pressure threshold for initiating pharmacologic therapy?

A

>135/85

61
Q

What is the mgmt of struvite nephrolithiasis

A

Stone removal

62
Q

What are 4 diagnostic criteria for SIADH

A

Hypo-osmolar hyponatremia, Euvolemia, Urine osmolality inappropriately greater than plasma osmolality, no other obvious cause (Addision, Hypothyroid)

63
Q

Intervention that reduces the risk for contrast-induced nephropathy

A

IV NS

64
Q

What is the acid-base disorder associated with laxative abuse?

A

Normal Anion Gap Metabolic Acidosis

65
Q

What is the renal replacement modality preferred for critically ill, unstable patients in acute kidney injury

A

Continuous Renal Replacement Therapy

66
Q

What is the cancer risk associated with acquired cystic kidney disease?

A

RCC

67
Q

What are two drug classes that are recommended by JNC 8 for treating HTN in patients with CKD but WITHOUT DM

A

Same as if they had DM; ACE inhibitor or ARB

68
Q

What are two treatment goals for cardiorenal syndrome?

A

Improve cardiac function and fluid balance

69
Q

What fractional excretion test diagnosis prerenal AKI in patients taking diuretics?

A

FeUrea

70
Q

At what CKD stage is referral to a nephrologist appropriate?

A

Stage G4 or G5

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