AKI/CKD

Question 1

What is the likely diagnosis in a patient with a recent seizure who has a large amount of blood on urinalysis with few RBCs on microscopy?

Answer 1

Myoglobinuria (secondary to rhabdomyolysis)

Question 2

5 Consequences of CKD:

Answer 2

• Hyperkalemia
• Metabolic acidosis
• Secondary hyperparathyroidism
• Anemia
• Uremia

Question 3

Rhabdomyolysis releases heme pigments into the bloodstream, which may cause:

Answer 3

Acute tubular necrosis (nephrotoxic)

Question 4

Oliguria, elevated serum creatinine, granular muddy brown casts, proteinuria, and patchy necrosis of the proximal tubule indicate:

Answer 4

Acute tubular necrosis (ATN)

Question 5

Which type of nephrotic syndrome is most commonly associated with renal vein thrombosis?

Answer 5

Membranous nephropathy

Question 6

What is the initial treatment for prerenal acute kidney injury?

Answer 6

IV normal saline bolus

Question 7

What is the most common cause of abnormal hemostasis in patients with chronic renal failure?

Answer 7

Platelet dysfunction as consequence of Uremia

Question 8

The polyuric phase of AKI is characterized by

Answer 8

the loss of several electrolytes

Question 9

During the recovery phase of acute tubular necrosis, there is increased risk for

Answer 9

hypokalemia and renal wasting of other electrolytes and minerals

Question 10

How does renal insufficiency cause secondary hyperparathyroidism?

Answer 10

↓ phosphate excretion → ↑ serum phosphate binds to calcium → ↓ free calcium → ↑ PTH release

Question 11

What is the likely diagnosis in a patient with chronic kidney disease that develops bone pain?

Answer 11

Renal osteodystrophy (due to secondary hyperparathyroidism)

Question 12

How do levels of parathyroid hormone change in chronic renal disease?

Answer 12

Increased (secondary hyperparathyroidism)

Question 13

What is the earliest sign of diabetic nephropathy?

Answer 13

Microalbuminuria (30–300 mg/day)

Question 14

What is the likely underlying etiology of kidney disease with GBM thickening, mesangial expansion, and glomerular sclerosis?

Answer 14

Diabetic nephropathy

Question 15

The most common side effect of erythropoietin stimulating agents is

Answer 15

Hypertension

Question 16

What is the likely underlying etiology of kidney disease with arteriosclerotic lesions of renal arterioles?

Answer 16

Hypertension

Question 17

What would the platelet count and bleeding time show for uremia-induced platelet dysfunction?

Answer 17

• Platelet count = normal
• Bleeding time = prolonged

Question 18

What acid-base disorder does uremia cause?

Answer 18

High anion gap metabolic acidosis

Question 19

What acid-base disorder is a consequence of renal failure?

Answer 19

Metabolic acidosis

Question 20

What is the likely diagnosis in a chronic renal failure patient that presents with pleuritic chest pain that improves when leaning forward?

Answer 20

Uremic pericarditis

Question 21

Uremia presenting with encephalopathy, pericarditis, or bleeding is managed with:

Answer 21

Hemodialysis

Question 22

What is the most common cause of death in dialysis and renal transplant patients?

Answer 22

Cardiovascular disease

Question 23

What is the most important intervention for preventing contrast-induced nephropathy?

Answer 23

Adequate IV hydration

Question 24

What is the earliest sign of diabetic nephropathy?

Answer 24

Microalbuminuria (30–300 mg/day)

Question 25

What hematologic laboratory values are consistent with abnormal hemostasis due to chronic renal failure? - PT: - PTT: - Platelet count: - Bleeding time:

Answer 25

- Normal - Normal - Normal - Prolonged

Question 26

What is the most common cause of secondary hyperparathyroidism?

Answer 26

Chronic kidney disease (CKD)