AST 4 Quizzes

Question 1

What kind of risk factor are nephrotoxins?

Answer 1

Exposure

Question 2

What mechanism(s) do RAS inhibitors use?

Answer 2

-decrease glomerular hypertension
-decrease proteinuria

Question 3

What causes hypocalcemia?

Answer 3

Hyperphosphatemia

Question 4

What acid/base disorder results from altitude, and what drug treats it?

Answer 4

respiratory alkalosis
acetazolamide

Question 5

What drug acts on site II of the nephron (the loop of Henle)?

Answer 5

Furosemide

Question 6

What is a complication of late-stage SHPT?

Answer 6

Osteo- disorders

Question 7

Why is furosemide an efficacious diuretic?

Answer 7

-The region it acts on is responsible for 20-30% of filtration
-it disrupts the counter-current multiplier

Question 8

What site in the nephron is responsible for diuretic-induced hypokalemia?

Answer 8

Site IV- collecting duct

Question 9

What is the recommended treatment for shock-induced (?) Anion Gap Metabolic Acidosis?

Answer 9

Norepinephrine

Question 10

What is the preferred term for acute renal insufficiency?

Answer 10

Acute kidney disease

Question 11

What diuretic acts at site III, the distal tubule?

Answer 11

HCTZ (thiazides)

Question 12

What class of medications can cause pre-renal AKI?

Answer 12

diuretics

Question 13

True or false: Loading doses should be avoided in patients with kidney impairment

Answer 13

False: if anything is changed, it should be the maintenance dosing

Question 14

Where is the ultrafiltrate in the nephron?

Answer 14

Site I (proximal tubule)

Question 15

Which part of the nephron does triamterene affect?

Answer 15

Site IV (collecting duct)

Question 16

What differentiates chronic kidney disease?

Answer 16

Adaptation

Question 17

__1__ are used to prevent esophageal varices from bleeding by __2__ the __3__ vasculature

Answer 17

1. Non-selective beta blockers
2. Vasoconstricting
3. Splanchnic

Question 18

Which of the following beta blockers are non-selective:
Acebutolol
Metoprolol
Timolol

Answer 18

Timolol

Question 19

What type of anemia is associated with low hemoglobin and elevated MCV?

Answer 19

macrocytic, normochromic

Question 20

What is required to diagnose SBP?

Answer 20

ONLY a PMN count>250
(WBC count x Poly %)

Question 21

What drugs treat Non-Alcoholic Fatty Liver Disease?

Answer 21

None!

Question 22

How long should SBP be treated with antibiotics?

Answer 22

5 days
(7 days for prophylaxis)

Question 23

If a patient on epoetin has an Hgb of 11.2 when checked, what should be done to their dosing?

Answer 23

Decreased by 25%

Question 24

What should patients be advised when taking po ferrous sulfate?

Answer 24

take with food for tolerability

Question 25

How to diagnose a patient with CKD?

Answer 25

-More than 3 months! -eGFR<60?

Question 26

What treatment should be given to a CKD patient with a phos level 5.6 and calcium level 10.2?

Answer 26

Sevelamer 800 mg po tid with food

Question 27

G3a/A2 patient on HCTZ not controlling hypertension

Answer 27

keep HCTZ dose and initiate losartan

Question 28

What lab value is most important to determine liver function?

Answer 28

Albumin

Question 29

What is the pathophysiology of anemia in CKD?

Answer 29

1. shortened RBC lifespan 2. uremic inhibition of epoetin 3. Up-regulation of hepcidin

Question 30

What drug should be discontinued in a hospitalized CKD patient to avoid AKI?

Answer 30

furosemide (diuretics)

Question 31

A patient has been on ergocalciferol for 2 weeks and their 25(OH) vitamin D level is unchanged. What should be done to their dosing?

Answer 31

Keep dose the same, wait another few weeks

Question 32

What lab test helps to determine the etiology of ascites?

Answer 32

SAAG (serum ascites albumin gradient)

Question 33

What are the indications for dialysis?

Answer 33

Acidosis, EIOU

Question 34

Which form of dialysis can cause hypotension?

Answer 34

IHD

Question 35

How is the severity of ascites determined?

Answer 35

amount of fluid AND response to diuretics

Question 36

What drug should be avoided in kidney failure?

Answer 36

morphine/codeine

Question 37

What analytic determines the severity of alcoholic hepatitis and whether to start steroids?

Answer 37

Maddrey Discriminant Function (MDF) start steroids if over 32

Question 38

What is a common chronic condition leading to kidney failure?

Answer 38

Hypertension

Question 39

Which diuretic's mechanism of action works with the pathophysiology of ascites?

Answer 39

Spironolactone

Question 40

What severity is an acute variceal bleed?

Answer 40

Active bleeding is ALWAYS severe life-threatening

Question 41

When should 25% albumin be given in ascites?

Answer 41

Only to patients who undergo large-volume paracentesis

Question 42

How will decreasing dialysate flow rate affect the rate of drug removal?

Answer 42

Decrease the rate of drug removal

Question 43

How is HRS-AKI (hepatorenal syndrome-acute kidney injury) treated?

Answer 43

vasopressors and albumin

Question 44

What vasoactive substances operate in the liver?

Answer 44

nitric oxide and endothelins

Question 45

What scale is used to evaluate hepatic encephalopathy?

Answer 45

West Haven Criteria

Question 46

How often is intermittent hemodialysis delivered?

Answer 46

2-3 times/week

Question 47

How does the dialysate in IHD run?

Answer 47

countercurrent to blood flow through the filter

Question 48

What is a common cause for acute kidney failure?

Answer 48

Drug toxicity

Question 49

What factors make a drug likely to be cleared by the kidneys?

Answer 49

-Low molecular weight -low protein binding -low volume of distribution

Question 50

In what two conditions is a TIPS procedure a possible treatment?

Answer 50

-variceal bleeding -ascites

Question 51

What is the Lille score used for?

Answer 51

Alcoholic hepatitis when steroids are not working

Question 52

What OTC pain medication is appropriate in cirrhotic patients, and at what dose?

Answer 52

Acetaminophen, max 2 g/day