Board Vitals Nephrology and Urology Flashcards
(122 cards)
1
Q
Which two medical conditions are associated with renal tubular acidosis type 4?
A
- Diabetes mellitus
- HIV
2
Q
Which renal tubular acidosis is associated with non-anion gap metabolic acidosis and hypokalemia, with urine pH > 5.5?
A
RTA type 1 (distal RTA)
3
Q
Which renal tubular acidosis is associated with non-anion gap metabolic acidosis, glycosuria, proteinuria, hyperphosphaturia and hypokalemia?
A
RTA type 2 (proximal RTA)
4
Q
What is RTA type 3?
A
A combination of RTA type 1 and 2
5
Q
Which renal tubular acidosis in the only one with hyperkalemia?
A
RTA type 4
6
Q
What should you do first in a catheterized patient with acute kidney injury post-operatively?
A
Check to make sure the urinary catheter is not obstructed.
7
Q
Patient has bladder pain with associated urinary symptoms for more than 6 weeks without explained cause.
Diagnosis?
A
Bladder pain syndrome/interstitial cystitis
8
Q
What is the treatment for bladder pain syndrome/interstitial cystitis?
A
Amitriptyline
9
Q
What is the most common cause of nephrotic syndrome in adults?
A
Membranous nephropathy
10
Q
How do you definitively diagnose the cause of nephrotic syndrome?
A
Renal biopsy
11
Q
In what condition are proximal tubules unable to reabsorb bicarbonate, resulting in too much for the distal tubule to handle and a net bicarbonate loss in the urine?
A
RTA type 2 (proximal RTA)
12
Q
In what condition do collecting/distal tubules fail to secrete hyodrogen ions into the lumen of the nephron, causing hydrogen ion buildup in the blood and acidemia?
A
RTA type 1 (distal RTA)
13
Q
Contrast-enhanced CT of urinary tract shows “golf-ball-on-tee” sign. What does this indicate?
A
Renal papillary necrosis
14
Q
Can chronic NSAID use lead to renal papillary necrosis?
A
Yes
15
Q
What is the preferred route of antibiotics in case of peritoneal dialysis related peritonitis?
A
Intra-peritoneal
16
Q
What is the preferred route of antibiotics in case of peritoneal dialysis related peritonitis in an unstable patient?
A
Intravenous
17
Q
Can patients with acute interstitial nephritis have a rash?
A
Yes
18
Q
Can patients with acute interstitial nephritis have a fever?
A
Yes
19
Q
Can patients with acute interstitial nephritis have eosinophils in their urine?
A
Yes
20
Q
Are eosinophils in the urine diagnostic of acute interstitial nephritis?
A
No
21
Q
Can patients with acute interstitial nephritis have proteinuria?
A
Yes
22
Q
Can patients with acute interstitial nephritis have arthralgias?
A
Yes
23
Q
What does bone pain indicate in the setting of urinary retention and elevated PSA?
A
Metastatic prostate cancer
24
Q
Are urine cultures always positive in urinary tract infections?
A
No
25
What is the preferred imaging study for a patient presenting with nephrolithiasis?
CT Abdomen without contrast
26
Does the CT of the abdomen need to be done with contrast to identify kidney stones?
No
27
Which is more sensitive for detecting kidney stones - CT or MRI?
CT
28
Which bacteria predisposes to staghorn calculi?
Proteus mirabilus
29
Post-infectious glomerulonephritis is characterized by transiently low serum complement levels that are reversible without intervention.
True or false?
True
30
Are the complement levels low, normal or high in proliferative lupus nephritis?
Low
31
Are the complement levels low, normal or high in IgA glomerulonephritis?
Normal
32
Are the complement levels low, normal or high in Pauci-immune rapidly progressive glomerulonephritis?
Normal
33
Does amitriptyline increase or decrease the risk of urinary retention?
Increases risk of urinary retention
34
What needs to be present to diagnose hepato-renal syndrome?
Non-responsiveness in renal function following a fluid challenge.
35
In the treatment of prostate cancer - name three treatments that cause erectile dysfunction and urinary incontinence in order going from the treatment that causing the highest risk to the one that causes the lowest risk (and is still a treatment i.e. not active surveillance).
- Radical prostatectomy
- External beam radiation therapy
- Brachytherapy
36
Which part of the kidney has tubular fluid with the highest osmolarity and a low antidiuretic hormone state?
Descending loop of Henle
37
Which part of the kidney has tubular fluid with high osmolarity and a high antidiuretic hormone state?
Collecting duct
38
What fractional excretion of sodium is consistent with pre-renal disease?
< 1%
39
What fractional excretion of urea is consistent with pre-renal disease?
< 35%
40
Should the FENa or FEUrea be calculated in patients who take diuretics?
FEUrea
41
Can hemodialysis cause hyperkalemia due to hemolysis?
Yes (rare complication)
42
A patient has euvolemic hyponatremia - along with low serum osmolality, high urine osmolality, and high urine sodium.
Diagnosis?
SIADH
(Syndrome of inappropriate diuretic hormone secretion)
43
What is the treatment of the hypertension and edema of post-streptococcal glomerulonephritis?
Diuretics
44
What kind of kidney disease occurs due to infectious endocarditis?
Acute crescentic glomerulonephritis
45
To increase the GFR does the filtration coefficient need to increase or decrease?
Increase
46
To increase the GFR does the glomerular capillary hydrostatic pressure need to increase or decrease?
Increase
47
To increase the GFR does the Bowman's space hydrostatic pressure need to increase or decrease?
Decrease
48
To increase the GFR does the Bowman's space oncotic pressure need to increase or decrease?
Increase
49
To increase the GFR does the glomerular capillary oncotic pressure need to increase or decrease?
Decrease
50
What type of incontinence has detrusor hyperactivity?
Urge incontinence
51
What type of incontinence has impaired detrusor contractility?
Overflow incontinence
52
What type of incontinence has urethral hypermobility?
Stress incontinence
53
Can multiple sclerosis cause impaired inhibition of the detrusor muscle?
Yes
54
Man presents with 1 - 2 cm painless ulcer on penis, with erythematous margins, and non-tender inguinal lymphadenopathy.
Diagnosis?
Primary syphilis
55
Which organism causes syphilis?
Treponema pallidum
56
Man presents with red papule on penis, that progresses into painful ulceration on an undermined base with overlying yellow exudate, and painful inguinal lymphadenopathy.
Diagnosis?
Chancroid
57
What organism causes chancroid?
Haemophilus ducreyi
58
Man presents with painless ulcer on penis, with tendency to bleed and no inguinal lymphadenopathy.
Diagnosis?
Lymphogranuloma inguinale
59
What organism causes lymphogranuloma inguinale?
Klebsiella granulomatosis
60
Man presents with painless ulcer on penis, and develop bilateral, painful swollen inguinal or femoral lymph nodes 4 - 6 weeks later.
Diagnosis?
Lymphogranuloma venereum
61
What organism causes lymphogranuloma venereum?
Chlamydia trachomatis
62
What is the first-line treatment for a patient with benign prostate hyperplasia?
Finasteride
63
Does oxybutynin affect prostatic growth?
No
64
Which medication is the only medication currently approved for treating benign prostate hyperplasia with concomitant erectile dysfunction?
Tadalafil
65
Which disease are endolymphatic sac tumors associated with?
Von Hippel Lindau
66
Which condition is Von Hippel Lindau associated with…
Renal cell carcinoma or polycystic kidney disease?
Renal cell carcinoma
67
What is a Argyll-Robertson pupil?
- Do not constrict with light
- Accommodate
68
Which disease is aniridia associated with?
WAGR syndrome (Wilms tumor, Aniridia, Genitourinary abnormalities, mental Retardation)
69
Which disease is sensorineural hearing loss associated with?
Alport syndrome
70
Are patients with polycystic kidney disease at higher risk of mitral valve prolapse?
Yes
71
What is the most common cause of death in patients on chronic dialysis?
Cardiovascular disease
72
What is a more common cause of death in patients on chronic dialysis - infection or cardiovascular disease?
Cardiovascular disease
73
Which is the treatment of recurrent kidney stones in patients with cystinuria who do not respond to conservative measures?
Tiopronin
74
What prostate cancer screening should be done for patients who are aged between 55 to 69 years?
Individualized
Discuss methods and pros and cons
75
What percentage does the GFR drop to immediately after a hemi-nephrectomy (kidney donor)?
50%
76
What percentage does the GFR drop and recover to 6 weeks after a hemi-nephrectomy (kidney donor)?
80%
77
What kind of kidney disease does lead exposure cause?
Tubulointerstitial nephritis
78
What treatment is expected to be initiated in bone metastases from prostate cancer?
Denosumab
or
Bisphosphonates
79
Patient has painful erection with abnormal angulation of penis during erection.
Diagnosis?
Peyronie disease
80
What is the treatment of Peyronie disease?
Conservative treatment
81
What is the initial treatment approach to stress urinary incontinence in women?
Behavioral modification
Pelvic floor muscle exercises
82
What is the treatment of acute T-cell mediated rejection of a renal transplant?
- Antithymocyte globulin (ATG)
- IV glucocorticoids
83
What is the treatment of antibody mediated rejection of a renal transplant?
- Plasmapharesis
- IV immunoglobulins (IVIG)
- Glucocorticoids
84
Does renal tubular acidosis have an anion gap?
No
85
What is the goal hemoglobin in chronic kidney disease in patients treated with erythropoietin stimulating agents?
10 - 11 g/dL
86
What medication can be used to decrease PTH level in secondary hyperparathyroidism?
Cinacalcet
87
How long does it take for acute tubular necrosis to recover?
4 weeks
88
Renal function should be optimized before surgery?
True or false?
Yes/True
89
What is the most common cause of nephrotic syndrome in children?
Minimal change disease
90
Which infectious disease is membranous glomerulopathy associated with?
Hepatitis B
91
What is the treatment of minimal change disease causing nephrotic syndrome?
Prednisone (oral)
92
What percentage of people with skin positivity to penicillin will also react to cephalosporins?
3%
93
Which inherited progressive glomerular disease is associated with sensorineural hearing loss and ocular abnormalities?
Alport disease
94
What is the etiology of Alport disease?
Mutation in gene encoding type IV collagen
95
Which condition has deficient galactosylation of IgA1?
IgA nephropathy
96
Which condition has inactivation of TSC1 and TSC2 genes?
Tuberous sclerosis
97
What kind of disorder is Fabry disease?
Lysosomal storage disorder
98
A defect in the gene encoding for alpha-galactosidase A on chromosome X is seen in which disease?
Fabry disease
99
Which glomerulonephritis has normal light microscopy and podocyte effacement on electron microscopy?
Minimal change disease
100
Which glomerulonephritis has crescentic necrotizing glomerulonephritis on light microscopy?
Rapidly progressive glomerulonephritis (RPGN)
101
Which glomerulonephritis has enlarged and hypercellular glomeruli on light microscopy and electron-dense sub-endothelial deposits on electron microscopy?
Mesangial proliferative glomerulonephritis (MPGN)
102
Which glomerulonephritis has solidification of glomerular tufts on light microscopy and diffuse podocyte fusion on electron microscopy?
Focal segmental glomerulonephritis (FSGN)
103
In average risk men, what age should the discussion of pros and cons of prostate cancer screening commence?
50 years
104
Should nitrofurantoin be used in advanced renal disease?
No
105
Should a dose adjustment be made for trimethoprim-sulfamethoxazole in advanced renal disease?
Yes
106
What is the cause of renal disease in multiple myeloma?
- Light chain deposition disease in kidney
- Hypercalcemia
107
Phenylephrine can cause urinary retention.
True or false?
True
108
Risk of cataracts and glaucoma are increased in patients on glucocorticoids and is dose-related.
True or false?
True
109
Do staghorn calculi form in acidic or alkaline urine environments?
Alkaline
110
Do you need to repeat investigations to monitor treatment of complicated UTIs in patients who do not need hospitalization?
No
111
Which antihypertensive is appropriate for a patient with calcium oxalate stones?
Thiazide diuretics
112
What is the mechanism of action of thiazide diuretics?
Inhibition of NA/Cl cotransporter in the distal convoluted tubule
113
Significant renal impairment may be underestimated in the setting of low baseline creatinine.
True or false?
True
114
What is the next step in case of benign hematuria from exercise?
Repeat UA in 48 hours after exercise has stopped.
115
Is cyclosporine associated with higher rates of diabetes mellitus?
Yes
116
Which amino acid plays an important role in the excretion of excess acid during metabolic acidosis?
Glutamine
117
Which antiviral can cause crystal-induced nephropathy?
Acyclovir
118
Are casts present in prerenal azotemia?
No
119
What is required to maintain some kidney function in chronic kidney disease?
Prostaglandin synthesis
120
Do anti-C1Q or anti-dsDNA antibodies correlate more closely with disease activity of lupus nephritis?
Anti-C1Q antibodies
121
Ifosfamide can cause promixal tubular and glomerular injury.
True or false?
True
122
Which glomerulonephritis is HIV associated with?
Focal segmental GN
