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ABIM IM Recert > Board Vitals Nephrology and Urology > Flashcards

Board Vitals Nephrology and Urology Flashcards

1
Q

Which two medical conditions are associated with renal tubular acidosis type 4?

A
  • Diabetes mellitus
  • HIV
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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)

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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)

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4
Q

What is RTA type 3?

A

A combination of RTA type 1 and 2

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5
Q

Which renal tubular acidosis in the only one with hyperkalemia?

A

RTA type 4

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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.

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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

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8
Q

What is the treatment for bladder pain syndrome/interstitial cystitis?

A

Amitriptyline

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9
Q

What is the most common cause of nephrotic syndrome in adults?

A

Membranous nephropathy

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10
Q

How do you definitively diagnose the cause of nephrotic syndrome?

A

Renal biopsy

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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)

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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)

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13
Q

Contrast-enhanced CT of urinary tract shows “golf-ball-on-tee” sign. What does this indicate?

A

Renal papillary necrosis

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14
Q

Can chronic NSAID use lead to renal papillary necrosis?

A

Yes

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15
Q

What is the preferred route of antibiotics in case of peritoneal dialysis related peritonitis?

A

Intra-peritoneal

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16
Q

What is the preferred route of antibiotics in case of peritoneal dialysis related peritonitis in an unstable patient?

A

Intravenous

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17
Q

Can patients with acute interstitial nephritis have a rash?

A

Yes

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18
Q

Can patients with acute interstitial nephritis have a fever?

A

Yes

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19
Q

Can patients with acute interstitial nephritis have eosinophils in their urine?

A

Yes

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20
Q

Are eosinophils in the urine diagnostic of acute interstitial nephritis?

A

No

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21
Q

Can patients with acute interstitial nephritis have proteinuria?

A

Yes

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22
Q

Can patients with acute interstitial nephritis have arthralgias?

A

Yes

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23
Q

What does bone pain indicate in the setting of urinary retention and elevated PSA?

A

Metastatic prostate cancer

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24
Q

Are urine cultures always positive in urinary tract infections?

A

No

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25
Q

What is the preferred imaging study for a patient presenting with nephrolithiasis?

A

CT Abdomen without contrast

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26
Q

Does the CT of the abdomen need to be done with contrast to identify kidney stones?

A

No

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27
Q

Which is more sensitive for detecting kidney stones - CT or MRI?

A

CT

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28
Q

Which bacteria predisposes to staghorn calculi?

A

Proteus mirabilus

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29
Q

Post-infectious glomerulonephritis is characterized by transiently low serum complement levels that are reversible without intervention.

True or false?

A

True

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30
Q

Are the complement levels low, normal or high in proliferative lupus nephritis?

A

Low

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31
Q

Are the complement levels low, normal or high in IgA glomerulonephritis?

A

Normal

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32
Q

Are the complement levels low, normal or high in Pauci-immune rapidly progressive glomerulonephritis?

A

Normal

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33
Q

Does amitriptyline increase or decrease the risk of urinary retention?

A

Increases risk of urinary retention

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34
Q

What needs to be present to diagnose hepato-renal syndrome?

A

Non-responsiveness in renal function following a fluid challenge.

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35
Q

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).

A
  • Radical prostatectomy
  • External beam radiation therapy
  • Brachytherapy
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36
Q

Which part of the kidney has tubular fluid with the highest osmolarity and a low antidiuretic hormone state?

A

Descending loop of Henle

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37
Q

Which part of the kidney has tubular fluid with high osmolarity and a high antidiuretic hormone state?

A

Collecting duct

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38
Q

What fractional excretion of sodium is consistent with pre-renal disease?

A

< 1%

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39
Q

What fractional excretion of urea is consistent with pre-renal disease?

A

< 35%

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40
Q

Should the FENa or FEUrea be calculated in patients who take diuretics?

A

FEUrea

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41
Q

Can hemodialysis cause hyperkalemia due to hemolysis?

A

Yes (rare complication)

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42
Q

A patient has euvolemic hyponatremia - along with low serum osmolality, high urine osmolality, and high urine sodium.

Diagnosis?

A

SIADH
(Syndrome of inappropriate diuretic hormone secretion)

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43
Q

What is the treatment of the hypertension and edema of post-streptococcal glomerulonephritis?

A

Diuretics

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44
Q

What kind of kidney disease occurs due to infectious endocarditis?

A

Acute crescentic glomerulonephritis

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45
Q

To increase the GFR does the filtration coefficient need to increase or decrease?

A

Increase

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46
Q

To increase the GFR does the glomerular capillary hydrostatic pressure need to increase or decrease?

A

Increase

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47
Q

To increase the GFR does the Bowman’s space hydrostatic pressure need to increase or decrease?

A

Decrease

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48
Q

To increase the GFR does the Bowman’s space oncotic pressure need to increase or decrease?

A

Increase

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49
Q

To increase the GFR does the glomerular capillary oncotic pressure need to increase or decrease?

A

Decrease

50
Q

What type of incontinence has detrusor hyperactivity?

A

Urge incontinence

51
Q

What type of incontinence has impaired detrusor contractility?

A

Overflow incontinence

52
Q

What type of incontinence has urethral hypermobility?

A

Stress incontinence

53
Q

Can multiple sclerosis cause impaired inhibition of the detrusor muscle?

A

Yes

54
Q

Man presents with 1 - 2 cm painless ulcer on penis, with erythematous margins, and non-tender inguinal lymphadenopathy.

Diagnosis?

A

Primary syphilis

55
Q

Which organism causes syphilis?

A

Treponema pallidum

56
Q

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?

A

Chancroid

57
Q

What organism causes chancroid?

A

Haemophilus ducreyi

58
Q

Man presents with painless ulcer on penis, with tendency to bleed and no inguinal lymphadenopathy.

Diagnosis?

A

Lymphogranuloma inguinale

59
Q

What organism causes lymphogranuloma inguinale?

A

Klebsiella granulomatosis

60
Q

Man presents with painless ulcer on penis, and develop bilateral, painful swollen inguinal or femoral lymph nodes 4 - 6 weeks later.

Diagnosis?

A

Lymphogranuloma venereum

61
Q

What organism causes lymphogranuloma venereum?

A

Chlamydia trachomatis

62
Q

What is the first-line treatment for a patient with benign prostate hyperplasia?

A

Finasteride

63
Q

Does oxybutynin affect prostatic growth?

A

No

64
Q

Which medication is the only medication currently approved for treating benign prostate hyperplasia with concomitant erectile dysfunction?

A

Tadalafil

65
Q

Which disease are endolymphatic sac tumors associated with?

A

Von Hippel Lindau

66
Q

Which condition is Von Hippel Lindau associated with…

Renal cell carcinoma or polycystic kidney disease?

A

Renal cell carcinoma

67
Q

What is a Argyll-Robertson pupil?

A
  • Do not constrict with light
  • Accommodate
68
Q

Which disease is aniridia associated with?

A

WAGR syndrome (Wilms tumor, Aniridia, Genitourinary abnormalities, mental Retardation)

69
Q

Which disease is sensorineural hearing loss associated with?

A

Alport syndrome

70
Q

Are patients with polycystic kidney disease at higher risk of mitral valve prolapse?

A

Yes

71
Q

What is the most common cause of death in patients on chronic dialysis?

A

Cardiovascular disease

72
Q

What is a more common cause of death in patients on chronic dialysis - infection or cardiovascular disease?

A

Cardiovascular disease

73
Q

Which is the treatment of recurrent kidney stones in patients with cystinuria who do not respond to conservative measures?

A

Tiopronin

74
Q

What prostate cancer screening should be done for patients who are aged between 55 to 69 years?

A

Individualized
Discuss methods and pros and cons

75
Q

What percentage does the GFR drop to immediately after a hemi-nephrectomy (kidney donor)?

A

50%

76
Q

What percentage does the GFR drop and recover to 6 weeks after a hemi-nephrectomy (kidney donor)?

A

80%

77
Q

What kind of kidney disease does lead exposure cause?

A

Tubulointerstitial nephritis

78
Q

What treatment is expected to be initiated in bone metastases from prostate cancer?

A

Denosumab
or
Bisphosphonates

79
Q

Patient has painful erection with abnormal angulation of penis during erection.

Diagnosis?

A

Peyronie disease

80
Q

What is the treatment of Peyronie disease?

A

Conservative treatment

81
Q

What is the initial treatment approach to stress urinary incontinence in women?

A

Behavioral modification
Pelvic floor muscle exercises

82
Q

What is the treatment of acute T-cell mediated rejection of a renal transplant?

A
  • Antithymocyte globulin (ATG)
  • IV glucocorticoids
83
Q

What is the treatment of antibody mediated rejection of a renal transplant?

A
  • Plasmapharesis
  • IV immunoglobulins (IVIG)
  • Glucocorticoids
84
Q

Does renal tubular acidosis have an anion gap?

A

No

85
Q

What is the goal hemoglobin in chronic kidney disease in patients treated with erythropoietin stimulating agents?

A

10 - 11 g/dL

86
Q

What medication can be used to decrease PTH level in secondary hyperparathyroidism?

A

Cinacalcet

87
Q

How long does it take for acute tubular necrosis to recover?

A

4 weeks

88
Q

Renal function should be optimized before surgery?

True or false?

A

Yes/True

89
Q

What is the most common cause of nephrotic syndrome in children?

A

Minimal change disease

90
Q

Which infectious disease is membranous glomerulopathy associated with?

A

Hepatitis B

91
Q

What is the treatment of minimal change disease causing nephrotic syndrome?

A

Prednisone (oral)

92
Q

What percentage of people with skin positivity to penicillin will also react to cephalosporins?

A

3%

93
Q

Which inherited progressive glomerular disease is associated with sensorineural hearing loss and ocular abnormalities?

A

Alport disease

94
Q

What is the etiology of Alport disease?

A

Mutation in gene encoding type IV collagen

95
Q

Which condition has deficient galactosylation of IgA1?

A

IgA nephropathy

96
Q

Which condition has inactivation of TSC1 and TSC2 genes?

A

Tuberous sclerosis

97
Q

What kind of disorder is Fabry disease?

A

Lysosomal storage disorder

98
Q

A defect in the gene encoding for alpha-galactosidase A on chromosome X is seen in which disease?

A

Fabry disease

99
Q

Which glomerulonephritis has normal light microscopy and podocyte effacement on electron microscopy?

A

Minimal change disease

100
Q

Which glomerulonephritis has crescentic necrotizing glomerulonephritis on light microscopy?

A

Rapidly progressive glomerulonephritis (RPGN)

101
Q

Which glomerulonephritis has enlarged and hypercellular glomeruli on light microscopy and electron-dense sub-endothelial deposits on electron microscopy?

A

Mesangial proliferative glomerulonephritis (MPGN)

102
Q

Which glomerulonephritis has solidification of glomerular tufts on light microscopy and diffuse podocyte fusion on electron microscopy?

A

Focal segmental glomerulonephritis (FSGN)

103
Q

In average risk men, what age should the discussion of pros and cons of prostate cancer screening commence?

A

50 years

104
Q

Should nitrofurantoin be used in advanced renal disease?

A

No

105
Q

Should a dose adjustment be made for trimethoprim-sulfamethoxazole in advanced renal disease?

A

Yes

106
Q

What is the cause of renal disease in multiple myeloma?

A
  • Light chain deposition disease in kidney
  • Hypercalcemia
107
Q

Phenylephrine can cause urinary retention.

True or false?

A

True

108
Q

Risk of cataracts and glaucoma are increased in patients on glucocorticoids and is dose-related.

True or false?

A

True

109
Q

Do staghorn calculi form in acidic or alkaline urine environments?

A

Alkaline

110
Q

Do you need to repeat investigations to monitor treatment of complicated UTIs in patients who do not need hospitalization?

A

No

111
Q

Which antihypertensive is appropriate for a patient with calcium oxalate stones?

A

Thiazide diuretics

112
Q

What is the mechanism of action of thiazide diuretics?

A

Inhibition of NA/Cl cotransporter in the distal convoluted tubule

113
Q

Significant renal impairment may be underestimated in the setting of low baseline creatinine.

True or false?

A

True

114
Q

What is the next step in case of benign hematuria from exercise?

A

Repeat UA in 48 hours after exercise has stopped.

115
Q

Is cyclosporine associated with higher rates of diabetes mellitus?

A

Yes

116
Q

Which amino acid plays an important role in the excretion of excess acid during metabolic acidosis?

A

Glutamine

117
Q

Which antiviral can cause crystal-induced nephropathy?

A

Acyclovir

118
Q

Are casts present in prerenal azotemia?

A

No

119
Q

What is required to maintain some kidney function in chronic kidney disease?

A

Prostaglandin synthesis

120
Q

Do anti-C1Q or anti-dsDNA antibodies correlate more closely with disease activity of lupus nephritis?

A

Anti-C1Q antibodies

121
Q

Ifosfamide can cause promixal tubular and glomerular injury.

True or false?

A

True

122
Q

Which glomerulonephritis is HIV associated with?

A

Focal segmental GN

ABIM IM Recert (42 decks)

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