Diseases in Nephrology (AKI and CKD)

Question 1

Associated with multiple myeloma

Answer 1

Renal amyloidosis

Question 2

MOST common form of AKI

Answer 2

Prerenal azotemia

Question 3

MOST common cause of CKD

Answer 3

DM

Question 4

Patchy necrosis, PCT and LH affected, relatively short length of tubules affected

Answer 4

Ischemic type ATN (e.g. in hypovolemia)

Question 5

Extensive necrosis, PCT and DT affected, relatively longer lengths of tubules affected

Answer 5

Toxic type ATN (e.g. in use of aminoglycosides, radio-contrast dyes)

Question 6

Acts as an essential mediator of increased intraglomerular capillary pressure by selectively increasing efferent arteriolar vasoconstriction relative to afferent arteriolar tone

Answer 6

Angiotensin II

Question 7

MAJOR pathway for reducing excess total body K+

Answer 7

Renal excretion

Question 8

THREE broad categories of AKI

Answer 8

Prerenal azotemia
Intrinsic renal disease
Postrenal obstruction

Question 9

MOST common clinical conditions associated with prerenal azotemia

Answer 9

Hypovolemia
Decreased cardiac output
Medications that interfere with renal autoregulatory responses such as NSAIDs and inhibitors of angiotensin II

Question 10

MOST common causes of intrinsic AKI

Answer 10

Sepsis
Ischemia
Nephrotoxins

Question 11

Usual clinical course of contrast induced nephropathy

Answer 11

A rise in SCr beginning 24-48 hours following exposure
Peaking within 3-5 days
Resolving within 1 week

Question 12

MOST common protein in urine and produced in the thick ascending limb of the loop of Henle

Answer 12

Uromodulin/Tamm-Horsfall Protein

Question 13

Large kidneys observed in patients with CKD suggest the following:

Answer 13

Diabetic nephropathy
HIV-associated nephropathy
Infiltrative diseases
Occasionally acute interstitial nephritis

Question 14

Provide DEFINITIVE diagnostic and prognostic information about AKIs and CKDs

Answer 14

Kidney biopsy

Question 15

Hallmark of AKI

Answer 15

Buildup of nitrogenous waste products, manifested as an elevated BUN concentration (azotemia)

Question 16

Definitive treatment of the hepatorenal syndrome

Answer 16

Liver transplantation

Question 17

Continuous Renal Replacement Therapy is often PREFERRED in patients with

Answer 17

Severe hemodynamic instability
Cerebral edema
Significant volume overload

Question 18

Chronic renal failure typically corresponds to:

Answer 18

CKD stages 3-5

Question 19

End-stage renal diseases refers to

Answer 19

Stage 5 CKD (

Question 20

Protein-creatining ratio

Answer 20

Signifies chronic renal damage - persistence in the urine of:
>17 mg of albuming/g creatinin in males
2517 mg of albuming/g creatinin in adult females

Question 21

Good SCREENING test for eraly detection of renal disease

Answer 21

Microalbuminuria (esp. in DM)

Question 22

Thiazide diuretics have limited ability in

Answer 22

Stages 3-5 CKD

Question 23

Alkali supplementation may be recommended to slow catabolism and CKD progression when

Answer 23

Serum bicarbonate concentration falls below 20-23 mmol/L

Question 24

Water restriction is indicated only if there is

Answer 24

Hyponatremia and volume overload

Question 25

OPTIMAL management of secondary hyperparathyroidism and osteitis fibrosa

Answer 25

Preventation

Question 26

Major side effect of calcium-based phosphate binders

Answer 26

Total-body calcium accumulation and hyper calcemia

Question 27

LEADING cause of morbidity and mortality in patients at every stage of CKD

Answer 27

Cardiovascular disease

Question 28

Major risk factor for ischemic cardiovascular disease

Answer 28

Presence of any stage of CKD

Question 29

One of the most common complications of CKD

Answer 29

Hypertension

Question 30

Among the strongest risk factors for cardiovascular morbidity and mortality in CKD

Answer 30

Left ventricular hypertrophy and dilated cardiomyopathy

Question 31

ABSENCE of hypertension may signify the presence of

Answer 31

Self-wasting form of renal disease Effect of antihypertensive therapy Volume depletion May signify poor left ventricular function

Question 32

CKD pateints with DM or proteinuria >1g per 24 h blood pressure should be reduced to

Answer 32

125/75 mmHg (salt restriction should be the first line of therapy

Question 33

Normocytic, normochromic anemia is

Answer 33

Observed as early as stage 3 CKD | Almost universal by stage 4

Question 34

PRIMARY cause of anemia

Answer 34

Insufficient production of erythropoietin by the diseases kidneys

Question 35

ESSENTIAL to ensure an optimal response to EPO in patients with CKD

Answer 35

Iron supplementation

Question 36

Target Hgb concentration in CKD

Answer 36

100-115 g/L

Question 37

Peripheral neuropathy usually becomes clinically evident after the patient reaches

Answer 37

Stage 4 CKD

Question 38

Common in advanced CKD and is often an indication for initiation of dialysis

Answer 38

Protein energy malnutrition (a consequence of low caloric and protein intake)

Question 39

Assessment for protein-energy malnutrition should begin at

Answer 39

Stage 3 CKD

Question 40

Metformin is contraindicated when the

Answer 40

GFR is less than half of normal

Question 41

FIRST line of management of pruritus in CKD

Answer 41

Rule out unrelated skin disorders, such as scabies and treatment of hyperphosphatemia

Question 42

Indication for therapy with ACE inhibitors or ARBs

Answer 42

Protein excretion >300 mg (especially in DM nephropathy)

Question 43

MOST important initial diagnostic step in the evaluation of a patient presented with elevated serum creatinine is

Answer 43

To distinguish newly diagnosed CKD from acute or subacute renal failure

Question 44

Renal failure in glomerulonephritis BEST correlates histologically with

Answer 44

Appearance of tubulointestinal nephritis rather than with with the type of inciting glomerular injury