MKSAP-3

Question 1

When you are evaluating for gross hematuria, what age puts you at a high risk?

Answer 1

> 35 years

If younger send if you have risk factors for malignancy of the urinary tract i.e. smoker

Question 2

For gross hematuria, what is the choice of imaging?

Answer 2

Contrast enhanced CT urogram to look for stones, masses, cyst on the kidney

If CT is negative, NEXT
Would be cystoscopy to look for bladder pathology

Question 3

Do you need to investigat gross e hematuria in the setting that the patient has bleeding disorder or is receiving antiplatelet or anticoagulant therapy?

Answer 3

Yes

Question 4

Drug-induced cause of minimal-change disease

Malignancy cause

Answer 4

NSAID
Pamidronate
Interferons
Lithium

Malignancy Hodgkin’s lymphoma thymoma

Question 5

Nephritic or nephrotic:

Class I-IV lupus is more___wears class V typically presents with___

Answer 5

Nephritic

Proteinuria and nephrotic

Question 6

Nephrotic syndrome in African-Americans, think___

Answer 6

Focal segmental glomerulosclerosis

Question 7

And aspirin toxicity, is important to maintain the serum pH___in order to avoid this CNS complication___

Therefore treatment is with___medication and it works by doing this___

Answer 7

Maintain serum pH 7.5-7.55

Avoid Salicylate acid accumulation into the CNS which tends to be promoted when there is acidosis

IV bicarb, works by increasing urine elimination of salicylate with a goal of increasing urine pH

Question 8

Many patients with calciphylaxis have severe secondary___and elevated___electrolytes

Answer 8

Secondary hyperparathyroidism
Elevated calcium phosphorus product

Question 9

What medication is routinely used for calciphylaxis?

Answer 9

Sodium thiosulfate

Calcium emetics i.e. suppress parathyroid hormone, because normalized calcium and phosphate levels are also at risk

Question 10

what is resistant HTN

Answer 10

BP above goal despite THREE antiHTN meds

or

BP @ goal but required 4 or more BP meds (ONE OF THEM WAS A DIURIETIC)

Question 11

what BP is considered severe pre eclampsia

Answer 11

> 160
110

Question 12

when is urological intervention needed in patients with renal calculi?

Answer 12

Urologic intervention is required in all patients with evidence of infection, acute kidney injury, intractable pain, and stones that fail to pass
or stones >10mm

(typically >6mm 50% time will pass in 2wks)

Question 13

Treatment of tumor lysis syndrome ___

Answer 13

includes prompt initiation of isotonic volume expansion and rasburicase to rapidly reduce serum urate levels

(Rasburicase is a urate oxidase enzyme that metabolizes urate to allantoin, a significantly more water-soluble compound)

Question 14

pre eclampsia tx

Answer 14

mg
bp control with nifed, labetol
get baby out

Question 15

pre eclampsia severe form

Answer 15

hellp syndr

bp>160/110