Nephrology

Question 1

Contrast-associated nephropathy prophylaxis for patients who have an estimated GFR < 30 or AKI

Answer 1

IV NS pre- and post-procedure

Question 2

Initial step in the management of newly diagnosed membranous nephropathy

Answer 2

Evaluation for secondary forms of the disease, including cancer screening in patient’s > 65 years of age

Question 3

Most appropriate treatment for myeloma cast nephropathy aimed at reducing the concentration of free light chains

Answer 3

Chemotherapy

Question 4

Indications for kidney biopsy

Answer 4

1) glomerular hematuria
2) severely increase albuminuria
3) acute or chronic kidney disease
4) Kidney transplant dysfunction or monitoring

Question 5

Initial therapy for severe preeclampsia

Answer 5

Magnesium, antihypertensive medication, immediate delivery of the fetus

Question 6

Management for kidney stone > 10 mm

Answer 6

Removal, ie via lithotripsy

Question 7

Indication for management of chronic hypertension in pregnant women

Answer 7

Persistent systolic > 160 mmHg or diastolic > 110 mmHg blood pressure in the absence of end-organ damage to avoid over treatment of hypertension and associated fetal risk

Question 8

Management for symptomatic hypermagnesemia

Answer 8

Immediate treatment with IV calcium gluconate while awaiting HD

Question 9

NAGMA + negative urine anion gap

Answer 9

GI loss (diarrhea)

Question 10

Primary therapeutic intervention in most patients with renal artery stenosis

Answer 10

Medical management, including correction of modifiable cardiovascular risk factors

Question 11

Initial management of hyperphosphatemia in CKD

Answer 11

Low phosphate diet

Question 12

NAGMA, hypokalemia, glycosuria (without hyperglycemia), low-molecular-weight proteinuria, and renal phosphate wasting.

Answer 12

Type 2 (proximal) RTA

Question 13

Most common form of nephrotic syndrome in black patients

Answer 13

Focal segmental glomerulosclerosis

likely mediated in large part by variants in the APOL1 gene

Question 14

Bacteria associated with struvite crystals (coffin-lid appearance)

Answer 14

Urea-splitting organisms (Proteus, Klebsiella, Pseudomonas

Question 15

Most appropriate management for lithium -induced nephrogenic DI

Answer 15

Amiloride

Blocks the epithelial sodium channel in the collecting tubule and prevents the uptake of lithium by these cells

Question 16

Appropriate management for recurrent gross hematuria and URI in younger patients with IgA nephropathy in the absence of proteinuria

Answer 16

Clinical observation

Question 17

Appropriate management for salicylate toxicity in an otherwise well-appearing patient

Answer 17

IV sodium bicarbonate

Question 18

Definitive diagnostic test for lupus nephritis

Answer 18

Kidney biopsy

Question 19

Calcifications in the dermal arterioles resulting in painful ischemic skin lesions and has an increasingly recognized complication of ESRD. Many patients have severe secondary hyperparathyroidism and elevated calcium-phosphorus product

Answer 19

Calciphylaxis (calcific uremic arteriolopathy)

Question 20

Preferred initial agent for hypertension in black patients

Answer 20

Calcium channel blocker or thiazide diuretic

Question 21

Appropriate management for adults with stage 1 hypertension (SBP 130-139 or DBP 80-89) who have an estimated 10-year ASCVD event risk of < 10%

Answer 21

Non-pharmacological therapy

Question 22

Appropriate management for adults with stage 1 hypertension (SBP 130-139 or DBP 80-89) who have an estimated 10-year ASCVD event risk of > 10%

Answer 22

Nonpharmacological and antihypertensive drug therapy

Question 23

Most effective treatment to facilitate the passage of uric acid stones

Answer 23

Urinary alkalinization with potassium citrate

Question 24

Necrotizing and crescenteric glomerular nephritis with linear staining for IgG on immunoflorescence

Answer 24

Anti-glomerular basement membrane antibody disease

Question 25

Chronic interstitial nephritis with fibrosis and dense lymphoplasmacytic infiltrates

Answer 25

IgG4-related kidney disease

Question 26

Most appropriate management for acute tumor lysis syndrome

Answer 26

Isotonic fluids and rasburicase

Question 27

Gold standard for diagnosis of kidney stones

Answer 27

Noncontrast helical CT of the abdomen and pelvis

Question 28

Serum bicarbonate level in which metabolic acidosis should be treated with alkaline therapy in patients with CKD

Answer 28

< 22 mEq/L

Question 29

Autosomal dominant type IV collagen abnormality that causes thinning of the GBM, resulting IN hematuria but usually without proteinuria or abnormal kidney function. Diagnosis can be made by kidney biopsy, although this is not usually required and the setting of a good clinical in family history

Answer 29

Thin glomerular basement membrane disease, a.k.a. benign familial hematuria

Question 30

Serological testing which diagnosis primary membranous nephropathy

Answer 30

Anti-phospholipase A2 receptor (Anti-PLA2R)

Question 31

Leading cause of death among patients with CKD

Answer 31

Cardiovascular disease

Question 32

Electrolyte abnormality associated with ferric carboxymaltose, IV iron preparation

Answer 32

Hypophosphatemia caused by renal phosphate wasting

Question 33

Appropriate management for primary hyperaldosteronism

Answer 33

Aldosterone receptor antagonist, such as eplerenone

Question 34

Hepatitis virus associated with cryoglobulinemic glomerulonephritis

Answer 34

Hepatitis C virus

Question 35

hypokalemic metabolic alkalosis and frequently hypomagnesemia and high-normal serum calcium levels

Answer 35

Gitelman syndrome

Question 36

Most common etiology of immune complex MPGN

Answer 36

Hepatitis C virus infection

Question 37

Management for infection-related glomerulonephritis

Answer 37

Supportive and aimed at the infectious etiology

Question 38

Gold standard for pathologic diagnosis of amyloidosis

Answer 38

apple-green birefringence with congo red stain

Question 39

Pharmaceutical management that can slow kidney function decline in adults at risk for progressive autosomal dominant polycystic kidney disease

Answer 39

Tolvaptan, blockade of the renin-aldosterone system

Question 40

Resistant hypertension, metabolic alkalosis, hypokalemia

Answer 40

Primary hyperaldosteronism

Question 41

Etiology of hypokalemia with PPI use

Answer 41

Hypomagnesemia