Nephrology

Question 1

Signs and symptoms of Nephrotic syndrome? (4)

Answer 1

PALE
1. >3.5g/ day proteinuria
2. Hypoalbuminemia
3. Hyperlipidemia
4. Edema

Question 2

Male adolescent with glomerulonephritis , hearing and visual impairment and abnormal deposition of collagen in the eyes and middle ear.

Answer 2

Alport Syndrome
“Can’t see, Can’t pee, Can’t hear a Bee”

Question 3

Average GFR of 47 year old man?

Answer 3

93ml/ min / 1.73 m2

Formula:
140- Age in yrs

Question 4

Movement of water from places with lower sodium concentration to higher sodium concentration?

Answer 4

Osmosis

Question 5

Chronic glomerulonephritis expected urinalysis findings ?

Answer 5

1. Hematuria with dysmorphic RBCs
2. RBC casts
3. Protein excretion >500mg /d

Question 6

Chronic glomerulonephritis expected serum findings ?

Answer 6

LDL cholesterol of 150mg/ dl

Question 7

Minimum size of kidney stone that can block the ureter ?

Answer 7

8mm ( ureteral diameter is 5mm-8mm)

Question 8

Most common cause of uncontrolled BP elevation in secondary hypertension?

Answer 8

Renovascular stenosis

Question 9

Drug associated with the development of renal cell carcinoma

Answer 9

1. Aspirin
2. Ibuprofen
3. Paracetamol

Question 10

Smoking increases risk of renal cancer by how much?

Answer 10

2 times the risk

Question 11

Although not always present , the classic pathologic term for intrinsic acute kidney injury is?

Answer 11

Acute tubular necrosis

Question 12

Most common etiology of AKI?
a. Prerenal
b. Renal
c. Postrenal

Answer 12

Prerenal

Question 13

Drugs that can lead to prerenal AKI?

Answer 13

1. NSAIDs
2. ACE Inh
3. ARBs

Question 14

Drugs that can lead to intrinsic AKI?

Answer 14

1. Contrast agents
2. Antibiotics ( Vancomycin, Aminoglycosides)
3. Chemotherapeutic agents ( Cisplatin, Carboplatin)

Question 15

Typical fractional excretion of Sodium ( FeNa) in prerenal AKI?

Answer 15

<1%

Question 16

Typical BUN / Creatinine ratio in prerenal AKI?

Answer 16

> 20%

Question 17

Presence of muddy brown granular casts and tubular epithelial cells in the urine is more suggestive of what form of AKI?

Answer 17

Intrinsic AKI (especially sepsis-associated and ischemic)

Question 18

Most common clinical course of contrast nephropathy?

Answer 18

1. Rises in SCr in 24-48 hrs
2. Peaks in 3-5 days
3. Resolves in 1 week

Question 19

Most common protein in urine?

Answer 19

Uromodulin or Tamm-Horsfall protein

Question 20

Most common cause of secondary hypertension?

Answer 20

Primary renal disease

Question 21

Electrolyte imbalance that lead to prolonged QT interval?

Answer 21

1. Hypocalcemia
2. Hypokalemia
3. Hypomagnesemia

Question 22

Rapid correction of hyponatremia may lead to?

Answer 22

Osmotic demyelination Syndrome (ODS) , previously known as Central Pontine Myelinosis (CPM)

Question 23

Most common cause of hyponatremia?

Answer 23

GI losses in Diarrhea

Question 24

Classic ECG finding in Hyperkalemia? (4)

Answer 24

1. Tall, peaked T waves (5.5-6.5)
2. Loss of P waves (6.5-7.5)
3. Widened QRS Complex (7-8)
4. Sine wave (>8)

Question 25

Leading cause of CKD

Answer 25

Diabetic Nephropathy

Question 26

Primary cause of anemia in CKD ?

Answer 26

Insufficient production of EPO

Question 27

Target hemoglobin concentration in CKD ?

Answer 27

100-115 g/L

Question 28

CKD stage if eGFR is 30

Answer 28

Stage III B

Question 29

GFR peaks at what value during the 3rd decade of life?

Answer 29

120ml/ min / 1.73 m2

Question 30

In a px with CKD , a GFR of less than what value would indicate ed-stage renal disease and necessitate renal replacement therapy?

Answer 30

<15ml/ min / 1.73 m2

Question 31

Stage of CKD where the normocytic normochromic anemia appears?

Answer 31

As early as Stage 3 CKD , Universal by Stage 4

Question 32

Normocytic and Normochromic anemia is universal in what stage of CKD?

Answer 32

Stage 4

Question 33

Stage of CKD where assessment for peotein -energy malnutrition should begin?

Answer 33

Stage 3

Question 34

Stage of CKD where peripheral neuropathy becomes clinically evident?

Answer 34

Stage 4

Question 35

On renal ultrasound, kidneys are bilaterally small in CKD except? (4)

Answer 35

1. Diabetic nephropathy 2. HIV 3. Infiltrative Disease 4. Polycystic Kidney Disease

Question 36

Preferred antihypertensive for hypertensive patients with concomitant CKD?

Answer 36

ACE Inhibitors or ARBs

Question 37

Leading cause of morbidity and mortality in patients at every stage of CKD?

Answer 37

Cardiovascular Disease