nephrology

Question 1

do not correct hyponatremia faster than ______________

Answer 1

8mEq/L/day

Question 2

do not correct hypernatremia faster than _____________

Answer 2

10mEq/day

Question 3

location of type 2 RTA

Answer 3

Proximal tubule

Question 4

location of type 1 RTA

Answer 4

Distal tubule

Question 5

location of type 4 RTA

Answer 5

collecting duct

Question 6

defect type of type 2 RTA

Answer 6

impaired HCO3 reabsorption

Question 7

defect type of type 1 RTA

Answer 7

impaired H+ excretion

Question 8

defect type of type 4 RTA

Answer 8

lack of/ no response to aldosterone

Question 9

minimum urine pH of type 2 RTA

Answer 9

PH <5.5

Question 10

minimum urine pH of type 1 RTA

Answer 10

pH >5.5

Question 11

minimum urine pH of type 4 RTA

Answer 11

pH <5.5

Question 12

which RTA do you see stones

Answer 12

type 1 RTA

Question 13

RTA with high serum K+

Answer 13

type 4 RTA

Question 14

BUN/Cr ratio >20 indicates

Answer 14

prerenal AKI

Question 15

FeNa <1% or FEUrea<35%

Answer 15

prerenal AKI

Question 16

muddy brown granular cast

Answer 16

ATN

Question 17

white cell casts

Answer 17

AIN

Question 18

envelope-shaped crystal on UA

Answer 18

Ethylene glycol

Question 19

most common cause of CKD

Answer 19

DM

Question 20

Indication of hemodialysis

Answer 20

• A: Severe acidosis
• E: Electrolyte imbalances (severe hyperkalemia)
• I: Intoxicants (encephalopathy not otherwise explained, lithium)
• O: Overload (severe volume overload refractory to diuretics)
• U: Uremic symptoms (uremic pericarditis, pleuritis)

Question 21

URI symptoms + hematuria

Answer 21

• IgA nephropathy (Berger’s disease)

Question 22

• Hematuria + hemoptysis only

Answer 22

• Goodpasture’s syndrome

Question 23

Hematuria + deafness

Answer 23

• Alport syndrome (hereditary nephritis)

Question 24

children > adults; abdominal pain + purpura (w/o

thrombocytopenia or coagulopathy) + arthralgias + renal disease

Answer 24

HSP/IgA vasculitis:

Question 25

MAHA, thrombocytopenia, bloody diarrhea, acute renal injury→ renal failure; risks: age <5yrs. or > 75 yrs., shiga toxin-producing E. coli often implicated from raw meat, unpasteurized milk

Answer 25

HUS:

Question 26

MAHA, thrombocytopenia, altered mental status, abd. pain/N/V, renal involvement common but less severe presentation

Answer 26

TTP:

Question 27

lung involvement, sinus involvement, skin/purpura findings, neurologic dysfunction. ANCA+ glomerulonephritis

Answer 27

Granulomatosis with polyangiitis (formerly Wegeners):

Question 28

atopy/asthma, | eosinophilia, renal involvement →ANCA+ glomerulonephritis

Answer 28

Eosinophilic granulomatosis with polyangiitis (Churg Strauss):

Question 29

arthralgias, rashes/ulcers, HTN, abd. pain, renal insufficiency, neurologic dysfunction. • Lungs usually spared • Not associated with ANCA • Associated with Hep B and Hep C infection

Answer 29

Polyarteritis nodosa:

Question 30

Hyaline cast

Answer 30

Dehydration or normal