Renal

Question 1

Causes of sterile pyuria

Answer 1

Viruses, tuberculosis, nephritic syndrome and kawasaki disease

Question 2

Causes of ketonuria/ketonemia

Answer 2

Diabetic Ketoacidosis
Euglycemic ketoacidosis(SGLT2)
Starvation ketosis
Keto diet(low carb)
IEMs(rare)

Question 3

The gaps caused by ethylene glycol

Answer 3

1. HAGMA
2. High serum osmolarity gap
3. Lactate gap

Question 4

Key investigation in NAGMA

Answer 4

ABG and urine pH tro RTA

Question 5

Key investigation in HAGMA

Answer 5

Albumin?

Question 6

Causes of mixed HAGMA and NAGMA

Answer 6

Pancreatitis?

Question 7

Most common cause of hyponatremia

Answer 7

Thiazide diuretics

Question 8

Serum osmolarity is a surrogate for?

Answer 8

ADH levels

Question 9

Criteria for SIADH

Answer 9

Decreased serum osmo
Clinical euvolemic
Urine osm >100
Urine Na >40
Normal thyroid and adrenal fn
Normal renal fn
No diuretic use
No acid base or potassium abnormality

Question 10

Causes of pseudohyponatremia

Answer 10

High lipids
Myeloma
IVIG

Question 11

What to check in hypernatremia

Answer 11

Water deficit

Question 12

ABCDE of CKD Cx

Answer 12

Anemia
Blood pressure:HTN
Calcium and BMD
Decompensation : Uremia
Electrolytes and Acid

Question 13

Triad of acute interstitial Nephritis

Answer 13

Fever, rash, serum eosinophilia

Question 14

Triad of acute interstitial Nephritis

Answer 14

Fever, rash, serum eosinophilia

Question 15

3 forms of Renal Replacement Therapy

Answer 15

1. Peritoneal dialysis
2. Hemodialysis
3. Renal transplant
4. Renal supportive care(palliative)

Question 16

Most common cause of Hemolytic Uremic Syndrome

Answer 16

Shiga toxin of EHEC

Question 17

Triad of HUS

Answer 17

MAHA, thrombocytopenia and AKI

Question 18

Stain for amyloidosis(monoclonal gammopathy)

Answer 18

Congo red

Question 19

Common Cx of Peritoneal Dialysis

Answer 19

Hypokalemia due to lack of K in PD UF

Question 20

Type A vs Type B lactic acidosis

Answer 20

A is in the presence of hypoxia and hypoperfusion eg sepsis

B is in absence of hypoxia eg liver disease and reduced clearance of lactate

Question 21

Calculation of serum osmolarity

Answer 21

(Na x2 ) + glucose + urea(for non hyperglycemic emergencies)

Question 22

Triad of PD peritonitis

Answer 22

1) Abdo pain/ cloudy effluent
2) PD effluent cell count NC >100 (>50% neutrophilia/left shift)
3) Positive effluent culture

Question 23

Mx of PD peritonitis

Answer 23

Intraperitoneal Cefazolin + Gentamicin
IP vancomycin + gentamicin if MRSA pt
IV abx if bactermic/septic

Question 25

Adrenal medulla produces

Answer 25

Catecholamines

Question 26

Adrenal Zona Glomerulosa produces

Answer 26

Aldosterone(mineralocorticoid)

Question 27

Adrenal Zona fasciculata produces

Answer 27

Cortisol ?

Question 28

Adrenal Zona Reticularis produces

Answer 28

Androgens

Question 29

Endocrine causes of Secondary HTN and hypoK

Answer 29

Primary hyperaldosteronism Cushings syndrome Pheochromocytoma Hyperthyroidism

Question 30

Test for primary hyperaldosteronism

Answer 30

Salt loading test showing unsuppressible aldosterone

Question 31

Screening test for pheochromocytoma

Answer 31

Urinary metanephrines(produced in adrenals unlike catecholamines)

Question 32

Treatment of HypoNa, HyperK and Metabolic acidosis in stable pt

Answer 32

Sodium bicarbonate IV furosemide if hypertensive emergency

Question 33

Types of Glomerulonephritis that cause low C3 levels

Answer 33

Lupus Nephritis and post infectious GN

Question 34

Causes of hypokalemia, alkalosis and hypertension

Answer 34

1) Conn syndrome 2) Cushing syndrome 3) Liddle syndrome(renal tubulopathy)

Question 35

Specific Mx of intermittent claudication

Answer 35

1. Exercise therapy 2. Pharm -antiplatelet -antiHTN -prostaglandin

Question 36

Investigation that will detect minimal change disease

Answer 36

Electron microscopy

Question 37

Cause of hypokalemia with metabolic acidosis

Answer 37

Renal Tubular acidosis

Question 38

Labs to confirm Conn's syndrome

Answer 38

Renal panel - hypokalemia ABG - metabolic alkalosis Aldosterone/renin ratio: high Adrenal vein sampling Salt loading test Urine: ?

Question 39

Labs to conform pheochromocytoma

Answer 39

Urine metanephrines Serum metanephrines(paired) -patient has to avoid catecholamine containing foods

Question 41

Target Hb for patients with hemoglobin

Answer 41

13

Question 42

Hall mark for kidney biopsy in SLE

Answer 42

Full house staining pattern with diffuse granular immune complex deposition

Question 43

Most common type of lupus nephritis

Answer 43

Class 4