Renal

Question 1

Side effects of beta agonists?

Answer 1

• Hypokalemia
• tachycardia

Question 2

What cation should you check if your K is low?

Answer 2

Mag

Question 3

Does RTA cause hyper or hypokalemia?

Answer 3

Hypokalemia

Question 4

High risk patient for hematuria

Answer 4

> 60 y/o, >30 pack year smoking hx, >25 RBCs or gross hematuria

Question 5

What is the management of hematuria in high risk patient?

Answer 5

Cystoscopy and CT urography or MR urography (if contraindication to CT)

Question 6

Who are low risk hematuria patients?

Answer 6

Women<50, men<40 who have never smoked and UA with <3 erythrocytes

Question 7

Who should undergo imaging work for hematuria?

Answer 7

Anyone with gross hematuria >35 OR of any age who have risk factors for Lower UTI

Question 8

BP goal for pts with common abilities (DM, ASCVD, CKD, CHF)

Answer 8

<130/80

Question 9

What are causes of isotonic hyponatremia (Serum Osm 275 to 295)

Answer 9

Hypertriglyceridemia and multiple myeloma

Question 10

Most common cause of SIADH?

Answer 10

Medication’s (thiazides, Haldol, TCAS, theroid, cyclophosphamide, SSRI)

Question 11

What is the MOA of Tolvaptan

Answer 11

ADH antagonist

Same as Demeclocycline

Question 12

Nephrogenic diabetes, insipidus is commonly caused by which psychiatric medication?

Answer 12

Lithium

Question 13

Pathophysio of Central DI

Answer 13

Can’t make enough ADH. Can’t keep that water in…so dilute urine

Question 14

Pathophysio of nephrogenic DI

Answer 14

Resistant to effects of ADH

Question 15

Is mild hyponatremia, a normal physical change of pregnancy?

Answer 15

Yes ( you see a 4 to 5 point decrease and no tx is needed

Question 16

What is stage one hypertension?

Answer 16

SBP 130-139
DBP 80-89

Question 17

What is tx for stage one hypertension?

Answer 17

-non-pharmalogic therapy if 10 yr ascvd risk <10

• NPT + first line drugs if clinical CV disease or 10 yr ascvd risk greater or equal to 10%

Question 18

How do you define stage two hypertension?

Answer 18

BP greater than equal to 140/90

Question 19

How do you treat stage two hypertension?

Answer 19

Start 2 first line drugs of different classes

Question 20

How do you treat salicylate toxicity?

Answer 20

IV Sodium bicarbonate

Question 21

Which common rheumatology drug is Not safe in pregnancy?

Answer 21

Mycophenolate mofetil

(Hydroxychloroquine is safe… It makes pregnant women HAPPY)

Question 22

What is first line therapy for nephrotic range FSGS

Answer 22

High dose glucocorticoids

Question 24

What are the two types of polyuria that lead to hypernatremia?

Answer 24

Water diuresis (dilute urine)

Or

Solute diaries’s (U Osms 300-600)

Question 25

How do you distinguish electrolyte versus solute Diuresis?

Answer 25

Look at the total electrolyte in the urine. 2x UNa + UK. If the total electrolyte in the urine is less than 50% of the urine osmolality, solute Diuresis

Question 27

What type of cast do you see in acute interstitial nephritis?

Answer 27

Leukocyte casts

Question 29

How does an atrial myxoma present?

Answer 29

LA mass on interseptal wall. Common in middle-aged people, more female. Can cause embolic symptoms, fevers, chills, anorexia, and night sweats.

Question 30

Presentation of BPPV

Answer 30

10 to 30 seconds episode of brief vertigo and nausea with head turns (such as turning in bed)

Question 31

What causes vertigo, lasting for days, nausea and often vomiting?

Answer 31

Vestibular neuronitis

Question 32

How does labyrinthitis present?

Answer 32

Same as vestibular neuritis but also with hearing loss

Question 33

Which test helps diagnose BPPV?

Answer 33

Dix hallpike. Unidirectional nystagmus

Question 34

Meniere disease

Answer 34

Vertigo, hearing loss and tinnitus

Question 35

Hearing loss, vertigo and a painful face rash

Answer 35

Ramsay hunt

Question 36

BPPV tx

Answer 36

- repositioning with Epley maneuver

Question 37

Tx for Ménière’s disease

Answer 37

Vestibular rehab and or diuretics

Question 38

What time frame should you consider antiviral therapy for influenza?

Answer 38

If sxs started no longer than 48 hours ago and if someone is high risk. Don’t need routine testing except in high risk patients. Get a PCR

Question 39

Is the MMR vaccine live??

Answer 39

Yes. So is the intranasal influenza and varicella vaccine?

Question 41

Tx of severe MR?

Answer 41

Surgery is preferred

Question 42

Antihistone antibody

Answer 42

Drug induced lupus

Question 43

Anticentromere antibody

Answer 43

Systemic sclerosis

Question 44

cANCA and MPO

Answer 44

GPA

Question 45

Patients with sjogrens are at higher risk for what?

Answer 45

Lymphoma (especially if there is gland enlargement, low C4, monoclonal, gammopathy, and cryoglobulinemic vasculitis

Question 46

Clinical presentation and treatment of Familia Mediterranean fever?

Answer 46

Presents with fever, abdominal pain, rash, and arthritis. Treat with colchicine for prophylaxis

Question 47

Ankylosing spondylitis is associated with which G.I. disease?

Answer 47

Inflammatory bowel disease