RENAL DISORDER

Question 1

Which of the following is a feature of proximal RTA?

A. Acidic urine
B. Alkaline urine
C. Inability to secrete H+
D. Nephrocalcinosis

Answer 1

A. Acidic urine

Question 2

A 15-year old male was diagnosed of Ewing sarcoma. He underwent chemotherapy with Ifosfamide. He came in today for his 3rd cycle of chemotherapy but he complained of sudden onset of weakness of both lower extremities. You requested for a stat serum K, which was low at 2.3 mmol/L. You are considering Fanconi syndrome. Which of the following is NOT part of the syndrome?

A. Acidic urine
B. Distal RTA
C. Low-molecular weight proteinuria
D. Phosphaturia, aminoaciduria, glycosuria, uricosuria, and elevated urinary sodium or potassium

Answer 2

B. Distal RTA

Fanconi syndrome:
Proximal RTA

nelson: characterized by low-molecular-weight proteinuria, glycosuria, phosphaturia, aminoaciduria, and proximal RTA

Question 3

This particular diagnostic tool is commonly used in Hemolytic Uremic Syndrome

A. Renal Ultrasound
B. Kidney Biopsy
C. Clinical Criteria
D. Stool exam

Answer 3

C. Clinical Criteria

nelson:
Kidney biopsies are only rarely performed in HUS because the diagnosis is usually established by clinical criteriaand the risks of biopsy
are significant during the active phase of the disease.

Question 4

Which of the following scenarios point to acute kidney injury as defined by KDIGO?

A. An intubated adolescent for PCAP D who was anuric for 10 hrs already
B. A 3-year old child admitted for AGE with severe
dehydration who’s repeat serum creatinine was 1.5mg/dl (baseline serum creatinine 1mg/dl).
C. A 5-year old child admitted for dengue severe who’s urine output is 0.3mg/kg/hr in 3 hours.
D. A 10-year old child admitted for sepsis with an increase in serum creatinine of 0.2mg/dl

Answer 4

B. A 3-year old child admitted for AGE with severe
dehydration who’s repeat serum creatinine was 1.5mg/dl (baseline serum creatinine 1mg/dl).

Question 5

SG, 10 year old/F came in due to dysuria and suprapubic pain. The following is/are true of SG’s condition:

A. Results in renal injury
B. Always present with fever
C. Caused by ascending infection
D. Some children will present with occasional diarrhea

Answer 5

C. Caused by ascending infection

Question 6

Water and electrolytes are freely filtered at the level of the glomerulus. Which part of the tubule is the site of
most sodium reabsorption?

a. Distal tubule
b. Loop of Henle
c. Collecting duct
d. Proximal tubule

Answer 6

d. Proximal tubule

Question 7

A 7-year old child came in due to fever, rash, and arthralgia. He had a history of PCAP 2 weeks ago wherein he was given Amoxicillin with good compliance. One day PTC, mother noted fever hence self-medicated again with Amoxicillin. This morning, he developed a maculopapular rash and joint pains. You suspect acute interstitial nephritis. What is the most appropriate treatment?

a. Perform immediate dialysis
b. Eliminate the suspected causative agent.
c. Perform renal biopsy to confirm diagnosis
d. Administer corticosteroids to prevent the progression acute kidney injury.

Answer 7

b. Eliminate the suspected causative agent.

Question 8

The following diseases commonly presents with hematuria:

a. Goodpasture’s syndrome
b. Minimal Change Disease
c. Post Streptococcal Glomerulonephritis
d. Rapidly Progressive Glomerukonephritis

Answer 8

c. Post Streptococcal Glomerulonephritis

Question 9

This particular renal disease is commonly associated with hypoxic or ischemic insults to neonates .

A. Cortical necrosis
B. Renal vein thrombosis
C. Toxic Acute Kidney Injury
D. Thin Basement Membrane
Disease

Answer 9

A. Cortical necrosis

Question 10

An 8-year old boy came in at the ER with a chief complaint of gross hematuria. This was noted 2 days after he had URTI. Pertinent physical examination revealed stage 1 hypertension and periorbital and bipedal edema. The rest of the PE was unremarkable. You are considering IgA nephropathy. Which is a feature of the disease?

a. Low serum C3
b. Elevated serum IgA
c. Nephrotic-range proteinuria
d. Rapid progression is common

Answer 10

c. Nephrotic-range proteinuria

serum C3-normal
serum IgA-not helpful; elevated only in 15% of patients
rapid progression-rare

Question 11

A 12-year oldchild was referred to you due to recurrent episodes of hematuria.Which of the following is NOT part of your differential diagnosis?

a. PSGN
b. IgA Nephropathy
c. Alport syndrome
d. Thin basement membrane
disease

Answer 11

a. PSGN

Question 12

Which of the following is TRUE of UTI?

a. Imaging is needed to make the clinical diagnosis of UTI or pyelonephritis.
b. If the culture shows > 50,000 colony-forming units/mL of a single pathogen(suprapubic or catheter sample) and the urinalysis has pyuria or bacteriuria in asymptomatic child, the child is considered to have a UTI.
c. It is recommended to start antibiotic prophylaxis in children with a first episode ofpyelonephritis.
d. All of the above are correct.

Answer 12

b. If the culture shows > 50,000 colony-forming units/mL of a single pathogen(suprapubic or catheter sample) and the urinalysis has pyuria or bacteriuria in asymptomatic child, the child is considered to have a UTI.

Question 13

Which of the following associations is INCORRECT?

a. Atrial natriuretic factor: sodium excretion
b. Angiotensin II: increase sodium reabsorption
c. Aldosterone: increase potassium reabsorption
d. Norepinephrine: decrease filtered sodium load

Answer 13

c. Aldosterone: increase potassium reabsorption

Question 14

5-year old child was brought to the ER due to sudden onset of pallor, weaknessand anuria. She was treated for AGE with some dehydration 5 days prior.Laboratory findings include elevataed serum BUN and creatinine, anemia andthrombocytopenia. Which of the following is part of its management?

a. Platelet transfusion
b. Start Metronidazole IV
c. Monitoring of potential complications
d. All of the above.

Answer 14

c. Monitoring of potential complications

Question 15

The following are TRUE regarding toxic nephropathy EXCEPT

a. Treatment is supportive.
b. Pharmacologic agents are the most common cause.
c. Contrast agents cause direct tubule cell injury and renal vasoconstriction.
d. Diminished urine output is the hallmark of contrast-induced nephropathy.

Answer 15

d. Diminished urine output is the hallmark of contrast-induced nephropathy.

Question 16

A 17-year old male was seen at the ER due to elevated creatinine and hypertension. He had recurrent episodes of gross hematuria but otherwise asymptomatic. He also complained of new onset visual and hearing problems. His father and uncles on the paternal side are on hemodialysis of unknown cause.
Which of the following is TRUE of the disease?

A. Gross hematuria is the most prominent feature of the
disease.
B. The risk of progression is highest in patients with X-linked inheritance.
C. The most common cause is mutation in the genes coding for COL4A3 and COL4A4.
D. The presence of hematuria, anterior lenticonus, sensorineural deafness is enough to make the diagnosis.

Answer 16

D. The presence of hematuria, anterior lenticonus, sensorineural deafness is enough to make the diagnosis.

Question 17

An 8-year old boy was brought to the ER due to edema. He presented with tea-colored urine 4 days ago and periorbital and bipedal edema 1 day PTC. No consult was done. No medication was given. There was no history of fever, LBM, vomiting, rashes, sore throat, cough. Pertinent physical findings include hypertension, periorbital and bipedal edema, clear breath sounds, with multiple healed skin lesions on his lower extremities. Which is NOT an expected course of the disease?

A. Persistently low serum C3
B. Acute phase will resolve in 6-8 weeks.
C. Persistent microscopic hematuria can persist for 1-2
years
D. Urinary protein excretion and hypertension normalize by 4-6 weeks.

Answer 17

A. Persistently low serum C3

Question 18

The gold standard in measuring kidney function is

A. Iohexol
B. Cystatin C
C. Serum creatinine
D. Inulin clearance

Answer 18

D. Inulin clearance

Question 19

What is the estimated GFR in a 10-year old child with a height of 130cm and serum creatinine of 2mg/dl?

A. 26 ml/min/1.73m2
B. 28 ml/min/1.73m2
C. 30 ml/min/1.73m2
D. 31 ml/min/1.73m2

Answer 19

B. 28 ml/min/1.73m2

Question 20

For extraglomerular hematuria, the 1st step in evaluating your patient would be:

A. do renal ultrasound
B. request for urine culture
C. do urinalysis of siblings, parents
D. request for serum protein and creatinine

Answer 20

B. request for urine culture

Question 21

Membranous nephropathy is one of the most common causes of nephrotic syndrome in adults. Which of the following is the most common cause?

a. SLE nephritis
b. Chronic hepatitis B
c. Congenital syphilis
d. All of the above

Answer 21

d. All of the above

Question 22

True of Membranoproliferative Disease EXCEPT:

a. poor prognosis
b. low C3 levels
c. male and female predilection
d. local features provide the type
of MPGN

Answer 22

d. local features provide the type

Question 23

The most common cause of hematuria in children is:

a. UTI
b. PSGN
c. IgA Nephropathy
d. Nephrolithiasis

Answer 23

a. UTI

Question 24

Anti-GBM nephritis is characteristic of this renal disease:

a. RPGN
b. HSP Nephritis
c. Alport syndrome
d. SLE Nephritis

Answer 24

c. Alport syndrome

Question 25

Goodpasture's Disease involves the following triad **EXCEPT**: a. Pulmonary hemorrhage b. Rapidly progressive GN c. Elevated Anti-GBM Ag titers d. Linear disposition of Immunoglobulin G

Answer 25

c. Elevated Anti-GBM **Ag** titers

Question 26

Abnormally split and laminated glomerular basement membrane is characteristic of this renal disease: A. Alport syndrome B. Membranous nephropathy C. Goodpasture's syndrome D. Thin basement membrane disease

Answer 26

A. Alport syndrome

Question 27

This triad of signs and symptoms is the classic presentation of Acute Tubulointerstitial Nephritis. A. Fever,rash,arthritis B. Fever,rash,arthralgia C. Fever, rash, low serum creatinine D. Fever, blisters, high serum creatinine

Answer 27

B. Fever,rash,**arthralgia**

Question 28

A 5-year old boy came in to you due to hematuria. The mother described it as **tea-colored**. Urinalysis revealed hematuria with d**eformed RBCs**. What is the most likely involved part of the urinary tract? A. Glomerulus B. Proximal tubule C. Distal tubule D. Urinarybladder

Answer 28

A. Glomerulus

Question 29

In SLE nephritis, which of the following findings require an aggressive treatment? Fibrous Wire-loop lesion Glomerulosclerosis All of the above

Answer 29

All of the above

Question 30

This disease is characterized by predominance of IgA immunoglobulin withmesangial glomerular deposits in the absence of systemic disease. Hereditary Nephritis Alport syndrome Berger’s Nephropathy Thin Basement membrane Disease

Answer 30

Berger’s Nephropathy

Question 31

The glomerular capillary wall is composed of 3 important layers. The predominant cell/layer involved in most glomerular diseases characterized by heavy proteinuria is the a. Podocyte b. Endothelial cell c. Glomerular membrane d. All of the above

Answer 31

a. Podocyte

Question 32

A 10-year old child came in at the OPD due to generalized edema and frothy urine. THere was no hematuria, hypertension and history of streptococcal infection. You suspect nephrotic syndrome. Which of the following is a finding that will NOT support your diagnosis? a. Proteinuria +1 b. Serum albumin of 2g/L c. Cholesterol of 250mg/dl d. Urine protein 550mg/dl, urine creatinine 150mg/dl

Answer 32

a. Proteinuria +1

Question 33

Tubular transport capabilities of neonates and young infants are less than those of adults. Which of the following is NOT a characteristic of young infants? a. Reduced tubular immaturity b. Reduced glomerular filtration rate c. Decreased concentrating gradient d. Increased responsiveness to antidiuretic hormone

Answer 33

d. Increased responsiveness to antidiuretic hormone

Question 34

Which of the following is TRUE of RPGN? a. Cellular crescents is a late finding b. The crescents involved the visceral epithelial cells d. None of the above is correct c. The hallmark of the disease is the histopathologic finding of epithelial crescents involving more than 50% of the glomerul d. None of the above is correct

Answer 34

c. The hallmark of the disease is the histopathologic finding of epithelial crescents involving more than 50% of the glomerul

Question 35

Which of the following is a cause of pre-renal AKI? a. Neurogenic bladder b. Acute tubular necrosis c. Tumor lysis syndrome d. AGE with moderate dehydration

Answer 35

d. AGE with moderate dehydration

Question 36

Tubulointerstitial Nephritis is characterized by the ff involvement of one of the structures EXCEPT: a. Glomerulus b. Distal tubules c. Proximal tubules d. Loop of Henle e. Urinary Bladder

Answer 36

a. Glomerulus sparing of glomerulus and vessels

Question 37

Case 3 A 16yo/F came in at the Emergency Room due to seizure. Further history taking revealed a history of fever associated with rashes and joint pains. Her chest xray revealed pleural effusion. She was previously admitted in Cebu due to same condition but went home against medical advice. Prior her discharge, a kidney biopsy was done which revealed 75% of the glomeruli involved with active sediments. She is hypertensive and urinalysis releaved 4+ proteinuria. What is her WHO classification? a. Minimal Mesangial LN b. Focal Proliferative LN c. Diffuse Proliferative LN d. Mesangial Proliferative LN

Answer 37

c. Diffuse Proliferative LN

Question 38

True of her treatment? a. Immunosuppressive therapy b. Goal to normalize C3 and C4 c. Goal to normalize renal function and proteinuria d. all of the above

Answer 38

d. all of the above

Question 39

End Stage Renal Disease is a state in which a patient’s renal dysfunction has progressed to the point at which homeostasis and survival can no longer be sustained by medical management. a. TRUE b. FALSE

Answer 39

a. TRUE

Question 40

In acute poststreptococcal glomerulonephritis, ASO titer is elevated after pharyngeal infection and rarely after a cutaneous one. a. TRUE b. FALSE

Answer 40

a. TRUE

Question 41

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Terminal hematuria

Answer 41

B- Lower urinary tract source of hematuria

Question 42

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Deformed RBCs -

Answer 42

A- Upper urinary tract source of hematuria

Question 43

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Cola-colored urine

Answer 43

A- Upper urinary tract source of hematuria

Question 44

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Bright red/pink urine

Answer 44

B- Lower urinary tract source of hematuria

Question 45

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Proteinuria < 100 mg/dL via dipstick - B

Answer 45

B- Lower urinary tract source of hematuria

Question 46

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Presence of renal tubular casts

Answer 46

A- Upper urinary tract source of hematuria

Question 47

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Originates from the nephron

Answer 47

A- Upper urinary tract source of hematuria

Question 48

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Originate from the pelvocaliceal system, ureter, bladder, or urethra

Answer 48

B- Lower urinary tract source of hematuria

Question 49

MATCHING TYPE: A- Upper urinary tract source of hematuria B- Lower urinary tract source of hematuria C- Both Originate from the glomerulus, tubular system or interstitium

Answer 49

A- Upper urinary tract source of hematuria

Question 50

A 5-year-old/F came in due to red urine. Hematuria is defined as: a) Persistence of presence of more than 5 red blood cells/low power field in an uncentrifuged urine b) Persistence of presence of more than 5 red blood cells/low power field in a centrifuged urine c) Persistence of presence of more than 5 red blood cell/high power field in an uncentrifuged urine d) Persistence of presence of more than 5 red blood cells/high power field in a centrifuged urine

Answer 50

c) Persistence of presence of more than 5 red blood cell/high power field in an uncentrifuged urine

Question 51

The following are multi-systemic diseases that can cause hematuria in children EXCEPT: a) Berger Disease b) Henoch Schonlein Purpura c) SLE Nephritis d) Hemolytic Uremic Syndrome e) none of the above

Answer 51

a) Berger Disease *isolated renal disease*

Question 52

TM, 7yo/F was brought to the emergency room due to seizures. Mother claimed that she has been complaining of decreased frequency of urination with red urine 3 days ago, headache, and blurring of vision a day prior to admission. On admission, the following are the laboratory examination you may request: a) CBC with platelet count b) Urinalysis c.) C3 d) ASO titer e) All except A f) All of the above

Answer 52

f) All of the above

Question 53

The following are the expected results of TM’s work-up EXCEPT: a) CBC with platelet count – Anemia b) ASO titer – Normal c) Urinalysis – Red Blood Cells d) C3 – Low e) None of the above

Answer 53

e) None of the above

Question 54

After the laboratory results came out, you diagnosed her with Acute Glomerulonephritis TM’s condition is expected: a) 3-4 weeks after streptococcal pharyngitis b) 4-5 weeks after streptococcal pyoderma c) Both are correct d) Both are incorrect

Answer 54

d) Both are incorrect * 1-2 weeks after streptococcal pharyngitis * 3-6 weeks after streptococcal pyoderma

Question 55

Treatment of TM’s condition includes the following EXCEPT: a) Salt and fluid restriction b) Anti-hypertensives like ACE inhibitors, Ca channel antagonists, and vasodilators c) Directed at treating the acute effects of renal dysfunction and hypertension d) Systemic antibiotic therapy of 1 week

Answer 55

d) Systemic antibiotic therapy of 1 week 10 days penicillin

Question 56

You decided to discharge TM. Your advice to her mother includes: a) Microscopic hematuria can persist up to 24 months b) Blood pressure normalizes in 1 month c) Urinary protein excretion normalizes in 6 weeks d) All of the above

Answer 56

d) All of the above 1-2 years hematuria may persist 4-6 weeks protein normalizes

Question 57

NE, 10 years old/M was brought to the clinic due to edema. There was no history of hematuria. Vital signs: BP:90/60mmHg, HR:99, RR:25. Pertinent PE findings are facial and scrotal edema and positive for fluid wave test. 8. What are your expected urinalysis result of NE? 9. a) With or without microscopic hematuria b) 3+ or 4+ proteinuria c) Both d) None of the above

Answer 57

c) Both

Question 58

What are the expected laboratory results of NE’s condition? a) Urine protein:creatinine ratio < 2.0 b) Elevated C3 and C4 c) Albumin < 3.0 g/dL d) Cholesterol > 200mg/dL

Answer 58

d) Cholesterol > 200mg/dL

Question 59

Two days after consult, NE came back with her laboratory results. But she started complaining of abdominal pain and fever. 10. What is/are the possible etiologic agent(s) of NE’s condition? a) Pneumococcus b) Gram negative bacteria c) Both d) None of the above

Answer 59

c) Both

Question 60

SG, 10 years old/F came in due to dysuria and suprapubic pain. 11. The following is/are true of SG’s condition: a) Caused by ascending infection b) Some children will present with occasional diarrhea c) Results in renal injury d) Always presents with fever

Answer 60

a) Caused by ascending infection

Question 61

A 16yo/F came in at the emergency room due to seizure. Further history taking revealed a history of fever associated with rashes and joint pains. Her chest X-ray revealed pleural effusion. She was previously admitted in Cebu due to the same condition but went home against medical advice. Prior to her discharge, a kidney biopsy was done which revealed 75% of the glomeruli involved with active sediments. She is hypertensive and urinalysis revealed 4+ proteinuria. 12. What is her WHO classification? a) Diffuse Proliferative LN b) Focal Proliferative LN c) Minimal Mesangial LN d) Mesangial Proliferative LN

Answer 61

a) Diffuse Proliferative LN

Question 62

True of her treatment? a) Immunosuppressive therapy b) Goal to normalize renal function and proteinuria c) Goal to normalize C3 and C4 d) All of the above

Answer 62

d) All of the above

Question 63

A 5-year-old/F was brought to the ER due to rash and abdominal pain. She previously had cough and cold a week prior 15. 14. True of her condition a) Most common medium vessel vasculitis b) Character to rash is purpuric c) 75% develop renal manifestation d) 25% progress to CKD if untreated

Answer 63

b) Character to rash is purpuric

Question 64

Triad of microangiopathic hemolytic anemia, thrombocytopenia, and renal insufficiency. 15. All are true of the **most common** form, EXCEPT? a) Atypical form b) Occurs 5-7 days after fever, vomiting, abdominal pain, and diarrhea c) Caused by STEC d) Transmitted by unpasteurized milk

Answer 64

a) Atypical form

Question 65

Matching type: A) Upper Urinary Tract Sources of Hematuria B) Lower Urinary Tract Sources of Hematuria C) Both Proteinuria > 100mg/dL via dipstick

Answer 65

A) Upper Urinary Tract Sources of Hematuria

Question 66

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE

Question 67

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE JL was given prednisone for 4 weeks but her urinalysis still showed 3+ proteinuria

Answer 67

E. STEROID RESISTANT

Question 68

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE HM is a diagnosed case of nephrotic syndrome 2 months ago however had first morning urine protein creatinine ratio of 1.0 and a reading of 3+ for 3 consecutive days

Answer 68

B.RELAPSE

Question 69

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE CC came to your clinic due to edema. Past Medical History: She is a diagnosed case of Nephrotic Syndrome May 2019. She had 2 relapses since then.

Answer 69

C. FREQUENTLY RELAPSING

Question 70

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE HM was treated then repeat urine protein:creatinine ration is <0.1 and <1+ protein on urine dipstick testing for 3 consecutive days

Answer 70

A. REMISSION

Question 71

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE MD was diagnosed with nephrotic syndrome and responded well with her prednisone treatment hence her nephrologist started tapering her steroids but her edema recurred and her urinalysis revealed 4+ proteinuria for 3 days

Answer 71

D. STEROID DEPENDENT

Question 72

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE PM was diagnosed with nephrotic syndrome and on steroid treatment for 4 weeks and her 3 days daily urinalysis revealed negative for proteinuria.

Answer 72

F. RESPONSE

Question 73

A. REMISSION B.RELAPSE C. FREQUENTLY RELAPSING D. STEROID DEPENDENT E. STEROID RESISTANT F. RESPONSE AJ was diagnosed with nephrotic syndrome and responded well with her prednisone treatment hence her nephrologist started tapering her steroids until discontinued. However, 1 week after discontinuation of prednisone, her edema recurred and her urinalysis revealed 4+ proteinuria for 3 days

Answer 73

D. STEROID DEPENDENT

Question 74

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS Caused by antimicrobials

Answer 74

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS

Question 75

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS Presents with fever, rash, and arthralgia with rising creatinine

Answer 75

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS

Question 76

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS Caused by tacrolimus

Answer 76

B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS

Question 77

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS Treatment includes Prednisone

Answer 77

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS

Question 78

A. ACUTE TUBULOINTERSTITIAL NEPHRITIS B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS Common in congenital urologic disease

Answer 78

B. CHRONIC TUBULOINTERSTITIAL NEPHRITIS

Question 79

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI diminished effective circulating arterial volume

Answer 79

A. PRERENAL AKI

Question 80

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI structural kidney damage is absent

Answer 80

A. PRERENAL AKI

Question 81

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI obstruction of urinary tract

Answer 81

C. POSTRENAL AKI

Question 82

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI neurogenic bladder

Answer 82

C. POSTRENAL AKI

Question 83

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI sepsis

Answer 83

A. PRERENAL AKI

Question 84

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI posterior urethral valves

Answer 84

C. POSTRENAL AKI

Question 85

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI renal parenchymal damage

Answer 85

B. INTRINSIC RENAL AKI

Question 86

A. PRERENAL AKI B. INTRINSIC RENAL AKI C. POSTRENAL AKI nephrotoxic insults

Answer 86

B. INTRINSIC RENAL AKI

Question 87

TRUE OR FALSE. In acute poststreptococcal glomerulonephritis, ASO titer is elevated after pharyngeal infection and rarely after cutaneous one

Answer 87

TRUE

Question 88

TRUE OR FALSE. Renal tubular acidosis is a disease state characterized by a non-anion gap metabolic alkalosis in the setting of a normal or near normal GFR

Answer 88

FALSE metabolic acidosis

Question 89

TRUE OR FALSE. Urinary Tract Infection is caused by Escherichia coli in 50% of cases

Answer 89

FALSE 54-67%

Question 90

TRUE OR FALSE. End Stage Renal Disease is a state in which a patient’s renal dysfunction has progressed to the point at which homeostasis and survival can no longer be sustained by medical management

Answer 90

TRUE

Question 91

TRUE OR FALSE. Streptozyme screen is the best singe antibody titer to document cutaneous streptococcal infection

Answer 91

FALSE antideoxyribonuclease B level

Question 92

What is the most common cause of acute renal failure in children? a. Hemolytic-Uremic Syndrome b. Henoch-Schonlein Purpura Nephritis c. Goodpasture Syndrome d. Chronic Tubulointerstitial Nephritis

Answer 92

a. Hemolytic-Uremic Syndrome

Question 93

Linear IgG on immunofluorescence is found in this particular renal disease that manifests as acute glomerulonephritis. a. Ig A Nephropathy b. Goodpasture Syndrome c. Poststreptococcal Glomerulonephritis d. Rapidly Progressive Glomerulonephritis

Answer 93

b. Goodpasture Syndrome

Question 94

Which of the following manifests with hypertension in 70% of cases: a. Ig A nephropathy b. Goodpastures Syndrome c. Poststreptococcal GN d. Rapidly progressive glomerulonephritis

Answer 94

c. Poststreptococcal GN

Question 95

Alport syndrome is a genetically heterogenous disease caused by mutations in the gene coding for: a. Type 1 collagen b. Type II collagen c. Type III collagen d. Type IV collagen

Answer 95

d. Type IV collagen

Question 96

What is the most severe form of lupus nephritis? a. WHO Class II nephritis b. WHO Class III nephritis c. WHO Class IV nephritis d. WHO Class V nephritis

Answer 96

c. WHO Class IV nephritis

Question 97

What strain causes acute poststreptococcal GN? a. Streptococci viridans b. Group C streptococci c. Group B A-hemolytic streptococci d. Group A B-hemolytic streptococci

Answer 97

d. Group A B-hemolytic streptococci

Question 98

Membranous Lupus Nephritis is less commonly seen as an isolated lesion and it also belongs to this WHO classification. a. Class I Nephritis b. Class II Nephritis c. Class IV Nephrits d. Class V Nephritis

Answer 98

d. Class V Nephritis

Question 99

What is the most common cause of chronic glomerulonephritis in older children and adults? a. Ig A nephropathy b. Nephrotic Syndrome c. Poststreptococcal GN d. Membranoproliferative GN

Answer 99

d. Membranoproliferative GN

Question 100

What differentiates HSP nephritis from Ig A nephropathy? a. proteinuria b. gross hematuria c. purpuric rash d. Crescent formation

Answer 100

c. purpuric rash

Question 101

Patients with membranous glomerulopathy are at increased risk for: a. Renal artery thrombosis b. Hemolytic-Uremic syndrome c. Renal vein thrombosis d. Membranoproliferative GN

Answer 101

c. Renal vein thrombosis

Question 102

A child presented with fever, nausea, vomiting and flank pain, what will be your likely diagnosis? a. Cystitis b. Bacteriuria c. Pyelonephritis d. Vesico-uretral reflux

Answer 102

c. Pyelonephritis

Question 103

Very rarely does acute renal failure occurs in this primary renal disease that manifests as acute glomerulonephritis. a. Ig A Nephropathy b. Post streptococcal GN c. Good pasture Syndrome d. Rapidly Progressive GN

Answer 103

a. Ig A Nephropathy

Question 104

A 14-year-old adolescent girl presented with palpable purpuric rash on the buttocks and lower extremities with arthritis of ankles and knees. Investigation as follow; erythrocyte sedimentation rate, C- reactive protein, and white blood cell count are elevated, the platelet count is normal, urinalysis show evidence of hematuria. a. IgG b. IgM c. IgA d. IgE

Answer 104

c. IgA

Question 105

What precedes Hemolytic-Uremic syndrome: a. Pneumonia b. Amoebiasis c. Nephritis d. Diarrhea by shiga-like toxin E. Coli

Answer 105

d. Diarrhea by shiga-like toxin E. coli

Question 106

A 10-year old male who previously had URTI, presents with BP of 140/100, gross hematuria. C3 levels are normal, Ig A levels are elevated, what is the primary treatment for this patient? a. Steroids b. Antibiotics c. Blood pressure control d. Renal transplant

Answer 106

a. Steroids

Question 107

The histopathologic finding of crescents in glomeruli is the hallmark of this particular renal disease that manifests with acute nephritis. a. HSP Nephritis b. Cresentic GN c. Membranoproliferazive GN d. Hemolytic Uremic Syndrome

Answer 107

b. Cresentic GN

Question 108

What is suggestive of poststreptococcal glomerulonephritis? a. Increase C3 levels b. Decrease C3 levels c. Normal C3 levels d. Increase serum Ig A levels

Answer 108

b. Decrease C3 levels