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RENAL module - 4th year > 2015 module exam > Flashcards

2015 module exam Flashcards

1
Q

Patient with increased serum osmolarity, urine osmol was 200-300 with water deprivation, after ADH administration urine osmol was 900

A) complet ecentral DI
B) Partial central DI
C) Complete nephrogenic DI
D) Partial nephrogenic DI

A

A) complete central DI

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2
Q

Patient with septic shock and creatinine was 300?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

E) ARF

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3
Q

Girl with periorbital edema and frothy urine?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

A) nephroticsyndrome

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4
Q

Man with DVT and proteinuria >7.5 g/24 hr?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

A) nephroticsyndrome

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5
Q

A boy with proteinuria when standing, but not when lying down?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

C) isolated proteinuria

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6
Q

Man with histopathological findings of Focal Segmental Glomerulosclerosis (FSGS)?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

A) nephroticsyndrome

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7
Q

Man with slow decline in renal function?

A) nephroticsyndrome
B) nephritic syndrome (glomerulonephritis) 
C) isolated proteinuria
D) CRF
E) ARF
A

D) CRF

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8
Q

Patient with SLE, what will you find in histopathological examination?

A

Endocapillary proliferation

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9
Q

Which of the following has the lowest clearance?
A) Urea
B) Potassium
C) Aspirin

A

B) Potassium (this is the answer according to Dr.Slava (K has the lowest clearance because its 86% reabsorbed while urea is only 50% reabsorbed)

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10
Q

Defect/change in what structure would increase albumin permeability?

A) Basal lamina of glomerulus
B) Endothelial capillary
C) Pedicles
D) Primary podocyte

A

C) Pedicles

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11
Q

Loss of –ve charge of the basement membrane would allow filtration of which of the following the most?

A) Hc03-
B) Cl-
C) Albumin
D) Hemoglobin

A

C) Albumin

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12
Q

Forensic: curved marks seen during manual strangulation?

A) Pressure abrasion 
B) Punctatewound
C) Sliding abrasion
D) Stab wound 
E) Laceration
A

A) Pressure abrasion (they meant nail marks)

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13
Q

Forensic: When does redistribution of blood stop in hypostasis?

A) 1hr
B) 2hrs
C) 6hrs
D) 8hrs

A

D) 8hrs

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14
Q

Forensic: 3 cm wound with regular edges and a curved end + a blunt end?

A

Stabwound

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15
Q

Forensic: autopsy of an elderly man, with Oblique mark that was stronger on one side than the other (asymmetric) + cadaver had deep hemorrhage and hyoid bone fracture. What is the cause?

A) Manual strangulation
B) Ligature
C) Suicidal hanging
D) Judicial hanging

A

A) Manual strangulation

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16
Q

Forensic: Which of the following structures is mostly seen in cadaveric spasm?

A) Eyelids
B) Jaw
C) Hands
D) legs

A

C) Hands

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17
Q

What would increase sodium reabsorption?

A) Increased dopamine
B) Increase glucose filtration (Glomerulo-tubular balance)

A

B) Increase glucose filtration (Glomerulo-tubular balance)

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18
Q

Patient with inherited cysteinuria?

A) SGLT1
B) SGLT2
C) SLC3A1
D) GLUT 2

A

C) SLC3A1

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19
Q

familial glycosuria?

A) SGLT1
B) SGLT2
C) SLC3A1
D) GLUT 2

A

B) SGLT2

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20
Q

What is the basis of polyuria in diabetes mellitus?

A

Osmosis by glucose in the urine

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21
Q

What causes nephrosclerosis in a man with hypertension?

A) Hyaline arteriolosclerosis
B) Hyperplastic arteriolosclerosis

A

A) Hyaline arteriolosclerosis

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22
Q

Patient with proteus infection. Which renal stone is caused by this infection?

A

Struvite stone

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23
Q

Which of the following stones are radiolucent on X-ray? (OR Which of the following stones can’t be seen in plain x-rays?)

A) Calcium
B) Uric acid
C) Struvite
D) Cysteine

A

B) Uric acid

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24
Q

What is true in metabolic acidosis because of chronic renal failure?

A

NH4 excretion is decreased

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25
Q

A patient with metabolic acidosis due to methanol ingestion, what is the best measure used?

A) Strong ion gap
B) Serum anion gap
C) Effective strong ion difference
D) Strong ion difference

A

A) Strong ion gap (confirmed by dr Zoran)

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26
Q

Tan-colored tumor with a diagnostic stellate scar?

A) Oncocytoma
B) clear cell carcinoma
C) papillary adenocarcinoma
D) angiomyolipoma

A

A) Oncocytoma

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27
Q

What causes obstruction of urine in ischemic ATN?

A) Tubular cell shedding into the lumen
B) Hydronephrosis

A

A) Tubular cell shedding into the lumen

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28
Q

What causes an increase in K secretion?

A) NKCC inhibitor
B) ADH

A

A) NKCC inhibitor (b/c it increases tubular flow)

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29
Q

Increases single effect?

A) ADH
B) decreased stretch of atrial receptors
C) increased stretch of volume receptors

A

A) ADH

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30
Q

decreases free water secretion?

A) ADH
B) decreased stretch of atrial receptors
C) increased stretch of volume receptors

A

A) ADH

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31
Q

decreases ANP?

A) ADH
B) decreased stretch of atrial receptors
C) increased stretch of volume receptors

A

B) decreased stretch of atrial receptors

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32
Q

What increases medullary interstitial concentration?

A

Constriction of medullary vascular pericytes

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33
Q

which organ is affected on the right side when there is perirenal effusion without perforating the renal fascia?

A) Liver
B) Ascending colon
C) Stomach
D) spleen

A

A) Liver

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34
Q

What is moved in surgery to access tumors in the right renal hilum?

A

Duodenum

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35
Q

What secretes creatinine?

A

PCT

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36
Q

What has prominent brush border?

A

PCT

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37
Q

What is present in posterior part of empty bladder?

A

Seminal vesicle

38
Q

how does cyclosporine induce nephropathy?

A) acute tubular necrosis
B) tubular obstruction
C) preglomerular vasoconstriction 
D) rhabdomyolysis
E) osmotic nephrosis
A

C) preglomerular vasoconstriction

39
Q

If we have high Ph, low Pco2, low Hco3, what is the acid base disorder in this patient?

A) Respiratory alkalosis
B) Respiratory acidosis
C) Metabolic alkalosis
D) Metabolic acidosis

A

A) Respiratory alkalosis

40
Q

What is on the superior part of male bladder?

  1. Sigmoid colon
  2. Seminal vesicle
  3. Uracus
A
  1. Sigmoid colon
41
Q

What is related to the anterior surface of the left kidney and not covered by peritoneum?

A

Pancreas

42
Q

Calculate free water clearance. You just need to plug the given values into the following equation:

A

Free water clearance = V - [(Urine Osm x V) / Plasma Osm]

43
Q

Calculate clearance of substance X (PAH clearance = 660, Creatinine clearance = 110, concentration of X was 2 mg/ml, Tm of reabsorption was 200)

A) 20ml/min
B) 10ml/min

A

B) 10ml/min

44
Q

What is the renal blood flow if creatinine cl= 90ml/min, PAH cl= 600 ml/min, hematocrit = 40%?

A) 600ml/min
B) 1000ml/min
C) 1090 ml/min
D) 1200 ml/min

A

B) 1000ml/min

45
Q

What is the consequence of hypophosphatemia?

A) Decreased buffering of acid in blood
B) Decreased acid (or H+) excretion in urine

A

B) Decreased acid (or H+) excretion in urine

46
Q

What 2 structures are involved in renal entrapment syndrome of the left renal vein?

A) Aorta and superior mesenteric artery
B) Aorta and duodenum

A

A) Aorta and superior mesenteric artery

47
Q

What is likely to be seen after 3 days of drug use?

A

Lymphocytes and eosinophils

48
Q

What causes increase in ultrafiltration pressure and GFR?

A

Afferent arteriole dilation

49
Q

What causes constant GFR with increase in filtration fraction?

A

Angiotensin II

50
Q

What is the effect of increased NaCl delivery to macula densa on GFR?

A

GFR reverted back to normal as a result of constriction of afferent arteriole

51
Q

What is mechanism for managing the serum [K+] increase after a meal?

A

Muscle Na/K ATPase

52
Q

What is the response to an Increased K+ in diet?

A

More BK and ROMK

53
Q

What would happen if the K+ concentration was low in diet?

A

internalization of ROMK channel into the CP

54
Q

US examination in utero reveals bilateral absence of the kidneys in a fetus at 34 weeks of gestation. The baby is born alive at term but dies 12 hours after birth. Which of the following is the most likely cause of death?

A) Internal bleeding 
B) Cardiomyopathy 
C) Hydrocephalus 
D) Anuria
E) Lung immaturity
A

E) Lung immaturity

55
Q

Increased calcium and intracellular signaling causing BK insertion?

A

Tubular flow

56
Q

Graph of Clinical med lecture 4 of diabetes insipidus: Which line represents complete central diabetes insipidus?

A) A 
B) B 
C) C 
D) D 
E) E
A

B) B

57
Q

What is used to treat 7 mm stone of lower urethra?

A) Urethroscopy
B) Percutaneous urethroscopy
C) Open urethroscopy

A

A) Urethroscopy

58
Q

Best method for a 3-cm stone in kidney?

A) Opensurgery
B) PCN

A

B) PCN

59
Q
  1. What triggers increased osmolarity in the interstitium?
A

ADH secretion

60
Q

a young female presented with hypertension what is the initial imaging modality to evaluate the cause of HTN?

A) CTKUB
B) Angiography for renal arteries
C) Plain KUB
D) IVU
E) Renal doppler ultrasound
A

E) Renal doppler ultrasound (possible renal artery stenosis)

61
Q

Patient with 6 cm cyst, what would support that it is a benign cyst?

A) enhanced CT
B) was 5 cm 6 years ago
C) irregular border
D) has soft and hard parts inside it

A

B) was 5 cm 6 years ago

62
Q

Method of choice for renal stone diagnosis?

A

CT KUB

63
Q

What is the mechanism of acidosis in cystic kidney disease?

A) Decreased NH4 excretion
B) Decreased bicarbonate secretion

A

A) Decreased NH4 excretion

64
Q

Patient with serum Na= 135, serum osmolarity was low (270?), urine osmolarity was low. What is the diagnosis?

A) Nephrogenic DI
B) Central DI
C) Psychogenic DI

A

C) Psychogenic DI

65
Q

Plasma anion gap 25
Plasma bicarbonate 16
Based on this data, what is the most logical conclusion about his acid-base status

A) Normal anion gap acidosis
B) High anion gap acidosis
C) Mixed high anion gap and normal anion gap
D) Mixed metabolic acidosis and metabolic alkalosis

A

B) High anion gap acidosis

66
Q

What is the first finding in diabetic nephropathy?

A) Decreased GFR
B) Microalbuminuria

A

B) Microalbuminuria

67
Q

What will be seen in a person after a road traffic accident with extensive blood loss?

A

Diffuse cortical necrosis

68
Q

What will be seen in a person after ethylene glycol ingestion?

A

Proximal tubule necrosis

69
Q

What will be seen in a person who was dehydrated for a long period of time?

A

Necrosis anywhere along the nephron

70
Q

What is the definition of acute renal failure?

A

Increase in serum creatinine more than 26 mol in 48 hrs

71
Q

40 YO smoker male presented with rapid progressive renal failure and hemoptysis. He died 2 days later. Microscopic features of his kidneys would show:

A) Crescent formation
B) IgA
C) congo red mesangial
D) spikes in basement membrane 
E) focal glomerular sclerosis
A

A) Crescent formation

72
Q

what is the reason for clinical findings in Syndrome of inappropriate Anti-Diuretic hormone?

A) hyponatremia due to excess water
B) hyponatremia due to Na+deficiency
C) decrease urine osmolarity
D) increase plasma osmolarity

A

A) hyponatremia due to excess water

73
Q

What develops from the diverticulum from the mesonephric duct?

A) Proximal tubules
B) Loop of henle
C) Collecting duct

A

C) Collecting duct

74
Q

What’s the difference between glomerular and tubular proteinuria?

A) Dipstick
B) Hypoalbuminemia

A

B) Hypoalbuminemia

75
Q

which of the following vascular lesions of the kidney is found in hypertensive nephrosclerosis as evidence of hypertension related end organ damage?

A) granulomatous arteritis
B) necrotizing arteriolitis
C) hyaline arteriosclerosis
D) hyperplastic arteriosclerosis 
E) polyarteritis nodusa
A

C) hyaline arteriosclerosis

76
Q

Patient with rheumatoid arthritis developed proteinuria and edema? What will be found?

A

Amyloid

77
Q
  1. Which of the following renal tumors is most like associated with VHL?

A) Wilms tumor
B) Angiomyolipoma
C) Clear cell
D) Oncocytoma

A

C) Clear cell

78
Q

Which of the following tumors has numerous mitochondria in their cells?

A) Angiomyolipoma
B) Nephroblastoma
C) Clear cell carcinoma 
D) Oncocytoma
E) Papillary carcinoma
A

D) Oncocytoma

79
Q

Female with chronic Hepatitis B infection developed Nephrotic syndrome. She has spikes in GBM. What is the ultrastructure abnormality seen under EM?

A) Sub-epithelium deposits
B) Sub-endothelium deposits

A

A) Sub-epithelium deposits

80
Q

A healthy person on a high sodium diet:

A) Fusion of NCC in the luminal membrane of PC
B) Increased dopamine release
C) Hypertension
D) Increased expression of ENaC in PC

A

B) Increased dopamine release

81
Q

What inhibits renal stones formation?

A) Arginine
B) Lysine
C) Pyrophosphate
D) Struvite

A

C) Pyrophosphate

82
Q

What sample is used in a patient with Schistosoma infection?

A) MSU
B) Terminal urine

A

B) Terminal urine

83
Q

Which protein is affected in ADPKD?

A) polycystin 1
B) fibrocystin

A

A) polycystin 1

84
Q

a 34 y/o male presented with ADPKD & HTN what would you do for his BP?

A) alpha blocker
B) loop diuretic
C) beta blocker
D) ACE inhibitor

A

D) ACE inhibitor

85
Q

What is the treatment of choice for 10mm lower uretric stone?

A) PCNL
B) uretroscopy 
C) SW
D) NSAID
E) alpha blocker
A

B) uretroscopy

86
Q

A patient is having a referred pain to the hypogastric region due to irritation in the urinary bladder mucosa. Which of the following nerve carrying pain is responsible for this referred pain?

A) Cavernous nerve
B) Sympathetic nerve
C) Parasympathetic nerve
D) pudendal nerve

A

B) Sympathetic nerve

87
Q

Patient with SLE on hemodialysis developed anemia with MCV 90 (91-100 normal range). What should be investigated as the cause of anemia?

  1. Iron
  2. Folate
  3. vitamin b12 deficiency
  4. vitamin D deficiency
A
  1. Folate
88
Q

A 50-year-old female developed normochromic, normocytic anemia with a declining GFR. What could be the underlying issue?

A

Secondary parathyroidism

89
Q

Microscopic section of child tumor showed primitive glomeruli, tubules with stroma and blastema. What is the diagnosis?

A) Nephroblastema
B) Clear cell carcinoma
C) Transitional cell carcinoma

A

A) Nephroblastema

90
Q

A 57 years old female with flank pain. Her hemoglobin dropped from 11 to 7. What could be her condition?

A) Retroperitoneal bleeding
B) Cystitis
C) Infection of a cyst
D) Kidney stone

A

A) Retroperitoneal bleeding

RENAL module - 4th year (17 decks)

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