2023 ITE Nephrology

Question 1

What medication can cause transient decrease in serum potassium?

Answer 1

Albuterol

Question 2

How does albuterol cause a decrease in K?

Answer 2

intracellular shifts in potassium (NKATPase)

Question 3

When is contrast induced nephropathy PROPHYLAXIS indicated?

Answer 3

Normal saline pre and post procedure when estimated GFR is below 30 or in setting of AKI (make sure the procedure is urgent/emergent)

Question 4

When is contrast nephropathy prophylaxis not indicated?

Answer 4

GFR: >45

Question 5

What is the best next step after confirming diagnosis of membranous nephropathy?

Answer 5

phospholipase A2 receptor (PLA2R) antigen test

positive: primary MN
negative: need to look for secondary MN

Question 6

What are secondary causes of membranous nephropathy that must be ruled out regardless of PLA2R status?

Answer 6

Lupus
Drug
Hepatitis

Malignancy

Question 7

In patients with CKD who have been started on ACE/ARB, what should be rechecked?

Answer 7

Cr and K in 2-3 weeks

Question 8

What level of increase in creatinine necessitates decreasing the dose of or discontinuing these agents?

Answer 8

> 30% (Steph Curry)

Question 9

What screening should be pursued in patients with acquired cystic kidney disease?

Answer 9

malignancy: renal cell carcinoma (cysts could transform into malignancy)

annual Renal US

Question 10

Treatment for myeloma cast nephropathy?

Answer 10

chemotherapy to reduce concentration of free light chains

Question 11

Most likely complication within first 12 months of diagnosis of nephrotic syndrome

Answer 11

VTE

Question 12

Indications for kidney biopsy

Answer 12

1) AKI/CKD of unclear cause
2) Glomerular hematuria
3) Severely increased albuminemia
4) Kidney transplant dysfunction or monitoring

Question 13

Metabolic alkalosis, with normotension/hypotension low potassium and low phosphate

Metabolic alkalosis with hypertension, low potassium

Answer 13

1) Bartter syndrome

2) Liddle Syndrome