FINAL EXAM

Question 1

In a patient with nephrotic syndrome, shortness of breath you will find
a. All answers are correct
b. Respiratory alkalosis
c. Edema
d. Low urinary sodium excretion

Answer 1

a. All answers are correct

Question 1

2. Tubular proteinuria is present in
   a. Fanconi syndrome
   b. Hypertension
   c. Conn syndrome
   d. Cushing syndrome

Answer 1

a. Fanconi syndrome

Question 2

3. In a patient with low cardiac output you will find the following changes in renal function except
   a. Positive value of the free water clearance
   b. Constriction of the efferent glomerular arterioles
   c. Low value of the renal fractional excretion of sodium
   d. Increased glomerular synthesis of prostaglandins

Answer 2

a. Positive value of the free water clearance

Question 3

4. Which effect is not observed in acute prerenal failure
   a. Reduced blood flow to the juxtamedullary nephrons
   b. Increased renal production of prostaglandins
   c. Vasodilation of the afferent arteriole due to tubuloglomerular feedback
   d. Increased glomerular filtration fraction

Answer 3

d. Increased glomerular filtration fraction

Question 4

5. In nephrotic syndrome with the selective proteinuria you will not find
   a. Increased urinary fibrinogen loss
   b. Increased urinary albumin loss
   c. Increased proteins reabsorption in proximal tubules
   d. Increased blood fibrinogen level

Answer 4

a. Increased urinary fibrinogen loss

Question 5

6. Which statement is true for overflow proteinuria
   a. Glomerular filtration barrier is unchanged
   b. Dysfunction of the proximal tubules results in lack of protein reabsorption
   c. Increased urinary loss of albumin
   d. Increased urinary loss of high molecular weight proteins

Answer 5

a. Glomerular filtration barrier is unchanged

Question 6

7. A 34 year old woman has had restlessness, nervousness, insomnia, tachycardia, intolerance to
   hot and exophthalmos. Laboratory studies show a low plasma TSH concentration, high plasma
   T3 concentration. Which of the following abnormalities is the most likely cause for these
   findings?
   a. Hashimoto thyroiditis
   b. Iatrogenic hypothyroidism syndrome
   c. Graves disease
   d. Autoimmune

Answer 6

c. Graves disease

Question 7

8. A 34 year old woman has had restlessness, nervousness, insomnia and intolerance to hot.
   Laboratory studies show a low plasma TSH concentration, high plasma T3 concentration. Which
   of the following abnormalities is the most likely cause for these findings?
   a. Iatrogenic hyperthyroidism syndrome
   b. Autoimmune hypothyroidism
   c. Pituitary deficiency
   d. Hyperthyroidism

Answer 7

d. Hyperthyroidism

Question 8

9. A 34 year old woman has had constipation, lethargy, fatigue and intolerance to cold. Laboratory
   findings show a high plasma TSH concentration, high plasma antiperoxidase antibodies. Which
   of the following abnormalities is the most likely cause for these findings?
   a. Thyroid adenoma
   b. Iatrogenic hyperthyroidism syndrome
   c. Pituitary adenoma
   d. Hashimoto thyroiditis

Answer 8

d. Hashimoto thyroiditis

Question 9

10. In a patient with Cushing disease you will not find
    a. Increased plasma cortisol
    b. Lack of diurnal rhythm of secretion of glucocorticoids
    c. Reduced plasma ACTH
    d. Hyperglycemia

Answer 9

c. Reduced plasma ACTH

Question 10

11. A 54 year old man has had headaches for 5 months. On physical examinations, he is found to
    have a blood pressure of 170/110 mmHg. Laboratory studies show a high urinary vanillyl
    mandelic acid, high plasma renin activity. Which of the following abnormalities is the most likely
    cause for these findings?
    a. Adrenal adenoma
    b. Iatrogenic cushing syndrome
    c. Pituitary adenoma
    d. Pheochromocytoma (tumor on adrenal gland)

Answer 10

d. Pheochromocytoma (tumor on adrenal gland)

Question 11

12. A 44 year old man has had headaches for 4 months. On physical examination, he is found to
    have a blood pressure of 170/110 mmHg. Laboratory studies show high sodium concentration,
    low potassium concentration, low plasma renin activity, high plasma aldosterone concentration,
    in normal range blood glucose level. Which of the following abnormalities is the most likely
    cause for these findings?
    a. Iatrogenic cushing syndrome
    b. Adrenal adenoma (conns syndrome)
    c. Pituitary adenoma
    d. Pheocromocytoma

Answer 11

b. Adrenal adenoma (conns syndrome)

Question 12

13. A 19 year old diabetic patient is brought to the emergency room for nausea, vomiting for 12
    hours and abdominal pain. On examination, it was found that his insulin pump has stopped.
    Which of the following are likely to be associated with this presentation
    a. Increased blood pH
    b. Increased serum ketones
    c. Increased glucagon concentration
    d. Increased insulin concentration

Answer 12

b. Increased serum ketones