MKSAP Nephro II

Question 1

Macroscopic hematuria requires ____ referral even if self-limited and even if they are on antiplatelet or anticoagulant therapy.

Answer 1

Urology

Question 2

What are the hallmarks of tubulointerstitial nephritis?

Answer 2

Sterile pyuria and leukocyte casts

Question 3

Brown or tea-colored urine with dysmorphic erythrocytes or acanthocytes and or erythrocyte casts on urine sediment are consistent with:

Answer 3

glomerulonephritis

Erythrocyte casts are recognized by their cylindrical or tubular structure and inclusion of small, agranular spherocytes and, when present, are specific for hematuria of glomerular origin.

Question 4

When does contrast-induced nephropathy result in an increase in serum creatinine and ATN?

Answer 4

Within 48 hours of exposure

Question 5

What is the classic triad associated with acute interstitial nephritis (but only occurs 10-30% of the time)

Answer 5

fever, rash, eosinophilia

Urinalysis is characterized by hematuria, pyuria, and/or leukocyte casts and possibly eosinophiluria.

Drug-induced AIN is characterized by a slowly increasing serum creatinine 7 to 10 days after exposure; however, it can occur within 1 day of exposure if the patient has been exposed previously.

Question 6

Risk factors associated with vancomycin nephrotoxicity include (5)

Answer 6

1. chronic kidney disease
2. prolonged therapy
3. doses ≥4 g/d
4. trough concentrations >15 mg/L
5. concomitant use of loop diuretics.

Question 7

Urine micro with numerous renal tubular epithelial cell and granular casts, FENA >2% associated with ischemia or toxins

Answer 7

acute tubular necrosis (ATN)

Question 8

Treatment of acute symptomatic hyponatremia includes a 100-mL bolus of 3% saline to increase the serum sodium level by ____ to ____.

Answer 8

2 to 3 mEq/L

Question 9

_____ usually occurs in young persons, particularly women, and is suggested by an abrupt onset of HTN in a patient under 35 yo. An elevation of serum creatinine of more than ___ from baseline after initiation of an ACEI is a clue that renovascular HTN may be present.

Answer 9

Fibromuscular dysplasia; 30%

Question 10

Plasma fractionated metanephrines are obtained to screen for a ____.

Answer 10

pheochromocytoma

Question 11

. Stone passage decreases with increasing size of the stone. Only 50% of stones >___ mm will pass spontaneously, whereas stones >___ mm are extremely unlikely to pass spontaneously.

Answer 11

6; 10

Question 12

Do thiazides increase or decrease urinary calcium excretion?

Answer 12

Decrease

Question 13

How does sarcoidosis cause hypercalcemia (and hypercalciuria and lead to nephrocalcinosis)?

Answer 13

peripheral conversion of 25-hydroxyvitamin D to 1,25-dihydroxyvitamin D by activated macrophages (PTH is typically suppressed)

Question 14

___ is common in normal pregnancy due to plasma volume increases with water retention greater than sodium retention; no treatment is necessary.

Answer 14

Mild hyponatremia

Question 15

Statin is recommended for patients aged >50 with eGFR < ____.

Answer 15

60