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Part 1 Boards > Nephrology/GI/Nutrition > Flashcards

Nephrology/GI/Nutrition Flashcards

1
Q 
Which type is very deadly w/ pregnancy causing fulminant hepatits?
 A. Hepatitis B
 B. Hepatitis C
 C. Hepatitis D
 D. Hepatitis E
A

Hepatitis E- occurs more in India and Southeast Asia in rivers

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2
Q

After the doctor uses a needle to aspirate a mass the patient goes into anaphylaxis. What was most likely encountered?
A. Abscess due to Entamoeba histolytica
B. Abscess due to Echinococcus granulosus
C. Hydatid Cyst due to Entamoeba histolytica
D. Hydatid Cyst due to Echinococcus granulosus

A

Hydatid Cyst due to Echinococcus granulosus

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3
Q 
Tetracycline causes which type of liver disease morphology?
A. Microsteatosis
B. Macrosteatosis
C. Necrosis
D. Hepatitis
A

Microsteatosis

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4
Q 
Drug-Induced liver disease causing fibrosis is due to which drug?
A. Methotrexate
B. Steroids, erythromycin
C. Amiodarone
D. Acetaminophen
A

Amiodarone

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5
Q 
Which of the following morphological change due to drug induced liver disease is matched incorrectly?
A. Acetaminophen-Necrosis
B. Isoniazid, Halothane- Hepatitis
C. Steriods, Erythromycin- Cholestasis
D. Methotrexate- Microsteatosis
A

Methotrexate causes MACROsteatosis

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6
Q 
This disease begins as diffuse lymphocyte rich infiltrate with secondary granulocyte inflammatory cells.
A. Ulcerative Colitis
B. Gluten-sensitive Enteropathy
C. Crohn's Disease
D. Selective IgA deficiency
A

UC = granulocyte inflammatory cells

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7
Q 
This disease begins as lymphocytic infiltration then develops classic macrophage-containing granulomatous lesions. 
A. Ulcerative Colitis
B. Gluten-sensitive Enteropathy
C. Crohn's Disease
D. Selective IgA deficiency
A

Crohn’s = granulomatous lesions

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8
Q 
A patient presents with decreased ceruloplasmin and is later diagnosed with Wilson's disease. Which of the following is characteristic of this disease?
A. Kimmel-Wilson lesions
B. Kayser-Fleischer ring
C. Roth spots
D. Epstein pearls
A

Kayser-Fleischer ring - golden brown corneal ring

remember Wilson’s is characterized by “Copper is Hella BAD” Ceruplasmin decreased, Cirrhosis, Corneal deposits, Copper accumulation, Carcinoma, Hemolytic Anemia, Basal ganglia degeneration Asterixis Dementia, Dyskinesia, Dysarthria

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9
Q

Barett’s Esophagus is a transition of _________ epithelium to __________ epithelium.
A. Keratinized stratified squamous - Nonciliated columnar
B. Keratinized stratified squamous - Ciliated columnar
C. Nonkeratinized stratified squamous- Ciliated columnar
D. Nonkeratized stratified squamous -Nonciliated columnar

A

Nonkeratized stratified squamous-nonciliated columnar

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10
Q 
Crohn's disease is associated with all of the following except:
A. Any portion of the GI tract 
B. Always with rectal involvement
C. Cobblestone mucosa and creeping fat
D. noncaseating granulomas
A

Always with rectal involvement is incorrect, this answer would be true for Ulcerative Colitis. However with Crohn’s disease there is always rectal sparing.

remember for Crohn’s think of a FAT GRANny and an old CRONE SKIPPING down a COBBLESTONE road away from the WRECK (rectal sparing).

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11
Q 
Ulcerative colitis is associated with all of the following except:
A. Ulcers and bloody diarrhea
B. Always with rectal involvement 
C. sclerosing cholangitis
D. skip lesions
A

Skip lesions is incorrect, this answer would be true for Crohn’s disease. However with ulcerative colitis there are continuous colonic lesions.

remember with UC ULCCCERS ulcers, large intestine, continuous, colorectal carcinoma, crypt abscesses, extends proximally, red diarrhea, sclerosing cholangitis

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12
Q 
Which is a marker of alcoholic hepatitis?
A. increased ALT > AST
B. increased AST > ALT
C. decreased ceruloplasmin
D. increased ALP
A

increased AST > ALT

remember Make a toAST with alcohol (usually ratio > 1.5)

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13
Q

If I said mallory bodies, you would say _____?

A

Alcoholic hepatitis

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14
Q 
What is the cause of hepatic encephalopathy?
A. increased NH3 production
B. increased O2 production
C. increased NH4 generation
D. decreased NO2 production
A

Increased NH3 production and absorption or decreased NH3 removal/metabolism. Increased NH4 production is the treatment for hepatic encephalopathy by giving lactulose.

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15
Q 
Increased alpha fetoprotein is diagnostic for?
A. Hepatic adenoma
B. alpha-1 antitrypsin deficiency
C. Wilson's disease
D. Hepatocellular carcinoma
A

Hepatocellular carcinoma

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16
Q 
A 40 year old patient presents with a benign liver tumor, a biopsy is not performed due to risk of hemorrhage. What type of tumor does this patient have?
A. Angiosarcoma
B. Hepatic adenoma
C. Metastases
D. Cavernous hemangioma
A

Cavernous hemangioma

Commonly occurs between 30-50yrs.

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17
Q 
Jaundice is abnormal yellowing of the skin and/or sclera that occurs when bilirubin levels are:
A. >0.5mg/dL
B. >1.0mg/dL
C. >1.5mg/dL
D. >2.0mg/dL
A

> 2.0mg/dL

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18
Q 
In this disease you will see the following
   LM: Mesangial proliferation
   IF: Mesangial IgA
   EM: Mesangial deposits
A. Alport Syndrome
B. Thin GBM disease
C. Berger disease
D. MPGN (Membrano-proliferative glomerulonephritis)
A

Berger disease (IgA Nephropathy)

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19
Q

Which of the following is not true regarding Alport syndrome?
A. Basket-weave pattern
B. Mutation in alpha 5 chain of collagen Type IV
C. wire looping of capillaries
D. sensorineural deafness and retinopathy

A

Wire looping of capillaries is incorrect, this would be correct for diffuse proliferative GN (DPGN) and it is the most common cause of death in SLE (think WIRE LUPUS).

remember for Alport syndrome “can’t see, can’t pee, can’t hear a buzzing bee”

20
Q 
This nephrotic syndrome shows apple green birefingence under poloarized light with congo red stain. 
A. Diabetic GN
B. Amyloidosis
C. Minimal change disease
D. Focal segmental glomerulosclerosis
A

Amyloidosis

21
Q 
What is the only glomerular disease with all immunoglobulin deposition IgG, IgA, IgM, C3, C4.
A. SLE
B. Diabetes
C. Amyloidosis
D. Acute tubular necrosis
A

SLE

22
Q 
Neutrophilic infiltrates and neutrophil casts in tubules are characteristic of which:
A. Acute Pyelonephritis
B. Chronic Pyelonepritis 
C. Acute tubular necrosis
D. Chronic tubular necrosis
A

Acute pyelonephritis

23
Q 
Thyroidization of the kidney is associated with \_\_\_\_\_.
A. Acute Pyelonephritis
B. Chronic Pyelonepritis 
C. Acute tubular necrosis
D. Chronic tubular necrosis
A

Chronic pyelonephritis

24
Q

Which statement is true regarding renal cell carcinoma?
A. there is a decreased incidence with smoking and obesity
B. symptoms do not include hematuria, abdominal mass, flank pain, fever and weight loss
C. it invades the renal vein early
D. it is associated with a gene deletion on chromosome 2

A

It invades the renal vein early is true about RCC.

-there is an increased incidence with smoking and obesity, symptoms are the one’s listed and it is associated with a gene deletion on chromosome 3 *RCC= 3 letters = chromosome 3

25
Q

If I said muddy brown cast, you would say ______?

A

ATN- acute tubular necrosis

26
Q

If I said WBC cast, you would say ________?

A

acute pyelonephritis or AIN

27
Q

If I said RBC cast, you would say _______?

A

GN- glomerular nephritis

28
Q

If I said eosinophils you would say _________?

A

AIN- acute interstitial nephritis

29
Q

If I said dipstick was positive for blood but no RBC you would say ________?

A

Rhadomyolysis

30
Q

Which of the following is false of pre-renal AKI?
A. it is the most common cause of AKI in the ambulatory patient
B. GFR is increased
C. FeNA is

A

GFR is decreased in pre-renal AKI due to the decreased hydrostatic pressure in the glomerulus

31
Q 
Which of the following is NOT an indication for acute hemodialysis:
A. uremia
B. intoxication (meds)
C. uncorrectable acidosis
D. hematuria
A

hematuria is incorrect

*remember* AEIOU 
A-uncorrectable acidosis
E-electrolyte resistant to treatment (hyperkalemia)
I- intoxication (meds)
O- overload (volume, pulmonary edema)
U- uremia
32
Q 
Which of the following is gold standard for urinary calculi diagnostic evaluation:
A. computed tomography (CT)
B. ultrasound
C. ESWL
D. x-ray
A

CT of the abdomen and pelvis without oral or intravenous contrast

33
Q

Which are indications for urgent intervention for urinary stones?
A. Obstructed urinary tract with infection
B. Intractable nausea/vomiting
C. Pain that is controlled by analgesics
D. A & B

A

A & B are correct, other indications are impending renal deterioration and pain refractory to analgesics

34
Q 
2/3 of ureteral stones pass within \_\_\_\_\_\_ and if they have not passed within this time frame intervention is needed.
A. 24 hours
B. 3 days
C. one week
D. four weeks
A

four weeks

35
Q

Select the correct order of kidney stone composition from most common to least common:
A. cystine - uric acid - calcium oxalate - struvite
B. calcium oxalate - ammonium magnesium phosphate - cystine -uric acid
C. Struvite - calcium oxalate - uric acide - cystine
D. calcium oxalate - ammonium magnesium phosphate - uric acid - cystine

A

calcium oxalate - ammonium magnesium phosphate (struvite) - uric acid - cystine

36
Q 
Involuntary urine leak with coughing, sneezing, lifting, straining or exercise is known as \_\_\_\_\_\_\_.
A. urge urinary incontinence
B. stress urinary incontinence 
C. this defines A & B
D. none of the above
A

stress urinary incontinence

37
Q 
You have diagnosed your patient with stress urinary incontinence and they have decided to pursue surgical treatment, what is your best option:
A. Midurethral sling placement
B. Periurerthral bulking agent injection
C. Pelvic floor strengthening exercises
D. there is no surgical options for SUI
A

Midurethral sling placement

38
Q 
Which of the following medications clear slowly with renal failure:
A. Insulin
B. Narcotics
C. Benzodiazepines 
D. some antibiotics
E. all of the above
A

All of the above

39
Q 
Flat t waves indicates:
A. hypokalemia
B. hyperkalemia
C. hyponatremia
D. hypernatremia
A

hypokalemia

40
Q 
Tented t waves indicates:
A. hypokalemia
B. hyperkalemia
C. hyponatremia
D. hypernatremia
A

hyperkalemia

41
Q 
If you replace sodium too fast to correct hyponatremia it can lead to:
A. brain swelling
B. sudden death
C. central pontine myelinolysis
D. parkinson's disease
A

central pontine myelinolysis

42
Q 
If you give fluids too fast to correct hypernatremia it can lead to:
A. brain swelling
B. sudden death
C. central pontine myelinolysis
D. parkinson's disease
A

brain swelling

43
Q 
This lies between the fibrous capsule and renal fascia:
A. perirenal fat
B. pararenal fat
C. peritoneum
D. kidney
A

PERIrenal fat

44
Q 
This lies just outside of the renal fascia:
A. perirenal fat
B. pararenal fat
C. peritoneum
D. kidney
A

PARArenal fat

45
Q

What is the cockcroft & gault equation?

A

Creatinine clearance = (140-age) X weight (kg) / serum creatinine x 72

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