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AMC MCQ > Neurology > Flashcards

Neurology Flashcards

1
Q

Glomerulonephritis:
1-post streptococcal glomeruolonephritis:
History

A

.URTI in the last 1-2 weeks

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2
Q

Glomerulonephritis

Organism……..

A

group A- beat hemolytic streptococci

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3
Q

Glomerulonephritis

Cp:

A

Oliguria

Edema

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4
Q

Glomerulonephritis

HTN

A

Tea-colored urine

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5
Q

Glomerulonephritis

Labs:

A

Hematuria and mild protenuria

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6
Q

Glomerulonephritis

Inv of choice

A

…renal biopsy

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7
Q

Glomerulonephritis TTT:

FIRST STEP

A

..admission

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8
Q

Glomerulonephritis Diet

A

increased carbohydrate and decrease protein

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9
Q

Anti-hypertensive drugs and fluid restriction for Glomerulonephritis is..

A

..most imp step

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10
Q

Glomerulonephritis Fate

A

over 95 % complete recovery

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11
Q

IgA nephropathy (Berger)

Most common type of )___________
Most common cause of _________ in kids

A

Most common type of glomerulonephritis

Most common cause of renal failure in kids

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12
Q

Berger’s History

A

.URTI in the last 1-2 days

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13
Q

Berger’s Cp

A

HTN

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14
Q

Labs (Berger’s)

A

.hematuria ( GROSS) and proteinuria…..best is biopsy

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15
Q

TTT (Beger’s)

A

.cortisone and control blood pressure

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16
Q

Renal affection 1-2 days of URTI =
Renal affection after 1-2 weeks =
Most common cause of renal failure in pediatrics =

A

Renal affection 1-2 days after URTI………IGA nephritis
Renal affection after 1-2 weeks……….post strep. Glomerulonephritis
Most common cause of renal failure in pediatrics…..IGA
nephritis

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17
Q

Thin basement membrane nephropathy: (benign hematuria) :

Is the most common cause of?

A

Most common cause of persistent glomerular bleeding in children and adults

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18
Q

Thin basement membrane nephropathy

Signs and symptoms:

A

Hematuria
Blood pressure, kidney function…… normal.
Mild proteinuria

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19
Q

Thin basement membrane nephropathy

Treatment

A

only reassurance.

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20
Q

Thin basement membrane nephropathy

Prognosis:

A

excellent prognosis.

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21
Q

Alport syndrome:

A

X-linked

Triad ( hematuria, ocular abnormalities and deafness)

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22
Q

hemolytic uremic syndrome :

Cause

A

:( E-coli O157-H7)

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23
Q

hemolytic uremic syndrome :

Source

A

..undercooked meat, unpasteurized milk

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24
Q

hemolytic uremic syndrome :

History

A

.bloody diarrhea

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25
Q

hemolytic uremic syndrome :

Age

A

Kids

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26
Q

Cp:

A

5- 7 days of infection…….intravascular hemolysis

Sudden pallor and irritability

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27
Q

hemolytic uremic syndrome :

Kidney affection

A

.oliguria and renal in sufficiency

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28
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA:

More in kids or adults?
Affected?

A

more in the adult
The same scenario but the CNS is the most commonly
Affected……neurological symptoms and fever

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29
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

Labs:

A

Low platelets
Schistocytes
Anemia

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30
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

TTT

A

plasmapharesis …….ttt of choice

Never to give platelets

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31
Q

Henoch schonlein purpura pathology:

A

IGA NEPHRITIS

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32
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

CP:

A

1-Hematuria
2-abdominal pain
3-joint pain esp. knee
4-rash ( maculopapular) affecting buttock and knee (vasulitis

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33
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

History

A

URTI

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34
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

Complication

A

Intussusceptions vvvvvv imp

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35
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

Fate

A

..usually resolve spontaneously

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36
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

TTT

A

USUALLY NONE

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37
Q

THROMBOTIC THROMBOCYTOPENIC PURPURA

Resistant cases…

A

.cortisone is the drug of choice

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38
Q

Proteinuria:
Orthostatic:
Age

A

usually kids and adolescent

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39
Q

Proteinuria

First step

A

.repeat the test

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40
Q 
Proteinuria
If still (+)
A

24 h urine collection

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41
Q

Proteinuria

TTT

A

….reassure

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42
Q

Proteinuria Transient:

Causes:

A

.fever, exercise, dehydration, cold exposure, seizure

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43
Q

Proteinuria Transient

Fate

A

resolve spontaneously…..reassure

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44
Q

What if this proteinuria is recurrent…..biopsy …vvvv imp???

A

Proteinuria and hematuria in kids with URTI

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45
Q

Proteinuria and hematuria in kids with URTI

First step

A

repeat the test after recovery from the URTI

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46
Q

Nephrotic syndrome marked?

A

marked edema esp. periorbital

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47
Q

Nephrotic syndrome Cp:

A

Most common type

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48
Q

Nephrotic syndrome Labs:

A

Proteinuria ++++
Hypoalbuminemia
Hyperlipidemia

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49
Q

Nephrotic syndrome Renal functions

A

usually normal

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50
Q

Nephrotic syndrome Complications:

A

1-Infections

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51
Q

Nephrotic syndrome Organism

A

streptococcus pnemoniae

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52
Q

Nephrotic syndrome Most common area affected

A

..spontaneous bacterial peritonitis

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53
Q

Nephrotic syndrome 2-thrombophilia…

A

…esp renal vein thrombosis

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54
Q

Nephrotic syndrome
TTT:
Mild cases

A

.home management and bed rest

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55
Q

Nephrotic syndrome

Severe cases

A

hospital admission

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56
Q

Nephrotic syndrome

Diet

A

increase protein

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57
Q

Nephrotic syndrome

Drug of the choice

A

steroid

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58
Q

Nephrotic syndrome

If resistant

A

.immunosuppressive

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59
Q

Vesicoureteral reflux is?

A

Abnormal backflow of urine from bladder to kidney

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60
Q

Vesicoureteral reflux

Cp:

A

recurrent UTI infections

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61
Q

Vesicoureteral reflux

Complications:

A

Recurrent pyelonephritis…..scarring…..renal failure

62
Q

Vesicoureteral reflux

Inv:

A

VCUG……….of choice

63
Q

Vesicoureteral reflux

Inv for the scars

A

..DMSA scan

64
Q

Vesicoureteral reflux

Grades

A

..1-5 according to severity

65
Q

Vesicoureteral reflux

Fate

A

majority resolve by age 6-7 ys

Grade 5 rarely resolves

66
Q

Vesicoureteral reflux

TTT:

A

Prophylactic antibiotics (trimethoprim sulpha)……continuously

67
Q

obstructive uropathy:
1-posterior urethral valve:
Complications:

A

Renal failure

Hydronephrosis

68
Q 
obstructive uropathy (PUV)
Diagnosis:
69
Q 
obstructive uropathy (PUV)
TTT:
A

Decompress the bladder with catheter

Transurethral ablation

70
Q

2-ureteropelvic junction obstruction is the most common cause of :

A

Most common cause of obstructive uropathy

71
Q 
obstructive uropathy (UJO)
Cp:
A

Hydronephrosis…..renal mass and pain

Recurrent UTI

72
Q

obstructive uropathy (UJO)
Inv:
Prenatally

73
Q 
obstructive uropathy (UJO)
 INV After birth
74
Q 
obstructive uropathy (UJO)
TTT
A

endoscopic ttt

75
Q

Hepatorenal syndrome:

A

Severe liver cell failure
New onset renal failure with no explanation
No improvement in renal functions with fluids or diuretics

76
Q

Hepatorenal syndrome

Labs

A

.increased creatinine and BUN

77
Q

Hepatorenal syndrome

TTT:

A

OCTREOTIDE

78
Q

Athero-emboli after catheter:

A

..vvvvvvvvvimp

79
Q

Athero-emboli

Cause

A

cholesterol emboli

80
Q

Athero-emboli

Cp:

A

History of catheterization

Blue/purple skin lesion in finger and toes

81
Q

livedo reticularis is?

A

…Network like rash

82
Q

livedo reticularis

Labs:

A

Eosinophilia

83
Q

livedo reticularis

TTT

84
Q

Contrast induced nephropathy:
History of radiological procedures
Labs

A

increased creatinin

85
Q

Contrast induced nephropathy

Prevention

A

…hydration vvvvvvvvvvvviml

86
Q

ANALGESCIC INDUCED NEPHROPATHY:

A

Long intake of analgesic e:g: analgesics

87
Q

ANALGESCIC INDUCED NEPHROPATHY

Labs

A

increased creatinine

88
Q

ANALGESCIC INDUCED NEPHROPATHY

TTT

A

stop the drug

89
Q

GOOD PASTURE SYNDROME:

A

vvvvvvvvvvvvvvv imp

90
Q

GOOD PASTURE SYNDROME
Affection of 2 organs:
Lung

A

.hemoptysis and dyspnea

91
Q

GOOD PASTURE SYNDROME
Affection of 2 organs:
Kidney

A

.hematuria

92
Q

GOOD PASTURE SYNDROME

x-ray

A

.bilateral lung involvement

93
Q

GOOD PASTURE SYNDROME

Screening……

A

.anti basement membrane antibody

94
Q

GOOD PASTURE SYNDROME

Most accurate

A

.renal biopsy…..linear deposit

95
Q

GOOD PASTURE SYNDROME

TTT

A

plasmapharesis and steroid

96
Q

Wegner granulomatosis:
Affection of 3 organs:
1.)URT……

A

.sinusitis, epistaxis, otitis

97
Q

Wegner granulomatosis:
Affection of 3 organs
2.)LRT……

A

..cough and hemoptysis

98
Q

Wegner granulomatosis:
Affection of 3 organs
3.) Kidney…

99
Q

Wegner granulomatosis

Best initia

A

.C-ANCA antibody

100
Q

Wegner granulomatosis

Best accurate

A

..renal biopsy

101
Q

Wegner granulomatosis

TTT

A

steroid and cyclophosphamide

102
Q

Renal failure:
Types:
Prerenal……

A

.most common type

103
Q

Renal failure:
Types:
Hypotension e.g:

A

anaphylaxis

104
Q

Renal failure:
Types:
Hypovolemia e.g:

105
Q

Renal failure:
Types:
Intrinsic:

A

Toxins

Ischemia

106
Q

Renal failure:
Types:
Post renal:

A

Stones

BPH

107
Q

Renal failure

Cp:

A

Weakness, malaise, nausea , vomiting, confusion

108
Q

Renal failure

Complications…………

A

….vvvvvvvvvvvvvvvvvvvvvvvvv imp

109
Q

1-anemia

Type

A

.Iron defiency anemia

110
Q

1-anemia

TTT

A

erythropoietin

111
Q

2- hypocalcemia……

A

osteoporosis

112
Q

2- hypocalcemia…

TTT……

A

.ca and vit D

113
Q

3-bleeding

Cause

A

..platelets dysfunction

114
Q

4-hyperphosphatemia

A

…vvvvvvvvvvvvvvv imp

115
Q

4-hyperphosphatemia

TTT…

A

.dietary restriction and oral phosphate binders

116
Q

5- pericarditis

A

…vvvvvvvvvvvv imp

117
Q

5- pericarditis

Cp……

A

sharp chest pain increases with respiration and decreases with leaning forward

118
Q

5- pericarditis

ECG

A

ST segment elevation in all leads

119
Q

5- pericarditis

TTT………

A

.immediate dialysis

120
Q

ECG……

A

.Tall T-wave

121
Q

TTT…….

First step

A

Ca gluconate till dialysis is ready

122
Q

Second step…

123
Q

Dialysis:
Indications:

A

Hyperkalemia
Metabolic acidosis
Pericarditis
Fluid overload

124
Q

Complications of dialysis:

1-hypotension:

A

Most common complication with dialysis

125
Q

Complications of dialysis:
1-hypotension:
Cause

A

over removal of fluid

126
Q

1-hypotension:

TTT

A

.IV bolus fluid

127
Q

2-HTN

Cp……

128
Q

2-HTN

Cause

A

.over fluid infusion

129
Q

Types of Transplant: (4)

A

Autograft: transfer of tissue from and to the same person
Allograft: transfer between two genetically non-identical
Syngraft: transfer of tissues or organs from an identical twin
Xenograft: transfer of tissues or organs across species

130
Q

Types of graft rejections:

Rejection on table

A

1-.hyperacute

2-acute rejection

131
Q

Types of graft rejections:

1-Rejection on table

A

.hyperacute

132
Q

2-acute rejection

Timing of acute rejection

A

Timing of acute rejection….days to months

133
Q

2-acute rejection

Most common pathology

A

..acute tubular necrosis….vvvvv imp

134
Q

TTT of choice for acute rejection

135
Q

3-chronic rejection

A

.months to year

136
Q

TTT of chronic rejection

A

re transplantation

137
Q

Best ttt of renal failure?
Best donor for transplantation?
Most common cause of death with dialysis?
Antihypertensive contraindicted in renal impairment?
Best way to asses patient with renal failure?

A

Best ttt of renal failure…….transplantation
Best donor for transplantation…….living relative donor
Most common cause of death with dialysis…..CVS
Antihypertensive contraindicated in renal impairment…ACEI
Best way to asses patient with renal failure…..body weight

138
Q

Renal artery stenosis:
Causes:
Young Age?
Old Age?

A

Young age……fibromuscular dysplasia

Old age…….atherosclerosis (over 90% of cases)

139
Q

Renal artery stenosis

Cp:

A

Majority……asymptomatic

140
Q

Renal artery stenosis

HTN

A

Impaired renal functions

Exam…….abdominal bruit

141
Q

Renal artery stenosis

Labs:

A

Rennin…….increased (activation of rennin angiotensinogen

system)

142
Q

Renal artery stenosis

Investigation of choice

A

angiography

143
Q

Renal artery stenosis

TTT:

A

Unilateral………ACEI

Bilateral……..angioplasty and STENT……of choice

144
Q

Renal artery stenosis

ACEI

A

.CONTRAINDICATED WITH BILATERAL RENAL ARTERY STENOSIS

145
Q

Sterile pyuria:

Pus or organism

A

Pus but nooo organism

146
Q

Sterile pyuria

Causes:

A

TB ……vvvvvv imp

Incomplete ttt

147
Q

Overload in patients of renal failure:
Most common symptoms?
Most important inv?
Most imp ttt?

A

Most common symptom……….dyspnea
Most important inv………….ABG……vvvvvvvvvvvvvv imp
Most imp ttt…………dialysis

148
Q

Additional notes
Rash after URTI after receiving antibiotics???

Raised above surface and non blanching?
Raised above surface+joint pain + abd pain+hematuria?
Maculopapular rash after ampicillin?
Rash+wheezy chest +vomiting?

A

Raised above surface and non blanching…….vasculitis
Raised above surface+joint pain + abd pain+hematuria…….HSP
Maculopapular rash after ampicillin………EBV
Rash+wheezy chest +vomiting………anaphylaxis

149
Q

Most accurate way to asses fluid input and output in renal failure and cardiac patients

A

weight followed by 24 h urine

150
Q

HIV patient on antiretrovial drugs developed renal colic

A

.CT without contrast

The nephrotoxic combination of antibiotic is gentamycin+cephalexin.

AMC MCQ (14 decks)

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