Renal

Question 1

5 year old peeing at night dx?

Answer 1

get a 24 hr urine sample

Question 2

22 y/o w/ many hyaline in urine dx?

Answer 2

mixed mem glum

Question 3

child w/ abdominal mass + hema + HTA dx?

Answer 3

nephroblastoma

Question 4

long term use of what class causes hypokalemia, hypomagnesium, hypercalemia, and hyponatremia?

Answer 4

Thiazide diuretic

Question 5

MUDPILES mean?

Answer 5

Question 6

What does a prolonged QT mean?

Answer 6

low potassium

Question 7

which of the following is a first line treatment for atrial fibrillation (afib) with rapid ventricular rate (RVR)?

Answer 7

diltiazem

Question 8

which of the following is considered a first line therapy for PTSD?

Answer 8

3 weeks

Question 9

24yoF presents with a 1 day history of nausea, vomiting. she also reports dysuria and frequency x 3 days. Patient denies previous urinary tract infections or recent sexual activity. V/S: 102F temp, 100/min pulse, 16/min RR, 110/80 BP. urinary analysis is positive for nitrites and leukesterase +4, 80-100 WBC/hpf, 18,000 WBCs. what is the next appropriate treatmen

Answer 9

ceftriaxone (NOT TMP-SMX)

Question 10

67yoF with a history of breast cancer presents for a follow up 4 days after chemotherapy complaining of fatigue.
Labs:
serum Na+129
urine Na+ 30
serum osmolality 200
urine osmolality 400
what is the initial treatment?

Answer 10

fluid resuscitation

Question 11

which calcium salt dose provides 1-2 grams of elemental calcium per day?

Answer 11

calcium carbonate 1500mg BID

Question 12

60yoM with a history of heart failure is in the hospital because of an acute weight increase and edema. The patient is currently taking metoprolol, furosemide and lisinopril. A basic metabolic panel (BMP) reveals K+ 3.0 (low). what is the most appropriate initial daily dose of K+?

Answer 12

40 meq PO BID

Question 13

calculate the corrected serum calcium given the total serum calcium is 7.6 and the serum albumin is 2.8.

Answer 13

8.6
Ca 2+ = 0.8 (4 - serum albumin) + ca 2+

Question 14

what is the most common cause of atubular necrosis (ATN)?

Answer 14

hyperuricemia

Question 15

patients taking loop diuretics are at an increased risk for which of the following adverse drug reactions?

Answer 15

ototoxicity

Question 16

7yoM presents with a history of dark urine for three days. mom reports the patient had a strep infection 2 weeks ago. V/S are normal with an elevation in blood pressure 130/90. Physical exam reveals bilateral periorbital and hand edema. urinalysis is positive for blood and protein in the urine. a basic metabolic panel reveals → BUN 25 (elevated), serum Cr 1.7 (elevated). what is the most appropriate step for this patient?

Answer 16

give furosemide

Question 17

72yoM with a history of multiple myeloma presents with confusion, lethargy, nausea, and weakness. V/S are normal with an elevation in blood pressure of 135/95. The patient is altered to person only. On physical exam the abdomen is painful to palpation and there are decrease bowel sounds on auscultation. Labs:
Ca++ 12
albumin 3.5
BUN 28
Cr 2.5
what is the next step?

Answer 17

0.9% normal saline

Question 18

26yoF marathon runner presents with nausea, vomiting, cramps, lethargy, and confusion after running an ultramarathon in intense heat. the patient serum sodium (sNa+) is 122 (low). what is the next step?

Answer 18

3% NaCl solution

Question 19

49yo white M presents with left flank pain. he has a chronic history of pseudogout. V/S: 98.8F temp, 86/min pulse, 18/min RR, 173/99 BP. imaging reveals a 4mm stone in the left ureterovesical junction (UVJ) without hydronephrosis. UA confirms there is NO urinary tract infection and the renal function is normal. tamsulosin and analgesics are given. what else should be done for the patient?

Answer 19

discharge the patient with hydrochlorothiazide (HCTZ)

Question 20

67yoM presents w/ fever, chills, flank pain, and dysuria. He has a past medical history of bladder cancer and CT of the abdomen/pelvis reveals a trigonal mass, with hydronephrosis and perinephric edema. it has been determined that the patient is not a candidate for general anesthesia given his history of congestive heart disease (CHD). what is the next best step in the management of the patient?

Answer 20

order a consult for nephrostomy tube insertion

Question 21

63yoM is recently admitted for emesis secondary to a small bowel obstruction. nasogastric tube reveals aspiration of gastrointestinal contents.
Na+, K+, Cl, Ca++, CO2 → low
BUN → 45 elevated
Glu → 276 elevated Cr → 1.8 elevated what is the next step?

Answer 21

lactated ringers