Renal/ GUM

Question 1

Renal tubular acidosis (RTA) associated with abnormal H+ secretion and nephrolithiasis

Answer 1

Type I (distal) RTA

Question 2

RTA associated with abnormal HCO3- re absorption and rickets

Answer 2

Type II (proximal) RTA

Question 3

RTA associated with low aldosterone state

Answer 3

Type IV (distal) RTA

Question 4

Treatment of hyperNa

Answer 4

Unstable vital signs –> normal saline; D5W or half NS to replace free water loss

Question 5

DDx of hypotonic hypervolaemic hypoNa

Answer 5

Cirrhosis, CHF, nephrotic syndrome, AKI, CKD

Question 6

Chvostek & Trousseau signs

Answer 6

HypoCa

Question 7

Two most common cause of hyperCa

Answer 7

Malignancy & hyperparathroidism

Question 8

T-wave flattening & U waves

Answer 8

HypoK

Question 9

Peaked T waves & widened QRS

Answer 9

HyperK

Question 10

Treatment of HyperK

Answer 10

C BIG K
- calcium gluconate 10ml 10%
- bicarb (not UK)
- insulin 
- glucose 
- kayexalate
Or salbutamol to drive K in

Question 11

First line treatment of hyperCa

Answer 11

IV fluids

Question 12

Type of AKI with FeNa <1%

Answer 12

Pre renal

Question 13

49 yr old man presents with acute onset flank pain and haematuria

Answer 13

Nephrolithiasis

Question 14

Most common type of nephrolithiasis

Answer 14

Calcium oxalate

Question 15

Test of choice for nephrolithiasis

Answer 15

Non-contrast CTKUB

Question 16

USS shows bilateral enlarged kidney cysts. Associated brain anomaly?

Answer 16

Cerebral berry aneurysms (autosomal dominant poly cystic kidney disease)

Question 17

Haematuria, hypertension, oliguria

Answer 17

Nephritic syndrome

Question 18

Proteinuria, hypoalbuminaemia, hypelipidaemia, hyperlipiduria & oedema

Answer 18

Nephrotic syndrome

Question 19

The most common form of nephrotic syndrome in adults

Answer 19

Focal segmental glomerulosclerosis

Question 20

Nephritic syndrome presenting 3 days after UTI, normal C3

Answer 20

IgA nephropathy (Berger disease)

Question 21

Palpable purpura, arthralgia, abdominal pain

Answer 21

Henoch- Schönlein purpura

Question 22

Glomerulonephritis with deafness

Answer 22

Alport syndrome

Question 23

Glomerulonephritis with haemoptysis

Answer 23

Granulomatosis with polyangiitis (Wegeners) & Goodpastures syndrome

Question 24

Presence of red cell casts in urine sediment

Answer 24

Glomerulonephritis or nephritic syndrome

Question 25

Eosinophils in urine sediment

Answer 25

Allergic interstitial nephritis

Question 26

Waxy casts in urine sediment and Maltese crosses (seen with lipiduria)

Answer 26

Nephrotic syndrome

Question 27

Muddy brown casts

Answer 27

Acute tubular necrosis

Question 28

Drowsiness, asterixes, nausea, pericardial friction rub

Answer 28

Uraemia syndrome seen in patients with renal failure

Question 29

55 year old man is diagnosed with prostate cancer. Treatment options?

Answer 29

Wait, surgical resection, radiation therapy and/or androgen suppression

Question 30

Haematuria in a 50yo smoker

Answer 30

Bladder cancer

Question 31

Haematuria, flank pain, palpable flank mass

Answer 31

Renal cell carcinoma

Question 32

Testicular cancer associated with beta-hCG

Answer 32

Choriocarcinoma

Question 33

Most common type of testicular cancer?

Answer 33

Seminoma - type of germ cell tumour

Question 34

Most common histology of bladder cancer

Answer 34

Transitional cell carcinoma

Question 35

Complication of overly rapid correction of hypoNa?

Answer 35

Central pontine myelinolysis

Question 36

Salicylate ingestion occurs in what type of acid base disorder?

Answer 36

Anion gap acidosis & primary respiratory alkalosis due to central respiratory stimulation

Question 37

Acid-base disturbance commonly seen in pregnant women

Answer 37

Respiratory alkalosis

Question 38

55 year old man presents with irritating and obstructive urinary symptoms. Treatment options?

Answer 38

BPH

No treatment, terazosin, finasteride or TURP