UWORLD RENAL

Question 1

palpable purpura, GN, non specific signs like arthrlagia, hepatosplenomegaly, low complement levels,
usually associated with HCV

Answer 1

cryoglobulinemia

Question 2

symptoms of hypercalcemia

Answer 2

weakness, GI distress, neuropsychiatric (confusion/stupor/coma)…patients also usually volume depleted due to polyuria and hypercalcemic induced nephrogenic DI.

Question 3

treatment of hypercalcemia

Answer 3

1. AGGRESSIVE FLUIDS
2. calcitonin
3. bisphosphonates (pamidronate, alendronate, zaote something acid), but may take longer to get rid of calcium

Question 4

MCC of kidney stones

Answer 4

calcium oxalate stones from fat malabsorption (chronic diarrhea, small bowel disease, resection)

Question 5

When to not use metformin

Answer 5

in critically ill patients

induces lactic acidosis which can be nephrotoxic

Question 6

chronic bladder pain worse with filling, relieved by voiding, increased urgency/frequency, dyspareunia. normal U/A

Answer 6

interstitial cystitis (painful bladder syndrome)…

exclude PID (cervical motion tenderness/fever), or UTI (nitrates/leuko esterase on UA)

Question 7

euvolemic (BUN:Cr < 20), hyponatremia with high urine Na and osmolarity, decreased serum osm, failure to correct with fluids

Answer 7

SIADH

Question 8

non anion gap metabolic acidosis + hyperkalemia + preserved/moderately reduced kidney function

Answer 8

type 4 RTA (hyperkalemic RTA)

Question 9

best way to test for DM nephropathy

Answer 9

urine microalbumin/Cr ratio

Question 10

When to give calcium gluconate for hyperkalemia?

Answer 10

K> 7.0 or ECG changes

Question 11

common causes of hyperkalemia

Answer 11

AKI
CKD
MEDICATIONS
RAAAS disorder

Question 12

side effect of H1-antihistamines (i.e. diphenhydramine)

Answer 12

anti-cholinergic effects = urinary retention (due to detrusor hypoactivity), eye/mouth dryness

Question 13

treatment for UNCOMPLICATED and COMPLICATED cystitis

Answer 13

uncomplicated - nitrofurantonin, bactrim, or fosfomycin
complicated - culture + quinolone?

complicated = pyelo, penis, procedure, pregnancy, immunocompromised, diabetes/renal failure

Question 14

MCC glomerulopathy associated with HIV

Answer 14

FSGS

Question 15

side effects of thiazides

Answer 15

hyperglycemia, increased LDL + triglycerides, increased uremia, hyponatremia, hypokalemia, hypomag, hypercalcemia

Question 16

hypotonic (serum osm< 275) hyponatremia + euvolemia + increased urine Osm, + increased urine Na

Answer 16

SIADH (associated with SSRIs in elderly as one cause)

Question 17

single kidney + low volume urine + flank pain

Answer 17

obstructive uropathy

Question 18

common side effect of rifampin

Answer 18

red/orange discoloration of urine; but must r/o renal diagnosis with u/a

Question 19

recent coronary procedure/catheterization, elevated serum creatinine, eosinophilia, hypocomplement, purple mottling of skin

Answer 19

cholesterol emboli (leads to multisystem involvement)…contrast nephropathy usually doesn’t present with multi system involvement

Question 20

elderly, combining analgesics-> renal failure

Answer 20

analgesic nephropathy from papillary necrosis or chronic tubuluointerstitial nephritis

Question 21

What can cause mixed metabolic acidosis and respiratory alkalosis

Answer 21

aspirin toxicity

Question 22

hypovolemic hypernatremia how to treat

symptomatic and asymptomatic

Answer 22

asymtomatic - d5w

symptomatic (hypotension, dehydration) - 0.9 saline FIRST then d5w after patient is euvolemic

Question 23

markedly elevated Ca, low PTH, normal/low phos

Answer 23

hypercalcemia of malignancy (due to secretion of PTH related protein by cancer cells…can be lung, head and neck, bladder, breast, ovarian cancers

Question 24

expected lab values in hypovolemia

Answer 24

increased BUN:Cr ratio, decreased urine Na (RAAAS system activated so sodium is reabsorbed and less excreted, also more K is excreted)

Question 25

hypercalcemia (polyuria, polydipsia), kidney stones, neuropsychiatric presenations (depression, psychosis, ood swings), HTN

Answer 25

primary hyperparathyroidism