W0 Practice Questions

Question 1

Hypertension, pruritus and xerosis are common findings in which patient?

Answer 1

Uremic patient

Question 2

Chronic renal failure presents with which LOW electrolyte imbalances?

Answer 2

LOW Ca++
LOW NA+

HIGH phosphate
Metabolic acidosis (low pH)

Hypocalcemia in chronic renal failure is due to two primary causes - increased serum phosphorus and decreased renal production of 1,25 (OH)2 vitamin D.

The former causes hypocalcemia by complexing with serum calcium and depositing it into bone and other tissues.

The latter causes hypocalcemia by decreasing the GI absorption of calcium.

Question 3

Hematuria
Red blood cells casts
Proteinuria

Answer 3

Nephritic syndrome

Question 4

Renal colic
Hematuria
UA — crystals resembling coffin lids and
KUB reveals staghorn calculus
What is this?
Treatment?

Answer 4

Percutaneous nephrolithotomy
Struvite stones

Question 5

Low purine diet for which type of stone?

Answer 5

Uric acid stone

Question 6

High fluid and low salt diet for which type of stone?

Answer 6

Cystine stone

Question 7

Treatment for stage 1 testicular seminoma

Answer 7

Orchiectomy and active surveillance
No chemo for this stage

Question 8

Which syndrome:
Proteinuria
Hyperlipidemia
Hypoalbuminemia

Answer 8

Nephrotic syndrome

Question 9

Tx for chronic bacterial prostatitis?

Answer 9

Levofloxacin (FQ)
Or
Bactrim

Needed to penetrate the prostate

Question 10

Treatment for pregnant patient with pyelonephritis

Answer 10

IV ceftriaxone (rocephin)

Question 11

Broad waxy casts in urinary sediment are a specific finding in what?

Answer 11

Chronic renal failure

Question 12

Hyaline casts in urinary sediment could be normal or could indicate 3

Answer 12

Dehydration
Strenuous exercise
Febrile illness

Question 13

Post op patient w/ increase BUN:Cr
FeNa <1%
Most likely diagnosis ?

Answer 13

Prerenal azotemia

Azotemia = elevated levels of urea

Question 14

Blood at end of urinary stream, origin? 2

Answer 14

Bladder neck
Prostatic urethral source

Question 15

Which is the preferred pharm agent to decrease bed wetting episodes?

Answer 15

Imipramine OR desmopressin

Question 16

Treatment of acute renal failure d/t rhabdo is best accomplished with ?

Answer 16

IV fluids (IV sodium bicarb)
Forced alkaline diuresi

Question 17

Treatment for acute prostatitis + toxic appearing, febrile…

Answer 17

Ampicillin & gentamicin

Question 18

Patient presents w/ oliguria, hematuria, protinuria following streptococcal pharyngitis 2 weeks ago

Answer 18

Acute glomerulonephritis
(Nephritic syndrome — post infectious GAS)

Question 19

Which medication to prevent progression of diabetic nephropahty?
What does it do?

Answer 19

ACEI

Prevents the progression of Proteinuria

They improve glomerulus hemo dynamics by decreasing glomerular pressure

Question 20

2-3 weeks post streptococcal infection, edema, HTN, cola-coloured urine
Dx?

Answer 20

Post streptococcal glomerulonephritis

Question 21

Edema, hypoproteinemia, hyperlipidemia, >3.5 proteinURIA in 24h.
Children post URI

Answer 21

Minimal change disease

Question 22

Medication that causes acute tubular necrosis?

Answer 22

Gentamicin — aminoglycosides

Question 23

Treatment of choice for a patient who develops acute urinary retention with acute bacterial prostatitis (non pharm)

Answer 23

Percutaneous suprapubic tube
Don’t want to catheterise a patient w/ acute bacterial prostatitis

Question 24

12 year old
Hematuria, cola urine, oliguria, edema of face and eyes in the morning
UA: RBCs, mild Proteinuria and RBC casts
Pharyngitis 2 weeks ago …

Answer 24

Glomerularnephritis — group A strep «post infectious»

Question 25

Prerenal azotemia is due to what?
Which is due to?

Answer 25

HyPOperfusion of kidneys
D/t:
—volume depletion from diuresis, hemorrhage and GI losses

Question 26

Treatment for acute epididymitis?
What time of bacteiria?

Answer 26

Ceftriaxone
Neisseria gonorrhoeae — gram negative intracellular diplococci

Question 27

White cell casts are indicative of?

Answer 27

Renal infection or inflammation:
—pyelo
—interstitial nephritis

Question 28

Red cell casts are indicative of?

Answer 28

Glomerulonephritis

Question 29

Patient presents with urge incontinence, some leakage, which medication?

Answer 29

Oxybutynin
Anticholinergics, relax pelvic muscles

Question 30

Patient w/ lupus, + significant peripheral edema,
UA: Proteinuria, hypoalbuminemia, hyperlipidemia
How to diagnose?

Answer 30

Renal biopsy — performed in adults w/ new onset nephrotic syndrome

Question 31

Chronic alcoholic presentations w/ hypokalemia must be treated with what? 2

Answer 31

IV magnesium
& potassium

Question 32

Pt w/ small cell lung cancer presents w/ hyponatremia, treatment?

Answer 32

Hypertonic saline

Question 33

Complication associated with nephrotic syndrome

Answer 33

DVT
Hypercoagulability may be due to the loss of anti-thrombin III, platelet abnormalities, hyperviscosity of blood caused by Hypovolemic and increased synthesis of clotting factors

Question 34

Which drugs for these:
Urge:
Stress
Overflow

Answer 34

Urge: anticholinergic
Stress topical estrogen in women
Overflow * alpha blockers**

Question 35

❗️[must know]
Explain the patho of SIADH and diabetes insipidus
And the impact on Na+

Answer 35

Syndrome of Inappropriate (release) of Antidiuretic Hormone ( “SIADH” ):
—SIADH characterised by oliguria
—Increased water being absorbed
—Increase in intravascular volume
—Diluting Na+ in solution
—Which presents in the lab as low serum Na+

Diabetes Insipidus ( “DI” ):
—A syndrome clinically characterized by polyuria and polydipsia, most commonly either 2/2:
—Decreased production of ADH by the hypothalamus or decreased release f/ posterior pituitary (aka “Central DI”) ← so this is also a central dysfunction
—Decreased renal response to serum ADH (“Nephrogenic DI”) ← various inherited syndromes, ADPKD, ESRD
—DI is highly associated with HyperNatremia (but sometimes HypoNa too)

Question 36

❗️[must know]
Hyponatremia
Clinical features, 3 dangerous ones

Answer 36

Seizures
Coma
Brainstem herniations

Question 37

❗️[must know]
Patient admission for UTI

Answer 37

recent procedure!