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Internal Medicine > WSCredit 2 Renal > Flashcards

WSCredit 2 Renal Flashcards

1
Q

All of the following would cause edema except:

  • Hypertension
  • Liver disease
  • Incompetent venous valves
  • Hypoproteinemia
A

Hypertension

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2
Q

What are the clinical signs of hypovolemia?

  • Oliguria and cold extremities
  • Bradycardia and dyspnea
  • Hypertension and vertigo
  • Polyuria and alkalosis
A

Oliguria and cold extremities

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3
Q

High anion gap is due to:

  • Accumulation of lactate
  • Renal failure
  • Diarrhoea
  • Benzodiazepine intoxication
A

Accumulation of lactate

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4
Q

Auditory problems have often patients suffering from:

  • Gouty nephritis
  • Alport disease
  • Diabetic nephropathy
  • AD polycystic kidney disease
A
  • Alport disease
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5
Q

In peritoneal dialysis the inflow fluid is rendered hyperosmolar by the addition of

  • ATP
  • polyethylene glycol
  • Sodium
  • Glucose or icodextrin
A

Glucose or icodextrin

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6
Q

Increased risk of intracranial bleeding is associated with:

  • Oxalate stones
  • AD polycystic kidney disease
  • Renal tubular acidosis
  • Agenesis of one kidney
A

AD polycystic kidney disease

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7
Q

To compensate for metabolic acidosis … will:

  • Decrease respiratory rate
  • Increase respiratory rate
  • Excrete more monohydrogen phosphate
  • Excrete more bicarbonate ions
A

Increase respiratory rate

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8
Q

Life threatening complication of the correction of chronic hyponatremia might be:

  • Hypotension
  • Pontine myelinolysis
  • Seizures
  • Hypokalemia
A

Pontine myelinolysis

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9
Q

The falling blood pH and rising partial pressure of CO2 due to pneumonia or emphysema indicates:

  • Metabolic alkalosis
  • Respiratory alkalosis
  • Metabolic acidosis
  • Respiratory acidosis
A
  • Respiratory acidosis
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10
Q

Typical blood elements found in patients with microangiopathic haemolytic anemia of patients with TTP / HUS are:

  • Spherocytes
  • Microspherocytes
  • Schistiocytes
  • Acanthocytes
A

Schistiocytes

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11
Q

Glomerular filtration rate in healthy women during 2nd and 3rd trimester of pregnancy is

  • Increased
  • Unchanged
  • First increases, then suddenly decreases
  • Decreases
A

Increased

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12
Q

Which condition would cause a drop in … (pCO2?? Or pH ?? don’t know)

  • Hyperventilation
  • Shock
  • Vomiting
  • Hypernatremia
A

Shock

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13
Q

Which EKG results would you expect to find in hyperkalemia ?

A

Peaked t wave

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14
Q

Hyperkalemia is caused by:

A

Potassium excess
Reduced excretion: acute and chronic kidney disease
hypocortisolism, hypoaldosteronism
potassium-sparing diuretics, ACE inhibitors, angiotensin receptor blockers, NSAIDs, and trimethoprim-sulfamethoxazole
Type IV renal tubular acidosis
myolysis, tumor lysis, hemolysis
Increased intake (high potassium diet, K+ containing IV fluids)
Extracellular shift
Acidosis → ↑ extracellular H+ → inhibition of the Na+/H+ antiporter → ↓ intracellular Na+ → ↓ sodium gradient inhibits the Na+/K+-ATPase → ↑ extracellular K+ concentration
Hyperkalemia → ↑ extracellular K+ concentration → ↑ potassium gradient stimulates the Na+/K+-ATPase → ↑ extracellular Na+ → ↑ sodium gradient stimulates the Na+/H+ antiporter → ↑ extracellular H+ → acidosis
Exceptions: In renal tubular acidosis and acetazolamide toxicity, findings include hypokalemia and metabolic acidosis.
Hyperosmolality
Insulin deficiency (manifests with hyperglycemia)
rhabdomyolysis, tumor lysis syndrome, hemolysis
Drugs
Beta-blockers
Succinylcholine: (esp. when given with preexisting burns and/or muscle trauma)
Digoxin: inhibits the Na+/K+-ATPase → ↑ extracellular K+ concentration

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15
Q

Diabetic ketoacidosis is an example of which imbalance?

  • Respiratory acidosis
  • Metabolic alkalosis
  • Respiratory alkalosis
  • Metabolic acidosis
A

Metabolic acidosis

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16
Q

Suggestive clinical findings for renovascular hypertension are not:

  • Acute rate of onset
  • Severe and refractory hypertension
  • Onset of resistant hypertension before the age of 30 years
  • Mild hypertension and onset in elderly
A

Mild hypertension and onset in elderly

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17
Q

A renal bruit is associated with which of the following disorders:

  • Renal artery stenosis
  • Polyarteritis nodosa
  • Hypertensive nephropathy
  • Wegeners granulomatosis
A

Renal artery stenosis

18
Q

Immunosuppressive drugs used after (renal?) transplantation are all of the following (except?)

— Cyclosporine A
— Cyclophosphamide (or other source→“triple therapy”)
— Prednisone
— Mycophenolate mofetil

A

Cyclophosphamide (or other source→“triple therapy”)

19
Q

the effect of NSAIDs on (on the kidneys?) circulation:

A

Renal function impairment: Prostaglandins normally maintain renal blood flow by inducing vasodilation of the afferent arterioles. NSAIDS inhibit prostaglandin production, which leads to harmful hypoperfusion of the kidneys and reduced GFR.
Analgesic nephropathy: prolonged NSAID use results in tubulointerstitial nephritis and papillary necrosis

20
Q

Which of the values are in the normal renge for potassium:

  • 4.3
  • 3.3
  • 6.5
  • 2.8
A
  • 4.3
21
Q

Drug induced hyperkalemia is caused by:

  • Heparin (uncommon side effect only)
  • Digoxin
  • Beta agonists
  • ACE inhibitors
A

ACE inhibitors

22
Q

Hematuria in IgA nephropathy usually appears:

  • With a latency of 2-3 weeks after throat infections
  • With a latency of 2-3 weeks after infection of any origin
  • During an infection
  • With a latency of 2-3 weeks after a UTI
A

During an infection

23
Q

Optimal and most often used vascular access for chronic haemodialysis is:

  • CVC
  • Peritoneal catheter
  • AV fistula in forearm
  • PVC, usually in EJV
A

AV fistula in forearm

24
Q

An important means of regulating Na+ and H2O balance in the body is through secretion of aldosterone

—true
—false

A

True

25
Q

Ideal Kidney donor is:

Non-heart-beating donor
Transgenic pig
Living donor
Deceased donor

A

Living

26
Q

Hypovolemia can be caused by all of the following, except:

  • Aldosterone hypersecretion
  • Diarrhoea
  • Polyuria
  • Bleeding
A

Aldosterone hypersecretion

27
Q

Lab analysis in nephrotic syndrome does not reveal:

  • Proteinuria
  • Hypalbuminemia
  • Hypercholesterolemia
  • polyglobulia
A

polyglobulia

28
Q

Hyperventilation causes the pH to elevate:

  • True
  • False
A

True

29
Q

Which of the following EKG results would you expect in hyperkalemia

  • St depression
  • Tall t
  • T wave flattening
  • Short qrs
A

Tall t

30
Q

Urinary protein losses exceeding 0.150 g/24 h
- Cannot be ignored and must be further evaluated
- This trace of urine does not need further evaluation
- Must be further evaluated only in patients with simultaneous dysuria and another pathology
in urinary sediment
- Must be further evaluated only in patients with simultaneous dysuria and nycturia

A

Cannot be ignored and must be further evaluated

31
Q

A 62 year old man with COPD, baseline PCO2 8kPa and HCO3- 30mmol/l is administered to the hospital with somnolence and confusion following a flu-like syndrome.
Lab test showed pH 7.22, PCO2 10kPa, HCO3- 32 mmol/l, Na+ 141 mEq/l, K+ 4mEq/l. What is the underlying acid-base disorder?
- Respiratory acidosis plus metabolic acidosis
- Chronic respiratory acidosis
- Respiratory acidosis plus metabolic alkalosis
- Chronic respiratory acidosis plus acute respiratory acidosis

A

Chronic respiratory acidosis plus acute respiratory acidosis

32
Q

In peritoneal dialysis metabolic waste products diffuse from peritoneal capillaries into the dialysis fluid down concentration gradient

  • True
  • False
A

T

33
Q

A blood pH < 7.35 indicates acidosis but it does NOT tell you the cause

  • True
  • False
A

T

34
Q

Which condition would cause a drop in pH?

  • Shock
  • Hypervolemia
  • Vomiting
  • Hypernatremia
A

Shock

35
Q

What is the effect of NSAIDS on renal circulation?

  • NSAIDs cause dilation of afferent arteriole and increase renal perfusion pressure
  • NSAIDs cause constriction of afferent arteriole and decrease renal perfusion pressure
  • NSAIDs lead to vasoconstriction of vas efferens and increase glomerular perfusion
  • NSAIDs normalize glomerular perfusion in the case of severe diarrhoea
A

NSAIDs cause constriction of afferent arteriole and decrease renal perfusion pressure

36
Q

Which method of glomerular filtration rate assessment do we use to determine the stage of chronic kidney disease?

  • Serum cystatin C measurement
  • Calculation using MDRD formula
  • Acidification test
  • Mean urea and creatinine clearance
A

Calculation using MDRD formula

37
Q

Basic principle of hemodialysis is/are

— selective elimination of uremic toxins in bioreactor
— adsorption of immune complexes and uremic toxins
— separation of plasma by filtration
— diffusion of solutes across a semipermeable membrane and ultrafiltration

A

diffusion of solutes across a semipermeable membrane and ultrafiltration

38
Q

What electrolyte imbalance can be treated by administration of glucose and insulin

— hyperkalemia
—hypokalemia
— hyponstremia
— hypercalcemia

A

Hyperkalemia

39
Q 
Increased risk of urinary tract cancer is not associated with 
—smoking
—oxalate stones
—Heavy metals
—asbestos
A

Oxalate Stones

40
Q

Antineutrophil cytoplasmic antibodies are typically detected in

— any urinary tract infection
— wegener´s granulomatosis
— bacterial pyelonephritis
— renal vein thrombosis

A

wegener´s granulomatosis

41
Q

Abnormally high levels of CO2 in the blood would result in respiratory alkalosis

—True
—False

A

False —> acidosis

Internal Medicine (3 decks)

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