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GU > Zombie TBL Questions > Flashcards

Zombie TBL Questions Flashcards

1
Q

Question: Which of the following complications is not usually associated with autosomal dominant polycystic kidney disease (ADPKD)?
a) Aneurysms
b) Fetal pulmonary hypoplasia
c) Kidney stones
d) Flank/kidney pain

A

B: Fetal pulmonary hypoplasia

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2
Q

Question: A 52-year-old patient experiences acute kidney injury after being placed on an ACE inhibitor. She has a history of hypertension, hyperlipidemia, and chronic smoking. An abdominal bruit was noted on her last exam but never followed up on. What is the likely underlying cause of her AKI?

A

RAS

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3
Q

Question: The “golfball on a tee” sign and “ring shadow” sign on renal imaging are classically associated with which disorder?

A

Analgesic nephropathy (papillary necrosis)

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4
Q

Question: What can reduce the risk of nephrotoxicity in a CKD patient who must receive a procedure that utilizes IV contrast?

A

Administering normal saline IV before and after the procedure or discontinuing all other potentially nephrotoxic drugs

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5
Q

A patient with 150 mg/d secretion of protein in the urine would fit what A category of chronic kidney disease?

A

A2

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6
Q

Postinfectious glomerulonephritis is which type of glomerulonephritis?

A

Immune complex deposition

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7
Q

Why is hypercoagulability seen in nephrotic syndrome?

A

Urinary loss of protein C, protein S, and antithrombin

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8
Q

What medication has been shown to slow the progression of autosomal dominant polycystic kidney disease?

A

Tolvaptan (Samsca, Jynarque)

I think only jynarque technically works for ADPKD specifically

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9
Q

What class of drugs is classically known for inducing AKI in patients with bilateral renal artery stenosis?

A

ACEs/ARBs

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10
Q

What type of chronic kidney disease is associated with asymmetric kidneys
on imaging, displaying areas of thin atrophic parenchyma interspersed with enlarged
hypertrophic parenchyma?

A

vesicoureteral reflux (will consider chronic tubulointerstitial disease)

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11
Q

What current set of criteria are most commonly used (and most preferred) to
score the severity of acute kidney injury?

A

KDIGO

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12
Q

A pH of less than _____ in an AKI patient requires the start of urgent
hemodialysis.

A

7.1

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13
Q

A patient in AKI is found to have dark brown urine with a positive urine dip for
blood, but no red blood cells are visible on microscopy. What is the most likely cause?

A

Myoglobinuria

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14
Q

An ANCA level is helpful to diagnose which type of renal disease?

A

Pauci-immune GN

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15
Q

What condition would preclude the use of IV fluids in a patient with prerenal azotemia?

A

Volume overload or acute decompensated HF

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16
Q

In a patient with normally functioning kidneys and fluid volume excess, their urine osmolality should be:

A

Lower than usual

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17
Q

When is the best time to administer oral phosphate binder medications?

A

With a meal

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18
Q

A patient is found to have muscle weakness, hypotension, palpitations, and constipation. Their T wave on ECG tracing has diminished amplitude. What is their most likely electrolyte abnormality?

A

Hypokalemia

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19
Q

Vasopressin Receptor Antagonists are most useful in the treatment of what electrolyte or acid-base disorder?

A

Hyponatremia

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20
Q

This is produced by the liver as a waste by-product of protein breakdown:

A

Urea

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21
Q

Compared to an average patient, a vegan’s serum creatinine should be:

A

Lower

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22
Q

What type of nephron has the longest loop of Henle?

A

Juxtamedullary nephron

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23
Q

The system of shifting osmolality of the urine filtrate and surrounding tissue that allows the body to concentrate fluids is best known as:

A

Countercurrent mechanism

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24
Q

The specialized cells in the afferent arteriole that are the primary source of renin secretion are called:

A

JG cells

25
Q

The active form of vitamin D secreted by the kidneys is known as:

A

Calcitriol

26
Q

What is the gold standard for diagnosing renal
artery stenosis?

A

Renal artery angiography

27
Q

What finding would you expect to see on the
urinalysis of a patient with CKD?
○ RBC casts
○ Broad, waxy casts
○ WBC casts
○ “Muddy brown” casts

A

Broad, waxy casts

28
Q

What is the most common cause of chronic
tubulointerstitial disease?
○ Vesicoureteral reflux
○ Obstructive uropathy
○ Analgesic nephropathy
○ Nephrocalcinosis

A

Obstructive uropathy

29
Q

What is the most common physical exam finding
in Chronic Kidney Disease (CKD)?

A

HTN

30
Q

What is the most common cause of chronic
nephrotic glomerular disease among US patients?
○ Diabetes mellitus
○ Hypertension
○ Alcoholism
○ Acute kidney injury

A

DM

31
Q

What is the most common primary
glomerulonephritis worldwide?
○ Amyloidosis
○ Pauci-immune glomerulonephritis
○ Henoch-Schonlein purpura
○ Berger’s disease (IgA nephropathy)

A

Berger’s disease/IgA nephropathy

32
Q

What part of the kidney contains glomeruli?

A

Renal cortex

33
Q

This portion of the nephron secretes
protein-bound drugs:

A

Proximal tubule

34
Q

Creatine, the precursor to creatinine, comes
from what source(s)?

A
  • 50% liver
  • 50% diet
35
Q

A patient with a history of protracted vomiting who
has been NPO with continuous NG suction for the last 48 hours
develops agitation, dizziness, paresthesias, and muscle tetany.
What acid-base disorder is most likely?

A

Metabolic alkalosis

36
Q

A patient with acute kidney injury develops
symptomatic metabolic acidosis. What two primary modalities
are considered for treatment of metabolic acidosis in AKI?

A
  • Bicarb
  • Dialysis
37
Q

Which two lab values are used to stage CKD?

A
  • GFR
  • Albuminuria
38
Q

In the CKD patient, HTN, volume overload,
anemia, and accelerated atherosclerosis all increase the
workload of the heart which can lead to this complication:
○ Cardiogenic shock
○ Left ventricular hypertrophy
○ Cardiac tamponade
○ Cardiac arrhythmias

A

LVH

39
Q

A 4-yr-old patient presents with a patchy, palpable rash on the
lower extremities and buttocks. He also complains of belly pain, nausea, and
says his knees hurt. 10 days ago, this patient was treated for strep throat. UA
reveals hematuria and mild proteinuria. What is the most likely diagnosis?
○ Berger’s disease (IgA nephritis)
○ Minimal change disease
○ Henoch-Schonlein purpura
○ Post-streptococcal glomerulonephritis

A

Henoch-schonlein purpura

40
Q

Combination therapy with fibrates and statins in
CKD patients increases the risk of what condition?

A

Rhabdomyolysis

41
Q

Which of the following is not a risk factor for CKD?
○ Smoking
○ High triglycerides
○ Proteinuria
○ Hypertension

A

High triglycerides

42
Q

Cinacalcet, used in patients with advanced CKD,
acts primarily on which of the following organs?
○ Parathyroids
○ Liver
○ GI tract
○ Kidney

A

Parathyroid glands

43
Q

Which of the following medications would pose the
greatest risk of later development of AKI?
○ levothyroxine
○ acetaminophen
○ amoxicillin
○ potassium

A

Amoxicillin

44
Q

A patient in acutely decompensated congestive heart
failure has developed a significant elevation in serum BUN and
Cr and a fall in eGFR over the last 24 hours. The most likely type
of AKI present is:

A

Prerenal azotemia

45
Q

An AKI patient presents with potassium of 6.9 (normal: 3.5-5.0), weakness, palpitations, and EKG changes. What medication should be administered first to address the patient’s hyperkalemia?

A

IV calcium gluconate

46
Q

Hypernatremia is commonly a normal physiologic response
to which of the following disease states?
○ Hyperuricemia
○ Dehydration
○ Constipation
○ Hypertension

A

Dehydration

47
Q

Rhabdomyolysis is most strongly associated with which form
of acute kidney injury?
○ Acute glomerulonephritis
○ Acute prerenal azotemia
○ Acute tubular necrosis
○ Acute interstitial nephritis
○ Acute postrenal obstruction

A

ATN

48
Q

What is the GFR indication to begin dialysis in
chronic kidney disease patients?

A

GFR of <= 10

49
Q

Which of the following would be the first step in
treating a patient diagnosed with obstructive uropathy?
○ Administer Lasix (furosemide)
○ Perform a renal ultrasound
○ Remove obstruction
○ Administer antibiotics

A

Remove obstruction

50
Q

Levels of ________ are often elevated in CKD
patients, leading to reduced iron absorption and
decreased mobilization of iron from body stores.

A

Hepcidin

51
Q

Which organism is classically associated with
postinfectious glomerulonephritis?

A

GABHS

52
Q

Which of the following would not be appropriate to
treat the increased cardiac workload in CHF?
○ ACE inhibitor/ARB
○ Increased fluid intake
○ Sodium restriction
○ Furosemide (Lasix)

A

Increased fluid intake

53
Q

What is the most common complication of
peritoneal dialysis?

A

Peritonitis

54
Q

A CKD patient presents to the clinic with bone pain in her wrists
for a few weeks. On x-ray, “brown tumors” are seen. Her labs reveal an
elevated phosphorus level. What is the most appropriate initial step in the
management of this patient?
○ Start calcitriol (vitamin D)
○ Refer the patient for chemotherapy
○ Start oral phosphorus binders
○ Limit dietary phosphorus intake

A

Limit dietary phosphorus

55
Q

What is the most common complication of CKD?
○ Hyperkalemia
○ Hyperlipidemia
○ Hypertension
○ Bone disease
○ Anemia

A

HTN

56
Q

What is the most common presenting symptom
of Berger’s disease (IgA nephritis)?

A

An episode of gross hematuria

57
Q

A 3-yr-old girl presents with severe edema and foamy urine.
Labs reveal the presence of hyperlipidemia, severe proteinuria, and
hypoalbuminemia. What is the best initial treatment?
○ Lisinopril
○ Prednisone
○ Calcium carbonate
○ Amoxicillin

A

Prednisone

58
Q

Which of the following is not typically associated
with nephritic syndrome?
○ Oliguria
○ Hypertension
○ Hyperlipidemia
○ Hematuria

A

HLD

59
Q

Which of the following physical exam findings
would be most associated with a diagnosis of uremia?
○ Fever
○ Increased appetite
○ Shortness of breath
○ Dysuria

A

SOB

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