Medicine 6th Le Ay 2011-2012 Nephro Part

MEDICINE 6TH LE A.Y. 2011-2012 41. 41. A 35 y/o male patient, admitted for acute gastroenteritis with severe volume depletion was noted to have urine output of 20 ml/hr for the past 8 hours. He weighs 60 kg. a. To what stage of acute kidney injury would the patient be classified? b. Stage I c. Stage II d. Stage III e. NOTA 42. 55 y/o diabetic male admitted to the ICU for sepsis due to pneumonia, his latest labs showed serum creatinine of 6.5mg/dl. 4 months ago, he has proteinuria nad his serum creatinine was 2 mg/dl. The most likely diagnosis is: a. Acute kidney injury stage 2 b. Acute kidney injury stage 3 c. Acute kidney injury stage 2 on top of chronic kidney disease d. Acute kidney injury stage 3 on top of chronic kidney disease 43. AKIN (acute kidney injury network) stage 2 is equivalent to which aspect of the old RIFLE criteria: a. Risk b. Injury c. Failure d. Loss 44. Early biomarkers of acute kidney injury includes a. Urine NGAL b. Urine KIM-1 (kidney injury molecule-1) c. Urine NAG (N-acetyl glucosamide) d. AOTA 45. Which of the ff is also known as “super creatinine” a. BUN b. Cystacin C c. Serum NGAL d. Fetuin A 46. In the autoregulation of renal blood flow, at what level of systolic blood pressure does the renal blood flow starts to fall precipitously? a. Below 110 b. Below 100 c. Below 90 d. Below 80 47. Which of the ff is an endogenous nephrotoxin? a. Hemoglobin b. Bicarbonate c. Contrast media d. Amphotericin B 48. Which of the ff laboratory parameter is compatible with acute tubular necrosis: a. Fractional excretion of sodium = 0.7% b. BUN/Creatinine ratio = 30:1 c. Urine sodium = 40 meq/L d. Urine osmolality = 700 mosmol/L 49. A normal urinalysis in a patient with acute kidney injury is compatible with Team D5 – KVO

a. b. c. d.

acute bladder outlet obstruction acute tubular necrosis acute interstitial nephritis acute glomerulonephritis

50. Which of the ff has been proven to hasten recovery from acute tubular necrosis: a. infusion of low dose dopamine b. IV high dose furosemide c. Early hemodialysis d. NOTA 51. 23 year old hazing victim is noted to have scanty brown colored urine and rising levels of serum creatinine. What is the cause of the tubular injury a. RBC b. Myoglobin c. Hemoglobin d. Volume depletion 52. Which of the ff statements is true regarding prognosis of patients with Acute kidney injury a. There have a high mortality rate of about 50% b. Most common cause of death is uremia c. Less than 70% of survivors will recover renal function d. Use of CRRT (continuous renal replacement therapy) significantly improves survival 53. Which of the ff can increase the risk for NSAID induced nephrotoxicity a. Use of diuretics b. Advance age c. CHF d. AOTA 54. A 40 year old male came in your clinic for check-up. he wanted to know if he has a kidney problem since his mother died of renal complication of hypertension. His BP is 130/80, weight of 60kg. his creatinine is 0.8 mg/dL and his urinalysis and KUB ultrasound showed normal results. What stage of CKD does he belong to? a. He has no CKD b. Stage 0 c. Stage 1 d. Stage 2 55. A 50 year old female came in due to her regular check-up. She has been diabetic for 5 years. Her HBa1c is 7.5%, creatinine is 1.2 mg/dL and her urinalysis showed the ff: sp. gravity of 1.015, acidic, light yellow, no sugar, no protein, 0-2 WBC/hpf, 0-1 RBC/hpf, no casts, no bacteria. What is the next step to determine if she has renal damage? a. Repeat urinalysis and creatinine yearly b. Request for KUB Ultrasound c. Do a renal biopsy d. Request for a microalbuminuria test 56. What is the main reason for the development of salt and water retention in patients with CKD? a. Patients become anuric b. Renal disease disrupt the glomerulotubular balance Page 1 of 5

c. d.

There is impaired thirst regulation hence prompting the patient to drink more water They are resistant diuretic therapy

57. A 56 year old male was diagnosed to have CKD secondary to hypertensive nephrosclerosis. His BP is 170/90 and other pertinent PE findings include periorbital edema, distention of neck veins, bibasal crackles, and grade 2 bipedal edema. Serum Na id 128. Which should be the first thing that you will advise a. water restriction b. give higher doses of furosemide c. limit salt intake d. add calcium channel blocker to control BP 58. Which of the ff is a CKD related risk factor for CVD? a. Hyperparathyroidism b. Hypervolemia c. Hypertension d. Sympathetic overactivity 59. A 65 year old male, diagnosed to have CKD secondary to diabetic nephropathy cane in your clinic. his BP id 180/100 mmHg with PMI at 6th ICS LMCL. Creatinine is at 1.5 mg/dL and urinalysis showed sp. gravity of 1.015, ++++ protein, +sugar, 02 WBC, 0-1 RBC, no bacteria, few epithelial cells. Which of the ff is the plan of management a. BP control at