1. Which of the following statements about kidney biopsy is true?

(a) It is usually required to confi rm a diagnosis of diabetic nephropathy

(b) It causes bleeding in a minority of patients
(c) It is essential to diagnose anti-glomerular basement membrane disease
(d) It requires a general anaesthetic
(e) It should only be performed if it will change patient management

2. In someone aged 35 years with an eGFR of 65 ml/min/1.73 m 2

, by how much
does an albumin:creatinine ratio of 42 mg/mmol increase the risk of mortality
compared to no albuminuria?

(a) 1.5 times

(b) 2 times
(c) 4 times
(d) 9 times
(e) 12 times

3. When should a patient be transferred to the multidisciplinary team to prepare

them for dialysis?

(a) When the eGFR goes below 20 ml/min/1.73 m 2

(b) When the patient develops symptoms of uraemia
(c) When the eGFR goes below 10 ml/min/1.73 m 2
(d) When the rate of decline in eGFR is greater than 10 ml/min/1.73 m 2
/year
(e) When dialysis is likely to be needed within the next 12 months

4. Which of the following statements about a peritoneal dialysis catheter is true?

(a) Fluid should take under 20 min to drain out

(b) The tip should be located in the centre of the abdomen
(c) Fluid should be slightly cloudy on draining out
(d) Dried exudate (‘crusting’) at the exit site should be treated with antibiotics
(e) It should be replaced once a year to reduce the risk of infection

5. Which of the following statements about a kidney transplant patient is false?

(a) Infections after 12 months are usually due to conventional organisms

(b) Post-transplant lymphoproliferative disease is due to T cell proliferation

(c) Cotrimoxazole is used to prevent Pneumocystis jiroveci pneumonia (PJP)

(d) The commonest site of malignancy is the skin
(e) Post-transplant lymphoproliferative disease may regress if immunosup-pressive drugs
are stopped

6. Glomerulonephritis is a renal disease characterized by:

A. Inflammation of the glomeruli.

B. Stricture of the glomeruli.

C. Destruction of the glomeruli.

D. Hypertension.

7. In acute Glomerulonephritis the most common cause of infection is:

A. Syphilis

B. Measles

C. Steptococcus

D. Toxoplasmosis

8. Patients with acute glomerulonephritis may have mild hypertension due to:
A. Increased intravascular pressure.

B. Retention of sodium and fluid.

C. Increased heart rate due to fever.

D. Elevated liver enzymes.

9. In a patient diagnosed with acute glomerulonephritis the presence of nausea, vomiting, or

anorexia may indicate what complication.
A. Acute Renal Failure

B. Uremia

C. Sepsis

D. Wenckebach periodicity

10. A patient discharged with a diagnosis of glomerulonephritis should be instructed to call

the doctor if they gain how much weight?
A. 2 pounds in a day.

B. 2 pounds in a week.

C. 10 pounds in a day.

D. 2 kilograms in a day.

11. Anemia is a common condition. What happens when a person has anemia?
A. The body produces too much iron
B. The blood does not have enough red blood cells
C. The blood becomes thick
D. Too many white blood cells are produced

12. What is the most common cause of anemia?

A. Too little sleep

B. Too much sugar
C. Too little iron in the blood
D. Exposure to X-ray radiation

13. Which of these groups is the most likely to have anemia?

A. Men
B. Women
C. Teenagers
D. Older adults

14. How does anemia affect the body?

A. The blood doesn't deliver enough oxygen to the body

B. Blood becomes thin
C. Tissues retain fluids
D. None of the above

15. A lack of which of these will result in abnormally large red blood cells and a condition
called megaloblastic anemia?

A. Oxygen
B. Vitamin C
C. Vitamin B-12 and folic acid
D. Carbon dioxide

16. The feature NOT seen in hemolytic anemia is

A.Increased urobilinogen in urine

B.Increased serum bilirubin
C.Decreased iron stores
D.Increased stercobilinogen in stool

17. Following features are characteristic of intravascular red cell destruction EXCEPT

A.Increased haptoglobin
B.Hemosiderinuria
C.Hemoglobinuria
D.Hemoglobinemia
18. The feature indicative of extravascular red cell destruction is
A.Hemoglobinemia
B.Decreased haptoglobin
C.Splenomegaly
D.Hemoglobinuria

19. Hemolytic anemia is characterized by all EXCEPT

A.Thrombocytopenia
B.Increased erythropoietin levels
C.Increased reticulocytes
D.Erythroid hyperplasia

20. The following is NOT a feature of hemolytic anemias

A.Accumulation of products of hemoglobin

B.A shortened red cell life span
C.Elevated erythropoietin levels
D.Defective DNA synthesis

21. How would you diagnose aplastic anemia?

a. Blood smear
b. Bone marrow biopsy
c. Spleen biopsy
d. CBC
e. Liver biopsy

22. Decreased or stopped production of alpha-globin chains results in HbH (4 gamma chains
together) and Hb Barts (4 beta chains together)

a. True
b. False

23. Aplastic anemia can be acquired (more common) and inherited. What are some of the
ways it can be
acquired?

a. Postviral infection
b. Pregnancy
c. Ionizing radiation
d. Drugs and chemicals
e. Idiopathic
f. All of above

24.. Fe is absorbed in the

a. Stomach
b. Duodenum
c. Jejunum
d. Ileum

25. Pica, a clinical presentation for Fe deficiency anemia, is

a. Itchiness
b. ED
c. Desire to eat weird things
d. A small woodland creature

26. Which lab investigations would you order if you suspect Fe deficiency anemia? (check all
that apply)

a. CBC
b. Blood smear
c. Serum iron
d. Serum ferritin
e. TIBC
f. All of the above

27.Which of the following confirmed values meet the diagnostic threshold for diabetes?

a) fasting blood glucose ? 140 mg/dl

b) random glucose > 160 mg/dl
c) 2 hour post prandial glucose ≥ to 126 mg/dl
d) fasting blood glucose ≥ 126 mg/dl

28.Which of the following statements is correct?

a) Insulin suppresses the activity of glycogen synthase

b) Insulin mediates glucose uptake in the brain

c) "Prediabetes" is a condition characterized by an increased risk for the future development

of type 2 diabetes

d) The rise in insulin concentration after meal ingestion is reduced in type 1 but not in type 2
diabetes

29.Insulin deficiency is associated with

a) Reduced lipolysis

b) Increased ketogenesis
c) Reduced gluconeogenesis

d) Reduced proteolysis

30.The risk factors for type 2 diabetes mellitus include:

a) family history

b) being overweight

c) high intake of dietary fat

d) All of the options listed are correct

31.The pathogenesis of hyperglycemia in type 2 diabetes includes all the following

mechanisms except for:

a) Increased glucose production by the liver

b) Impaired insulin secretion

c) Decreased glucose uptake from the skeletal muscle

d) All of the options given are correct

32. The thyroid produces hormones that regulate what bodily function?
A Metabolism
B Temperature
C Blood pressure
D Digestion

33. Weight loss, rapid heart rate, and heat sensitivity are likely symptoms of...
A Hypothyroidism (underactive thyroid)
B Hyperthyroidism (overactive thyroid)
C Thyroid cancer
D All of the above

34. Symptoms such as very high body temperature, rapid heartbeat, and shortness of breath
describe:
A Thyroid storm
B Thyroid crisis
C Thyroid failure
D Thyroid death

35. Thyroid disorders are sometimes mistaken for which disease or condition?
A Crohn's disease
B Menopause
C Pregnancy
D Posttraumatic stress disorder

36. What are early signs and symptoms of rheumatoid arthritis (RA)?
A Joint pain, tenderness, redness, and swelling
B Loss of joint range of motion
C Limping
D All of the above

37. Rheumatoid arthritis (RA) is different from some other forms of arthritis because it…
A Is more painful than other forms
B Occurs below the waist
C Is symmetrical, affecting the right and left sides of the body
D Generally occurs above the waist

38. Rheumatology is the branch of medicine that involves the study of…
A The immune system
B Musculoskeletal (muscles and bones) system
C Rheumatic diseases
D All of the above

39. The sudden appearance or worsening of RA symptoms is referred to as a(n)…

A Outbreak
B Flare
C Burst
D Eruption

40. What joints are most often affected by osteoarthritis?

A Hands
B Hips
C Both hands and hips
D Shoulders

41. What are risk factors for developing osteoarthritis?

A High blood pressure
B Weight loss
C Age over 55
D Steroid use

42. What medications are used to treat osteoarthritis?

A Acetaminophen (Tylenol)
B Nonsteroidal (NSAIDs)
C Hyaluronate injections
D Narcotic pain medications

43. All of the following statements are true about the pathogenesis of osteoarthritis (OA)
EXCEPT:

A.It is simply a “wear and tear” process.

B.Risk factors include aging, joint injury, obesity, and genetics.

C.X-rays may be normal despite significant pain from OA early in the process.

D.Current treatments for OA are directed to controlling pain, and none have been proven to
alter the progression of the disease.

44.All of the following statements are true about the clinical manifestations and diagnosis of
OA EXCEPT:

A.OA may be diagnosed on clinical grounds alone.

B.Without radiographic evidence of OA, the diagnosis cannot be made.

C.OA has a predilection for the knees, hips, and hand joints.

D.Prolonged morning stiffness or rapidly progressive pain might indicate a different

pathology.

45.All of the following statements are true about typical management of OA EXCEPT:

A.Goals of OA management are to minimize pain, optimize function, and tailor care to the
individual’s needs, goals, and values.

B.Nonpharmacologic interventions are the mainstay of OA management and should be tried

first.

C.Pharmacologic management of OA includes oral and topical nonsteroidal anti-

inflammatory drugs (NSAIDs), topical capsaicin, duloxetine, and intraarticular
glucocorticoids.

D.Pharmacologic management of OA includes opioids.

46. Which part of the body might be affected by lupus?

A. Joints
B. Skin
C. Kidneys
D. Heart
E. Brain
F. All of the above

47. What happens to the immune system of a person who has lupus?

A. The immune system makes antibodies against the body's cells

B. The immune system doesn’t make enough antibodies to fight off illness
C. The immune system doesn’t make any antibodies
D. None of the above

48. Besides SLE, which of these is another form of lupus?

A. Discoid lupus erythematosus
B. Lupus caused by certain medicines
C. Neonatal lupus
D. All of the above

49. Which group of people is more likely to have lupus?

A. African-American men
B. African-American women
C. Caucasian men
D. Caucasian women

50. Although the exact cause of lupus isn't yet known, which of these are believed to be
factors?

A. An inherited gene
B. Exposure to ultraviolet light
C. Estrogen
D. All of the above