Sarwar Sarkawt Asaad Nephrology Choose the single best answer: 1. The following are features of acute interstitial nephritis, except: a, In 90% of patients progress to chronic renal failure b. Fever c. Rash d. Eosinophilia e, Drugs are the most common cause 2. Extrarenal manifestations of polycystic kidney disease include the following, except: a. Mitral valve prolapses b. Diverticular disease of the colon c. Tendency to thrombosis d. Hepatic cysts e. Aneurysm at the Circle of Willis 3. The following drugs are contraindicated in pregnancy, except: (Amoxicillin is not contraindicated) a. Tetracycline b. Ciprofloxacin c, Amoxicillin d. Trimethoprim e. Fosfomycin 4. The following are complicated urinary tract infections, except: a. Leukaemic patient with pyuria b. Diabetic with asymptomatic bacteriuria c. Pregnant with pyuria d. Young adult female with low grade fever and hacmaturia . Male with frequency and urgency 5. In renovascular hypertension the following are false, except a. Angiotensin converting enzyme inhibitors are contraindicated b. Beta blockers are contraindicated ¢. Calcium channel blockers are safe d. Captopril renogram is the best screening test e. Magnetic resonance angiography is not useful for screening 6. Intype 4 renal tubular acidosis the following are true, except: a. Hypokalaemia -> if causes hyperkalaemia b. Diabetes mellitus is a cause c. Acidosis is mild 34|PageSarwar Sarkawt Asaad d. Aldosterone deficiency is a feature e. Captopril can be given safely in this condition 7. Spot the correct statement in respect of nephrogenic diabetes insipidus: Careeji) The diagnosis is excluded if urine osmolality >600 mosm/L May occur as a primary autosomal dominant disorder May be associated with chronic hypocalcaemia Thiazide is ineffective in treating this condition Chlorpropamide is of a potential benefit 8. Concerning manifestation of distal renal tubular acidosis, each of the following is tue, except: (Xarecii) Osteomalacia Renal calculi Constipation Renal failure Hyperkalaemia 9. Characteristics of benign orthostatic proteimuria include each of the following, except: (Xuree)i) . Non-selective Benign urine sediment <1 giday Typical diurnal fluctuation e. Increase with time 10.The following are typical features of the haemolytic uraemic syndrome, except: a. Reticulocytosis b. Low serum haptoglobin c. Thrombocytosis d. Fragmentation of red cell e. Negative coomb's test 11 Indications for urgent dialysis in uraemic patients include each of the following, except: a. Asterixis b. Pericarditis Hiccups Peripheral neuropathy e. Pulmonary ocdema 12.In patients with renal failure the following statements are false, except: a. Nitrofurantoin is a suitable antibiotic for treating UTI b. Hyperuricemia requires treatment with Allopurinol oe as epRege ae se ao 35|PageSarwar Sarkawt Asaad ¢. Calcitriol increases intestinal absorption of phosphate d, Furosemide increases GER c. B12 supplements are required a. Severe intractable diarrhoea b. Life-threatening alcohol withdrawal ¢. Unexplained digoxin toxicity @ Hypothyroidism e. Refractory cardiac arrhythmias 14.The followings are the features of renovascular hypertension, except: a. Severe hypertension is the feature Flash pulmonary oedema Renal failure can occur in some cases Family history is always positive . Angiotensin converting enzyme inhibitors are useful in many cases 15.The following drugs can be used in the treatment of urinary tract infections in pregnancy, except: a. Nitrofurantoin b. Sulfadiazine c. Fosfomycin d. Amoxicillin e. Ciprofloxacin 16.The followings are risk factors for renal cell carcinoma, except: a, Smoking Acquired renal cysts in haemodialysis patient Industrial toxin exposure Repeated heavy urinary tract infections e. Analgesic nephropathy 17.The followings are indications to screen for renovascular hypertension, except: a. Resistant hypertension b. Renal impairment after the use of angiotensin converting enzyme inhibitors c. Hypertension controlled with single drug d. Hypertension with asymmetry in the renal size c. Hypertension with atherosclerosis after the age of 55 years 18.Acute glomerulonephritis with a reduced serum complement level is not a characteristic of: a. Systemic lupus erythematosus aes ees 36|PageSarwar Sarkawt Asaad b. Cryoglobulinemia c. Ig-A nephropathy 4. Acute post-streptococcal glomerulonephritis e. Mesangiocapillary glomerulonephritis 19.A patient in end-stage renal failure who starts regular haemodialysis can confidently expect: a. Anaemia to improve b. To avoid developing renal bone disease c. To observe marked increase in urine output d. Nausea and vomiting to improve c. To find no need for salt restriction 20.The following are indications for urgent dialysis in uraemic patients, except: a. Pulmonary oedema b. Asterixis (flapping tremor) c. Serum potassium - 6.8 mmol/l d. Pericarditis e. Severe itching 21.Which of the followings is not a cause of polyuria? a. Nephrogenic diabetes insipidus b. Central diabetes insipidus c. Compulsive polydipsia d. Hypothyroidism e. Recovery from acute tubular necrosis, 22.Which of the followings is not an essential feature of nephrotic syndrome? a, Hypercholesterolemia Massive proteinuria Hypertension Ve PHN Hypoalbuminemia e. Ocdema 23. True observations about acute pyelonephritis includes each of the following, pt: Disease may be unilateral or bilateral 75% of infections are caused by E coli During pregnancy it may be asymptomatic It may be accompanied by rigor With adequate treatment urine may be sterile in a few weeks a. Is invariably secondary to tuberculosis elsewhere b. If pyuria is present, urine culture invariably shows bacteria 37|Page aes XCk eaoseSarwar Sarkawt Asaad c. Prednisolone given with treatment prevents ureteric stenosis 4d. Nephrectomy is indicated in cases of serious destruction of the kidney 25.During oliguric phase of ARF, the main dangers to life are each of the following, except: a. Pulmonary oedema b. Hyperkalaemia (eaboneneioose ¢. Metabolic alkalosis d. Uraemia e. Fulminant s 26.Conditions associated with hypercalciuria includes each of the following, except: a. Prolonged immobilization b. Inadequate intake of milk c. Hyperparathyroidism 4. Cushing’s syndrome e. Vitamin D intoxication 27.Features indicating chronicity of renal failure include each of the following, except: a. Band keratopathy . Peripheral neuropathy c. Small kidneys 4d. Renal osteodystrophy e. Anaemia 28.Which of the followings is an early manifestation of CRF? a. Anorexia temic infections s b. Pruritus c. Nocturia 4. Bone pain e. Flapping tremor 29.Renal failure with haemoptysis is associated with each of the following, except: Good pastures syndrome Wegener's granulomatosis ARF with pulmonary oedema Renal vein thrombosis and pulmonary embolism Focal segmental GN 30.Spot the wrong statement regarding hepatorenal syndrome: (07e«/i) a. Associated with advanced liver failure b. May be precipitated by paracentesis oe ao 38|PageSarwar Sarkawt Asaad ¢. RBCs and RBC casts in urine d. Oliguria e. Aggravated by diuretic use 31.Renal failure with small kidneys includes each of the following, except: a, Post-obstructive atrophy .. Chronic pyelonephritis c. Medullary cystic disease Acute glomerulonephritis Renovascular disease Fever Rash Renal failure with microhaematuria Basophiluria e. Abnormal liver function tests 33.Nocturia is not a feature of which of the following conditions: a. Prostatism b, End stage renal failure c. Oedema states d. Diabetes mellitus e. Salt losing nephropathy 34.Urinary stigmata of glomerular disease include the following, except: a. Red cell casts b, Heavy proteinuria c. Pyuria 4. Dysmorphic RBCs Rifampicin Levodopa Senna Cyclosporine A Pyrazolidine salts (urisept) the following, except: (07e0/i) a. Dehydration b. Gastrointestinal haemorrhage c. Low protein intake d. Corticosteroid intake aege eae se 39|PageSarwar Sarkawt Asaad €. Congestive cardiac failure 37.Acute tubular necrosis characterized by each of the following, except: a. Urinary sodium <10 MEq/L -> should be >40 MEq/L b. Urinary osmolality < 400 mosm/L c. Urine/plasma osmolality = 0.9 - 1.05 d. Urine/plasma creatinine concentration < 15 38.The followings are usual presentations of acute interstitial nephritis, except: a. Fever Mild to moderate renal impairment Eosinophilia Rash e. Heavy proteinuria 39.The followings are truly matched, except: a. WBC in the urine - interstitial nephritis RBC cast - Glomerulonephritis c. Epithelial cell cast - Tubular necrosis d. Pyuria - Complicated UTI e. Complicated UTI - Pregnancy 40.The following are not indicated to screen for renovascular hypertension, except: a. 45-year-old man with mild hypertension b, 35-year-old lady with family history for hypertension ¢. 40-year-old male smoker with moderate hypertension controlled with one drug 4d, 60-year-old male with new onset severe hypertension and stroke e. 50-year-old with diabetes and mild hypertension 41. The followings are common paraneoplastic manifestations of renal cell carcinoma, except: a. Anaemia Polycythaemia Stroke Liver involvement Fever 42.The followings are true about polyeystic kidney disease, except: a, Is associated with cysts in other organs b. Cerebral ancurysm is a complication c. d e s ae s panes Colonic diverticula can be associated . Both types are associated with renal failure at the age of 30 years Can be associated with mitral valve prolapse 40|PageSarwar Sarkawt Asaad 43.The followings are associated with complicated UTIs, except: a. Diabetes mellitus Male sex Leukaemic patients Sexual intercourse Urinary tract instrumentation pass Haematuria Renal stones Renal vein thrombosis Hypertension Loin pain epoge a. Obesity b. Chronic obstructive airway disease c. Previous appendicectomy d. Rheumatoid arthritis ¢. Peripheral vascular disease 46.The dose of the following drugs should be modified in uraemic subjects, except: a. Vancomycin Cimetidine Bumetanide Digitoxin ¢. Gentamycin 47.Concerning membranous nephropathy each of the following is true, except: a. Is not accompanied by circulating immune complexes b. Is the glomerulopathy most commonly associated with Hodgkin's disease c. Remits spontaneously in about 1/3 of affected adults Is a recognised cause of hypertension It may lead to renal failure aes oe Diabetic ketoacidosis Uraemia Alcohol abuse Renal tubular acidosis Septic shock passe a. Post-obstructive diuresis 41 [PageSarwar Sarkawt Asaad b. Patients undergoing insulin and fluid replacement for diabetic ketoacidosis c. Hypovolemia due to gastrointestinal losses d. Patients commencing therapy with Ethacrynic acid e. Patient commencing therapy with Amiloride 50.Management of hyperkalaemia may include each of the following, except: a. Administer 50ml:50% dextrose IV with insulin b, Administer 50ml:8.4% sodium bicarbonate IV c. Administer 20ml:10% calcium gluconate IV 4. Prescribe 20 mg enalapril orally €. Prescribe 15g cation-exchange orally 51.Symmetrical diabetic neuropathy includes all the following, except: a. Sensory Neuropathy b. Motor Neuropathy c. Mixed neuropathy d. Autonomic Neuropathy e. Truncal neuropathy 52.A 43-year-old uraemic patient is on regular haemodialysis. He complains that many features of the disease have not improved after many sessions of haemodialysis. Which one of the following usually improved by dialys a. Anaemia b. Encephalopathy c. Hyperlipidaemia d. Osteodystrophy ¢. Peripheral neuropathy 53.A 35-year-old on regular haemodialysis for 5 years. Alll the following are potential complications during haemodialysis, except: a. Anaphylactoid reaction b. Fever c. Hyperglycaemia d. Hypotension e. Muscle cramps 54,On the routine evaluation of a 60-year-old diabetic man, his ECG shows peaked tall T wave. Which of the following is not a potential cause of hyperkalaemia? a. ACE Inhibitor. b. Chronic renal failure c. Insulin therapy d, Rhabdomyolysis. e. Spironolactone 42|PageSarwar Sarkawt Asaad 55.A 30-year-old man is found to have macroscopic haematuria, proteinuria of 1.5 g/24 hours and a serum creatinine level of 1.9mg/dL. Past history was notable for red urine 6 months ago. What is the most likely diagnosis? a. Diabetic nephropathy b. Focal segmental glomerulosclerosis c. IgA nephropathy d. Membranous glomerulonephritis €. Minimal change nephropathy 56.A 52-year-old lady presents with nephrotic syndrome, renal biopsy confirmed the diagnosis of membranous nephropathy. Her condition cannot be attributed to which one of the following conditions: a. Careinoma of stomach Hepatitis B infection c. Hypothyroidism d. Lymphoma e. Systemic lupus erythematosus 57.In the treatment of minimal change nephropathy, the following statement is correct Diureties should be avoided Steroids usually control proteinuria Diagnosis in children requires histological confirmation Immunosuppressant therapy is never indicated €. Impaired renal function commonly develops 58.When cither or both renal arteries are stenosed, the followings are accepted as a clinical presentation, except: a, Hypokalaemia Multidrug resistant hypertension Flash pulmonary oedema Heavy proteinuria Target organ damage by severe hypertension following are poor prognostic signs in ADPKD, except Repeated stone formation Male sex Repeated attacks of gross haematuria Type 1 is worse than type 2 c. Increasing size of cysts 60.The followings are false about renal cell carcinoma, except: a. Radiosensitive tumour b. Chemosensitive tumour s oe ee ees 59.The ope ao 43|PageSarwar Sarkawt Asaad c. Surgery is not effective d. If one metastatic lesion is diagnosed surgery still can be done e. Fever is not a feature of this tumour 61.Oliguria more likely to be due to prerenal failure than intrinsic renal failure if: Urine free of red blood cells or casts Urine:plasma urea ratio <3 Urine osmolality <350 mosm/L In the presence of hypertension, raised VP and good peripheral circulation e. Urinary sodium >10mM 62.1n asymptomatic chronic renal failure: a, There is increase in tubular excretion of urate b, Serum ionised (calcium) is normal ¢. Serum (phosphate) characteristically increased before GFR falls to 30ml/min 4. Increase serum (alkaline phosphatase) mainly due to liver isoenzyme €. Decrease in blood pressure accompanied by increase in extracellular fluid 63.Causes of acidosis with normal lactate includes all the following, except: a. Metformin. Salicylates Methanol Ethylene glycol e. Paraldehyde 64.1n polycystic kidney disease the followings are true, except: a. Anaemia may be a feature b. Polycythaemia may be present initially ¢. proteinuria is a poor prognostic sign d. Repeated attacks of gross haematuria is a good prognostic sign e. Renal failure is a usual event at the end 65.RBC and RBC casts in urine examination is characteristic in which of the following: a. Acute tubular necrosis Acute cortical necrosis Acute post streptococcal glomerulonephritis Acute interstitial nephritis, e. Heart failure patients 66,Renovascular hypertension is suggested by which of the following: oe ae s ao s ao 44|PageSarwar Sarkawt Asaad Well controlled hypertension by one drug Strong family history of hypertension Malignant hypertension Hypertension in 40 years of age person e. Flush pulmonary oedema is not a feature 67.The following are true about urinary tract infection, except: a. Septicaemia may complicate the infection b. May complicate pregnancy c. In children is usually uncomplicated d. In young women is self-limited e. In males is usually complicated 68.Which of the following drugs should be used with caution in patients with renal artery stenosis: a. Lisinopril b. Nifedipine c. Thiazides d. Methyldopa e. Diltiazem 69.What is the most likely outcome of minimal change nephropathy in a 16- year-old male? a. Persistent hypertension b. Full renal recovery c. A tendency to relapse d. Persistent proteinuria ¢. Permanent renal impairment 70.In uraemic acidosis, which of the following is the most unlikely anion to be seen? a. Hippurate b. Sulphate c. Phosphate d. B hydroxyl butyrate eege e. Urate 71 Rapidly progressive glomerulonephritis may complicate all the following, except: 1- ANCA-associated vasculitis (Wegener a. Wegener's granulomatosis granulomatosis) 2- Immune complex b. Good pasture synd: disorders: Postinfectious GN, lupus . Good pasture syndrome nephritis, 1gA nephropathy, c. Focal segmental glomerulonephritis cryogiobullnemia, Idiopathic, d. Henoch-Schoenlein purpura ‘membranoproliferative GN e. Ventriculoarterial shunt 3: Anti-GBM antibody ( goodpasture syndrome) 45|PageSarwar Sarkawt Asaad 72.All the following drugs are recognized causes of nephrotic syndrome, except: a, Captopril b. Amlodipine ©. Gold d. NSAID e. Penicillamine 73.ARF is not a predicted complication of: a. Malignant hypertension b. Coronary artery angiography ¢. Minimal change nephropathy 4. Lymphoma chemotherapy e. Congestive heart failure 74.1n CRF a. Uraemia is a common cause of death b. Vasopressin may be used for treatment of epistaxis c. Expected kidney transplant 5 years survival is 60% d. Treatment of anaemia cannot aggravate hypertension ¢. Hypercholesterolemia is a common finding 75.In IgA nephropathy, the following is not true: a. Most patients are young adults b. Hypertension is common c. Mesangial cell proliferation d. Nephrotic range proteinuria is rare . Poor response to treatment 76.1n systemic vasculitis: a. Polyarteritis nodosa cause focal glomerulonephritis b. Cyclophosphamide should not be used ¢. Fever is uncommon az Wegner's granulomatosis causes renal infarction e. Plasma exchange may be helpful 77.When either or both renal arteries are stenosed the followings are accepted as a clinical presentation, except: a. Hypokalaemia b. Multidrug resistant hypertension c. Flash pulmonary oedema d. Heavy proteinuria e. Target organ damage by severe hypertension 78.The followings are poor prognostic signs in ADPKD, except: a. Repeated stone formation 46|PageSarwar Sarkawt Asaad b. Male sex c. Repeated attacks of gross haematuria d. Type 1 is worse than type 2 e. Increasing size of cysts 79.The following are false about renal cell carcinoma, except: a. Radiosensitive tumour Chemosensitive tumour Surgery is not effective If one metastatic lesion is diagnosed surgery still can be done Fever is not a feature of this tumour 80.In diabetic nephropathy the following facts are true, except: Angiotensin inhibitors are the drug of choice Haematuria is not part of the disease ‘A BP of 140/90 is accepted as a target in heavy proteinuric diabetics Retinopathy is a well-recognized association with diabetic nephropathy e. Microalbuminuria is an early sign 81.A patient presents with hyperkalaemia, which is the urgent way to decrease potassium level? a. Calcium gluconate \_~ b. Insulin and glucose c. Normal saline a Qe. 82.In which patients’ asymptomatic bacteriuria may present? a. Pregnaney b. Male c. Children d. Diabetic patient e 83.A pregnant patient has complicated UTI, the culture shows gram negative cocci, what is the treatment? a. Nitrofurantoin . Gentamicin ¢. Trimethoprim a e. 84.A patent diagnosed with polycystic kidney disease with positive family history. What the best way to diagnose familial polycystic kidney disease? a. CT of abdomen ppes eege s iprofloxacin 47|PageSarwar Sarkawt Asaad b. Genetic study of PKDI of the patient c. Genetic study of the patient and two family members d. US eo. _ 85.0n urine analysis if leukoesterase is positive, what does that mean? a. Presence of WBC b. Suggests presence of bacteria ¢. Indicate that the bacteria changes nitrate to nitrite d. Excluding the WBC e 86.Blood test shows the following range: a. Albumin 51g/l b. Potassium 3.5-3.6 mmol/L c. Sodium 135-145 mol/L d. e 87.In asymptomatic chronic kidney disease, there a. Increased liver enzyme due to liver isoenzyme b. Normal calcium level c. Increased phosphate 4d. e 88. What is the best way to prevent of progression of chronic kidney disease? a. Glycaemic control. b. Lipid control c. Smoking cessation 4. LDL control e 89.A Urine dipstick positive for blood could be caused by: a. Exercise b. Ramipril ting red meats d. Smoking a. 90.Which of the following is not a side effect of Erythropoietin therapy? a. Bleeding b. Infection ¢. Pure red cell aplasia a e 48|PageSarwar Sarkawt Asaad 91.A case diagnosed with membranous glomerulonephritis, the indication for starting immunosuppressive therapy include all, except: a. Female b. c. a a. 92.Which of the following is wrong regarding anaemia in CKD: a. Anaemia in CKD appears when GFR is less than 30 b, Anaemia in CKD is well tolerated because of increase in 2,3DPG c. Anaemia maybe due to relative decrease in erythropoietin d, Anaemia is less severe in patients with polycystic kidney disease 93. Which of the following is wrong about renal cell carcinoma? a. Biopsy is indicated in all types of renal tumours b c. a. 94,One of the following is uncomplicated UTI: a. UTI in a pregnant lady b. UTI in old male ¢. UTI in metabolic disorder 4. UTI in premenopausal women 95.Most common cause of chronic kidney disease in developed countries is: a, Diabetes b, Hypertension c. Hyperlipidaemia a... 96.All the following are complications of haemodialysis, except: a. Hyperglycaemia b. Anaphylactic shock c. Muscle cramps d. Hypotension 97.A known case of RA, presented with shortness of breath and chest pain, tachycardia, BP 80/70 and ECG change showed low voltage QRS. What is the diagnosis? . Acute Pericarditis b. Constrictive pericarditis c. Cardiac tamponade 4. Hypertrophic cardiomyopathy S 49|PageSarwar Sarkawt Asaad 98.Which of the following is not a cause of positive dipstick proteinuria? a. Microalbuminuria b. ©. a. 99.Sterile pyuria can occur in the following conditions, except: a, Renal tuberculosis b. Renal cell carcinoma c. Cystitis d. Trauma to urinary tract e. Appendicitis 100. Best test for diabetic nephropathy screening: Creatinine clearance Serum creatinine level Ultrasonography Glucose tolerance test Urine albumin 101. Patient developed sepsis. He has renal impairment. Which antibiotic requires a major reduction in its dose: a. Isoniazid b. Eythromycin ¢. Gentamicin d. Doxycycline e. Ampicillin 102. Which of the following is not a cause of hyperkalaemia? a. Insulin therapy b. Spironolactone c. ACE Inhibitors a. 103. An old patient admitted and diagnosed as having stroke, he’s on NG tube for 5 days, recently developed confusion. Which electrolyte disturbance might be the cause of his confusion? a. Hypocaleaemia b. Hypernatremia c. Hypokalaemia a. 104. Risk factors for RCC include all, except: a. Smoking b. Obesity epege 50|PageSarwar Sarkawt Asaad c. Female gender d. Male gender 105. Male patient known to have HTN, on routine urine dipstick blood + was found. What could be the cause? Excessive meat intake last night Smoking Obesity Exercise Taking Ramipril 106. Indications for biopsy in AIN includes all, except: a. Uncertainty of the diagnosis b. Heavy proteinuria and haematuria c. Marked Renal impairment d. Mildly impaired renal function 107. Patient admitted for dialysis her potassium level is 7.5 mmol/L. What is the quickest way to decrease her potassium level? a. Haemodialysis b. IV calcium gluconate ©. da... 108. Treatment of UTI in pregnancy all are accepted, except: a. Nitrofurantoin b. Fosfomycin c. Amoxicillin 4. Ciprofloxacin 109. Cause of acute flash pulmonary oedema: a. RCC b. PCKD Renal artery stenosis d. AIN 110. One of the following is not a bad prognostic factor in IgA nephropathy: a. Presence of proteinuria, b. Presence of microscopic haematuria, c. Presence of macroscopic haematuria d. Renal impairment. 111. The following are typical features of the haemolytic uraemic syndrome, except: a. Reticulocytosis b. Low serum haptoglobin c. Thrombocytosis sees insulin+ dextrose= best way 51|PageSarwar Sarkawt Asaad 4d, Fragmentation of red cell e. Negative coomb's test 112. Which of the following is not frequently associated with microscopic haematuria? a. Infeetive endocarditis b. Stones ¢. Minimal change disease 4. Urinary Tract Infection ¢. Glomerulonephritis 113. What is the most malignant renal tumour? a, Wilm’s tumour b, Renal Cell Carcinoma c. Sarcoma d. Leiomyofibroma 114, A 43-year-old uraemic patient is on regular haemodialysis. He complains that many features of the disease have not improved after many sessions of haemodialysis. Which one of the following usually improved by dialysis? a. Anaemia Encephalopathy Hyperlipidaemia Osteodystrophy . Peripheral neuropathy 118, In which of the following circumstances would the treatment of anaemia with erythropoietin still be expected to be effective? a, Aluminium toxicity Folate deficiency Hyperkalaemia Infection Iron deficiency 116. In which of the following asymptomatic bacteriuria should be treated? a, Pregnancy b, Catheterisation ¢. Spinal cord injury d. Old age 117. Most common cause of chronic kidney disease is: a, Diabetes b. Hypertension Hyperlipidemia eaes epog d. e, $2|PageSarwar Sarkawt Asaad 118. Which of the following is not a risk factor for PCKD? (Autosomal dominant type) a, Male gender Hypertension PKDI Elderly diagnosed sae 119. Which of the following about minimal change nephrotic syndrome is correct? a b.. ¢. Minimal change dis a e 120. A patient presenting with polycystic kidney disease with positive family history, which of the following is the next step to confirm the diagnosis? Ultrasound Genetic analysis Genetic analysis for 2 other family members MRI All of the above ¢ in adults require biopsy for diagnosis eae se Pick true T or false F for the following statements: 121. Type 2 renal tubular acidosis is commonly associated with renal stones. a. False 122. Renal vein thrombosis is a common complication of membranous GN, a. False 123. Statin should be prescribed for all patients on haemodialysis. a. False (myopathy???) 124. Diabetic nephropathy is a potential cause of heavy proteinuria. a. True 125. Hyperuricaemia is the main cause of uraemic acidosis. a. False (hyper-phospholipid) 126. Ponticelli protocol is an effective treatment for membranoproliferative GN. a. False (membranous) 127. Oliguric acute renal failure eventually progresses to chronic renal failure. a. False (22?) 128. Glomerulosclerosis in the context of acute GN is irreversible a. True 53|PageSarwar Sarkawt Asaad 129. Proliferative GN is the most serious manifestation of lupus nephritis. a, True 130. Serum Ferritin is the best indicator of anaemia of chronic kidney disease. a, False (transferrin) 131. Lisinopril may cure mild albuminuria in diabetic nephropathy. a. True 132. Protein, salt and water restriction are essential for patients with CRF. a. False (counselling) 133. Adynamic bone disease, may be treated with active vitamin D3 (calcitriol). a, False (vitamin D is the cause) 134, In adult polycystic kidney disease, disturbances in hepatic function are common a. False (rare) 135. In the context of CKD, minor elevation of serum creatinine starts at stage a. True 136. Definite diagnosis of adult diabetic nephropathy does not require renal biopsy, a, True 137. The normal range of serum sodium is 135 to 145 mol/L. a, False (mmol/L) 138. IgA nephropathy, may present with crescent formation. a, True 139, Steroid + cyclophosphamide induce cure in most patients with amyloidosis. a. False (Colchicine) 140. In CRF; diabetes mellitus is more likely to appear after kidney transplant, a, True 141. Renal artery stenosis is most common in young adults a. False 142. Severe loin pain in patients with IgA nephropathy is usually due to renal vein thrombosis. Membranous nephropathy a. False 143. Statin should be prescribed for all adult patients with glomerulonephritis. a. False 144, Heavy proteinuria is a feature of non-inflammatory glomerulonephritis. a. True 145. Life-long treatment is usually required for ANCA-associated vasculitis, $4|PageSarwar Sarkawt Asaad a. False 146. All patients with membranous nephropathy should receive steroids. a. False 147. Polyuria is a recognized feature of hypokalaemia, a. False 148. Immune complexes of mesangiocapillary GN contains immunoglobulin or complements. a. False 149. SLE may present just as lupus nephritis without other features of the disease. a. True 150, Proper management of early chronic kidney disease may induce cure. a. False 151. Adult PD commonly presents with intracranial aneurysms. a. True 152. Food restriction is essential for patients with CRF. a. False 153. In CRE, hyperphosphatemia is easily controlled by phosphate binders. a. False 154, In early stage of diabetic nephropathy, immunosuppressive drugs may induce cure. a. False 155. Scrum creatinine is not elevated unless the GFR at <60m)/min. a. True 156. Renal biopsy is indicated for all patients with lupus nephritis. a. True 1S 7amITHelrat option tolmgenttyaeduce sermm PORESIMETISI CREE SE insulin +ghucose is acute reduction of potassium a. False 158. Post-streptococeal GN, commonly presents with crescent formation and low serum complements. a, False (rarely) 159. Interstitial nephritis usually presents with: skin rash, fever, eosinophilia, cosinphiluria and urinary RBC cast. a. False 160. In CRF; uraemic nausea and vomiting are indications for dialysis a, True 161. Polyuria is a recognized feature of hyperkalaemia, a, True/False 55|PageSarwar Sarkawt Asaad 162. Renal vein thrombosis is a well-known complication of nephritic syndrome. a, True/False 163. Statin should be prescribed for all patients with proteinuria, a. False 164, Heavy proteinuria is a feature of immune-mediated glomerulonephritis. a. False (inflammatory) 165. adult change nephropathy eventually progresses to renal failure. a. False 166. Alport’s syndrome is associated with low serum complements. a. False 167. Immune complexes of mesangiocapillary GN contains immunoglobulin only. a. False 168. ‘Thickening of GBM explain the manifestations or membranous nephropathy. a, True 169. Active urine sediment is a recognized feature of pre-renal azotaemia. a. False 170. In CRE, hyperphosphatemia is easily managed by dietary counselling, phosphate binders and dialysis. a. False/True 171. In diabetic nephropathy, albumin may not be detected in urine a. False 172. Diagnosis of minimal change nephropathy always require renal biopsy. a. False 173. The first option to urgently reduce serum potassium is IV calcium gluconate. a. True/False 174, Lifelong monthly penicillin injection is required to prevent poststreptococcal GN relapse. a. False 175. In CRF; uremic myalgia & body ache are indications for dialysis. a. True 176. Food counselling is essential for patients with CRF. a, True 177. Renal osteodystrophy is usually in late stage of acute renal failure. a. False (chronic) 178. Alport’s syndrome is the most common inherited cause of ESRD. a. False 56|PageSarwar Sarkawt Asaad 179. Serum creatinine start to raise at stage 3 CKD. a, True 180. Definite diagnosis of diabetic nephropathy always requires renal biopsy, a. False 181. IV 10% calcium carbonate is the first option in managing hyperkalaemia, a. False 182. IgA nephropathy, commonly presents with crescent formation. a, False (may present) 183. Ponticelli protocol induce cure in most patients with membranous nephropathy. a. False (not most) 184. In CRF, diabetes mellitus is more likely to appear after kidney transplantation. a. True 185. Polyuria is a recognised feature of psychogenic polydipsia. a. True 186. Renal vein thrombosis is not an uncommon complication of diabetic nephropathy. a. False (rare) 187. Statin should be prescribed for patients with proteinuria of 4g/day. a. True 188, Heavy proteinuria is a feature of inflammatory glomerulonephritis. a, False (non-inflammatory) 189. Hyperuricaemia (uric acid) is the main cause of uraemic acidosis. a, False 190, Treatment of minimal change nephropathy should include steroids and immunosuppressive drugs. a. False (not always) 191. Most adult patients with acute renal failure eventually progres renal failure. a. False (not that common) 192. Immune complexes of mesangiocapillary GN contains IgG and IgA only, a. False (more) 193. Proliferative GN explains the manifestations of membranous nephropathy. a, False (not proliferative) 194, Proper management of carly chronic kidney disease never induce cure. a, True 195. Lisinopril may exacerbate renal impairment, a. True to chronic 57|PageSarwar Sarkawt Asaad 196. Oliguria is a recognised feature of hypercalcaemia. a. False 197. The best treatment for renal vein thrombosis is good hydration and diuretics. a. False 198. Lisinopril may be used for the treatment of leg oedema. a, True 199. Adult polycystic kidney disease is associated with low serum complements. a, False 200. Immune complexes of mesangiocapillary GN may not contain immunoglobulin. a. True 201. Urine albumin is the most sensitive test for detecting diabetic nephropathy. a. True 202. Diagnosis of minimal change nephropathy in adults does not require renal biopsy. a. False 203. The first option to urgently reduce serum potassium is insulin. a. False 204. In CRF, uraemic malnutrition is an indication for dialysis. a. True 205. Deep venous thrombosis is not a cause of generalised oedema. a. True 206. Spironolactone is a recognised cause of oedema. a. False 207. Renal vein thrombosis is a well-known complication of IgA nephropathy. a. False 208. Diagnosis of membranoproliferative GN always require renal biopsy. a. True 209, Statin should be prescribed for all patients with heavy proteinuria. a. False Answer the following questions according to their case: 210. A 32-year-old man presents with a deep colour urine of one day duration. He was well until three days ago when he developed a chest discomfort, low grade fever and dry cough which lasted for approximately 48 hours. He had a similar episode | year ago. He denies having rash, joint pain and dysuria, 58|PageSarwar Sarkawt Asaad His BP 155/95 mmHg. GUE reveals 15-20 RBC, | + protein, dysmorphic RB and occasional RBC cast. a, What does the findings on urinalysis tell you? I. Glomerulonephritis b. What is your provisional diagnosis and why? I. IgA Nephropathy because young adult, 3 days post-, chest infection, and recurrent nephritis c. Are there any investigation that may help you to differentiate this disease from other? I. _ Renal biopsy (mesangial IgA deposit) d. What are the changes that may accompany an aggressive form of this condition? 1. Crescent formation (renal biopsy), renal impairment Match the most appropriate Group 2 statement to Group 1: fee fem 1. Hyperparathyroidism A. Small size kidney 2. Diabetic nephropathy B. Renal vein thrombosis 3. Nephrotic syndrome C. Osteitis fibrosis cystica 4, Post-streptococcal glomerulonephritis D. High serum vitamin D 5. Pre-renal azotaemia E, Hypertension F. Low serum complement G. Plain (normal) urine ‘Answer Key: IC, 2E, 3B, 4F, SG Cnr! 1. A patient with kidney failure, who was diagnosed with focal segmental glomerulosclerosis. Recently he has 6.7 potassium level (?). What is your next step? re A. Renal biopsy 2. A case with features of nephrotic syndrome (membranous GN). What is the next step? B. CBC 59|PageSarwar Sarkawt Asaad 3. A case that has deep coloured urine, periorbital oedema, and low C3. Has a history of sore throat 3 weeks ago? C. IgA Nephropathy D. Post-streptococcal glomerulonephritis E, Renal artery stenosis F. Initiation of haemodialysis Answer Key: IF, 2A, 3D. 1. A young female patient that has palpitations, sweating, high blood pressure, and positive urine catecholamines. A. Cushing syndrome 2. A female patient has obesity, bruising, stretch marks, hirsutism, B. Renal artery stenosis, and high blood pressure. 3. A patient that has hypertension and peripheral artery disease, C. Renovascular hypertension D. Chronic kidney disease E. Pheochromocytoma F. Hypematraemia Answer Key: 1E, 2A, 3B 60|Page