Which is common finding in acute glomerulonephritis a. Pulmonary congestion due to volume expansion* b. Hypovolemia due to tubular dysfunction c.

Uniformly progresses to chronic renal failure if untreated d. Urine showing leukocytes and eosinophils

Which finding is fairly specific for chronic renal failure a. Anemia b. Hyaline casts c. Broad casts in urinalysis* d. Proteinuria e. Hypocalcemia

Nephrotic syndrome is associated with a. Excessive renal salt and water loss b. Hyperlipidemia due to lipoprotein excess* c. Bleeding due to loss of clotting factors d. Hypothyroidism due to loss of thyroid-binding globulin

A patient with chronic renal failure will be expected to have which of the following findings due to the mechanisms described a. Hypercalcemic due to elevated PTH hormone b. Prolonged bleeding due to decreased synthesis of clotting factors c. Anemia due to increased red cell destruction d. Hypermagnesemia due to decreased renal excretion*

A high fractional excretion of sodium is typically found in a. Heart failure b. Urinary tract obstruction c. Acute tubular necrosis* d. Acute glomerulonephritis e. Hepatorenal syndrome

Which of the following nephron segment is correctly paired with its function a. Distal tubule and bicarbonate reclamation b. Loop of Henle and potassium regulation c. Proximal tubule and urinary concentration d. Collecting tubule and water regulation*

Which of the following statements is true in the management of acute renal failure a. Metabolic acidosis is fully corrected with bicarbonate b. Hyperphosphatemia is primarily managed with dialysis c. Low-dose dopamine is used to shorten the duration of renal failure d. Hypervolemia is managed with high-dose loop diuretics e. Hyponatremia is corrected by administration of sodium salts*

Which of the following describes bone abnormalities in patients with chronic renal failure a. Osteitis fibrosis cystica is a result of oversuppression of PTH b. Adynamic bone disease is associated with myopathy c. Osteomalacia is due to excessive accumulation of magnesium d. Hyperparathyroidism responds well to 1,25 dihydroxyvitamin D e. Amyloidosis is similar in etiology to patients who are not on dialysis*

Which one of the following statements is true concerning hematologic disorders in CRF a. Resistance to erythropoietin is most commonly due to aluminum overload

b. Erythropoietin administration is associated with worsening hypertension* c. The major cause of death in CRF is sepsis d. Abnormal bleeding responds best to platelet transfusion e. Leukocyte function is generally unimpaired

Which of the following measures has not been shown to retard progression of renal failure a. Aggressive BP control b. Decrease in protein intake c. ACE inhibitors above other antihypertensives d. Erythropoietin for anemia*

In patients with chronic renal failure, which of the following adaptations are normal a. Fractional excretion of sodium increases due to suppression of aldosterone b. Metabolic acidosis due to loss of bicarbonate in the urine c. Increased potassium loss through extrarenal mechanisms* d. Decreased fractional excretion of water due to ADH resistance

Which of the following serologic finding is associated with linear staining of the glomerulus on immunofluorescence a. Anti-GBM antibody* b. Low complement immune complex glomerulonephritis c. ANCA associated renal disease d. Membranoproliferative glomerulonephritis

Antineutrophil cytoplasmic antibody (ANCA) is typically present in which systemic disease a. Goodpasture s syndrome b. Wegener s granulomatosis* c. Systemic lupus erythematosus d. Thrombotic thrombocytopenic purpura

Post infectious glomerulonephritis is characterized by which of the following a. Most cases in an epidemic are subclinical* b. Hematuria typically develops within a week of infection c. More common with pharyngeal than cutaneous strep infection d. Focal proliferative glomerulonephritis seen on renal biopsy e. Children are often left with residual renal impairment

Which of the following is true of anti-GBM (glomerular basement membrane) syndrome a. The clinical presentation is largely the same in different age groups b. The target antigen in the glomerulus is elastin c. Complement levels are typically normal* d. Plasmapheresis enables dialysis-dependent patient to recover renal function e. Transplantation is contraindicated because of disease recurrence

Prerenal azotemia is associated with a. High fractional excretion of sodium b. Granular casts in the urine c. Use of angiotensin-converting enzyme (ACE) inhibitors in unilateral renal artery stenosis d. Evolution to acute tubular necrosis if untreated*

The pathologic findings of predominant small artery involvement with intimal proliferation and sometimes with thrombosis, also termed thrombotic microangiopathy , is found in which renal disease a. Membranoproliferative glomerulonephritis b. Hemolytic uremic syndrome* c. Microscopic polyarteritis d. Analgesic nephropathy

Leukocytes and white cell casts in the urine are typically seen in a. Radiocontrast nephropathy b. Methicillin-induced renal insufficiency* c. Aminoglycoside nephrotoxicity d. Rhabdomyolysis

Elevated anion gap and osmolar gap in a patient with renal failure suggests a. ethylene glycol ingestion* b. isopropanol ingestion c. mannitol infusion d. radiocontrast administration

Which may cause acute renal failure in patients with nephrotic syndrome a. Dietary protein restriction b. ACE inhibitors c. Lipid-lowering agents d. Loop diuretics*

Hyponatremia with a low urine sodium is associated with a. SIADH b. congestive heart failure* c. recent thiazide use d. hypothyroidism

Which disease presents with predominantly tubulointerstitial involvement a. Systemic lupus erythematosus b. Sjgren s syndrome* c. Rheumatoid arthritis d. Essential mixed cryoglobulinemia

Which disease presents with predominantly glomerular involvement a. Analgesic nephropathy b. Uric acid nephropathy c. Lead nephropathy d. Light chain deposition disease*

Which of the following patients would be better served by undergoing continuous ambulatory peritoneal dialysis rather than intermittent hemodialysis as treatment of chronic renal failure a. Patient with poor vision due to diabetic retinopathy b. Patient with cardiomyopathy sensitive to fluid overload* c. Patient with severe COPD d. Very obese patient

A patient on long-term lithium comes into your office complaining of polyuria; you would expect his serum sodium to be a. Elevated because he has central diabetes insipidus b. Elevated because he has nephrogenic diabetes insipidus c. Nearly normal because he is drinking increased amounts of water* d. Low because he is suffering from psychogenic polydipsia

Concerning the association between potassium and bicarbonate abnormalities, which of the following is true a. The regulation of potassium excretion occurs largely in the loop of Henle, and this is why loop diuretics cause hypokalemia b. Metabolic alkalosis is associated with volume depletion caused by diuretics* c. Hypokalemia generally results in the increased production of aldosterone d. Volume depletion inhibits reabsorption of bicarbonate in the proximal tubule

Which of the following is characterized by normal tension, hypokalemia, and metabolic alkalosis a. Sjgren s syndrome b. Hyperaldosteronism c. Liddle s syndrome d. Barrter s syndrome*

A 25-year-old man with flank pain is found to have three cysts in each kidney, normal hepatic and renal function, and family history is not clear. He is most likely to have a. Autosomal dominant polycystic kidney disease* b. Autosomal recessive polycystic kidney disease c. Acquired cystic disease d. Medullary sponge kidney

Growth retardation, hypophosphatemia, and glycosuria may be associated with a. Type 1 RTA b. Type 2 RTA* c. Type 4 RTA d. Diabetic nephropathy

Which is an accurate statement concerning diabetic nephropathy a. Most patients with type 2 diabetes will develop this problem b. It is almost always associated with retinopathy in type 1 diabetes* c. ACE inhibition is only indicated for patients with hypertension d. Routine dipstick urine should be performed to screen for early disease

Which of the following is a secondary cause for focal segmental sclerosis

a. Hodgkin s disease b. Colon cancer c. HIV disease* d. Hepatitis C infection

A patient with Crohn s disease passes a kidney stone; the most likely composition is a. Calcium phosphate b. Uric acid c. Struvite d. Calcium oxalate*

The metabolic disorder induced by diarrhea and by acetazolamide are best differentiated by a. Serum anion gap b. Blood gas analysis c. Urine anion gap* d. Urine pH e. Serum potassium

Which of the following would be a characteristic finding in obstructive nephropathy due to benign prostatic hypertrophy a. Hyperkalemia b. Polyuria and nocturia* c. Hematuria d. Suprapubic discomfort

Cirrhosis is a cause of a. Hypervolemic hyponatremia* b. Isovolemic hyponatremia c. Hypovolemic hyponatremia d. Pseudohyponatremia

Which of the following statements characterizes minimal change disease a. It is associated with renal insufficiency despite treatment b. It is associated with selective proteinuria* c. It is the most common cause of nephrotic syndrome in adults d. It is diagnosed on light microscopy after kidney biopsy

Which of the following findings would favor essential hypertension over secondary hypertension a. Presence of hypokalemia and alkalosis b. Presence of hyperinsulinemia and obesity* c. Presence of grade III fundoscopic findings d. Presence of aortic aneurysm

A patient with long-standing COPD who develops vomiting would have which of the following blood gas and electrolyte patterns Sodium Chloride Bicarbonate pCO2 pH a. 139 105 25 38 7.44 b. 139 89 35 47 7.49* c. 140 95 25 40 7.42 d. 139 92 32 30 7.65

A patient with cardiomyopathy on chronic diuretics suffers acute respiratory arrest from aspiration has which of the following patterns Sodium Chloride Bicarbonate pCO2 pH a. 140 87 37 63 7.39 b. 140 104 26 60 7.26 c. 140 114 16 40 7.22 d. 140 96 33 75 7.26*

A patient with diabetic ketoacidosis along with a bout of viral gastroenteritis resulting in diarrhea has which of the following patterns Sodium Chloride Bicarbonate pCO2 pH a. 140 109 12 26 7.29* b. 140 115 15 30 7.30 c. 140 103 15 25 7.34 d. 140 102 25 58 7.26

Hyperkalemia may be caused by a. Trimethoprim* b. Albuterol c. Licorice d. Cisplatin

A middle-aged patient with an elevated serum creatinine, hypertension,and mild anemia comes to you for evaluation . Urine dipstick shows trace protein without red cells or cellular casts. A 24-hours urine collection reveals 5 g of protein. The most likely etiology is a. Focal segmental sclerosis b. Hypertensive nephrosclerosis c. Amyloidosis d. Multiple myeloma*

Which of the following is a common cause of isolated hematuria with isomorphic red cells in the urine a. Alport s syndrome (hereditary nephritis) b. Thin basement membrane disease c. Idiopathic hypercalciuria* d. IgA nephropathy

A 26-year-old woman with a history of mitral valve prolapse comes in with 1 week of fever that started 3 days after a dental procedure. Her urine contains red cells and her rheumatoid factor is elevated. Which of the following serologic

abnormalities is expected to be present a. Anti-GBM antibody b. Low serum complement levels* c. Antineutrophil cytoplasmic antibody d. Elevated IgA levels

A 70-year-old man presents to you because he has not been feeling well for several months. He mainly complains of malaise and achiness. He takes ibuprofen occasionally for these symptoms. His urine shows protein and erythrocyte casts. A 24-h urine shows 1 g of protein per day. His creatinine clearance is 24 mL/min. About 4 months ago, his serum creatinine was normal. The most likely diagnosis is a. Amyloidosis b. Light chain deposition disease c. Nonsteroidal induced interstitial nephritis d. Vasculitis*