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Nephrology MCQs

Nephrology MCQs

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Published by Saeed Al-Yafei

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Published by: Saeed Al-Yafei on Dec 28, 2011
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07/24/2013

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NEPHROLOGY MCQS

  

BLOOD UREA  isn't affected by tubular excretion. (MCQ)
CAUSES OF  SPECIFIC GRAVITY  Add…. SICKLE CELL ANAEMIA. (MCQ)

ACUTE PAPILLARY NECROSIS  hematuria. (MCQ) THE MEDULLA IS MORE LIKELY TO BE AFFECTED IN SCA (causes of nephrogenic DI)

DEFINITIONS:
1) AZOTEMIA  only lab finding(no clinical manifestations) 2) UREMIA  lab & clinical 3) ESRF???? 4) CHRONIC RENAL DISEASE >6 MONTHS ****REMEMBER:ANY CASE OF A FEMALE WITH CRF…..DON'T FORGET TO ASK ABOUT THE 11 CITERIA OF SLE. (very important for the long case)

CAUSES OF BLEEDING TENDENCY
1) HEPARINE ADMINISTERATION DURING DIALYSIS 2) loss of clotting factors during dialysis

COMPLICATIONS OF HEMODIALYSIS??? BAD SHIP ???
      

B A D S H I P

= brain edema-bleeding = amyloidosis-atherosclerosis-air embolism = dementia-depression = serousitis = hypotension = infection-IEC = pruritis-pseudogout

Transfusion 5) hepatorenal $ 6) BILIRUBIN nephropathy . c) Na+ in urine <20mmol/l d)  Urine osmolarity(preserved function of the tubules) e) Fraction Na + excretion in urine<1 f) Good response to fluids.CAUSES OF RENAL FAILURE: ADD… 1) GOOD Pasture $ 2) Vasculitis 3) Drugs  penicillins-cephalo-sulphonamides-NSAIDs PRE-RF VS.) 1) PRE RENAL: a) Good prognosis. b) BUN/cr >20. RENAL FAILURE ??? (V. DD OF ARF + JAUNDICE: 1) MALARIA 2) G6PD 3) HU$ 4) DISMATCHED BL. IMP. 2) RENAL  (TOTALLY THE OPPOSITE TO THE ABOVE) CAUSES OF POST RF:   prostate ++ neurogenic bladder.

VUR isn't usually seen in adults. (esp. RIFAMPICINE  NIL $.IgA nephropathy . M/C presentation of chronic pyelonephritis is ASYMPTOMATIc.  enlarged kidneys…DD????  Add… IgA nephropathy .  Add…bilateral renal angle pain & tenderness./P.INVESTING OF ATN:   BUN/Cr <20(MCQ)…since it's renal causes p.OSAMA 2010) PENICILLINS & CEPHALOSPORINES  safe in pregnancy in TTT of UTI.SLE (TYPE 4)  ARF MEMBRABO-PROLIFERATIVE  L/M is called "TRAM-TRACK appearance" (double contour or splitting of the GBM) (very imp) NEPHRITIC:   CL. in children) CAUSES  Add… Bilharziasis CAUSES OF CHRONIC TIN (MCQ)      Stones reflux Wilson KC$ Chronic transplant rejection CAUSES OF ACUTE PYELONEPHRITIS: ADD…     BILHARZIASIS. (STRICTURES) . .REMEMBER: N = NSAIDS I = idiopathic L = lymphoma      CAUSES OF FSGN AMYLOIDOSIS CAUSES OF RPGN GOOD PASTURE  HBV – PAN ..38:add to the polyuric phase (UREA RETENTION =NATRIURETIC $) CAUSES OF MINIMAL CHANGE  ADD.CONGENITAL STENOSIS OR NARROWING (ADDED BY DR...SLE(type III) – analgesics.

URETERIC OBSTRUCYION causes:      cervical carcinoma hematuria pain STONES: REMEMBER:uric acid PPT also in renal parenchyma(MCQ) ADPKD:     ASSOCIATED WITH  hepatic-CVS-pancreatic anomalies C/P  Add…. CAUSES OF RTA I???(EH ELI BYA3MELO???) 1) 2) 3) 4) 5) 6) Lithium. chronic renal transplant rejection.<10 & plasma level <10 meq /l RTA IV??? CONSIDER IT EXACTLY ALDOSTERONE DEF. (MCQ) Sub-Dural Hge. Sjogren. filtered HCO3. DD REMEMBER: BERRY'S ANEURYSM IN??    IEC ADPKD.  RTA II  filtered HCO3->15 & plasma level=14-20meq/l . chronic pyelonephritis.   serum k. Hyperparathyroidism. associated with pancreatic cysts  DM nephropathy-amyloidosis kidney RADIOLOGY??  must search for it in the CT scan.

2) FIBROPLASIA: young female      total occlusion is rare ischemic renal is rare good prognosis middle or distal with beading appearance in U/s REMEMBER:DD OF hypokalemic HTN??? . Bad prognosis. Proximal stenosis.abdominal trauma. Ischemic renal atrophy. (MCQ)  U/s-duplex-MRA  of the cause =anticoagulants -COMPLICATIONS  pulmonary embolism INVESTIG TTT GLOMERULO-SCELROSIS IN: HTN-DM-F & S GN RAS: young female…HTN ??? 1st line  search for 2ry cause (SLE-RAS) 1) ATHEROSCLEROTIC:      Old male.ALPORT'S:     AR or XLR degeneration in GBM mutation in genes coding IV COLLAGEN remember  FANCONI $ CAUSES RICKETS RVT (P.hypercoagulable state .72)      CAUSES CL. /P  nephritic (membranous) . Total occlusion is common.HEAVY PROTEINURIA.  loin pain – hematuria .

ANALGESIC NEPHROPATHY  M/C cause of Chronic TIN. DRUGS CAUSING IDIOSYNCRACY???  NSAIDS – gold .penicillins – peniciilamin HYPER-NEPHROMA:    ADD TO C/P  presistant fever-disturbia in liver functions(MCQ) REMEMBER CAUSES OF POLYCYTHEMIA in kidney??? REMEMBER PARAMALIGNANT $  HCC – hypernephroma .lung cancer-stomach cancer ADD TO HEPATO-RENAL LINK:   IgA nephropathy  common in alcoholics liver cirrhosis LCF…bleeding tendency…ARF (pre-renal) .DRUGS THAT  BP     RENAL  Diruetics. ADD TO C/P  nephritic.

TESTICULAR TUMORS:     AGE SEMINOMA TTT. DM. BENIGN PROSTATIC HYPERTROPHY:     >60 ys old. extremes of age. UROPATHY . LOCAL SPREAD along the lumbosacral plexus osteolsclerotic bone metastasis 2) RISK FACTORS FOR PRE-ECLAMSIA:     1st preg / hydatiform mole in 1st trimester / twin preg. normal serum acid phosphatase. (MCQ) 3) URINARY BLADDER CARCINOMA:  mainly TRANSITIONAL CELL (in EGYPT  squamus cell) PAINLESS HEMATURIA.  Androgens. TERATOMAS  22-34  painless  radio & chemo sensitive   -FP &chronic gonadotrophins . Acute urinary retention & hematuria.THE UPCOMING DATA IS FOUND IN LANGE & DAVIDSON"S MCQ BUT THEY WEREN'T TAUGHT NEITHER IN ROUNDS NOR LECTURES: 1) PROSTATIC CANCER:      DRE  best screening test while PSA  best prognostic test SLOWLY PROGRESSIVE OBST . NOT HIV.    TTT  radiotherapy. SPREAD  early local but late metastasis.

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