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QUESTIONS 36 AND 37

A 43-year-old man &veloped cellulitis of his left lower extremity but resisted
medical evaluation for 2 weeks When it did not improve, he saw his physician, who
admitted him to the hospital !is admission serum
creatinine concentration was "2 m#$d% !e was treated with a 2-week course of
intravenous antibiotics that consisted of nafcillin, clindamycin, and #entamicin
&en days into this treatment, serum creatinine concentration is obtained and is 3'
m#$d% (enal ultrasound showed normal-si)ed kidneys without hydronephrosis
Possible causes of this patient's acute renal failure inclue
A! ATN
"! Acute "lo#erulonephritis
$! Aller"ic interstitial nephritis
D! A% &% an $ are correct!'
E! Onl( A an $ are correct!
On further e)aluation% he *as foun to ha)e a bloo pressure of +6,-./ ## 0"%a
ecrease in urine output to 1 3, #2-hour% an a urinal(sis that sho*e 34
protein% 34 he#o"lobin% re bloo cells% an re bloo cell an tubule epithelial
cell casts! &ase on these finin"s% the #ost li5el( ia"nosis is
A! 6enta#icin nephroto7icit(
&! Postinfectious acute "lo#erulonephritis'
$! 0(persensiti)it( reaction to beta8lacta# antibiotic
D! $annot eter#ine fro# infor#ation a)ailable
E None of the abo)e
True state#ents re"arin" poststreptococcal "lo#erulonephritis inclue
A! Seru# co#ple#ent% $3% an total he#ol(tic co#ple#ent are usuall( lo*!
&! Poststreptococcal acute "lo#erulonephritis has an e7cellent pro"nosis for
reco)er(
$! 6lo#erulonephritis can e)elop after rather s5in or phar(n"eal streptococcal
infections!
D! A% &% an $ are correct!'
E! Onl( A an $ are correct
The #ost co##on intrinsic 9pri#ar(: "lo#erular lesion is
A! Antl8"lo#erular base#ent #e#brane 96&;: "lo#erulonephritis
&! ;e#branoproliferati)e "lo#erulonephritis
$! A#(loiosis
D! I"A nephropath(!'
E! <ocal an se"#ental "lo#erulosclerosis
A =/8(ear8ol blac5 #an presents *ith hilar aenopath(%pul#onar( infiltrates%
an er(the#a noosu#! On transbronchial biops(% he is foun to ha)e
noncaseat#" "ranulo#as! Special stares of the tissue re)eal no or"anis#s!
Potential clinical renal #anifestations in this patient #a( inclue
A! 0(percalce#ic nephropath(
&! 0(posthenuria
$! 6ranulo#atous infiltration of the renal interstitiu#
D! I##une co#ple78#eiate "lo#erulonephritis
E! A% + % $% an D are correct!' 
<! None of the abo)e is correct
The h(percalce#ia of sarcoiosis
A! >eflects e7trarenal l ot8h(ro7(lation of 3/9O0: )ita#in D3
&! >arel( prouces nephrocalcinosis
$! >espons *ell to prenisone
D! Onl( A an $ are correct!'
E! A% &% an $ are correct
A *+-year-old man with end-sta#e renal failure from chronic #lomerulonephritis
presents with acute onset of #ross hematuria and mild flank pain !e has been on
dialysis for 4 years, and his course has otherwise been uneventful !e was afebtile
and the hematutia resolved without intervention
?hich of the follo*in" is #ost appropriate no*
A! >enal ultrasoun
&! $o#pute to#o"raph('
$! An"io"raph(
D! Intra)enous p(elo"raph(
E! None of the abo)e
True state#ents about ac@uire c(stic 5ine( isease 9A$AD: inclue all of the
follo*in" e7cept
A! A$AD occurs e7clusi)el( in he#oial(sls patients an not in patients
recei)in" peritoneal ial(sis!'
&! A$AD is rare in patients *ithout renal failure!
$! A$AD is fre@uentl( as(#pto#atic but can prouce pain% fe)er% an
he#aturia!
D! A$AD is associate *ith renal cell carcino#a!
E! A$AD has a #ale preo#inance
>enal cell carcino#a in ial(sis patients
A! >espons *ell to che#otherap(
&! Is rarel( bilateral
$! Does not occur in nati)e 5ine(s in renal transplant recipients
D! Infre@uentl( #etastasiBes unless the tu#or siBe is C 3 c#'
E! None of the abo)e is correct
In acute alcohol poisonin"
A! The ifference bet*een obser)e an calculate seru# os#olafit( is a rapi
*a( to eter#ine the e"ree of into7ication!
&! The arterial p0 correlates *ith the prouction of
#etabofites fro# alcohol eh(ro"enase!
$! Infusion of inhibitors of alcohol eh(ro"enase is efficacious!
D! A an $ are correct!
E! A% & an $ are correct'
True state#ents about t(pe ID renal tubular aciosis inclue all of the
follo*in" e7cept
A! 0(per5ale#ia is co##on!
&! >enal a##onia"enesis is i#paire!
$! Urine p0 is ne)er 1 /!/!'
D! It can occur urin" treat#ent *ith nonsteroial anti8infla##ator( a"ents!
E! It can e)elop fro# urinar( tract obstruction
Potential co#plications of A$E inhibitors inclue
A! Acute renal failure
&! Persistent cou"h
$! Acute se)ere h(potension
D! 0(per5ale#ia
E! A% &% $% an D are correct!'
<! Onl( A an $ are correct