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1. What are the two most common causes of acute renal failure in children in the UK?

a.Diabetes insipidus & pseudohypoparathyroidism
b. Diabetes insipidus & acute tubular necrosis
c. haemolytic uraemic syndrome & acute tubular necrosis
d. haemolytic uraemic syndrome & pseudohypoparathyroidism
e. Renal tubular acidosis & Bartter's syndrome
2. The backflow of urine from the renal pelvis into the papillary collecting ducts; associated
with a particularly high risk of renal scarring if UTIs occur.
a. Cystitis
b. Intrarenal reflux (IRR)
c. Incomplete emptying
d. Vesicouritis
e. Vesicoureteric reflux (VUR)
3. Results from the failure of union of the ureteric bud with the nephrogenic mesenchyme.
It is a non-functioning structure with large fluid-filled cysts with no renal tissue and no
connection with the bladder
a. Potter's syndrome
b. Multicystic dysplastic kidney (MCDK)+
c. Tuberous sclerosis
d. Autosomal recessive polycystic kidney disease (ARPKD)
e. Autosomal dominant polycystic kidney disease (ADPKD)
4. Premature division of the ureteric bud may result in this
a. Autosomal dominant polycystic kidney disease (ADPKD)
b. Multicystic dysplastic kidney (MCDK)
c. Horseshoe kidney
d. Duplex system
e. Autosomal recessive polycystic kidney disease (ARPKD)
5. Bilaterally enlarged kidneys early in life are most likely due to
a. renal vein thrombosis
b. Obstructed hydronephrosis
c. tuberous sclerosis
d. autosomal recessive polycystic kidney disease
e. Wilm's tumour
6. A rough estimate of GFR can be calculated using which formula?
a. height(cm)/60 * plasma creatinine (micrmol/L)
b. height(cm) x 20 / plasma creatinine (micrmol/L)
c. height(cm)/40 * plasma creatinine (micrmol/L)
d. height(cm) x 30 / plasma creatinine (mmol/L)
e. height(cm) x 40 / plasma creatinine (micrmol/L)
7. Frequently associated with a large bladder, dilated ureters and cryptorchidism
a. Absent musculature syndrome
b. Duplex system
c. Tuberous sclerosis
d. Horseshoe kidney
e. Bladder extrophy
8. Functional tumours that arise from chromaffin cells in the adrenal medulla. They account
for 0.1-0.2% of cases of systemic hypertension.
a. phaeochromocytoma
b. nephroblastoma
c. retinoblastoma
d. pyelonephroma
e. corticoma
9. What is used to treat hyperkalaemia?
a. salbutamol
b. sodium bicarbonate
c. glucose and insulin
d. calcium exchange resin
e. calcium carbonate
10. Antineutrophil cytoplasm antibodies are present and diagnostic in these diseases
a. IgA nephropathy
b. Generalised proximal tubular dysfunction
c. SLE
d. Renal calculi
e. Vasculitis
11. What should one do first following antenatal diagnosis of urinary tract anomaly?
a. Static nuclear medicine scanning
b. IVU
c. start prophylactic antibiotics
d. Ultrasound
e. MCUG
12. A triad of: acute renal failure, microangiopathic haemolytic anaemia, and
thrombocytopenia
a. Kell's syndrome
b. Fanconi syndrome
c. Goodpasture's syndrome
d. Haemolytic uraemic syndrome
e. Bartter's syndrome
13. What is the commonest cause of acute nephritis?
a. IgA nephropathy
b. Anti-glomerular basement membrane disease
c. Goodpasture's syndrome
d. Streptococcal infection
e. Vasculitis
14. Dimercaptosuccinic acid is used in which of the following?
a. Statitic nuclear medicine scanning
b. Micturating cystourethrography
c. MRI scan
d. Ultrasound
e. Intravenous uroethrography
15. Failure of fusion of the infraumbilical midline structures may result in
a. Absent musculature syndrome
b. Bladder extrophy
c. Duplex system
d. Tuberous sclerosis
e. Horseshoe kidney
16. Defined by a combination of heavy proteinuria (protein: creatinine ratio greater than
200 mg/mmol), hypoalbuminemia (less than 25 g/L), and generalized oedema (esp.
periorbital)
a. Glomerulritis
b. Glomerular nephritis
c. UTI
d. Neophritis
e. Nephrotic syndrome
17. Typically secondary to gastrointestinal infection with verocytotoxin-producting E.coli
O157:H7 or less often Shigella. Follows prodrome of bloody diarrhoea.
a. Kell's syndrome
b. Fanconi syndrome
c. Haemolytic uraemic syndrome
d. Bartter's syndrome
e. Goodpasture's syndrome
18. What is the incidence of chronic renal failure in children
a. 10 per 1,000,000
b. 1 per 8,000
c. 1 per 1,000,000
d. 1 per 5,000
e. 1 per 1000
19. The commonest type of renal calculi in childhood
a. calcium
b. xanthine
c. phosphate
d. cysteine
e. magnesium
20. The commonest of these is Alport's syndrome
a. Wegner's granulomatosis
b. Familial nephritis
c. Goodpasture's syndrome
d. Henoch Schonlein purpura
e. Polyarteritis nodosa
21. Recurrent necrotising vasculitis of medium and small muscular arteries. Angiography
demonstrates multiple aneurysms at vessel bifurcations. The classic form does not affect
small vessels and does not cause a glomerulonephritis.
a. Goodpasture's syndrome
b. Familial nephritis
c. Polyarteritis nodosa
d. Henoch Schonlein purpura
e. Wegner's granulomatosis
22. The most common cause of haematuria
a. Familial nephritis
b. Hypercalcuria
c. IgA nephropathy
d. Sickle cell disease
e. UTI
23. Which of the following is FALSE with regards to steroid sensitive nephrotic syndrome?
a. The median time for the urine to become protein free is 11 days
b. Children in relapse at at risk of pneumococcus infection
c. Renal histology is usually abnormal on light microscopy
d. There is good evidence for extending steroid treatment to 6 months
e. Children with this condition are susceptible to hypovolaemia
24. What is used to treat hyperphosphataemia?
a. glucose and insulin
b. sodium bicarbonate
c. salbutamol
d. calcium exchange resin
e. calcium carbonate
25. A congenital disease characterised by hamartomatous
lesions in the skin, nervous system and internal organs, principally heart and kidney. It is
dominantly inherited but many cases result from new mutations.
A, Autosomal dominant polycystic kidney disease (ADPKD)
b. Multicystic dysplastic kidney (MCDK)
c. Autosomal recessive polycystic kidney disease (ARPKD)
d. Tuberous sclerosis
e. Potter's syndrome
26. Does asymptomatic bacteriuria need treatment?
a.Yes
b. No
27. A rare condition occurring in sporadic and autosomally recessive forms. It is
incompatible with life. The key problem is bilateral renal agenesis. Renal agenesis causes
oligohydramnios.
a. Autosomal dominant polycystic kidney disease (ADPKD)
b. Multicystic dysplastic kidney (MCDK)
c. Potter's syndrome
d. Autosomal recessive polycystic kidney disease (ARPKD)
e. Tuberous sclerosis.
28. Radiographic examination of the urinary bladder after filling with contrast medium and
of the urethra during voiding. Used to identify vesicouteric reflex.
a. DMSA
b. Dynamic nuclear medicine scanning
c. Statitic nuclear medicine scanning
d. Intravenous uroethrography
e. Micturating cystourethrography
29. The commonest cause of secondary onset enuresis in children
a. Ectopic ureter
b. Emotional upset
c. Neuropathic bladder
d. Detrusor instability
e. Constipation
30. Oliguria
a. < 10 ml/kg/hour
b. < 15 ml/kg/hour
c. < 5 ml/kg/hour
d. < 20 ml/kg/hour
e. < 1 ml/kg/hour
31. What percentage of nephrotic syndrome cases in children are steroid sensitive?
a. 50-75%
b. 5-10%
c. 85-90%
d. 10-20%
e. 90-98%
32. What is the most common cause of chronic renal failure in children?
a. hereditary nephropathies
b. structural malformations
c. systemic disease
d. glomerulonephritis
e. idiopathic
33. Usually occurs between the ages of 3 and 10 years, is twice as common in boys, peaks
during the winter months and is often preceded by an upper respiratory infection. Cause
unknown.
a. Goodpasture's syndrome
b. Henoch Schonlein purpura
c. SLE
d. Wegner's granulomatosis
e. Polyarteritis nodosa
34. The combination of: characteristic skin rash, arthralgia, periarticular oedema, abdominal
pain, glomerulonephritis
a. Henoch Schonlein purpura
b. SLE
c. Polyarteritis nodosa
d. Wegner's granulomatosis
e. Goodpasture's syndrome
35. With regards to a child with a UTI, which of the following would be LEAST likely to be
considered a risk factor for renal damage?
a. due to E.Coli
b. has had septacaemia
c. known renal anomaly
d. more than one previous UTI
e. prolonged course of fever (> 48 hrs)
36. A burning discomfort worse on passing urine as a result of inflammation of the bladder.
A. There is an increased frequency of micturation.
b. Cystitis
c. Pyelonephritis
d. Hydronephrosis
e. Vesicouritis
f. UTI
37. With regards to a child with a first UTI, which of the following is FALSE?
a. Preventive measures include low fluid intake
b. Vesicoureteric reflux is a predisposing factor
c. Up to half have a structural abnormality of their urinary tract
d. Constipation is a predisposing factor
e. Pyelonephritis may ultimaely lead to chronic renal failure
38. May help to prevent renal osteodystrophy
A. decreased milk intake
B. calcium carbonate
C. activated vitamin D supplements
d. A&B
e. A, B & C
39. What is used to treat hypocalcaemia?
a.calcium exchange resin
b. sodium bicarbonate
c. Syrup of ipecac
d. salbutamol, glucose and insulin
e. calcium carbonate
40. Presents mainly in adolescent girls and young women. Commoner in Asians and Afro-
Caribbeans than Caucasians. Characterised by the presence of multiple autoantibodies,
including antibodies to double-stranded DNA. The C3 component of complement may be
low, particularly during active phases of the disease.
a. Goodpasture's syndrome
b. Henoch Schonlein purpura
c. Familial nephritis
d. SLE
e. Wegner's granulomatosis
41. What is the commonest organism for UTI?
a. Pseudomonas
b. Streptococci
c. Proteus
d. Staphlococci
E. coli
42. Which of the following is NOT an example of a possible
cause of acute prerenal failure
a, gastroenteritis
b. pyelonephritis
c. haemorrhage
d. burns
e. sepsis
43. Infection predisposes to the formation of phosphate stones by splitting urea to
ammonia and thus alkalinising the urine
a. E. coli
b. Pseudomonas
c. Streptococci
d. Proteus
e. Staphlococci
44. An anticholinergic medication used to relieve urinary and bladder difficulties, including
frequent urination and urge incontinence, by decreasing muscle spasms of the bladder.
a. Oxybutynin
b. Oxymorphone
c. Oxystat
d. Oxycodone
e. Oxycontin
45. May result from abnormal caudal migration
a. Horseshoe kidney
b. Multicystic dysplastic kidney (MCDK)
c. Autosomal recessive polycystic kidney disease (ARPKD)
d. Autosomal dominant polycystic kidney disease (ADPKD)
e. Duplex system
46. The most widely used initial treatment for nephrotic syndrome
a. NSAIDs
b. ACE inhibitors
c. salt restriction
d. diuretic therapy
e. oral corticosteroids
47. Refers to a generalised disturbance of renal tubular transport whether inherited or
acquired. Characterised by: aminoaciduria, glycosuria, phosphaturia, proximal renal tubular
acidosis, & rickets.
a. Wegner's granulomatosis
b. Fanconi syndrome
c. Goodpasture's syndrome
d. Bartter's syndrome
e. Polyarteritis nodosa
48. Usually uses MAG 3 and is particularily good for the detection of urinary obstruction
a. Micturating cystourethrography
b. Dynamic nuclear medicine scanning
c. Intravenous uroethrography
d. Ultrasound
e. MRI scan
49. The most common cause of flaccid neuropathic bladder is injury to the spinal cord at the
micturition center...
a. L3-L5
b. S2-S4
c. L5-S2
d. S1-S3
e. L4-S1
50. An autosomal recessive renal disorder. Presentation is often in childhood with
gastrointestinal upset, failure to thrive and polyuria. The metabolic derangement consists
of: hypokalaemic alkalosis, and elevated renin and aldosterone levels
a. Bartter's syndrome
b. Fanconi syndrome
c. Polyarteritis nodosa
d. Wegner's granulomatosis
e. Goodpasture's syndrome
51. Suggested by the child having growth failure, anaemia and disordered bone
mineralization
a. prerenal failure
b. acute on chronic renal failure
c. postrenal failure
d. peritonal renal failure
e. renal renal failure
Key
1. C
2. B
3. B
4. D
5. D
6. E
7. A
8. A
9. D
10. E
11. C
12. D
13. D
14. A
15. B
16. E
17. C
18. A
19. C
20. B
21. C
22. E
23. C
24. E
25. D
26. B
27. C
28. E
29. B
30. C
31. C
32. B
33. B
34. A
35. A
36. A
37. A
38. E
39. D
40. D
41. E
42. B
43. D
44. A
45. A
46. E
47. B
48. B
49. B
50. A
51. B