EXAM INTEGRATED THERAPEUTIC

1, An elderly male patient produced only 25 ml of urine in the past 24 hours. The
urologist discovers that prostatic hypertrophy is the cause. Which one of the
following best describes this patient's acute kidney injury( AKI ) ? A,
Prerenal oliguric B,Prerenal anuric. C,Postrenal anuric D,Intrinsic nonoliguric

2,Which of the following findings from a blood and urine samples indicates that a
fluid bolus should be given in a critically ill, newly oliguric patient? A,Fractional
excretion of sodium <1% B,BUN/serum creatinine ratio = 10. C,Many casts in
the urine sample. D,Serum sodium > 150 meq/L.

3,Which one of the following is an advantage that torsemide has over furosemide
therapy ? A,Torsemide can be given as a continuous infusion.
B,Torsemide has a more consistent oral bioavailability. C,Torsemide is less
expensive. D,Torsemide can be used in sulfa - allergic patients.

4,Which one of the following is a risk factor for developing acute kidney injury in a
patient about to receive intravenous contrast dye ? A,Dehydration.
B,Hypertension. C,Concomitant itraonazole. D,Female sex.

5,Which of the following is True regarding dopamine use in patients with

established intrinsic acute renal failure?

A,Doses of >5¥g/kg per minute are associated with increased urine output

B,Low dose dopamine is associated with faster recovery of renal function.

C,Low dose dopamine is associated with increased creatinine clearance.

D,Dopamine use has not been shown to improve mortality rates in this population

6,Which one of the following electrolytes usually must be restricted in patients

with ARI ? A,Chloride. B,Potassium. C,Bicarbonate. D,Calcium

7,Which one of the following may invalidate the calculation of the fractional
excretion of sodium in a patient with acute renal failure? A,Concurrent
gentamicin therapy. B,Ingestion of a 6-g sodium diet. C,Concurrent furosemide
therapy. D,Oliguria.

8,A patient is scheduled to receive intravenous contrast dye. Which of the

following would be the most appropriate intravenous solution to infusion to this
patient to prevent acute kidney injury? A,0.9% sodium chloride. B,20% albumin.
C,5% dextrose. D,20% mannitol.

9,The top leading cause of chronic kidney disease (CKD) A,Polycystic kidney
disease. B,Glomerulonephritis. C,Hypertension. D,Diabetes

10,

11,An independent risk factor that results in a faster decline worsening in kidney
function A,Hyperglycemia. B,Hypertension. C,Proteinuria. D,All the above

12,The risk factor of chronic kidney disease that is Not generally modified by
pharmacologic therapy or lifestyle modifications. A,Susceptibility factors.
B,Initiation factor. C,Progression factors. D,All the above

13,Diabetic patients should be screened for microalbuminuria every ____

A,Month B,3 months C,6 months D,12 months

14,In patients with diabetes and a GFR of less than 25 ml/min, Kidney disease
outcomes quality initiative (K/DOQI) guidelines on nutrition recommend a dietary
protein intake of A,0.20g protein kg/day B,0.28g protein kg/day C,0.60g protein
kg/day D,0.75g protein kg/day

15,Which class of anti hypertensive agent has demonstrated both decreased

proteinuria and preserved GFR independent of the degree of blood pressure
reduction in diabetic patients? A,Diuretics. B,CCBs C,ACE inhibitors. D,Beta
blockers

16,The national kidney foundation Hypertension and Diabetes Executive

committee working group recommends that patients with diabetes with or
without renal insufficiency have a target blood pressure of less than A,130/80
mm Hg B,160/90 mm Hg C,140/85 mm Hg D,125/75 mm Hg
17,According to the JNC 7 guidelines patients with renal insufficiency (chronic
kidney disease) and proteinuria should have a target blood pressure of less than
A,130/80 mm Hg B,160/90 mm Hg C,140/85 mm Hg D,125/75 mm Hg

18,Which of the following would be the best regimen to initiate in a diabetic

hypertensive patient with an creatinine clearance (eGFR) 30ml/min? A,ACE
inhibitor +loop diuretic. B,ACE inhibitor + thiazide diuretic C,CCB+ beta blocker
D,Beta blocker + loop diuretic

19,Which of the following class of anti hypertensive agent are anti hypertensive
agents of choice for all patients with chronic kidney disease ? A,Beta blockers
B,ACE inhibitors C,Loop diuretics D,CCB

20,For a patient initiating ACEIs therapy. Which of the following parameters

should be monitored frequently ? A,Glucose and pulse B,Na and urine acid
C,K,SCT and BP

21,The most common manifestation of drug induced kidney diseases is a decline

in the glomerular filtration rate (GFR) leading to A,Metabolic acidosis with
bicarbonaturia B,Oliguria C,Decline in GFR leading to risk in SCr and BUN
D,Hyperkalemia

22,True statement about presentation of Aminoglycoside associated

Nephrotoxicity? A,Observed within 5-10 days after initiation of therapy
B,Present with non-oliguria, microscopic hematuria and proteinuria. C,Higher
rates of toxicity seen with neomycin and gentamicin. D,All of the above

23,Are primary causes of acute tubular necrosis (ATN) except A,Amphotericin B.

B,Radiographic contrast media C,Diphenhydramine D,Aminoglycoside.

24,Which of the following statements regarding prevention of radiographic

contrast media nephrotoxicity is True? A,Dehydration should be corrected prior
to administration B,Use of low or iso-osmolar contrast agents C,The smallest
adequate dose of contrast media should be administered. D,All the above

25,A rise in serum creatinine of 20% from baseline within 3 to 5 days after
initiating ACE therapy indicates? A,Development of hemody namically mediated
renal failure. B,A decease in tubular secretion of creatinine C,The ACE
inhibitors has begun to exert its desired pharmacologic effect. D,Development
of acute allergic interstitial nephritis.

26,winch of the following is associated with acute allergic interstitial nephritis ?

A,Ibuprofen. B,Penicillin C,Sulfonamides. D,All the above.

27,In patients with nephrotic syndrome. Which of the following is Not expected to
be present? A,Proteinuria B,Edema C,Hematuria D,Hyperlipidemia

28,Which of the following is Not expected to reduce proteinuria when used for
patients with glomerulonephritis ? A,ACEI B,ARBs C,Dihydropyridin CCBs
Amilodipin. D,Non dihydropyridin CCBs Dilitiazem

29,Treatment of which of the following is expected to reduce the progression of

renal failure in patients with glomerulonephritis A,Edema B,Proteinuria
C,Hyperlipidemia D,Hematuria

30,ACEIs are often used in patients with glomerulonephritis because of their

ability to reduce A,Proteinuria B,Blood pressure C,Immunologically induced
glomerular damage. D,Both A and B.

31,All the following drugs have been implicated in ATN except. A,Amphotericin
B. B,Cisplatin. C,Diphenhydramine D,Streptomycin