[MCQ] Acute Kidney Injury & Chronic Kidney Disease- Part 6

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Acute Kidney Injury & Chronic Kidney Disease- Part 6

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Congratulations - you have completed Acute Kidney Injury & Chronic Kidney Disease- Part 6. You scored %%SCORE%% out of %%TOTAL%%. Your performance has been rated as %%RATING%%

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Question 1

Which of the following leads to hyporeninemic hypoaldosteronism ?

A	Diabetes mellitus
B	Obstructive uropathy
C	Sickle cell nephropathy
D	Sickle cell nephropathy

Question 1 Explanation:

In CKD, potassium levels may rise out of proportion to decline in GFR in conditions that lead to hyporeninemic hypoaldosteronism like diabetes, obstructive uropathy & sickle cell nephropathy

Question 2

Which of the following growth patterns is seen when cell mass of parathyroid glands increases with CKD ?

A	Diffuse hyperplasia (polyclonal)
B	Nodular growth (monoclonal) within diffuse hyperplasia
C	Diffuse monoclonal hyperplasia (“adenoma” or tertiary autonomous hyperparathyroidism)
D	Any of the above

Question 2 Explanation:

Owing to increased PTH production from parathyroid cells, its cell mass increases progressively with CKD. Growth patterns may be diffuse hyperplasia (polyclonal), nodular growth (monoclonal) within diffuse hyperplasia or diffuse monoclonal hyperplasia (“adenoma” or tertiary autonomous hyperparathyroidism)

Question 3

Brown tumor relates best with ?

A	Subcuteneous tissue
B	Bone
C	Brain
D	Liver

Question 3 Explanation:

Bone histology in hyperparathyroidism may show bone cysts, at times with hemorrhagic elements giving it brown color, hence the term brown tumor

Question 4

Adynamic bone disease can result from ?

A	Use of vitamin D preparations
B	Excessive calcium-containing phosphate binders
C	High-calcium dialysis solutions
D	All of the above

Question 4 Explanation:

Adynamic bone disease is a state of reduced bone volume & mineralization. It results from excessive PTH suppression from the use of vitamin D preparations or from excessive calcium exposure in the form of calcium-containing phosphate binders or high-calcium dialysis solutions.

Question 5

Calciphylaxis is best related to which drug ?

A	Aspirin
B	Statins
C	Warfarin
D	All of the above

Question 5 Explanation:

Calciphylaxis (livedo reticularis & ischemic necrosis) is seen almost exclusively in advanced CKD due to vascular occlusion secondary to extensive vascular calcification. Warfarin therapy decreases vitamin K–dependent regeneration of matrix GLA protein which prevents vascular calcification

Question 6

Which of the following is a phosphate binder ?

A	Calcium acetate
B	Calcium carbonate
C	Sevelamer
D	All of the above

Question 6 Explanation:

Phosphate binders are calcium acetate, calcium carbonate and Sevelamer.

Question 7

Which of the following is a consequence of a very low PTH level ?

A	Adynamic bone disease
B	Fracture
C	Ectopic calcification
D	All of the above

Question 7 Explanation:

In CKD, target PTH level should be between 150 and 300 pg/mL. Very low PTH levels cause adynamic bone disease, fracture and ectopic calcification

Question 8

Which of the following is not a negative acute-phase reactant ?

A	Transthyretin
B	Fetuin (AHSG)
C	Albumin
D	Fibrinogen

Question 8 Explanation:

Fetuin (AHSG), a glycoprotein is synthesized by hepatocytes & is present in the circulation. It has the highest capacity of inhibiting soft tissue calcification.

Question 9

Which of the following is associated with poor prognosis in late-stage CKD patients ?

A	Low blood pressure
B	Reduced body mass index
C	Hypolipidemia
D	All of the above

Question 9 Explanation:

In late-stage CKD, low BP, reduced BMI & hypolipidemia indicate the presence of a malnutritioninflammation state, with poor prognosis.

Question 10

In CKD patients with diabetes or proteinuria > 1 gram/day, blood pressure should be reduced to ?

A	110 / 70 mm Hg
B	125 / 75 mm Hg
C	135 / 85 mm Hg
D	140 / 90 mm Hg

Question 10 Explanation:

In CKD patients with diabetes or proteinuria > 1 gram/day, BP should be reduced to 125/75 mm Hg. Renoprotective effect of antihypertensive medications is gauged by consequent reduction of proteinuria

Question 11

Pericardial effusion is a side effect of ?

A	Prazosin
B	Minoxidil
C	Eplerenone
D	Labetalol

Question 11 Explanation:

Side effects of minoxidil include hypertrichosis and pericardial effusion

Question 12

Normocytic, normochromic anemia is almost always present by which stage of CKD ?

A	Stage 1
B	Stage 2
C	Stage 3
D	Stage 4

Question 12 Explanation:

Normocytic, normochromic anemia is almost always present by stage 4 of CKD.

Question 13

Primary cause of anemia in patients with CKD is ?

A	Insufficient erythropoietin (EPO)
B	Iron deficiency
C	Anemia of chronic disease
D	Bone marrow fibrosis

Question 13 Explanation:

Primary cause of anemia in patients with CKD is insufficient production of erythropoietin (EPO) by the diseased kidneys.

Question 14

Abnormal bleeding time and coagulopathy in renal failure may be reversed temporarily with ?

A	Desmopressin (DDAVP)
B	IV conjugated estrogens
C	Erythropoietin (EPO) therapy
D	All of the above

Question 14 Explanation:

Abnormal BT & coagulopathy in renal failure may be reversed temporarily with DDAVP, cryoprecipitate, IV conjugated estrogens, blood transfusions & EPO.

Question 15

Peripheral neuropathy of CKD becomes clinically evident after which stage of CKD ?

A	Stage 1
B	Stage 2
C	Stage 3
D	Stage 4

Question 15 Explanation:

Peripheral neuropathy usually becomes clinically evident after stage 4 of CKD

Question 16

Which of the following is true for peripheral neuropathy of CKD ?

A	Sensory nerves involved more than motor
B	Lower extremities involved more than upper
C	Distal parts of extremities involved more than proximal
D	All of the above

Question 17

Uremic fetor is due to breakdown of urea to ammonia in ?

A	Saliva
B	Lung
C	Mucous membranes of mouth
D	All of the above

Question 17 Explanation:

Uremic fetor (urine-like odor on breath) is due to breakdown of urea to ammonia in saliva

Question 18

Skin pigmentation in advanced CKD is due to ?

A	Chromogens
B	Chromolytes
C	Urochromes
D	Urochromes

Question 18 Explanation:

Patients become more pigmented in advanced CKD, even on dialysis due to deposition of retained pigmented metabolites called urochromes

Question 19

Nephrogenic fibrosing dermopathy is similar to ?

A	Guttate morphea
B	Scleromyxedema
C	Linear scleroderma
D	Diffuse fasciitis with eosinophilia

Question 19 Explanation:

Nephrogenic fibrosing dermopathy, seen in CKD, is a progressive subcutaneous induration on arms & legs similar to scleromyxedema.

Question 20

Which of the following can precipitate nephrogenic fibrosing dermopathy ?

A	Vitamin D
B	Metformin
C	Aluminum
D	Gadolinium

Question 20 Explanation:

Exposure to magnetic resonance contrast agent, gadolinium may precipitate nephrogenic fibrosing dermopathy or nephrogenic systemic fibrosis (NSF) between 5 & 75 days following exposure.

Question 21

CKD is likely if bilateral kidney size is ?

A	< 8.5 cm
B	< 9.0 cm
C	< 9.5 cm
D	< 10 cm

Question 21 Explanation:

Finding of bilaterally reduced kidney size (<8.5 cm) favors CKD

Question 22

Clear indications for initiation of renal replacement therapy include ?

A	Pericarditis
B	Progressive neuropathy due to uremia
C	Encephalopathy
D	All of the above

Question 23

Clear indications for initiation of renal replacement therapy include ?

A	Muscle irritability
B	Anorexia & nausea not relieved by protein restriction
C	Refractory fluid & electrolyte abnormalities
D	All of the above

Question 24

Clear indications for initiation of renal replacement therapy include ?

A	Unresponsive volume overload
B	Unresponsive hyperkalemia
C	Progressive metabolic acidosis
D	All of the above

Question 24 Explanation:

Clear indications for initiation of renal replacement therapy in CKD include pericarditis, encephalopathy, intractable muscle cramping, anorexia, nausea, malnutrition, & refractory fluid & electrolyte abnormalities (hyperkalemia).

Question 25

Clinical clues indicating the imminent development of uremic complications are ?

A	History of hiccoughing
B	Intractable pruritus
C	Morning nausea & vomiting
D	Morning nausea & vomiting

Question 26

Clinical clues indicating the imminent development of uremic complications are ?

A	Muscle twitching & cramps
B	Asterixis
C	Non-compliance of treatment
D	All of the above

Question 27

Calcium reabsorption in cortical thick ascending limb of Henle’s loop (cTAL) requires which of the following ?

A	PTH
B	1,25(OH)2D
C	Paracellin-1
D	Calbindin-D28k

Question 28

In cells & in ECF, phosphorus exists in which form ?

A	H2PO4–
B	NaHPO4–
C	HPO42–
D	All of the above

Question 29

In adults, above what level of fasting serum phosphate concentration is called Hyperphosphatemia ?

A	2.5 mg/dL
B	3.5 mg/dL
C	4.5 mg/dL
D	5.5 mg/dL

Question 30

Normally, the concentration of magnesium in serum is ?

A	0.7 to 1.2 mg/dL
B	1.2 to 1.6 mg/dL
C	1.7 to 2.4 mg/dL
D	2.4 to 2.9 mg/dL

Question 31

Which of the following should be supplemented in patients with hypomagnesemia ?

A	Calcium
B	Potassium
C	Phosphate
D	All of the above

Question 32

Which of the following prolong QT interval ?

A	Quinidine
B	Subarachnoid hemorrhage
C	Hypocalcemia
D	All of the above

Question 33

“Sine-wave” pattern in ECG is seen in ?

A	Hypokalemia
B	Hyperkalemia
C	Hypercalcemia
D	Hypothermia

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See all quizzes of Cellular and Molecular Biology of the Kidney at here:

1.Which of the following leads to hyporeninemic hypoaldosteronism ?
A. Diabetes mellitus
B. Obstructive uropathy
C. Sickle cell nephropathy
D. All of the above

2. Which of the following growth patterns is seen when cell mass of parathyroid glands increases with CKD ?
A. Diffuse hyperplasia (polyclonal)
B. Nodular growth (monoclonal) within diffuse hyperplasia
C. Diffuse monoclonal hyperplasia (“adenoma” or tertiary
autonomous hyperparathyroidism)
D. Any of the above

3. Brown tumor relates best with ?
A. Subcuteneous tissue
B. Bone
C. Brain
D. Liver

4. Adynamic bone disease can result from ?
A. Use of vitamin D preparations
B. Excessive calcium-containing phosphate binders
C. High-calcium dialysis solutions
D. All of the above

5. Calciphylaxis is best related to which drug ?
A. Aspirin
B. Statins
C. Warfarin
D. All of the above

6. Which of the following is a phosphate binder ?
A. Calcium acetate
B. Calcium carbonate
C. Sevelamer

D. All of the above

7. Which of the following is a consequence of a very low PTH level ?
A. Adynamic bone disease
B. Fracture
C. Ectopic calcification
D. All of the above

8. Which of the following is not a negative acute-phase reactant ?
A. Transthyretin
B. Fetuin (AHSG)
C. Albumin
D. Fibrinogen

9. Which of the following is associated with poor prognosis in late-stage CKD patients ?
A. Low blood pressure
B. Reduced body mass index
C. Hypolipidemia
D. All of the above

10. In CKD patients with diabetes or proteinuria > 1 gram/day, blood pressure should be reduced to ?
A. 110 / 70 mm Hg
B. 125 / 75 mm Hg
C. 135 / 85 mm Hg
D. 140 / 90 mm Hg

11. Pericardial effusion is a side effect of ?
A. Prazosin
B. Minoxidil
C. Eplerenone
D. Labetalol

12. Normocytic, normochromic anemia is almost always present by which stage of CKD ?
A. Stage 1
B. Stage 2
C. Stage 3

D. Stage 4

13. Primary cause of anemia in patients with CKD is ?
A. Insufficient erythropoietin (EPO)
B. Iron deficiency
C. Anemia of chronic disease
D. Bone marrow fibrosis

14. Abnormal bleeding time and coagulopathy in renal failure may be reversed temporarily with ?
A. Desmopressin (DDAVP)
B. IV conjugated estrogens
C. Erythropoietin (EPO) therapy
D. All of the above

15. Peripheral neuropathy of CKD becomes clinically evident after which stage of CKD ?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

16. Which of the following is true for peripheral neuropathy of CKD ?
A. Sensory nerves involved more than motor
B. Lower extremities involved more than upper
C. Distal parts of extremities involved more than proximal
D. All of the above
17. Uremic fetor is due to breakdown of urea to ammonia in ?
A. Saliva
B. Lung
C. Mucous membranes of mouth
D. All of the above

18. Skin pigmentation in advanced CKD is due to ?
A. Chromogens
B. Chromolytes
C. Urochromes
D. Renochromes

19. Nephrogenic fibrosing dermopathy is similar to ?
A. Guttate morphea
B. Scleromyxedema
C. Linear scleroderma
D. Diffuse fasciitis with eosinophilia

20. Which of the following can precipitate nephrogenic fibrosing dermopathy ?
A. Vitamin D
B. Metformin
C. Aluminum
D. Gadolinium

21. CKD is likely if bilateral kidney size is ?
A. < 8.5 cm
B. < 9.0 cm
C. < 9.5 cm
D. < 10 cm

22. Clear indications for initiation of renal replacement therapy include ?
A. Pericarditis
B. Progressive neuropathy due to uremia
C. Encephalopathy
D. All of the above
23. Clear indications for initiation of renal replacement therapy include ?
A. Muscle irritability
B. Anorexia & nausea not relieved by protein restriction
C. Refractory fluid & electrolyte abnormalities
D. All of the above
24. Clear indications for initiation of renal replacement therapy include ?
A. Unresponsive volume overload
B. Unresponsive hyperkalemia
C. Progressive metabolic acidosis
D. All of the above

25. Clinical clues indicating the imminent development of uremic complications are ?
A. History of hiccoughing
B. Intractable pruritus

C. Morning nausea & vomiting
D. All of the above
26. Clinical clues indicating the imminent development of uremic complications are ?
A. Muscle twitching & cramps
B. Asterixis
C. Non-compliance of treatment
D. All of the above
27. Calcium reabsorption in cortical thick ascending limb of Henle’s loop (cTAL) requires which of the following ?
A. PTH
B. 1,25(OH)2D
C. Paracellin-1
D. Calbindin-D28k
28. In cells & in ECF, phosphorus exists in which form ?
A. H2PO4–
B. NaHPO4–
C. HPO42–
D. All of the above
29. In adults, above what level of fasting serum phosphate concentration is called Hyperphosphatemia ?
A. 2.5 mg/dL
B. 3.5 mg/dL
C. 4.5 mg/dL
D. 5.5 mg/dL
30. Normally, the concentration of magnesium in serum is ?
A. 0.7 to 1.2 mg/dL
B. 1.2 to 1.6 mg/dL
C. 1.7 to 2.4 mg/dL
D. 2.4 to 2.9 mg/dL
31. Which of the following should be supplemented in patients with hypomagnesemia ?
A. Calcium
B. Potassium
C. Phosphate
D. All of the above
32. Which of the following prolong QT interval ?
A. Quinidine
B. Subarachnoid hemorrhage
C. Hypocalcemia
D. All of the above

Acute Kidney Injury & Chronic Kidney Disease

[MCQ] Acute Kidney Injury & Chronic Kidney Disease- Part 6

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Acute Kidney Injury & Chronic Kidney Disease- Part 6

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