The Quizzes about Kidneys diseases – Part 3 (25 test)

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The Quizzes about Kidneys diseases – Part 3 (25 test)
5 (100%) 2 votes

Select the ONE answer that is BEST in each case.

A 53-year-old woman is being treated for tuberculosis with INH and rifampin.

INH can result in impaired oxygen utilization, leading to lactic acidosis (type B), accumulation of lactate, and increased anion gap.

 

See all quizzes of  the Kidneys diseases at here:

Part 1Part 2 | Part 3 |

 

45. A 53-year-old woman is being treated for tuberculosis with INH and rifampin. (SELECT ONE)

(A) metabolic acidosis
(B) metabolic alkalosis
(C) respiratory acidosis
(D) respiratory alkalosis

46. A 69-year-old woman is taking large amounts of aspirin for osteoarthritis, and now complains of ringing in her ears and nausea. (SELECT ONE)

(A) metabolic acidosis
(B) metabolic alkalosis
(C) respiratory acidosis
(D) respiratory alkalosis

47. A 42-year-old man presents to hospital with dark black-colored stools and passing out while getting up. On examination he is diaphoretic, blood pressure 80/50 mm Hg supine, pulse 120/min, and the DRE is positive for melena. He is resuscitated in the emergency room. He has low urine output and develops renal failure from ATN. A few days later, his urine output increases to 200 cc/h. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

48. A 27-year-old woman presents because she is feeling unwell. Her examination is normal, but her serum sodium is 115 mEq/L. Her urine lytes: sodium 55 mEq/L, osmolality 100 mOsm/L. This condition causes the greatest amount of medullary washout. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

49. A 64-year-old man develops severe diarrhea after returning from a foreign holiday. He is hypovolemic clinically and is given normal saline. His serum sodium is 125 mEq/L and potassium is 2.5 mEq/L. He develops increased urine output with urine sodium of 10 mEq/L and osmolality of 200 mOsm/L. His polyuria can be caused by hypokalemia. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

50. A 34-year-old man is brought for evaluation because of bizarre behavior. He comments that he is voiding all the time of clear water-like urine. He has a past history of schizophrenia for which he is taking a major tranquilizer. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

51. A 38-year-old man is admitted to hospital for investigation of polyuria and a low serum sodium concentration. After a fluid deprivation test, there was no change in his urine osmolality. He was then given vasopressin (DDAVP) with no change in urine volume or urine osmolality after 2 hours. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

52. A 67-year-old man is admitted to hospital after a stroke. He has swallowing difficulties, and a nasogastric feeding tube is inserted to provide high protein content nutrition. After starting the tube feeds, he develops large amounts of urine output. His serum sodium is normal, and the urine values are sodium 60 mEq/L and osmolality 420 mOsm/L. (SELECT ONE)

(A) nephrogenic DI
(B) central DI
(C) primary polydipsia
(D) solute diuresis
(E) natriuretic syndrome

53. A 74-year-old man from a nursing home is not feeling well and is confused. He is not able to give any reliable history. His serum sodium is 120 mEq/L and osmolality is 265 mOsm/kg. On examination, his blood pressure is 100/50 mm Hg, pulse 100/min, and neck veins are not
visible. His urine sodium is 40 mEq/L and urine osmolality is 330 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

54. A 65-year-old woman is admitted to the hospital after a stroke resulting in left hemiparesis. She has no trouble swallowing and is on a full diet. One week later, on routine biochemistry, her sodium is 128 mEq/L and osmolality is 270 mOsm/kg. She has no symptoms and is euvolemic on clinical examination. Urine sodium is 40 mEq/L and urine osmolality is 450 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

55. A 42-year-old man is on amitriptyline for depression. Recently he has been feeling more lethargic and unwell. His clinical examination is normal. Serum sodium is 125 mEq/L and osmolality is 260 mOsm/kg, and urine sodium is 40 mEq/L and osmolality is 450 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

56. A 32-year-old man is feeling unwell and brought to the hospital. His serum sodium is 125 mEq/L. On examination, his blood pressure is 110/70 mm Hg, pulse 110/min supine, and sitting up causes him to feel light-headed with a drop in his blood pressure. His urine sodium is 5 mEq/L and urine osmolality is 800 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

57. A 57-year-old man is referred for assessment of his low serum sodium of 125 mEq/L. On examination, he has pitting edema and elevated neck veins. His urine sodium is 10 mEq/L and urine osmolality 350 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

58. A 63-year-old man is feeling unwell with symptoms of increased thirst and voiding. He is not taking any medications and there is no past medical history. Physical examination is normal, but his serum sodium is 130 mEq/L and serum osmolality is 310 mOsm/kg. (SELECT ONE)

(A) congestive heart failure (CHF)
(B) extrarenal sodium and fluid losses
(C) SIADH
(D) polydipsia
(E) essential hyponatremia
(F) renal failure
(G) endocrine cause of hyponatremia
(H) renal sodium and fluid losses
(I) artifactual
(J) osmotic
(K) impaired diuresis

 

 

59. A 30-year-old woman is having symptoms of muscle weakness and fatigue. On examination, her blood pressure is 120/80 mm Hg, pulse 80/min, JVP 4 cm, heart sounds normal, and lungs clear. Her serum potassium level is 2.5 mEq/L, and bicarbonate 30 mEq/L. The urine potassium is 10 mEq/L. (SELECT ONE)

(A) lower gastrointestinal (GI) losses
(B) prior use of diuretics

(C) RTA
(D) current use of diuretics
(E) malignant hypertension
(F) primary hyperaldosteronism
(G) glucocorticoid excess

60. A 55-year-old man is having symptoms of muscle weakness and fatigue. He has poorly controlled asthma and recently had an exacerbation. On examination, his blood pressure is 160/90 mm Hg, pulse 80/min, JVP 4 cm, heart sounds normal, and lungs clear. His serum potassium level is 2.5 mEq/L and bicarbonate 30 mEq/L. The urine potassium is 40 mEq/L. Plasma renin and aldosterone levels are low. (SELECT ONE)

(A) lower gastrointestinal (GI) losses
(B) prior use of diuretics

(C) RTA
(D) current use of diuretics
(E) malignant hypertension
(F) primary hyperaldosteronism
(G) glucocorticoid excess

61. A 44-year-old woman is having symptoms of muscle weakness and fatigue. On examination, her blood pressure is 120/80 mm Hg, pulse 80/min, JVP 4 cm, heart sounds normal, and lungs clear. Her serum potassium level is 2.5 mEq/L, bicarbonate 18 mEq/L, and anion gap is normal. The urine potassium is 40 mEq/L. (SELECT ONE)

(A) lower gastrointestinal (GI) losses
(B) prior use of diuretics

(C) RTA
(D) current use of diuretics
(E) malignant hypertension
(F) primary hyperaldosteronism
(G) glucocorticoid excess

62. A 30-year-old man is having symtoms of muscle weakness, fatigue, and headaches. On examination, his blood pressure is 180/100 mm Hg, pulse 80/min, JVP 4 cm, heart sounds normal, and lungs clear. His serum potassium level is 2.5 mEq/L and bicarbonate 30 mEq/L. The urine potassium is 40 mEq/L. Plasma renin is low and aldosterone is high. (SELECT ONE)

(A) lower gastrointestinal (GI) losses
(B) prior use of diuretics

(C) RTA
(D) current use of diuretics
(E) malignant hypertension
(F) primary hyperaldosteronism
(G) glucocorticoid excess

63. A 60-year-old woman is having symptoms of muscle weakness and fatigue. On examination, her blood pressure is 110/80 mm Hg, pulse 100/min, JVP 1 cm, heart sounds normal, and lungs clear. Her serum potassium level is 2.5 mEq/L, bicarbonate 15 mEq/L, and anion gap is normal. The urine potassium is 10 mEq/L. (SELECT ONE)

(A) lower gastrointestinal (GI) losses
(B) prior use of diuretics

(C) RTA
(D) current use of diuretics
(E) malignant hypertension
(F) primary hyperaldosteronism
(G) glucocorticoid excess

69. A 14-year-old girl develops a rash, abdominal pain, and arthralgias. She is also experiencing some nausea, vomiting, and crampy abdominal pain. On examination, she has a palpable purpuric rash on her buttocks and lower legs, a tender abdomen, and no active joint inflammation. Her stools test positive for blood, and urinalysis reveals RBCs and RBC casts. Her renal function deteriorates rapidly over several days. A renal biopsy is performed. (SELECT ONE)

(A) diffuse proliferative GN
(B) crescentic GN
(C) focal proliferative GN
(D) membranoproliferative GN
(E) minimal change GN
(F) focal segmental GN
(G) membranous GN
(H) deposition diseases
(I) nonimmune basement membrane
abnormalities

71. A 47-year-old woman with RA is being treated with nonsteroidal anti-inflammatory drugs
NSAIDs) and gold. She develops acute shortness of breath with hypoxemia and is admitted to the hospital. Admission urinalysis reveals 4+ proteinuria but no active sediment. A renal biopsy is performed. (SELECT ONE)

(A) diffuse proliferative GN
(B) crescentic GN
(C) focal proliferative GN
(D) membranoproliferative GN
(E) minimal change GN
(F) focal segmental GN
(G) membranous GN
(H) deposition diseases
(I) nonimmune basement membrane
abnormalities

72. A 19-year-old man, who is otherwise healthy, is found to have RBCs in his urine. There is no proteinuria. Evaluation of his family reveals that his mother also has hematuria. She has minimal renal impairment and, other than being hard of hearing, is in good health. A renal biopsy might show. (SELECT ONE)

(A) diffuse proliferative GN
(B) crescentic GN
(C) focal proliferative GN
(D) membranoproliferative GN
(E) minimal change GN
(F) focal segmental GN
(G) membranous GN
(H) deposition diseases
(I) nonimmune basement membrane
abnormalities

73. A 33-year-old man from Southeast Asia, without HIV infection, is diagnosed as having pulmonary tuberculosis. He is started on multiple medications, including INH and rifampin.
Three months later, he has developed edema. Liver tests are normal, and serum creatinine is increased by 30% over baseline. Urinalysis reveals 4+ proteinuria. A renal biopsy is performed. (SELECT ONE)

(A) diffuse proliferative GN
(B) crescentic GN
(C) focal proliferative GN
(D) membranoproliferative GN
(E) minimal change GN
(F) focal segmental GN
(G) membranous GN
(H) deposition diseases
(I) nonimmune basement membrane
abnormalities

75. A 43-year-old man had a subarachnoid hemorrhage from an intracranial aneurysm 8 years ago. He has also had progressive renal impairment associated with hematuria. The most likely diagnosis is (SELECT ONE)

(A) polycystic kidney disease
(B) medullary sponge kidney
(C) medullary cystic disease
(D) Liddle syndrome
(E) Bartter syndrome
(F) congenital nephrogenic DI
(G) RTA type I
(H) RTA type II
(I) X-linked hypophosphatemia
(J) cystinuria
(K) Fanconi syndrome

77. A 28-year-old man presents with a kidney stone. He is married to his first cousin, and 6 months earlier, his 8-year-old son had a kidney stone as well. The most likely diagnosis is (SELECT ONE)

(A) polycystic kidney disease
(B) medullary sponge kidney
(C) medullary cystic disease
(D) Liddle syndrome
(E) Bartter syndrome
(F) congenital nephrogenic DI
(G) RTA type I
(H) RTA type II
(I) X-linked hypophosphatemia
(J) cystinuria
(K) Fanconi syndrome

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