Marwah Medicine
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Disorders of Kidney Quiz 1
1 / 10
CKD patient lands in uremic encephalopathy. Which ABG report will be seen?
(Ref: Harrison 21st ed, p 2313; Harrison 20th ed, p 319) Renal failure of acute or chronic etiology will lead to metabolic acidosis. So, option b and d are ruled out. Option c indicates respiratory acidosis. In metabolic acidosis, pH, HCO3 and PCO2 all three are reduced.
2 / 10
A chronic renal insufficiency patient presents with peripheral edema and reduced urine output. Which of the following drugs is suited in this patient for management of high renin Hypertension?
3 / 10
A CKD patient has ECG findings of tall T waves. Which of the following derangement is likely to be found in this patient?
(Ref: Harrison 21st ed, p 2314; Harrison 20th ed, p 2114) Derangements in chronic kidney disease: Mnemonic ABCDE-P3 1. Acidosis: High anion gap metabolic acidosis 2. Bicarbonate is low, BP is spiking 3. Calcium is low 4. Vitamin D3 is low 5. Erythropoietin is low 6. Potassium, PTH (secondary) and Phosphate are elevated
4 / 10
Which is the most critical manifestation of CKD?
(Ref: Harrison 21st ed, p 2313; Harrison 20th ed, p 2114) Hyperkalemia occurs in Grade 4/5 CKD and will lead to cardiac conduction disturbances. This combined with metabolic acidosis will cause progressive deterioration unless hemodialysis is initiated.
5 / 10
After renal transplant, what is the most common opportunistic infection?
6 / 10
A 50-year-old patient develops cardiogenic shock following acute myocardial infarction. His urine output decreases in next few days. He has increased serum urea and creatinine, urine analysis reveals no glucose or protein but numerous hyaline casts are present. After few days he develops polyuria and serum creatinine levels fall. Histopathology of renal biopsy in this patient would reveal?
7 / 10
Investigations in a patient of oliguria revealed: Urine osmolality: 800 mosm/kg. Urinary sodium 10 mmol/L. BUN: creatinine = 20:1. The most likely diagnosis is?
8 / 10
A 28-year-old boy met with on accident and sustained severe crush injury. He is most likely to develop:
(Ref Harrison 20th edition, p 2103; Robbin's 7th/604, 605; Ghai 6th/574, Harrison 19th p 1799)Acute Renal failure is an established complication of crush syndrome with myoglobin causing blockage of kidney tubules.
9 / 10
Normal sized to enlarged kidneys in a patient with chronic renal failure is indicative of:
(Ref: Harrison 19th p 723)Bilaterally enlarged kidneys seen in:1. Diabetes mellitus2. Amyloidosis3. Polycystic kidneys4. HIV nephropathy5. Hydronephrosis bilateral
10 / 10
In chronic renal failure there is:
(Ref: Harrison 20th edition, p 2114; Harrison 19th p 1807)Causes of increased anion gap (> 12 mEq/L; “MUDPILERS”) Milk – alkali syndrome Uremia Diabetic ketoacidosis Propylene glycol Lactic acidosis Isoniazid intoxication Ethanol ethylene glycol Rhabdomyolysis/ renal failure SalicylatesA normal anion gap (6 – 12 mEqL) may indicate the following: Loss of bicarbonate (i.e., diarrhea) Recovery from diabetic ketoacidosis Ileostomy fluid loss Carbonic anhydrase inhibitors (acetazolamide, dorzola – mild, tupiramate) Renal tubular acidosis Arginine and lysine in parenteral nutritionA decreased anion gap (< 6 mEqL) may suggest the following: Hypoalbuminemia Plasma cell dyscaria Monoclonal protein Bromide intoxication
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