Pathophysiology - Pretest - Renal 1. Which finding is not common in acute glomerulonephritis [2002/02] a) Hypertension b) Red cell casts in the urine c) Peripheral eosinophilia d) Vascular congestion e) Oliguria 2. Which finding is fairly specific for chronic renal failure [2002/02] a) Anemia b) Hyaline casts c) Broad casts in urinalysis d) Proteinuria e) Hypocalcemia 3. Sterile pyuria is not a common finding in [2002/02] a) Chronic interstitial nephritis b) Renal transplant rejection c) Tuberculous infection d) Prostatic hypertrophy 4. Which finding is not found in atheroembolic acute renal failure a) Acute flank pain b) Livedo reticularis c) Arteriolar plaques in the retina d) Digital ischemia e) Eosinophilia 5. A high fractional excretion of sodium is typically found in a) Heart failure b) Urinary tract obstruction c) Acute tubular necrosis d) Acute glomerulonephritis e) Hepatorenal syndrome 6. In chronic renal failure which of the following is NOT a typical finding [2002/02] a) Hyperkalemia b) Anemia c) Hypercalcemia d) Prolonged bleeding time e) Hyperparathyroidism 7. Which of the following statements is true in the management of acute renal failure a) Metabolic acidosis is fully corrected with bicarbonate b) Hyperphosphatemia is primarily managed with dialysis c) Low-dose dopamine is used to shorten the duration of renal failure d) Hypervolemia is managed with high-dose loop diuretics e) Hyponatremia is corrected by administration of sodium salts 8. Which of the following describes bone abnormalities in patients with chronic renal failure a) Osteitis fibrosis cystica is a result of oversuppression of parathyroid hormone (PTH) b) Adynamic bone disease is associated with myopathy c) Osteomalacia is due to excessive accumulation of magnesium d) Hyperparathyroidism responds well to 1,25-dihydroxyvitamin D e) Amyloidosis in dialysis patients is similar in etiology to patients who are not on dialysis 9. Which of the following statements is true regarding hematologic disorders in CRF a) Reistance to erythropoietin is most commonly due to aluminum overload b) Erythropoietin is associated with worseing hypertension c) The major cause of death in CRF is sepsis d) Abnormal bleeding responds best to platelet transfusion e) Leukocyte function is generally unimpaired 10. Which of the following is useful in retarding progression of renal failure a) Aggressive blood pressure control b) Decrease in protein intake c) Angiotensin-converting enzyme (ACE) inhibitors more than other antihypertensive drugs d) Erythropoietin for anemia 11. Rapidly progressive glomerulonephritis is characterized by the following EXCEPT a) Red cell casts in urine b) Oliguria c) Hypertension d) Nephrotic syndrome e) Edema 12. Which of the following serologic findings is associated with linear staining of the glomerulus on immunofluorescence a) Anti-GBM (glomerular basement membrane) antibody b) Low-complement immune-complex glomerulonephritis c) Antineutrophil cytoplasmic antibody (ANCA)-associated renal disease d) Membranoproliferative glomerulonephritis 13. ANCA is typically present in which systemic disease a) Goodpasture's syndrome b) Wegener's granulomatosis c) Systemic lupus erythematosus (SLE) d) Thrombotic thrombocytopenic purpura (TTP) 14. Postinfectious glomerulonephritis is characterized by which of the following a) Most cases in an epidemic are subclinical b) Hematuria typically develops within a week of infection c) It is more common with pharyngeal than cutaneous streptococcus infection d) Focal proliferative glomerulonephritis is seen on renal biopsy e) Children are often left with residual renal impairment 15. Which of the following is true of Goodpasteur's syndrome [2002/02] a) The clinical presentation is largely the same in different age groups b) The target antigen in the glomerulus is elastin c) Complement levels are typically normal d) Plasmapharesis enables dialysis-dependent patients to recover renal function e) Transplantation is contraindicated because of disease recurrence 16. Which of the following is not a finding typical of nephrotic syndrome a) Increased susceptibility to infection b) Hypocalcemia c) Hyperlipidemia d) Increased tendency to bleed 17. Minimal change disease [2002/02] a) Is the most common cause of nephrotic syndrome in adults b) Has characteristic abnormalities on light microscopy c) Is a common cause of progressive renal insufficiency d) May be caused by intake of non-steroidal drugs e) Is usually treated with a combination of steroids and cytotoxic agents 18. Comparing focal sclerosis and membranous glomerulopathy which is NOT true a) Both can be idiopathic or secondary b) Focal sclerosis has a better long-term prognosis and responds better to steroids c) Malignancies are associated with membranous glomerulopathy d) The lesion in HIV is most commonly focal sclerosis e) Focal sclerosis is a common response to previous nephron loss or injury 19. Which is NOT true of membranoproliferative glomerulo-nerphritis a) It includes depressed complement levels b) It is associated with hepatitis C c) It is an immune-complex-mediated disease d) Type II is associated with C3 nephritis factor e) It responds to steroid therapy 20. Which may cause acute renal failure in patients with nephrotic syndrome [2002/02] a) Dietary protein restriction b) ACE inhibitors c) Lipid-lowering agents d) Loop diuretics 21. Which statement is NOT true of diabetic nephropathy a) It is the most common cause of renal failure in the United States b) Microalbuminuria is the first manifestation of the disease c) It is almost always associated with retinopathy in insulin-dependent diabetes mellitus (IDDM) d) ACE inhibitors are indicated only for patients with hypertension e) Hyperkalemia and type IV renal tubular acidosis (RTA) are commonly found 22. Which disease presents with predominantly tubulointerstitial involvement a) Systemic lupus erythematosus b) Sjogren's syndrome c) Rheumatoid arthritis d) Essential mixed cryoglobulinemia 23. Which disease presents with predominantly glomerular involvement a) Analgesic nephropathy b) Uric acid nephropathy c) Lead nephropathy d) Light-chain deposition disease 24. Which of the following is a common cause of isolated hematuria [2002/02] a) Alport's syndrome b) Thin-basement-membrane disease c) Amyloidosis d) IgA nephropathy 25. Hyperparathyroidism and nephrocalcinosis a) Type I RTA b) Type II RTA c) Type IV RTA 26. Urine pH always greater than 5.5 a) Type I RTA b) Type II RTA c) Type IV RTA 27. Nonsteroidal anti-inflammatory agents a) Type I RTA b) Type II RTA c) Type IV RTA 28. Fanconi's syndrome a) Type I RTA b) Type II RTA c) Type IV RTA 29. Both hepatic fibrosis and renal failure in children a) Autosomal dominant polycystic kidney disease b) Autosomal recessive polycystic kidney disease c) Medullary sponge kidney d) Juvenile nephronophthisis / medullary cystic disease 30. Small kidneys with interstitial fibrosis and renal failure a) Autosomal dominant polycystic kidney disease b) Autosomal recessive polycystic kidney disease c) Medullary sponge kidney d) Juvenile nephronophthisis / medullary cystic disease 31. Nephrocalcinosis, hematuria and urinary tract infection a) Autosomal dominant polycystic kidney disease b) Autosomal recessive polycystic kidney disease c) Medullary sponge kidney d) Juvenile nephronophthisis / medullary cystic disease 32. Hepatic cysts, intracranial aneurysm and colonic diverticuli a) Autosomal dominant polycystic kidney disease b) Autosomal recessive polycystic kidney disease c) Medullary sponge kidney d) Juvenile nephronophthisis / medullary cystic disease 33. Match the laboratory findings with vomiting a) pH 7.3, pCO2 30, HCO3 15, Anion gap 10 b) pH 7.38, pCO2 55, HCO3 30, Anion gap 12 c) pH 7.26, pCO2 60, HCO3 26, Anion gap 10 d) pH 7.49, pCO2 47, HCO3 35, Anion gap 15 34. Match the laboratory findings with COPD a) pH 7.3, pCO2 30, HCO3 15, Anion gap 10 b) pH 7.38, pCO2 55, HCO3 30, Anion gap 12 c) pH 7.26, pCO2 60, HCO3 26, Anion gap 10 d) pH 7.49, pCO2 47, HCO3 35, Anion gap 15 35. Match the laboratory findings with diarrhea a) pH 7.3, pCO2 30, HCO3 15, Anion gap 10 b) pH 7.38, pCO2 55, HCO3 30, Anion gap 12 c) pH 7.26, pCO2 60, HCO3 26, Anion gap 10 d) pH 7.49, pCO2 47, HCO3 35, Anion gap 15 36. Match the laboratory findings with respiratory arrest a) pH 7.3, pCO2 30, HCO3 15, Anion gap 10 b) pH 7.38, pCO2 55, HCO3 30, Anion gap 12 c) pH 7.26, pCO2 60, HCO3 26, Anion gap 10 d) pH 7.49, pCO2 47, HCO3 35, Anion gap 15 37. Match the type of hyponatremia with Addison's disease a) Hypervolemic hyponatremia b) Isovolemic hyponatremia c) Hyponatremic hyponatremia d) Pseudohyponatremia 38. Match the type of hyponatremia with nephrotic syndrome [2002/02] a) Hypervolemic hyponatremia b) Isovolemic hyponatremia c) Hyponatremic hyponatremia d) Pseudohyponatremia 39. Match the type of hyponatremia with hypothyroidism a) Hypervolemic hyponatremia b) Isovolemic hyponatremia c) Hyponatremic hyponatremia d) Pseudohyponatremia 40. Match the type of hyponatremia with hypertriglyceridemia a) Hypervolemic hyponatremia b) Isovolemic hyponatremia c) Hyponatremic hyponatremia d) Pseudohyponatremia 41. Hypertension with microangiopathic anemia a) Hyperaldosteronism b) Bartter's syndrome c) Scleroderma d) Renal artery stenosis e) Pheochromocytoma 42. Hypertension with elevated renin level a) Hyperaldosteronism b) Bartter's syndrome c) Scleroderma d) Renal artery stenosis e) Pheochromocytoma 43. Hypertension with metabolic alkalosis a) Hyperaldosteronism b) Bartter's syndrome c) Scleroderma d) Renal artery stenosis e) Pheochromocytoma 44. Hypertension with tachycardia a) Hyperaldosteronism b) Bartter's syndrome c) Scleroderma d) Renal artery stenosis e) Pheochromocytoma 45. Normotension with metabolic alkalosis a) Hyperaldosteronism b) Bartter's syndrome c) Scleroderma d) Renal artery stenosis e) Pheochromocytoma ----------Key---------- 1. (c) 2. (c) 3. (d) 4. (a) 5. (c) 6. (c) 7. (d) 8. (d) 9. (b) 10. (d) 11. (d) 12. (a) 13. (b) 14. (a) 15. (c) 16. (d) 17. (d) 18. (b) 19. (e) 20. (d) 21. (d) 22. (b) 23. (d) 24. (c) 25. (a) 26. (a) 27. (c) 28. (b) 29. (b) 30. (d) 31. (c) 32. (a) 33. (d) 34. (b) 35. (a) 36. (c) 37. (c) 38. (a) 39. (c) 40. (d) 41. (c) 42. (d) 43. (a) 44. (e) 45. (b)