Practice questions › Davidson's Principles of Medicine › Davidson's Medicine - Part 3: Clinical Medicine
18 Nephrology and urology MCQs
Davidson's Medicine - Part 3: Clinical Medicine · Davidson's Principles of Medicine · 8 practice questions
- Acute kidney injury
- Chronic kidney disease
- Glomerulonephritis and interstitial nephritis
- Renovascular disease
- Urinary tract infection
- Obstruction and prostate cancer
- Renal replacement therapy
- Glomerular disease
1. A 22-year-old woman has hypertension with beaded renal arteries, and a patient's creatinine rises 35% after starting an ACE inhibitor. Which statements are correct?
- AAtherosclerosis, and interstitial nephritis
- BFibromuscular dysplasia typically in women aged 15-30, and renal artery stenosis suspected because angiotensin II maintains GFR
- CTakayasu arteritis, and diabetic nephropathy
- DPolyarteritis, and pre-renal failure only
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B. Fibromuscular dysplasia typically in women aged 15-30, and renal artery stenosis suspected because angiotensin II maintains GFR Fibromuscular dysplasia narrows the artery with medial fibroplasia; a rise of 30% or more after ACE inhibitor or ARB raises suspicion of renal artery stenosis.
2. A haemodynamically unstable AKI patient needs renal support, and a haemodialysis patient is hepatitis B positive. Which statements are correct?
- AContinuous venovenous haemofiltration tolerated better but less efficient at clearing urea and potassium, and segregation facilities are needed for hepatitis B
- BTransplantation, and vaccination only
- CIntermittent haemodialysis, and no segregation
- DPeritoneal dialysis, and machine segregation only
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A. Continuous venovenous haemofiltration tolerated better but less efficient at clearing urea and potassium, and segregation facilities are needed for hepatitis B CVVH removes solutes by solvent drag; hepatitis B is easily transmitted while hepatitis C and HIV need machine segregation.
3. In CKD the blood pressure target and monitoring after ACE inhibitor initiation are asked. Which statements are correct?
- ABelow 160/100, and check at 6 months
- BBelow 100/60, and never check
- CBelow 140/90 for all, and check at 24 hours
- DBelow 130/80 with diabetes or ACR above 70 mg/mmol, and check function within 7-10 days accepting a fall of not more than 25%
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D. Below 130/80 with diabetes or ACR above 70 mg/mmol, and check function within 7-10 days accepting a fall of not more than 25% Target is below 140/90 without albuminuria; the drug is stopped during intercurrent illness such as vomiting.
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