Renal And Endocrine Clinmed
Renal, endocrine
Questions and Answers
- 1.
Which of the following is not a finding in acute renal failure?
- A.
Elevated BUN and creatinine
- B.
Asterixis
- C.
Hypokalemia
- D.
Anion gap metabolic acidosis
- E.
Clotting disorders
Correct Answer
C. HypokalemiaExplanation
Hypokalemia is not a finding in acute renal failure. Acute renal failure is characterized by elevated levels of blood urea nitrogen (BUN) and creatinine, which indicate impaired kidney function. Asterixis, a tremor of the hand, is also commonly seen in acute renal failure. Anion gap metabolic acidosis, a condition where the body produces excess acid, is another finding in acute renal failure. Additionally, clotting disorders can occur due to the dysfunction of the kidneys. However, hypokalemia, which refers to low levels of potassium in the blood, is not typically associated with acute renal failure.Rate this question:
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- 2.
Which is the most common cause of acute renal failure?
- A.
Prerenal azotemia
- B.
Acute tubular necrosis
- C.
Interstitial nephritis
- D.
Glomerulonephritis
Correct Answer
A. Prerenal azotemiaExplanation
Prerenal azotemia is the most common cause of acute renal failure. It occurs when there is a decrease in blood flow to the kidneys, leading to a reduction in urine output and accumulation of waste products in the blood. This can happen due to conditions such as dehydration, low blood volume, or decreased cardiac output. Acute tubular necrosis, interstitial nephritis, and glomerulonephritis are also potential causes of acute renal failure, but they are less common compared to prerenal azotemia.Rate this question:
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- 3.
Which of the following is associated with hyperglycemia and mannitol administration?
- A.
Isotonic hyponatremia
- B.
Hypertonic hyponatremia
- C.
Euvolemic hypotonic hyponatremia
- D.
Hypervolemic hypotonic hyponatremia
- E.
Hypovolemic hypertonic hyponatremia
Correct Answer
B. Hypertonic hyponatremia -
- 4.
Which of the following is treated with isotonic saline?
- A.
Isotonic hyponatremia
- B.
Euvolemic hyponatremia
- C.
Hypervolemic hyponatremia
- D.
Hypovolemic hypernatremia
Correct Answer
D. Hypovolemic hypernatremiaExplanation
Hypovolemic hypernatremia is treated with isotonic saline. Hypovolemic hypernatremia occurs when there is a deficit of both water and sodium in the body, leading to an increase in sodium concentration. Isotonic saline, which has the same concentration of sodium as the body, is used to replenish both water and sodium levels and restore fluid balance. This helps to correct the hypernatremia and increase blood volume.Rate this question:
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- 5.
What is the most common cause of hypokalemia?
- A.
Acidosis
- B.
Infectious diarrhea
- C.
Trimethoprim-sulfamethoxazole
- D.
Mineralcorticoid deficiency
- E.
Trauma
Correct Answer
B. Infectious diarrheaExplanation
Infectious diarrhea is the most common cause of hypokalemia. Diarrhea can lead to excessive loss of potassium through the stool, resulting in low levels of potassium in the body. This can occur due to infections caused by bacteria, viruses, or parasites, which can disrupt the normal absorption and transport of electrolytes in the intestines. Hypokalemia can lead to various symptoms such as muscle weakness, fatigue, and irregular heart rhythms. Therefore, infectious diarrhea should be considered as a potential cause when evaluating a patient with hypokalemia.Rate this question:
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- 6.
Treating hyperkalemia with intravenous calcium can cause which of the following?
- A.
Digitalis toxicity
- B.
Cerebral edema
- C.
Immediate death
- D.
Osteitis fibrosa cystica
Correct Answer
A. Digitalis toxicityExplanation
Treating hyperkalemia with intravenous calcium can cause digitalis toxicity. Calcium can enhance the effects of digitalis on the heart, leading to an increased risk of toxicity. Digitalis toxicity can manifest as symptoms such as nausea, vomiting, visual disturbances, and cardiac arrhythmias. It is important to monitor patients receiving both intravenous calcium and digitalis closely to prevent this potential complication.Rate this question:
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- 7.
What is the most common electrolyte abnormality in hospitalized patients?
- A.
Hyperkalemia
- B.
Hypocalcemia
- C.
Hypernatremia
- D.
Hyponatremia
Correct Answer
D. HyponatremiaExplanation
Hyponatremia is the most common electrolyte abnormality in hospitalized patients. This condition refers to low levels of sodium in the blood. It can be caused by various factors such as excessive fluid intake, certain medications, kidney problems, or hormonal imbalances. Hyponatremia can lead to symptoms like nausea, headache, confusion, seizures, and in severe cases, it can be life-threatening. Therefore, it is crucial for healthcare providers to monitor and manage sodium levels in hospitalized patients to prevent complications associated with hyponatremia.Rate this question:
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- 8.
Which electrolyte disturbance manifests with early signs of lethargy, irritability, and weakness and late symptoms of hyperthermia, delirium, seizures and coma?
- A.
Hypokalemia
- B.
Hyperkalemia
- C.
Hypernatremia
- D.
Hyponatremia
Correct Answer
C. HypernatremiaExplanation
Hypernatremia is a condition characterized by high levels of sodium in the blood. The early signs of hypernatremia include lethargy, irritability, and weakness. As the condition progresses, symptoms such as hyperthermia (high body temperature), delirium, seizures, and coma may occur. This is because high levels of sodium can disrupt the balance of water in the body, leading to dehydration and neurological symptoms.Rate this question:
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- 9.
Which of the following ECG changes suggests hypokalemia?
- A.
Peaked T waves
- B.
Biphasic QRS-T complexes
- C.
PR interval prolongation
- D.
Prominent U waves
Correct Answer
D. Prominent U wavesExplanation
Prominent U waves on an ECG suggest hypokalemia. U waves are small, rounded deflections that follow the T wave and represent repolarization of the Purkinje fibers. In hypokalemia, the U waves become more prominent and can appear taller than the T wave. This is due to delayed ventricular repolarization. Other ECG changes associated with hypokalemia include flattened or inverted T waves, ST segment depression, and an increased risk of arrhythmias. However, the most specific and characteristic finding for hypokalemia is the presence of prominent U waves.Rate this question:
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- 10.
Which is a cause of hyperkalemia?
- A.
Infectious diarrhea
- B.
Trauma
- C.
Acidosis
- D.
Alkaolsis
- E.
Aldosterone increases
Correct Answer
C. AcidosisExplanation
Acidosis is a cause of hyperkalemia because in acidosis, there is an increase in hydrogen ions (H+) in the blood. This leads to a shift of potassium ions (K+) from the intracellular space to the extracellular space, resulting in higher levels of potassium in the blood. This imbalance can disrupt normal electrical activity in the body, leading to various symptoms associated with hyperkalemia.Rate this question:
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- 11.
Which electrolyte is usually ignored in the calculation of anion gap?
- A.
Potassium
- B.
Chloride
- C.
Sodium
- D.
Bicarbonate
Correct Answer
A. PotassiumExplanation
The correct answer is potassium. The anion gap is a measure of the difference between the measured cations (positively charged ions) and anions (negatively charged ions) in the blood. It is used to evaluate acid-base disorders. The anion gap is typically calculated using the concentrations of sodium, chloride, and bicarbonate. Potassium is not included in the calculation because its concentration is usually similar to that of the other cations and does not significantly contribute to the anion gap.Rate this question:
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- 12.
Which is a cause of anion gap metabolic acidosis?
- A.
Spironolactone
- B.
Licorice
- C.
Uretero-pelvic shunt
- D.
Rhabdomyolysis
Correct Answer
D. RhabdomyolysisExplanation
Rhabdomyolysis is a condition characterized by the breakdown of muscle tissue, leading to the release of muscle cell contents into the bloodstream. This can cause an increase in the levels of organic acids in the blood, leading to anion gap metabolic acidosis. Spironolactone is a potassium-sparing diuretic and does not directly cause anion gap metabolic acidosis. Licorice can cause hypertension and hypokalemia but is not a direct cause of anion gap metabolic acidosis. A uretero-pelvic shunt is a surgical procedure used to treat urinary tract obstructions and is not associated with anion gap metabolic acidosis.Rate this question:
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- 13.
Which of the following is not a cause of euvolemic hypotonic hyponatremia?
- A.
Hyperglycemia
- B.
Endurance exercise
- C.
SIADH
- D.
Use of thiazide diuretics
- E.
Beer potomania
Correct Answer
A. HyperglycemiaExplanation
Hyperglycemia is not a cause of euvolemic hypotonic hyponatremia. Euvolemic hypotonic hyponatremia occurs when there is a dilution of sodium in the body due to excessive water intake or retention. Hyperglycemia, on the other hand, is high blood sugar levels and does not directly cause dilution of sodium.Rate this question:
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- 14.
Which is a cause of increased anion gap acidosis?
- A.
Hemorrhagic shock
- B.
Alcoholic ketoacidosis
- C.
Posthypocapnia
- D.
Uremia
- E.
Diabetic ketoacidosis
Correct Answer
D. UremiaExplanation
Uremia is a condition characterized by the buildup of waste products in the blood due to kidney dysfunction. This can lead to increased anion gap acidosis, as the kidneys are unable to effectively remove acid from the body. As a result, there is an accumulation of acidic substances in the blood, leading to a decrease in pH and an increase in the anion gap. This can cause symptoms such as fatigue, confusion, and shortness of breath.Rate this question:
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- 15.
Which is false of alkalosis?
- A.
It is more commonly saline responsive
- B.
Mild forms are generally well tolerated
- C.
It may be accompanied by low potassium
- D.
Symptoms include asterixis and myoclonus
- E.
It can be treated with NSS and discontinuance of diuretics
Correct Answer
D. Symptoms include asterixis and myoclonusExplanation
Alkalosis is a condition characterized by an elevated blood pH level. The given statement that symptoms include asterixis and myoclonus is false. Asterixis and myoclonus are actually associated with acidosis, not alkalosis. Alkalosis can cause symptoms such as muscle twitching, hand tremors, and muscle cramps, but not specifically asterixis and myoclonus. Therefore, this statement is incorrect.Rate this question:
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- 16.
What is the most common cause of glomerulonephritis?
- A.
Pseudomonas
- B.
E.coli
- C.
Group A strep
- D.
Drugs
- E.
Viruses
Correct Answer
C. Group A strepExplanation
The most common cause of glomerulonephritis is group A strep. This type of streptococcus bacteria can cause an infection in the throat or skin, which can then spread to the kidneys and lead to inflammation of the glomeruli. This inflammation can impair the kidneys' ability to filter waste and excess fluid from the blood, resulting in glomerulonephritis. Other factors such as genetics, autoimmune disorders, and certain medications can also contribute to the development of glomerulonephritis, but group A strep is the most common cause.Rate this question:
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- 17.
Which of the following conditions is associated with dense subepithelial deposits or "humps?"
- A.
Postinfectious glomerulonephritis
- B.
IgA nephropathy
- C.
Henoch-Schonlein purpura
- D.
Goodpasture's syndrome
- E.
Minimal change disease
Correct Answer
A. Postinfectious glomerulonephritisExplanation
Postinfectious glomerulonephritis is associated with dense subepithelial deposits or "humps" on renal biopsy. This condition occurs following an infection, typically a streptococcal infection, and is characterized by inflammation of the glomeruli in the kidneys. The immune response to the infection leads to the deposition of immune complexes in the glomerular basement membrane, causing the formation of these humps. This can result in hematuria, proteinuria, and decreased kidney function. IgA nephropathy, Henoch-Schonlein purpura, Goodpasture's syndrome, and minimal change disease are not typically associated with dense subepithelial deposits.Rate this question:
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- 18.
Which is associated with anti-GBM antibodies?
- A.
IgA nephropathy
- B.
Goodpasture's syndrome
- C.
Henoch-Schonlein purpura
- D.
Minimal change disease
- E.
Membranous nephropathy
Correct Answer
B. Goodpasture's syndromeExplanation
Goodpasture's syndrome is associated with anti-GBM antibodies. This autoimmune disease primarily affects the kidneys and lungs. The antibodies target the glomerular basement membrane (GBM), leading to inflammation and damage to the kidneys. This results in symptoms such as hematuria (blood in urine), proteinuria (protein in urine), and kidney failure. In addition to renal involvement, Goodpasture's syndrome can also cause pulmonary hemorrhage (bleeding in the lungs). Prompt diagnosis and treatment with immunosuppressive therapy and plasmapheresis are crucial to prevent further damage to the kidneys and lungs.Rate this question:
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- 19.
Which of the following is associated with foot process effacement on electron microscopy?
- A.
Goodpasture's syndrome
- B.
Henoch-Schonlein purpura
- C.
Minimal change disease
- D.
Membranous nephropathy
- E.
IgA nephropathy
Correct Answer
C. Minimal change diseaseExplanation
Minimal change disease is associated with foot process effacement on electron microscopy. Minimal change disease is a type of kidney disease characterized by the loss of the negatively charged particles in the glomerular basement membrane, leading to increased permeability. This results in the effacement or flattening of the foot processes of the podocytes, which can be seen on electron microscopy. Goodpasture's syndrome, Henoch-Schonlein purpura, membranous nephropathy, and IgA nephropathy are not typically associated with foot process effacement.Rate this question:
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- 20.
Which of the following is associated with membranous nephropathy?
- A.
Spike and dome pattern on biopsy
- B.
Most commonly seen in children
- C.
Cola-colored urine
- D.
Peripheral edema
- E.
Arthralgias
Correct Answer
A. Spike and dome pattern on biopsyExplanation
Membranous nephropathy is associated with a spike and dome pattern on biopsy. This pattern is characterized by the deposition of immune complexes along the glomerular basement membrane, leading to the formation of spikes and domes when viewed under a microscope. This condition is more commonly seen in adults rather than children. Other associated features of membranous nephropathy include cola-colored urine, peripheral edema, and arthralgias.Rate this question:
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- 21.
What is the most common cause of primary hyperaldosteronism?
- A.
Adrenal hyperplasia
- B.
Corticosteroid use
- C.
Adrenal adenoma
Correct Answer
A. Adrenal hyperplasiaExplanation
Primary hyperaldosteronism refers to a condition where there is excessive production of aldosterone hormone by the adrenal glands. It is most commonly caused by adrenal hyperplasia, which is the abnormal enlargement of the adrenal glands. In this condition, the adrenal glands produce an excessive amount of aldosterone, leading to increased sodium retention and potassium excretion in the kidneys. This results in high blood pressure and low potassium levels. Adrenal adenoma, a benign tumor of the adrenal gland, can also cause primary hyperaldosteronism, but it is less common than adrenal hyperplasia. Corticosteroid use is not a common cause of primary hyperaldosteronism.Rate this question:
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- 22.
What is a cause of secondary central diabetes insipidus?
- A.
Destruction of vasopressin by a circulating enzyme during pregnancy
- B.
Defect in the kidney tubules that interferes with water absorption
- C.
Amyloidosis
- D.
Pituitary stalk tumor
- E.
Lithium use
Correct Answer
D. Pituitary stalk tumorExplanation
A pituitary stalk tumor can cause secondary central diabetes insipidus. This tumor can disrupt the normal functioning of the pituitary gland, which is responsible for producing and releasing vasopressin (also known as antidiuretic hormone or ADH). Without sufficient vasopressin, the kidneys are unable to properly reabsorb water, leading to excessive urination and thirst, which are characteristic symptoms of diabetes insipidus.Rate this question:
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