Block 14 Glomerulneph Gentic Acid Base Polyuria

18 Questions | Total Attempts: 397

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Block 14 Glomerulneph Gentic Acid Base Polyuria

CTL Week 8 - Glomerulonephritis; developmental genetic disorder CTL Week 8 - Acid-base disorders; polyuria


Questions and Answers
  • 1. 
    A 5-year-old girl presents with the sudden onset of diffuse arthralgias, abdominal pain and skin rash. Physical examination shows a violaceous maculopapular rash on the lower torso. Urinalysis discloses oliguria and 2+ hematuria. Urine cultures are negative. This child's clinical presentation is commonly associated with which of the following diseases?
    • A. 

      Berger disease

    • B. 

      Goodpasture syndrome

    • C. 

      Hemolytic uremic syndrome

    • D. 

      Henoch-Schönlein purpura

    • E. 

      Polyarteritis nodosa

  • 2. 
    A 45-year-old woman has had symptoms of vulvovaginitis for the past 9 months caused by Candida. Lab tests reveal proteinuria and glycosuria with increased BUN and creatinine. If a renal biopsy were performed, which of the following would be most likely seen in the glomeruli on electron microscopic examination?
    • A. 

      Hypercellularity with thickened glomerular basement membrane (GBM) and duplication of the GBM

    • B. 

      Hypercellularity with PMN’s and subepithelial deposits

    • C. 

      Normocellularity with thickened GBM and subepithelial deposits

    • D. 

      Normal morphology with loss of epithelial foot processes

    • E. 

      Thickened GBM, mesangial proliferation and no deposits

  • 3. 
    A 54-year-old woman with squamous cell carcinoma of the lung develops bilateral pitting edema of the lower extremities. Laboratory studies show hyperlipidemia, hypoalbuminemia, and 4+ proteinuria. Urinalysis reveals no inflammatory cells or RBCs. Renal biopsy in this patient would most likely show which of the following patterns of glomerulopathy?
    • A. 

      Berger disease (IgA nephropathy)

    • B. 

      Goodpasture syndrome

    • C. 

      Membranous glomerulonephritis

    • D. 

      Minimal change glomerulonephritis

    • E. 

      Nodular glomerulosclerosis

  • 4. 
    From which of the following patients is this biopsy most likely taken?  A patient with:
    • A. 

      Goodpasture disease

    • B. 

      Systemic Lupus Erythematosus

    • C. 

      Lipoid Nephrosis

    • D. 

      Analgesic nephropathy

  • 5. 
    A 6-year-old African boy has a three-day history of nausea and vomiting accompanied by "cola-colored” urine.  His parents report a history of a sore throat "about three weeks ago".  Physical examination reveals pallor, pitting ankle edema, and blood pressure of 125/85 mm Hg (Reference Range: 105/60 mm Hg).  Microscopy of the urinary sediment demonstrates the structures shown for your evaluation below.  Which of the following renal syndromes does the patient most likely have?
    • A. 

      Nephritic syndrome

    • B. 

      Acute renal failure

    • C. 

      Nephrotic syndrome

    • D. 

      Urinary tract infection

  • 6. 
    A 53-year-old Caucasian male presents with peripheral edema. He has been healthly and physically active all his life. His family history is unremarkable. Physical examination reveals normal blood pressure with periorbital and bilateral ankle edema (+++). Urinalysis reveals proteinuria of 3.9 g/day with oval fat bodies seen under the light microscope. Which of the following is the most likely diagnosis?
    • A. 

      Acute interstial nephritis

    • B. 

      Acute tubular necrosis

    • C. 

      Nephritic syndrome

    • D. 

      Nephrotic syndrome

  • 7. 
    A 30-year-old heroin addict who is positive for the human immunodeficiency virus (HIV) is hospitalized because of generalized edema. Laboratory studies show proteinuria, hypoalbuminemia, hyperlipidemia, and lipiduria. Which of the following diseases is most likely to be diagnosed by a biopsy of the kidney?
    • A. 

      Lipoid nephrosis

    • B. 

      Focal segmental glomerulosclerosis

    • C. 

      Membranous nephropathy

    • D. 

      IgA nephropathy

    • E. 

      Amyloidosis

  • 8. 
    Which kidney disease characterized by nephrotic syndrome, microscopic hematuria, and glomerular deposits of C3 complement and properdin, and is caused by an autoantibody called C3 nephritic factor?
    • A. 

      Membranoproliferative glomerulonephritis type II

    • B. 

      Focal segmental glomerulosclerosis

    • C. 

      Membranous nephropathy

    • D. 

      IgA nephropathy

    • E. 

      Acute postinfectious glomerulonephritis

  • 9. 
    An autopsy revealed the following finding.                                               (See image of kidney) What is the most likely cause of death in this patient?
    • A. 

      Intracerebral hemorrhage cause by a ruptured Berry aneurysm

    • B. 

      Infection

    • C. 

      Hemorrhagic diathesis

    • D. 

      Acute renal failure

  • 10. 
    A 55 yo male presents to the Emergency Department with an acute onset of SOB and the following CXR: His acid-base data are:  pH 7.36, PaCO2 50, HCO3- 34     (pH 7.35-7.45, PaCO2 35-45, HCO3- 22-26) Which of the following best describes his acid-base disorder?
    • A. 

      Respiratory alkalosis with complete compensation

    • B. 

      Respiratory acidosis with complete compensation

    • C. 

      Metabolic alkalosis with complete compensation

    • D. 

      Metabolic acidosis with complete compensation

    • E. 

      Normal AB status

  • 11. 
    A 34year-old female with body image problems, presents with a long history of furosemide abuse.  Her most likely acid/base balance would be:
    • A. 

      Metabolic alkalosis with compensatory increased ventilation

    • B. 

      Metabolic acidosis with compensatory increased ventilation

    • C. 

      Metabolic acidosis with compensatory decreased ventilation

    • D. 

      Metabolic alkalosis with compensatory decreased ventilation

  • 12. 
    The body compensates for a primary metabolic acidosis by:
    • A. 

      Decreased renal absorption of HCO3

    • B. 

      Increased ventilation

    • C. 

      Increased renal absorption of HCO3

    • D. 

      Decreased ventilation

  • 13. 
    A 2nd year medical student was anxious about his performance in ICM lab with Dr. Cannon.  He felt numbness in his hands and tingling around his mouth.  Investigation showed: pH 7.48, PaCo2 of 30 mmHg and HCO3- of 23 mmoles/L.  Most likely diagnosis is
    • A. 

      Respiratory alkalosis

    • B. 

      Metabolic acidosis

    • C. 

      Respiratory acidosis

    • D. 

      Metabolic alkalosis

  • 14. 
    You are examining an anxious 23-year-old woman who was involved in a road traffic accident eight hours ago. You do not find any abnormal physical findings except tachypnea. Which of the following set of blood values would you expect to find in this patient?
    • A. 

      PH 7.55; Na+ 134 mEq/L; Cl- 101 mEq/L; HCO3- 36 mEq/L; pCO2 44 mm Hg

    • B. 

      PH 7.42; Na+ 131 mEq/L; Cl- 100 mEq/L; HCO3- 34 mEq/L; pCO2 48 mm Hg

    • C. 

      PH 7.51; Na+ 136 mEq/L; Cl- 103 mEq/L; HCO3- 20 mEq/L; pCO2 26 mm Hg

    • D. 

      PH 7.40; Na+ 135 mEq/L; Cl- 98 mEq/L; HCO3- 25 mEq/L; pCO2 39 mm Hg

  • 15. 
    You are examining a patient with a long-lasting history of a renal disease. You notice a uremic smell and whitish powder-like deposits on the patient’s skin. Laboratory investigations reveal pH 7.22; Na+ 144 mEq/L; Cl- 105 mEq/L; HCO3- 14 mEq/L; pCO2 31 mm Hg. Which of the following most accurately describes the acid-base balance of this patient?
    • A. 

      Compensated metabolic acidosis with normal anion gap

    • B. 

      Uncompensated metabolic acidosis with normal anion gap

    • C. 

      Compensated metabolic acidosis with increased anion gap

    • D. 

      Uncompensated metabolic acidosis with increased anion gap

  • 16. 
    Which of the following is the most likely mechanism of compensation in a patient with respiratory alkalosis?
    • A. 

      Increased bicarbonate reabsorption and decreased hydrogen excretion

    • B. 

      Increased bicarbonate reabsorption and increased hydrogen excretion

    • C. 

      Decreased bicarbonate reabsorption and decreased hydrogen excretion

    • D. 

      Decreased bicarbonate reabsorption and increased hydrogen excretion

  • 17. 
    A newly posted junior doctor had difficulty in finding out base deficit/ access for blood in given patient. An experienced senior resident gave him advise to find out quick method to determine acid-base composition of blood based on PCO2. Which of the following method he suggested to predict acid-base composition of blood?
    • A. 

      Ref ford nomogram

    • B. 

      Goldman constant field equation

    • C. 

      Siggard- Andersen nomogram

  • 18. 
    A 40-year-old man with polyuria has a urine osmolality of 50 mOsm. Despite drinking a large amount of water, his serum osmolarity is 316 mOsm. Upon administration of vasopressin, serum osmolarity decreases to 285 mOsm and urine osmolarity increases to 350 mOsm. What is the most likely diagnosis?
    • A. 

      Nephrogenic diabetes insipidus

    • B. 

      Primary diabetes insipidus

    • C. 

      Psychogenic polydipsia

    • D. 

      Severe water deprivation

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