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Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Diagnosis and Monitoring in Renal Failure
Page: 1

Question 1#Print Question

You are asked to consult on a previously healthy 68-year-old woman who presented with malaise and one episode of hematuria. She visited her primary care doctor 5 days ago for a “bladder infection” and was prescribed trimethoprim-sulfamethoxazole, which she has been taking. She is alert and oriented, and her physical examination is within normal limits. Her vital signs are normal. Her laboratory data are unremarkable except for elevated eosinophils, creatinine of 3 mg/dL, and urea 41 mg/dL. 

What would you expect to see in urine analysis?

A. Muddy brown cast
B. Red blood cell cast
C. White blood cell cast
D. Envelopelike crystals


Question 2#Print Question

You are asked to consult on a previously healthy 68-year-old woman who presented with malaise and one episode of hematuria. She visited her primary care doctor 5 days ago for a “bladder infection” and was prescribed trimethoprim-sulfamethoxazole, which she has been taking. She is alert and oriented, and her physical examination is within normal limits. Her vital signs are normal. Her laboratory data are unremarkable except for elevated eosinophils, creatinine of 3 mg/dL, and urea 41 mg/dL.

What management should you pursue next?

A. Administer fomepizole
B. Discontinue trimethoprim-sulfamethoxazole
C. Administer 500 mL bolus of normal saline
D. Obtain a computed tomography (CT) abdomen/pelvis with intravenous (IV) contrast


Question 3#Print Question

Which of the electrolyte abnormalities is associated with advanced chronic kidney disease?

A. Hyponatremia
B. Hypophosphatemia
C. Hypomagnesemia
D. Hypokalemia


Question 4#Print Question

You are working as an intensivist in a rural hospital where the emergency physician calls you to evaluate a patient for intensive care unit (ICU) admission. When you come to the emergency department (ED), you see a disheveled, cachectic, old gentleman who was brought in by his neighbor for altered mental status. His neighbor reports that the patient has been complaining about back pain, and he was taking some “over-the-counter” (OTC) pain medication. You cannot elicit any history from the patient, and his physical examination is unremarkable. His laboratory data show:

  • elevated creatinine of 2.1 mg/dL
  • sodium 147 mEq/L
  • potassium 5.8 mEq/L
  • chloride 113 mEq/L
  • bicarbonate 22 mEq/L
  • albumin 2 mg/dL
  • glucose 98 mg/dL

His arterial blood gas shows pH 7.39 and pCO2 38. 

What is the next test that you would order?

A. Obtain an acetaminophen level
B. Obtain a salicylate level
C. Obtain an alcohol level
D. Obtain a ketone level


Question 5#Print Question

You are working as an intensivist in a rural hospital where the emergency physician calls you to evaluate a patient for intensive care unit (ICU) admission. When you come to the emergency department (ED), you see a disheveled, cachectic, old gentleman who was brought in by his neighbor for altered mental status. His neighbor reports that the patient has been complaining about back pain, and he was taking some “over-the-counter” (OTC) pain medication. You cannot elicit any history from the patient, and his physical examination is unremarkable. His laboratory data show:

  • elevated creatinine of 2.1 mg/dL
  • sodium 147 mEq/L
  • potassium 5.8 mEq/L
  • chloride 113 mEq/L
  • bicarbonate 22 mEq/L
  • albumin 2 mg/dL
  • glucose 98 mg/dL

His arterial blood gas shows pH 7.39 and pCO2 38. 

What is the BEST next step of management?

A. Administer N-acetylcysteine
B. Start an insulin drip
C. Start emergent hemodialysis
D. Proceed with urine alkalization




Category: Critical Care Medicine-Renal, Electrolyte and Acid Base Disorders--->Diagnosis and Monitoring in Renal Failure
Page: 1 of 2