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Category: Prometric--->Nephrology
Page: 1

Question 1# Print Question

A 27-year-old man is investigated for haemoptysis. He is a non-smoker and has no respiratory history of note. Whilst awaiting a bronchoscopy he becomes lethargic and anorexic.

Blood tests show the following: 

  • Na+ 141 mmol/l
  • K+ 5.3 mmol/l
  • Urea 16.7 mmol/l
  • Creatinine 271 μmol/l

A renal biopsy is performed and shows linear IgG deposits along the basement membrane.

What type of antibodies are most likely to cause this type of presentation?

A. cANCA
B. IgA
C. pANCA
D. Anti-nuclear antibodies (ANA)
E. Anti-glomerular basement membrane (anti-GBM) antibodies


Question 2# Print Question

A 24-year-old woman is diagnosed as having nephrotic syndrome after being investigated for proteinuria. A diagnosis of minimal change glomerulonephritis is made.

What is the most appropriate initial treatment to reduce proteinuria?

A. Protein restriction in diet
B. No treatment shown to effective
C. Angiotensin-converting-enzyme inhibitor
D. Diuretic
E. Prednisolone


Question 3# Print Question

A 64-year-old female is brought to the Emergency Department by her family, who are concerned about her increasing confusion over the past 2 days. On examination she is found to be pyrexial at 38ºC.

Blood tests reveal: 

  • Hb 9.6 g/dl
  • Platelets 65 * 109/l
  • WCC 11.1 * 109/l
  • Urea 23.1 mmol/l
  • Creatinine 366 μmol/l

What is the most likely diagnosis?

A. Wegener's granulomatosis
B. Thrombotic thrombocytopenic purpura
C. Haemolytic uraemic syndrome
D. Idiopathic thrombocytopenic purpura
E. Rapidly progressive glomerulonephritis


Question 4# Print Question

A 45-year-old female with nephrotic syndrome develops renal vein thrombosis.

What changes in patients with nephrotic syndrome predispose to the development of venous thromboembolism?

A. Reduced excretion of protein S
B. Loss of antithrombin III
C. Reduced excretion of protein C
D. Loss of fibrinogen
E. Reduced metabolism of vitamin K


Question 5# Print Question

A 14-year-old girl is referred to the paediatric unit with reduced urine output and lethargy. She has been passing bloody diarrhoea for the past four days. On admission she appears dehydrated.

Bloods show the following: 

  • Na+ 142 mmol/l
  • K+ 4.8 mmol/l
  • Bicarbonate 22 mmol/l
  • Urea 10.1 mmol/l
  • Creatinine 176 μmol/l
  • Hb 10.4 g/dl
  • MCV 90 fl
  • Plt 91 * 109/l
  • WBC 14.4 * 109/l

Given the likely diagnosis, which one of the following organisms is the most likely cause?

 

A. Campylobacter
B. Giardiasis
C. E. coli
D. Salmonella
E. Shigella




Category: Prometric--->Nephrology
Page: 1 of 2