Multiple Choice Questions (MCQ)

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Category: Q&A Medicine--->Nephrology
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Question 6# Print Question

A 21-year-old college student presents to the Emergency Department with severe epigastric abdominal pain that radiates to her back. She is nauseous but has not vomited, and denies any diarrhea. She is admitted and her laboratory values show an elevated serum amylase and lipase.

Which of the following electrolyte abnormalities is associated with this disease?

A. Hypernatremia
B. Hyponatremia
C. Hyperkalemia
D. Hypokalemia
E. Hypocalcemia

Question 7# Print Question

A 52-year-old man presents for a routine physical examination. He has not been to a primary care physician since he was a teenager, and now he wants a colonoscopy since his friend was recently diagnosed with colon cancer. He denies any medical history and takes no medications. He is found to be hypertensive during his clinic appointment (164/98 mmHg), and the diagnosis of hypertension is later confirmed with the use of outpatient blood pressure monitoring. On examination, a bruit is heard over the left carotid artery, an S4 is heard on cardiac auscultation, and he has weak lower-extremity pulses. He has baseline laboratory tests drawn, is started on lisinopril, and is instructed to follow up for repeat laboratory work 1 week later. At the follow-up appointment, his blood pressure is 172/102 mmHg and the following laboratory results are seen.

What should be done next in the management of this patient? 

A. Add hydrochlorothiazide
B. Add metformin
C. Stop lisinopril
D. Continue the current management and repeat laboratory tests in 2 weeks

Question 8# Print Question

A 38-year-old woman presents to her physician with fatigue and edema. She is an IV drug abuser and has been diagnosed with chronic hepatitis C infection. A urinalysis shows 1+ protein, 1+ blood, and red blood cell (RBC) casts. The rest of her laboratory values are shown below.

  • Blood urea nitrogen 25 mg/dL
  • Creatinine   1.7 mg/dL
  • Total protein   6.1 g/dL
  • Albumin   3.7 g/dL
  • C3   68 mg/dL (normal range 75–175 mg/dL)
  • C4   <2 mg/dL (normal range 14–40 mg/dL)

Laboratory testing 2 weeks ago showed a normal creatinine (0.8 mg/dL). A renal biopsy is performed which shows glomerular crescent formation. Antinuclear antibody, antinuclear cytoplasmic antibody, and antiglomerular basement membrane (GBM) antibody testing is negative.

Which of the following is the most likely diagnosis?

A. Granulomatosis with polyangiitis
B. Systemic lupus erythematosus (SLE)
C. Membranoproliferative glomerulonephritis
D. IgA nephropathy
E. Goodpasture syndrome

Question 9# Print Question

A 69-year-old man presents to the physician for fatigue and bone pain. His workup shows that he is anemic with the presence of an M-protein in the serum and urine, and he is diagnosed with multiple myeloma. Some of his other laboratory values are shown below.

  • Sodium   140 mEq/L
  • Potassium   3.2 mEq/L
  • Chloride   114 mEq/L
  • Bicarbonate   16 mEq/L
  • Phosphorus   1.9 mg/dL

An arterial blood gas shows that he has a pH of 7.3 and a PaCO2 of 35 mmHg. He has urine studies performed, which are significant for glucosuria, a urine pH of 7.8 after bicarbonate infusion, and a fractional excretion of bicarbonate of 25%.

Which of the following best represents the acid/base abnormality in this patient?

A. Anion gap metabolic acidosis with a compensatory respiratory alkalosis
B. Nonanion gap metabolic acidosis with a compensatory respiratory alkalosis
C. Anion gap metabolic acidosis with a primary respiratory acidosis
D. Nonanion gap metabolic acidosis with a primary respiratory acidosis

Question 10# Print Question

A patient with end-stage renal disease caused by diabetic nephropathy is scheduled to start dialysis due to fluid overload and electrolyte abnormalities.

Which of the following best represents the likely changes seen in her laboratory results? (Note: Hb is hemoglobin, PTH is parathyroid hormone, TG is triglycerides.)

A. (A)
B. (B)
C. (C)
D. (D)

Category: Q&A Medicine--->Nephrology
Page: 2 of 8