Multiple Choice Questions (MCQ)

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

Question 36# Print Question

A 62-year-old woman with a long history of COPD presents to her physician for routine laboratory tests. She is currently healthy without any recent illnesses or changes in medications. Her laboratory values show a serum bicarbonate level of 36 mEq/L.

Which of the following best represents the natural compensatory response to this patient’s acid/base disorder?

A. Increased reabsorption of HCO3 in the nephron
B. Decreased reabsorption of HCO3 in the nephron
C. Increased respiratory rate and/or tidal volume
D. Decreased respiratory rate and/or tidal volume
E. Increased HCO3 absorption in the GI tract

Question 37# Print Question

A mother brings her 18-year-old son into the physician for a routine physical examination before starting college. He has no past medical history, does not take any medications, and denies any current symptoms. His vitals and physical examination are completely normal; however, a urine dipstick is positive for 1+ protein. A urine protein to creatinine ratio estimates that he is excreting 220 mg of protein per day. The patient has another urine sample collected 1 week later that shows persistent proteinuria.

Which of the following is the most likely cause of proteinuria in this patient?

A. Orthostatic proteinuria
B. Minimal change disease
C. Acute interstitial nephritis
D. Exercise-induced proteinuria

Question 38# Print Question

A 62-year-old man with a history of hypertension, well-controlled diabetes, and coronary artery disease presents with shortness of breath. A history is obtained, with pertinent positives including orthopnea and leg swelling. His blood pressure is 146/94 mmHg with a heart rate of 84 beats per minute. The patient has an S3 on cardiac auscultation, bilateral rales are heard along the lung bases, and there is pitting edema around the ankles. Laboratory tests are ordered, which show a creatinine of 2.4 mg/dL (baseline 1.0 mg/dL).

What is the next step in managing this patient’s renal failure?

A. IV fluids
B. Give ketorolac to increase the GFR
C. Systemic corticosteroids
D. IV furosemide

Question 39# Print Question

An older man is admitted to the hospital with weakness and palpitations. An ECG is performed and shown below.

Which of the following is NOT a cause of this electrolyte abnormality?

A. Excessive insulin administration
B. Metabolic acidosis
C. Ischemic bowel
D. Excessive β-blocker administration
E. Excessive ACE inhibitor administration

Question 40# Print Question

A 41-year-old woman is placed on enalapril to treat her hypertension. She has no significant medical history and is otherwise healthy. She has her laboratory samples drawn 5 days later, which show a serum potassium of 4.2 mEq/L, a BUN of 13 mg/dL, and a creatinine of 1.1 mg/dL (baseline 0.9 mg/dL). A urinalysis is normal.

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

A. Continue the current medication
B. Discontinue enalapril and start hydrochlorothiazide
C. Discontinue enalapril and start losartan
D. Add hydrochlorothiazide
E. Add ibuprofen to normalize the GFR

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