d.
2.
Answer is [hide]C[hide]
8.
Answer is [hide]a[hide]
3.
4.
9.
Patient with ethanol ingestion fell down & has head trauma. 3
days later he develops confusion & coma. Electrolytes show
hypernatremia (Na=170) from 140 at the time of admission.
Plasma osmolarity is 300. The most common cause
a. Decreased water intake
b. Increased diuresis
c. Nephrogenic DI
d. Central DI
e. Inappropriate saline infusion
Answer is [hide]D[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
6.
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5.
c.
d.
Amyloidosis
Chronic analgesic & scarring kidneys
b.
c.
d.
139/85 mmHg
140/80 mmHg
150/90 mmHg
Answer is [hide]a[hide]
Answer is [hide]a[hide]
12. The most frequent
stenosis is
a.
b.
c.
d.
Answer is [hide]a[hide]
Answer is [hide]a[hide]
13. Diabetic patient with peritoneal dialysis develops severe
peritonitisand C/S shows multiple Gram +ve & Gram ve
organisms. The most appropriate investigation needed is
a. Transperitoneal angiography
b. CT
c. USG for the lumen of the catheter
d. Placute interstitial nephritis X-Ray abdomen
19. Infant having UTI. The best sensitive investigation for infection
a. High WBC in urine
b. Leukocytosis in blood (CBC)
c. Urea esterase in urine dipstick
d. Presence of leukocytic cast in urine
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
21. 65 years old male with microscopic hematuria needs to donate
his 54 years old wife with ESRD. His chemsitry is normal. He
asks about your opinion
a. Encourage him as microscopic hematuria is
not significant
b. Discourage him for his isolated hematuria
c. ________________
d. ________________
Answer is [hide]a[hide]
22. The most likely to cause nephrocalcinosis & papillary
calcification. All are true except
a. Sarcoidosis
b. Primary hyperparathyroidism
c. NSAIDs
d. Type-I RTA
e. Medullary cystic disease
Answer is [hide]c[hide]
23. Hemoperfusion is most appropriate treatment in
a. Ethanol intoxication
b. Methanol intoxication
c. Theophylline intoxication
d. NSAIDs intoxication
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Answer is [hide]D[hide]
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Answer is [hide]a[hide]
Answer is [hide]c[hide]
DR.MUNJI EXAM
24. In case of hyponatremia Na=128, the least likely to occur
a. Total body Na decreased
b. Total body Na increased
c. Total body water increased
d. Total body Na & water decreased
e. None of the above
Answer is [hide]a[hide]
25. Patient with aortic aneurysm, underwent surgery for aneurysm
correction, shows deteriorated kidney function. The most comon
cause is
a. Acute tubular necrosis
b. Analgesic nephropathy
c. Cholesterol embolization
d. ___________________
Answer is [hide]a[hide]
26. CHF on diuretics developed weakness & carpopedal spasm,
prolonged QT interval & depressed ST segment. The most
common cause is
a. Hyperkalemia
b. Hypomagnesemia
c. Hyperphosphatemia
d. Hypophosphatemia
Answer is [hide]B[hide]
27. In rhabdomyolysis all of the following occurs except
a. Hyperkalemia
b. Hyperphosphatemia
c. Hypercalcemia
d. Hyperuricemia
e. Hypocalcemia
Answer is [hide]C[hide]
28. Drugs that decrease the cyclosporin level
a. Trimethoprim
b. Fluconazole
c. Erythromycin
d. Rifampicin
Answer is [hide]c[hide]
36. What is the acid base disturbance caused by aspirin
a. Respiratory alkalosis & metabolic acidosis
Answer is [hide]a[hide]
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Answer is [hide]D[hide]
Answer is [hide]b[hide]
44. Pyelonephritis with E. Coli isolated, patient not improving with
antibiotics. Radiography shows gas in renal parenchyma
a. Add clindamycin
b. Add amphotericin B
c. Emergency nephrectomy
d. .
Answer is [hide]c[hide]
Answer is [hide]d[hide]
trimethoprim
Answer is [hide]a[hide]
Answer is [hide]b[hide]
40. Cardiovascular calcification in CKD is due to
a. Hyperparathyroidism/hyperphosphatemia??
b. Hypocalcemia
c. Hypercalcemia
d. High calcium intake
e. High Vitamin D intake
Answer is [hide]a[hide]
coronary artery
Answer is [hide]a[hide]
42. Serum creatinine is not exact indicator of GFR, because of all of
the following except
a. It varies with weight
b. It varies with diet
c. It varies with age
d. It varies with medication
e. None of the above
Answer is [hide]e[hide]
43. Which of the following can best lower serum K immediately
a. Ca gluconate
b. Insulin glucose infusion
c. Calcium resonium
d. NaHCO3
e. 2 agonists
Answer is [hide]a/b???[hide]
Answer is [hide]B[hide]
48. Which of the following is related to chromosome 3
a. Tuberous sclerosis complex
b. ADPKD
c. Von Hippel Lindau disease
d. Recklinghausen disease
Answer is [hide]c[hide]
49. Diabetic patient on HD with multi access failure, currently
having no access. What to do
a. Permanent catheter
b. Venous graft
c. Renal transplantation
d. CAPD
e. Conservative
Answer is [hide]a/b??????[hide]
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b.
c.
d.
e.
Metabolic alkalosis
Metabolic acidosis with respiratory alkalosis
Metabolic acidosis with respiratory acidosis
Respiratory alkalosis partially compensated
Answer is [hide]e[hide]
Answer is [hide]e[hide]
57. Regarding urinary tract TB, all are true except
a. Urinary obstruction
b. Isolation of mycobacteria in urine
c. Painless hematuria
d. Sterile pyuria
Answer is [hide]a[hide]
Answer is [hide]d/e??????[hide]
52. Study HEMO: high flux dialyzer with 1.7=Kt/V and standard
dialyzer with Kt/V 1.3. what can do higher dialysis mortality
a. Increase
b. Decrease
c. No change
d. ..
Answer is [hide]c[hide]
53. HCO3=30, K=3, urinary potassium=10, pH=7.26, chloride=96.
These results are compatible with
a. GI loss
b. Diuretic abuse
c. Bartters syndrome
d. RTA
Answer is [hide]a[hide]
54. CMV should be diagnosed best with
a. Anti CMV IgG
b. Anti CMV IgM
c. CMV antigen
d. Isolation of CMV
Answer is [hide]c[hide]
Answer is [hide].a[hide]
Answer is [hide].[hide]
Answer is [hide]d[hide]
62. Patient admitted after myocardial infarction & treated with
coronary stenting. Few days later, he developed a skin rash,
oliguria & renal impairment. What is the most likely diagnosis
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a.
b.
c.
d.
a.
b.
c.
d.
ATN
Acute interstitial nephritis
Ac. GN
Cholesterol embolization
Answer is [hide]d[hide]
71. Cyclophosphamide used in treatment of
a. cANCA (Wegeners granulomatosis)
Answer is [hide]a[hide]
72. Indomethacin
a.
a.
Answer is [hide]D[hide]
64. Patient diagnosed having renal cell carcinoma of upper pole of
the left kidney. Before doing surgery what should be done
a. MRI abdomen
b. Urinary catecholamine levels
c. Angiography
d.
73. Diarrhea
Answer is [hide]a[hide]
74. Methanol intoxication
a. High anion gap metabolic acidosis
Answer is [hide]a[hide]
Answer is [hide]a[hide]
65. Factor associated with poor prognosis in FSGS is
a. Associated HTN
b. Heavy Proteinuria
c. Hematuria
d. .
Answer is [hide]a[hide]
66. Anemia in CKD patient on erythropoietin therapy & allergic to
for IV iron..
a. Change iron sucrose or iron
b. Increase EPO dose
c.
d.
Answer is [hide]a[hide]
67. Diabetic patient having ESRD, When to start renal replacement
therapy
a. Before diagnosis of DM
b. GFR < 20
c. GFR <15
d. GFR <10
Answer is [hide]c[hide]
68. Cyclosporine
Answer is [hide]e[hide]
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a.
d.
Desmopressin
c.
d.
Answer is [hide]d[hide]
Answer is [hide]b[hide]
79. Erythropoietin is increased in all of the following except
a. Polycystic kidney disease
b. Renal artery stenosis
c. Renal cell carcinoma
d. Nephrogenic DI
Answer is [hide]d[hide]
80. Treatment of non invasive transitional cell carcinoma of bladder
is
a. Radiotherapy
b. Transluminal urethral resection of bladder
tumor
c. Palliative radiotherapy
d. Radical cystectomy
Answer is [hide]b[hide]
Answer is [hide]e[hide]
81. What is the most predisposing cause of CA bladder
a. History of smoking & cyclophosphamide
b. _____________
c. _____________
d. _____________
Answer is [hide]a[hide]
82. A patient on HD for 7 years has pain in both hands started in
antecubital fossa, radiating to volar aspect of the hand & marked
at night & early morning. On examination numbness (thumb,
index & middle fingers) & hand grip is normal. What is the most
likely finding
a. Osteophytes in cervical vertebra C5-C6
b. Uremic osteodystrophy
c. 2 microglobulinemic deposition in flexor
retinaculum
d. Carpal tunnel syndrome
Answer is [hide]a/c???[hide]
83. Best treatment of diabetic nephropathy with Proteinuria
a. Frusemide
b. Captopril
c. Dipyridamol
d. Nifedipine
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Answer is [hide]b[hide]
Answer is [hide][hide]
Answer is [hide]B[hide]
Answer is [hide]d[hide]
Answer is [hide]a[hide]
Answer is [hide]e[hide]
93. A case of hypokalemia with normal BP, (K=3) & HCO3=32.
Urinary K is 10 mmol. What is the cause
a. Diuretics
b. Vomiting
c. Hyperaldosteronism
d. Bartter syndrome
e. Corticosteroids
99. A case of head trauma & urine output 300 ml/h, urine osmolarity
< 600, and plasma osmolarity 321. Which is the best treatment
to replace urine output
a. Normal saline
b. Dextrose saline
c. Normal saline in dextrose
d. Colloids
e. Aqueous vasopressin
Answer is [hide]b[hide]
Answer is [hide]a[hide]
Answer is [hide]b[hide]
103. Best solution to give in contrast nephropathy
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Answer is [hide]d[hide]
Answer is [hide]c[hide]
Answer is [hide]b[hide]
96. NaHCO3 infusion
metabolic acidosis
a.
b.
c.
d.
a.
b.
c.
d.
Normal saline
D5%
Half normal saline
Crystalloids
c.
d.
Answer is [hide]b[hide]
Answer is [hide]a[hide]
Aspirin
Supportive
Answer is [hide][hide]
106. Pheochromocytoma
a. Decreased ECF ???
Answer is [hide]a[hide]
107. Diabetes mellitus
a.
b.
108. A patient with loss of skin turgor, obtundation & normal BP.
Na= 160. You should give dextrose with which of the following
a. Normal saline
b. Half normal saline
c. NaHCO3
d. Water 150 cc/h
Answer is [hide]d/a????[hide]
109. Pneumococcal peritonitis is present in which of the following
a. Minimal change GN
b. Mesenteric adenitis
c. Acute appendicitis
d. Acute cholecystitis
Answer is [hide]a[hide]
110. Regarding prune belly syndrome
a. Other name Eagle Barrette Syndrome
b. Scoliosis is present
c. Intrauterine fetal death
d. Obstructed prostatic urethra
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118. ABGs
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10
b.
c.
d.
SLE
Post-infectious GN
IgA nephropathy
a.
b.
c.
d.
Osteomalacia
Adynamic bone disease
Osteoporosis
Osteopetrosis
Answer is [hide]d[hide]
Answer is [hide]a[hide]
172. Complications of NSAIDs nephropathy
185. Patient with DM on HD developed hypotension, echo is normal,
what is the most likely cause:
a. Inappropriate dry weight
b. Autonomic neuropathy
c. Dialysis reaction
173. Hypernatremia
174. Hypo & Hyperphosphatemia
175. Commonest cause of death in CKD (infections & CV diseases)
Answer is [hide]b[hide]
176. What is the cause of calcification in HD
a. Hyperphosphatemia
b. Vitamin D intake
c. Increased Ca intake
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
182. Patient has DM has right flank pain & fever: USG shows gas in
renal parenchyma
a. Emphysematous pyelonephritis
b. Xanthomatomas
c. Stone disease
d. Psoas abscess
e. Perinephric abscess
Answer is [hide]b[hide]
189. Patient diagnosed with unilateral renal artery stenosis, the best
next investigation:
a. MRA
b. CTA
c. DTPA scan
d. Captopril scan
Answer is [hide]a[hide]
183. The most common renal tumor in children is:
a. Ureter tumor
b. Renal cell cancer
c. Transurethral cell cancer
d. Squamous cell cancer
**The most common cancer is Wilms tumor (nephroblastoma)
Answer is [hide]a[hide]
190. The treatment of unilateral renal artery stenosis is:
a. ACEI
b. ARBs
c. Calcium channel blockers
d. Beta blockers
Answer is [hide]a[hide]
Answer is [hide]b[hide]
184. Vitamin D deficiency is associated with:
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b.
c.
d.
Calcium phosphate
Cystine stone
Uric acid stone
Answer is [hide]..[hide]
193. The best treatment of tumor lysis syndrome:
a. Hydration
b. Sodium bicarbonate
c. Hydration & N-acetyl cystein
d. Theophylline
Answer is [hide]a[hide]
194. DM is associated with:
a. RTA 1
b. RTA 2
c. RTA 4
Answer is [hide]c[hide]
195. Patient with DM started with ACEI, patient developed <20%
rise in creatinine, what is the next step:
a. DC ACEI
b. Continue ACEI
c. Start ARB
d. Patient has unilateral RAS
Answer is [hide]b[hide]
196. The best access for HD:
a. AVF
b. AVG
c. Permanent catheter
d. Temporary catheter
Answer is [hide]d[hide]
203. Autosomal dominant FSGS is associated with defect in:
a. Podocin
b. TRCP6
**AD FSGS caused by defect in ACTN4 encodes a membrane
protein -actinin-4 ,TRCP6, CD2AP
AR FSGS caused by defect in
NPHS1 encodes a membrane protein nephrin
NPHS2 encodes a membrane protein podocin
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197. Patient initiated HD 2 weeks ago and developed DVT in leg &
purpura, the most likely diagnosis:
a. Heparin induced thrombocytopenia 1
b. Heparin induced thrombocytopenia 2
c. Hypercoagulopathy
d. DIC
**Clinical features of heparin-induced thrombocytopenia (HIT)
that help distinguish it from other forms of thrombocytopenia
include the timing of onset (usually 5-14 d after beginning an
immunizing exposure to heparin), the severity of the
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Answer is [hide]a[hide]
Answer is [hide]c[hide]
Answer is [hide]b[hide]
204. The most common cause of nephrotic syndrome in children is:
a. Minimal change disease
b. Membranous nephropathy
c. Mesengioproliferative GN
d. FSGS
e. IgA Nephropathy
Answer is [hide]a[hide]
211. Patient on thiazide diuretics, what is most common:
a. Hyponatremia
b. Hypernatremia
c. Hyperkalemia
d. Hypermagnesemia
Answer is [hide]a[hide]
Answer is [hide]a[hide]
212. The best initial treatment of hypercalcemia is:
a. Hydration
b. Hydration & Frusemide
c. Bisphosphonates
d. Calcitonin
206. The best treatment for anti-GBM along with steroids is:
a. Plasmapheresis
b. Hemodialysis
c. HD & PP
d. Conservative treatment
Answer is [hide]a[hide]
Answer is [hide]a[hide]
207. Patient with SLE has hypertension, hematuria, proteinuria&
mild renal impairment. What is the WHO classification?
**Stages are (WHO classification)
I Minimal mesangial LN mild, normal urine analysis and
creatinine
II Mesangial proliferative LN HEMATURIA, PU, no HTN
III Focal LN HEMATURIA, PU, RI not progressive, HTN
IV Diffuse LN HEMATURIA, PU, RI, HTN
V Membranous LN can be clinically silent!!!
VI Advanced sclerosing LN slowly progressive RI, PU, bland
urine sediment
208. Collapsing FSGS is associated with:
a. HIV
b. CMV
c. HCV
d. EBV
e. Heroin
Answer is [hide]a[hide]
Answer is [hide]c[hide]
primary
membranous
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** Many risk factors have been found, such as male sex, HLA
type DR3+/B8+, white race, advanced age, and
tubulointerstitial changes or focal sclerosis found with renal
biopsy. In addition, nephrotic syndrome, elevation of
immunoglobulin G excretion or beta2-microglobulin excretion,
low serum albumin, high serum cholesterol, an elevation of
urinary excretion of complement activation products, impaired
renal function at diagnosis, and, finally, hypertension are
associated with a higher risk of renal function deterioration
during follow-up
Answer is [hide]a[hide]
217. Malignant HTN is associated with:
a. Vision loss
b. Acute LVF
d.
Nephrocalcinosis
Answer is [hide]d[hide]
Answer is [hide]a[hide]
Answer is [hide]c[hide]
Answer is [hide]a[hide]
226. CAPD is associated with:
a. Fluid overload
b. Protein loss
c. Glucose intolerance
d. All of the above
e. None of the above
Answer is [hide]d[hide]
Answer is [hide]d[hide]
220. Patient started on treatment for high BP, develops the following
labs: Na 125, K 3.2, Ca 3.1, the most likely drug is:
a. Beta blockers
b. Thiazides
c. Calcium channel blockers
d. Frusemide
Answer is [hide]b[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]b[hide]
229. Patient with alcohol intake history, presented with coma and pH
7.23, labs???, he is likely to have:
a. Alcoholic ketoacidosis
b. Non anion gap acidosis
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Answer is [hide]a[hide]
231. 45 years old lady on HD since 3 yrs, on cellulose acetate
dialyzer, 3x per wk with 1.5m2 dialyzer, has Kt/V 1.42, what
would you suggest:
a. Change to low flux dialyzer
b. Change to high flux dialyzer
c. Change to polysulfone dialyzer
**Minimum of sp Kt/V > 1.2 is required for a 3x/wk dialysis,
and a target of Kt/V >1.4, therefore dialysis is adequate, and no
need to change anything.
Answer is [hide]a[hide]
232. Patient with colonic carcinoma, presented with proteinuria,
underwent renal biopsy, the expected diagnosis:
a. FSGS
b. MCD
c. MNP
Answer is [hide]c[hide]
233. 50 years old male has RBC+ in urine dipstick, but microscopy
for RBC is negative, the cause is:
a. Hb in urine
b. High sp gravity of urine
c. High osmolarity of urine
Answer is [hide]a[hide]
234. 70 yrs old male with diarrhea, and volume loss, admitted in
hospital, labs show: Na 170, K 3.8, the management is:
a. Normal saline
b. D5 0.45S
c. RL
Answer is [hide]a[hide]
235. 60 yrs female with h/o alcoholic over dose admitted to hospital,
develops diarrhea, the expected acid base changes:
a. NaKClHCO3pH levels
b. High AG metabolic acidosis
c. Metabolic alkalosis
d. Metabolic acidosis + alkalosis
e. Normal AG metabolic acidosis
Answer is [hide]a/e???[hide]
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Answer is [hide]a[hide]
Rifamicin
Answer is [hide]c[hide]
250. 25 yrs old male with microscopic hematuria, undergoes biopsy
normal on LM, most likely diagnosis:
a. MNP
b. FSGS
c. Thin basement membrane disease
Answer is [hide]c[hide]
245. All of the following can cause acute interstitial nephritis except:
a. Paracetamol
b. Rifampicin
c. NSAID
Answer is [hide]a[hide]
246. Patient with HD for 8 yrs with shoulder & bone pains, cute
interstitial nephritis, B2 amyloidosis is provisional diagnosis, to
confirm the test is:
a. X rays bones
b. Amyloid component in**
**The Amyloid found in bone cysts is different, but the B2M
levels are not indicative
Answer is [hide].[hide]
247. 30 yrs old female with 14 wks gestational amenorrhea and mild
proteinuria, the option for anti hypertensive is:
a. ACEI
b. Thiazides
c. Labetolol
Answer is [hide]c[hide]
248. Regarding UTI in pregnancy, most correct statement is:
a. Acute pyelonephritis occurs in 1-2% of all
pregnancies
b. Pyelonephritis is very common
c. 50% will develop asymptomatic bacteruria
**2-10% will develop asymptomatic bacteruria,of these patients
more than 40% will develop pyelonephritisoverall
pyelonephritis is 1-2% of all pregnancies.
Answer is [hide]a[hide]
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Answer is [hide]b[hide]
249. 24 yrs old female with microscopic hematuria, normal RFT, h/o
grandfather on HD, uncle with CKD and deafness, likely
diagnosis is:
a. ADPCKD
b. ARPCKD
c. Alports syndrome
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d.
270. 40 years old male with nephrotic syndrome, the most common
cause is:
a. Membranous nephropathy
Answer is [hide]a[hide]
278. Young male with episodic hypertension & nervousness, next
step is:
a. 24 hours urine collection for catecholamines
280. Dialysis patient, always HTN, for the last few months has predialysis pressure of 100/50, whats next step:
a. Do echo
281. DM, ESRD, has failed AVF on both upper limbs, what is the
next step:
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Answer is [hide]a[hide]
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Perm catheter
CAPD
Kidney transplant
Observation
b.
c.
Acetazolamide
Diarrhea
Answer is [hide]b[hide]
290. In which of the following condition with high AG metabolic
acidosis, NaHCO3 shows decrease mortality:
a. Septic shock
b. Alcoholic ketoacidosis
c. Acute kidney injury
d. Ethanol toxicity
e. Heroin toxicity
283. Patient on HD, single pool Kt/V 1.2, whats the next step:
a. Keep on same treatment
Answer is [hide]d[hide]
291. Plasma volume is:
a. 2/3 ECF
b. Minimal amount of ECF
c. 1/3 ECF
Answer is [hide]c[hide]
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Answer is [hide]e[hide]
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a.
b.
c.
d.
Answer is [hide]a[hide]
298. Patient has oliguria, muddy brown casts:
a. ATN
b. Acute interstitial nephritis
c. GN
306. CKD patient with generalized bone pains (PTH, Ca, PO4, ALP)
all normal:
a. Adynamic bone disease
307. All of the following are characterized by low complement
except: (CWA)
a. IgA nephropathy
Answer is [hide]a[hide]
299. Patient with Burketts lymphoma, started allopurinol, he
presented with picture of tumor lysis syndrome:
a. Frusemide
b. PD
c. HD
Answer is [hide]c[hide]
Answer is [hide]a[hide]
Answer is [hide]d[hide]
Answer is [hide]a[hide]
311. Patient
with
hematuria,
biopsy
LM
showed
mesangioproliferation, EM showed deposits in mesangium:
a. IgA NP
Answer is [hide]a[hide]
317. HTN patient, started of ACEI, Cr increased to 115, what is next:
a. Reassure
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Answer is [hide]b[hide]
Answer is [hide]c[hide]
329. In infancy, oliguria is defined as: (CWA)
a. 0.1 ml/kg/hr
b. 0.3
c. 0.5
d. 1
**Infants <1ml/kg/hr, children <0.5, Adult <400
Answer is [hide]d[hide]
330. Patient with MI has cardiac catheterization. 3 weeks later he
presented with painful blue toes and fatigue, the diagnosis is:
a. Cholesterol emboli
b. Contrast induced nephropathy
c. Rhabdomyolysis
d. Tumor lysis syndrome
Answer is [hide]a[hide]
Answer is [hide]d[hide]
324. Patient with nephrotic syndrome developed ESRD after 2 years
(no biopsy), underwent 1st renal transplantation, failed after 2
months, then did 2nd renal transplantation, 6 month later
developed nephrotic syndrome, what is the most likely cause:
a. FSGS
325. Renal transplantation with h/o hyperlipidemia, she cannot
tolerate statin, has Hirsutism, the best immunosuppressant:
a. MMF + TAC
b. mTOR + TAC
c. mTOR + AZA
Answer is [hide]a[hide]
Answer is [hide]b[hide]
335. Patient with SLE, has DPGN active, but she is concerned about
sterility, whats next:
a. MMF
b. AZA
c. Plasmapheresis
**If a female patient asks about pregnancy then give her AZA, if
male patient asks about sterility then give MMF
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328. A CKD patient with PTH 350, Ca 2.63, PO4 2.5, ALP 594, what
is the treatment?
a. Calcitriol
b. Ca acetate
c. Sevelamer
d. None of the above
Answer is [hide]b[hide]
336. What will 0.9% NS do:
a. Decrease osmolality
b. No change in osmolality
c. Will decrease osmolality first then increase
**In mammals, normal saline is osmotically balance
Answer is [hide]b[hide]
Answer is [hide]c[hide]
Answer is [hide]b[hide]
Answer is [hide]a[hide]
342. Indication to start HD in diabetic
a. GFR < 10
b. GFR < 15
c. GFR < 20
Answer is [hide]b[hide]
343. DM & CKD with Cr 40, GFR 20, next step:
a. Vascular access
b. Start HD
c. Wait for uremic manifestation
351. Patient with CKD and DM, develop MI, for coronary
angiography, what is the next treatment / precaution for contrast
induced nephropathy:
a. Hydration
b. Theoplylline
c. Adenosisn
d. NaHCO3
e. None of the above
Answer is [hide]..[hide]
Answer is [hide]d[hide]
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Answer is [hide]a[hide]
21
Answer is [hide]b[hide]
a.
b.
c.
NSAID
cause
tubulointerstitial,
the
Acidification
defect
in
Antibiotics,
concentrating defect in NSAID
Recovery is different
Fever, arthralgia, rash present in 20% of
NSAID and 80% in antibiotics
Answer is [hide]c[hide]
Answer is [hide]a[hide]
354. Patient with rheumatoid arthritis on aspirin, the acid base is:
a. Respiratory alkalosis + metabolic acidosis
355. Best antibiotics for asymptomatic UTI in pregnancy:
a. Nitofurantoin
b. Ciprofloxacin
c. Ampicillin
d. Amoxicillin
e. TMP/SMX
Answer is [hide]d????.[hide]
Answer is [hide]c[hide]
363. Patient with lung carcinoma, labs show urinary Na 29, plasma
Na 129, plasma osmolality 258, urinary osmolality < 100,
thyroid function tests normal, what is the treatment:
a. Fluid restriction
364. 32 years female, weakness, deny diuretic abuse, vomiting,
excessive urine, urinary Na 59, normotensive, urinary potassium
30, HCO3 32, what is the diagnosis:
a. Diuretics
b. Diarrhea
c. Vomiting
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
Answer is [hide]a[hide]
369. Patient with DM, HTN, Cr 268, K 5.5 5.9, the best
antihypertensive drug is:
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and
Page
352. Antimicrobial
difference is:
a.
b.
c.
d.
e.
ACEI
ARBs
Frusemide
Amiloride
Propranalol
Answer is [hide]c[hide]
hemorrhage,
with
Answer is [hide]c[hide]
378. Skin manifestations of atheroembolic disease?
379. What are the ECG changes in hyperkalemia?
Answer is [hide]b[hide]
371. Lady with DM, mild proteinuria on ACEI, asking about
pregnancy. What is the effect of pregnancy on her KFT.
a. No effect
b. Will worsen along pregnancy
c. KFT will improve
Answer is [hide]a[hide]
372. Most common cause of hypernatremia and polyuria is:
a. DM
b. DI
Answer is [hide]b[hide]
Answer is [hide]e[hide]
381. All can cause acute interstitial nephritis except:
a. Azathioprine
b. Cyclosporin
c. Lithium
d. NSAID
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Page
Answer is [hide]c[hide]
386. Patient with renal colic, KUB free, IVP filling defects, the cause
is:
a. Uric acid stone
Answer is [hide]b[hide]
Answer is [hide]a[hide]
398. 7 y/o male with asymptomatic hematuria, father has the same
issue, no proteinuria, brother has the same issue, work up is
negative, the diagnosis is:
a. Benign familial hematuria**
402. Patient on CAPD, with bone pain, this is mainly due to:
a. Adynamic bone disease
b. Osteitis fibrosa cystica
c. Osteoporosis
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Answer is [hide]c[hide]
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d.
Answer is [hide]a[hide]
403. Patient on CAPD, on 2.5 x 2 exchanges, 4.25 x 2 exchanges,
with SOB and LL edema. PET given Cr = 0.92, Ur = 1, D4/D0 S
= 0.2 Next step is:
a. Change to nocturnal exchange 10 12 hrs
b. Change to 4.25 x 4 exchanges
**PET Test
Level
Waste removal
Water removal
Regimine
High
Fast
Poor
APD
(short
dwells, frequent
exchange)
Average
Okay
Okay
APD, CAPD
Low
Slow
Good
CAPD
b.
c.
d.
S. aureus
C. albicans
S. typhi
Answer is [hide]b[hide]
Answer is [hide]b[hide]
406. The difference between tacrolimus & cyclosporine is:
a. Hirsutism
b. Hepatotoxic
c. Nephrotoxic
d. Neurotoxic
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Answer is [hide]d[hide]
25
After
ADH
Vasopressin
Level
Normal
>700
< 10%
increase
>2
CDI
< 300
> 50%
increase
<1
NDI
< 300
< 50%
increase
>5
Diagnosis
426. 7 year old child on PD .C/O peritonitis. found to have fungal inf.
Received flucanazol according to culture but no response after
2wk Rx. Second choice:
a. Wait 2wk then resume PD dialysis.
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26
Answer is [hide]c[hide]
b.
c.
Change to itracanazol
Remove catheter & start HD till treated
Answer is [hide]c[hide]
427. Pt.75 year old C/O chest pain at catheter, found to have urea 2.5,
creatinine 79 mmol. lab result due to:
a. Dehydration
b. Old age
c. Low protein diet
Answer is [hide][hide]
428. A 35 year old female previously well, not HTN or DM, take
only OCC pill, vitamins, c/o 20-30 time polyuria, Na 143, sugar
normal, creatinine normal, urine osmolarity.>160 the cause is:
a. DI.
b. NDI
c. Phy. polydypsia.
Answer is [hide][hide]
429. Pt DM, on HD failed his fistula both arm next step:
a. Graft.
b. Change to PD.
c. Perm catheter
434. A 37 years old male came for investigations, all was normal
including urine analysis. His father and uncle are on HD because
of ADPKD. What next step:
a. CT scan
b. IVP
c. Renal U/S
d. Genetic testing
Answer is [hide]c[hide]
435. A 17-year-old male brought by family after high dose salicylic
acid starts with vomiting nausea. Then coma best Rx:
a. Infusion NaHCO3
b. Charcoal
c. HD
Answer is [hide]c[hide]
436. Old age male with history of decrease oral intake, Na172, spot
urinary Na 10, normal BP. Best Rx.:
a. DW5%
b. DW5% +.45% NS
c. NS.9
Answer is [hide]a[hide]
Answer is [hide]c[hide]
430. Pt do IVP found papillary necrosis, cupping, outer scar suspect:
a. Analgesic nephropathy
b. Bilateral cortical necrosis
c. Acute interstitial nephritis
Answer is [hide]a[hide]
431. All cause normal size kidney in CKD except:
a. Sarcoidosis
b. Scleroderma
c. Nephrosclerosis
Answer is [hide]b[hide]
438. Best to prevent AKI for pt. going for catheter whose c/o chest
pain, DM, creatinine 170:
a. Mannitol
b. Frusemide
c. NS.9%
Answer is [hide]c[hide]
Answer is [hide]c[hide]
432. A 5-year-old child has Steroid resistant nephritic syndrome. The
most common cause:
a. Membranous nephropathy
b. Minimal change disease
c. FSGS
Answer is [hide]c[hide]
Answer is [hide]c[hide]
440. Pt. IHD, CABG, Cr 150, dry skin, urinary spot Na<10. Best to
decrease renal failure:
a. Frusemide
b. Theophylline
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Answer is [hide]d[hide]
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c.
Volume expansion
d.
Answer is [hide]c[hide]
Answer is [hide]b[hide]
445. Kidney transp. Recipient live related donor, found to have fever
& SOB, suspect CMV best diagnosis is:
a. CMV IgM.
b. CMV IgG.
c. CMV Ag.
d. CMV PCR.
Answer is [hide]d[hide]
447. Patient has DM on losartan for 36 month what the most control
point:
a. Albuminuria
b. HTN
c. Cholesterol
Answer is [hide]a[hide]
448. In pregnant c/o dysuria, fever which of the following true;
a. Fever is diagnostic.
b. 100,000 colonies collect in aseptic tech
almost diagnostic of inf.
c. 10,000-1000 c collected under aseptic
technique may diagnostic in asymptomatic
bacteruria
Answer is [hide]b[hide]
455. Pt known case of Nephrotic syndrome refused previously
kidney Biopsy, transplanted, after 2year rejection the most
common cause of his disease:
a. MNP
b. MCN
c. FSGN
Answer is [hide]c[hide]
456. In isolated hematuria best treatment:
a. Supportive
457. The main site for Mg+2 reabsorption
a. Thick ascending loop of Henle
458. On treatment with trimethoprim the cause of hyperkalemia:
a. Affect on principle cells on Na channel.
459. Treatment of hyperkalemia:
28
Answer is [hide][hide]
Page
zamorih@hotmail.com
a.
b.
c.
d.
Calcium resonium
Salbutamol
HD
All of the above
a.
Answer is [hide]d[hide]
460. 42-pt with dehydration Na163, K6.2 best shift K from ECF IS:
a. Insulin + glucose
b. NaHCO3
c. NS.9%
Ca oxalate
Answer is [hide]a[hide]
Answer is [hide]a[hide]
461. Which of the following treatment with NaHCO3 decreases
mortality:
a. Alcoholic acidosis
b. Ethylene glycol
c. Heroin
Answer is [hide]b[hide]
462. Transplantation pt. the diff between Azathioprine
Mycophenolate mofetil
a. Deceases mortality
b. Prolong survival
c. Less episodes of rejection
&
Answer is [hide]c[hide]
471. Patient having DM,HTN, still high BP, K 5.5-5.9 best Rx:
a. Propranalol
b. ACEI
c. ARBs
d. Frusemide
Answer is [hide]c[hide]
463. On acute interstitial nephritis difference between NSAID and
antibiotic case:
a. Fever and rash 20% in NSAID 80% in
antibiotic
464. Young patient with severe hypertension has suspicion of
renovascular stenosis:
a. CT scan
b. Doppler US
c. Renal angiogram
Answer is [hide]c[hide]
465. Best treatment for CKD-4 anemia:
a. Parentral iron
b. Folic acid
c. Recombinant erythropoietin
Answer is [hide]d[hide]
472. Waxy cast which true:
a. Should not found in normal person
473. All cause increase erythropoietin except:
a. ADPKD
b. Acquired renal cyst
c. Renal artery stenosis
d. Nephrogenic diabetes insipidus
Answer is [hide]d[hide]
474. Rate of peritonitis decrease in rate because of;
a. Good selected pt.
b. Good hygiene
c. Treatment a nosocomial carrier of staph
aureus
Answer is [hide]d[hide]
Answer is [hide]c[hide]
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Answer is [hide]b[hide]
29
475. Pt with CKD follow up lab Ca10.5, PO4 6.2, PTH 351 best Rx:
a. Sevelamer
Answer is [hide]a[hide]
477. Pt operated for hemongioblastoma, later found infiltration Lung,
bilateral renal cyst with mass in the Left kidney BP150/90, pulse
110 beats/min most diagnostic:
a. MRI
b. Renal US
c. 24 hr urine for catecholamines
Answer is [hide]c[hide]
478. Pt treated for tumor with chemotherapy not treated before with
allopurinol, c/o loin pain, fatiguelab high creatinine, urea,
decrease urine output most next step:
a. IVF
b. PD
c. NaHCO3
d. HD
Answer is [hide]d[hide]
479. Pt on ICU chest trauma fail chest, develop diarrhealab PH
7.39,the result is:
a. Metabolic acidosis
480. All of the following decease Frusemide response except:
a. Decrease GFR
b. Antibody against Frusemide
c. Increase protein bond to Frusemide on
tubule
d. NSAID
Answer is [hide]b[hide]
Answer is [hide]d[hide]
Answer is [hide]c[hide]
483. Pt hypertension receive ACE treatment his creatinine now 115
after 1 wk what next:
a. Reassure inform that reach plateau with 1
month
484. One of the following indicate for urgent dialysis:
a. Slow deterioration of renal function
b. Hyperphosphatemia
c. Sever hyperkalemia
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Answer is [hide]b[hide]
Answer is [hide]c[hide]
493. All of the following are risk factors for renal stone formation
except
a. RTA
b. Gold
c. Cystinosis
d. Dehydration
a.
b.
c.
d.
Renal biopsy
Urine analysis
Serum complement
USG abdomen
Answer is [hide]a[hide]
504. A patient developed rash & impaired RFTs after antibiotics use.
What is most likely diagnosis
a. Acute interstitial nephritis
Answer is [hide]a[hide]
505. Cyclosporine is associated with all except
a. Chronic interstitial nephritis
b. Hypertension
c. Hirsutism
d. ..
Answer is [hide]d[hide]
506. Gentamicin toxicity
507. Analgesic nephropathy can be associated with all except
a. Nephrocalcinosis
b. Malignant hypertension
c. Papillary necrosis
d. Increased risk of transitional cell carcinoma
Answer is [hide]a[hide]
508. A patient has right sided flank pain radiating to groin &
associated urinary symptoms. Abdominal xray is normal. CT
scan showing a 2 cm opacity. What is most likely diagnosis
a. Cystine stone
b. Uric acid stone
c. Calcium oxalate stone
Answer is [hide]b[hide]
509.
Answer is [hide]d[hide]
510. PSGN
501. Henoch Schonlein purpura, histopathology
a. Mesangial proliferation
Answer is [hide]e[hide]
31
10-20%
30-40%
50-60%
Page
Answer is [hide][hide]
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d.
60-80%
Answer is [hide]d[hide]
Answer is [hide][hide]
Answer is [hide]..[hide]
Answer is [hide]c[hide]
516. Asymptomatic bacteruria
a. Present in 50% of pregnancies
b. Wait until becomes symptomatic
c. Immediate treatment
Answer is [hide]c[hide]
517. All antibiotics are safe in pregnancy except
a. Ampicillin
b. Amoxicillin
c. Cefalexin
d. Nitrofurantoin
e. Quinolones
Answer is [hide]d[hide]
Answer is [hide]e[hide]
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Answer is [hide]b[hide]
Page
a.
Low C3
Answer is [hide]c[hide]
Answer is [hide]d[hide]
538. What will not lower serum K levels
a. Calcium gluconate
Answer is [hide][hide]
531. NaHCO3 is helpful in which of the following metabolic acidosis
a. AKI
b. Ethylene glycol poisoning
c. Diabetic ketoacidosis
d. Lactic acidosis
Answer is [hide][hide]
542. A 35 years old man denying any H/O nausea, vomiting
presented with generalized weakness. On examination, there is
postural drop. BP 100/60 mmHg. Labs K=2.8, HCO3=33,
urinary K= 36. What is the most likely cause
a. Bartter syndrome
b. Gitelmans syndrome
c. Thiazide abuse
d. Self induced vomiting
Answer is [hide]c[hide]
Answer is [hide]b/a[hide]
Answer is [hide]a[hide]
544. A case of reperted upper respiratory tract infection with renal
impairment. CXR showing B/L opacities. Urine analysis
showing red cell casts. What is the most likely diagnosis
a. Wegeners granulomatosis
b. IgA Nephropathy
c. Henoch Schonlein purpura
d. Post streptococcal GN
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33
541. Patient post CABG, has oliguria, dry skin. Urinary Na 10. What
is the most likely treatment
a. Frusemide
b. Mannitol
c. Fluid expansion
d. Theophyline
Page
Answer is [hide]d[hide]
Answer is [hide]a[hide]
545. A patient on HD 3/week, has developed ascites. Various
investigation.. what is the most appropriate treatment
a. Ascitic tap
b. Leevens shunt
c. TIPPS
d. Aggressive UF
than
Answer is [hide]..[hide]
Answer is [hide]..[hide]
546. Type-I RTA
547. A young patient started on ACEi. After one week his creatinine
115 mmol/L. what is the best step
a. Stop ACEi
b. Reassure & continue ACEi
c. Reduce the dose
d. .
Answer is [hide]b[hide]
548. Best way to diagnose CMV in post transplant patients
a. CMV Ab IgG
b. CMV Ab IgM
c. CMV Ag
d. CMV PCR
Answer is [hide]d[hide]
549. A 62 years man wants to donate his kidney
550. A post transplantation patient developed sudden pain in his big
toe. He is taking azathioprine, steroids & cyclosporine. Uric acid
is 8.5. What is the most likely immediate action
a. NSAIDs
b. Colchicine
c. Allopurinol
d. Decrease dose of cyclosporine
Answer is [hide]d[hide]
551. Drugs which decreases cyclosporine levels
a. Fluconazole
b. Erythromycin
c. Isoniazide
d. Metocloperamide
e. Nifedipine
Answer is [hide]a[hide]
557. Difference between pre-renal & renal AKI
558. Which one is better indicator of AKI
a. Serum BUN/creatinine ratio
b. Urinary Na
c. Urinary FENa
d. Urine osmolarity
Answer is [hide]c[hide]
Answer is [hide]d[hide]
Answer is [hide][hide]
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Page
Answer is [hide][hide]
556. A 72 years old man having oliguria but urea & creatinine are
almost normal. What is the most likely reason
a. Old age
b. Low protein diet
c. Protein energy malnutrition
d.
a.
b.
c.
d.
e.
USG abdomen
Ascitic tap
Viral serology
Echocardiography
Liver function tests
b.
c.
d.
Answer is [hide][hide]
561. An elderly asymptomatic patient having hypertension & asthma.
He is smoker for last 30 years. Came for follow up. Labs
showing Na 128. What is the most likely treatment
a. Hypertonic saline
b. Fluid restriction
c. Dextrose water
d. Normal saline
Answer is [hide]b[hide]
569. Best treatment of anemia in CKD-4
a. Oral iron
b. IV iron
c. Folic acid
d. Erythropoietin
Answer is [hide]d[hide]
563. A patient of Nephrotic syndrome, responding well to Frusemide
40mg, but now increasing dose is required. What is the least
likely cause
a. Antibodies to Frusemide
1/3 of ECF
2/3 of ECF
Almost all of ECF
Half of ECF
565. A diabetic patient had cardiac arrest during dialysis. What is the
most likely cause
a. MI
b. Hypoglycemia
c. Air embolism
d. Excessive UF
Answer is [hide]a[hide]
566. Patient developed left sided pneumothorax after internal jugular
catheter insertion. Chest tube must be inserted where
a. Right 2nd intercostals space midclavicular
line
b. Left 2nd intercostals space midclavicular line
c. Left side ant axillary line
d. Left side posterior axillary line
Answer is [hide]c[hide]
567. A young patient has hypertension. To confirm the renovascular
hypertension, which investigation you will perform
a. USG kidneys
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Answer is [hide]a[hide]
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Answer is [hide]c[hide]
574. A 30 weeks pregnant female has BP= 150/100 mmHg. What is
the best management plan
a. Terminate pregnancy
b. Admit to hospital & observe
c. Atenolol
d. ..
Answer is [hide]a[hide]
575. All are side effects of cyclosporine except
a. Hirsutism
b. Interstitial nephritis
c. Tremors
d. Gum hyperplasia
e. .
Answer is [hide]..[hide]
576. A 62 years old diabetic patient has GFR 17ml/min. He has no
contraindication for renal transplantation. What should be the
next management plan
a. PD
b. HD trial
c. Transplantation
d. Wait
Answer is [hide]c[hide]
577. 12 years old boy dipstick urine +1 protein. What is the next most
appropriate investigation
a. Creatinine clearance
b. 24 hours urinary proteins
c. USG
d. No further investigations
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36
Answer is [hide]b[hide]
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