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c.

d.

PLEASE DO NECESSARY CORRECTIONS WHEREVER


REQUIRED & EMAIL BACK ME SO THAT OTHERS
COULD GET BENEFIT AS WELL

Aggressive diuresis with diuretics


Administration of fomepizole
Answer is [hide]a[hide]

DR. FAYZA EXAM


7.
1.

The most common side effect of tacrolimus over cyclosporin is


a. More neurotoxic
b. More nephrotoxic
c. More hepatotoxic
d. Gingival hyperplasia
Answer is [hide]a[hide]

2.

Patient with SLE on treatment. She wants to take ant SLE


treatment but also wants to preserve her fertility to get pregnant.
She should use prednisolone plus
a. Azathioprine
b. Mycophenolate
c. Cyclosporin
d. Tacrolimus

Answer is [hide]C[hide]
8.

Answer is [hide]a[hide]
3.

The procedure of veno-venal CRT is suitable for patient with


a. DM
b. ESRD
c. Hypertensive emergency & AKI
d. Malignancy & CKD
e. _________________
Answer is [hide]a[hide]

4.

The most appropriate chemistry (ABGs) for salicylate poisoning


is
a. Respiratory alkalosis & metabolic acidosis
b. ______________
c. ______________
d. ______________

In case of hypernatremia Na=170 & plasma osmolality 320, the


most probable condition will be
a. Increased intracellular volume increased
osmolarity >328
b. Decreased ICV and decreased osmolarity <
328
c. Decreased ICV and increased osmolarity
328
d. No change in ICV and osmolarity 420

Male refused from military services because of microscopic


hematuria, but his sensori-neural examination & eye
examination are normal & his other labs are normal, His brother
has the same symptoms without proteinuria. What is the
prognosis in the future
a. Patient will develop CRF in 20 years
b. Needs transfusion at sometime
c. No abnormality will occur usually
d. Will need immediate management
Answer is [hide]c[hide]

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.

A 36 years old male came in ER after suicide attempt &


ingestion of anti-freeze sloution. His HCO3 is 12, PCO2= 22,
Na=138, K=4.8, Cl=98. The immediate management will be
a. Immediate HD
b. No traetment as there is no more acidosis

Please Send Your Nephro Exam MCQs

10. Patient with microscopic hematuria & proteinuria within few


days following upper respiratory tract infection. Renal biopsy
showing
a. Electron dense deposits on electron
microscopy
b. IgA deposition in the mesangium by
immunoflourecsnce
c. Proliferation& increased matrix of the
mesangium with dense deposits
d. All of the above
Answer is [hide]d[hide]
11. The commonest cause of Normal sized kidney despite ESKD is
a. Scleroderma
b. Polycystic kidney

Dr. Zahid Hafeez

zamorih@hotmail.com

The most appropriate method to diagnose unilateral renal vein


thrombosis is
a. Differential renin measurement in renal
artery
b. Differential renin measurement in renal vein
c. Ultrasonography
d. MR/CT venography

Page

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.

action of ACEi with unilateral renal artery


Frequently causes renal failure
Is appropriate treatment for hypertension
Inhibition of renin activity of the kidney
__________________

18. 5 years boy with ESRD will require HD or Continuous renal


replacement therapy when GFR less than
a. 15%
b. 20%
c. 30%
d. 80%

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]

15. Pregnant female with UTI. The most correct Answer is


a. 50% have asymptomatic bacteruria
b. No treatment indicated
c. Urgent IVU to detect cause
d. Observe the patient untill the symptoms
appear and then treatment with antibiotics.
e. Immediate
propmpt
treatment
if
asymptomatic bacteruria
Answer is [hide]D[hide]
16. The best method (gold standard) for estimation of GFR is
a. Cockroft Gault formula
b. 24h creatinine clearance
c. Inulin clearance
d. Modification of diet in renal disease study
equation
Answer is [hide]c[hide]
17. Diabetic patient with ESRD needs to decrease BP less than
a. 130/80 mmHg

Please Send Your Nephro Exam MCQs

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

Dr. Zahid Hafeez

zamorih@hotmail.com

Answer is [hide]D[hide]

20. Drugs that decrease cyclosporine levels in the blood is


a. Fluconazole
b. Trimethoprim
c. ___________
d. ___________

Page

14. Diabetic patient has UTI on treatment. Culture sensitivity,


electrolytes & blood chemistry are normal but computerized
tomography shows gas in renal parenchyma. Which treatment to
add
a. Clindamycin
b. Amphotericin B
c. Other antibiotics
d. Emergency nephrectomy

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

30. Renal agenesis is associated with all except


a. Meckels diverticulum
b. Imperforate anus
c. Vertebral malformations
d. Cardiac abnormalities
Answer is [hide]a[hide]
31. All of the following antibiotics are safe in pregnancy except
a. Amoxicillin
b. Quinolone
c. Nitrofurantoin
d. Tetracycline
Answer is [hide]b[hide]
32. How to diagnose UTI in pregnancy
a. 105 bacteria/ml
b. 1000 to 10000 bacteria/ml
c. ..
d. ..
Answer is [hide]a[hide]
33. Patient having diarrhea & dehydration & taking antibiotics. How
to differentiate the pre-renal azotemia from antibiotics toxicity
a. ..
b. ..
c. ..
d. ..
Answer is [hide][hide]

Answer is [hide]C[hide]
28. Drugs that decrease the cyclosporin level
a. Trimethoprim
b. Fluconazole
c. Erythromycin
d. Rifampicin

34. How to distinguish action of NSAIDs from Antibiotics on


kidney
a. Rash & eosinophilia
b. ..
c. ..
d. ..
Answer is [hide]a[hide]

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]

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

29. Patient with ESRD due to DM-2 has creatinine clearance


<17ml/min/kg. his transplantation workup shows no obstacles
for transplantation. What will be your decision
a. Transplant now
b. Peritoneal dialysis
c. Hemodialysis
d. Transplant of trial of dialysis

Page

Answer is [hide]D[hide]

35. Which is more characteristic of CKD


a. Hypophosphatemia
b. Hypokalemia
c. Hypocalcemia
d. Hypoglycemia

37. What is the mechanism of action of Lithium toxicity on kidney


a. Chronic interstitial nephritis
b. Acute interstitial nephritis
c. Acute urinary obstruction
d. Diabetes mellitus
Answer is [hide]a[hide]
38. Which is characteristic of ATN
a. Hyaline cast
b. RBCs casts
c. WBC cast
d. Muddy brown cast

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]

47. Microscopic hematuria in family (brother & his sister). What is


the most likely diagnosis
a. Autosomal recessive Alports Syndrome
b. Thin basement membrane disease
c. IgA nephropathy

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

Please Send Your Nephro Exam MCQs

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]

41. A patient developed dusky leg after


manipulation. What is the most likely cause
a. Cholesterol embolization

46. Patient having renal impairment, hemoptysis & B/L opacities in


CXR. What is the most likely diagnosis
a. Wegeners granulomatosis
b. Good pasture syndrome
c.
..
d. ..

50. Flail chest, HCO3=15, PCO2=30, pH=7.56


a. Metabolic acidosis

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

39. What is the mechanism of action of


Nephrotoxicity
a. ATN
b. Acute interstitial nephritis
c. GN
d. ..

45. What is the best treatment for DI


a. Desmopressin
b. ..
c. ..
d. ..

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]

51. How to follow up SLE


a. ANA
b. Anti DNA
c. CRP
d. Complement levels
e. Anti Ds DNA

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]

58. In peritoneal dialysis, when you change solute concentration


from 2.25% to 4.5% glucose, the result is
a. ..
b. ..
c. ..
d. ..
e. More UF
Answer is [hide].[hide]
59. 60 years old diabetic patient having GFR=17 ml/min/1.73m2.
His relative wants to donate him kidney and has no
contraindication. What should be done
a. Transplant now
b. Wait after a trial of dialysis
c. ..
d. ..
e. ..
Answer is [hide]????a[hide]
60. A 63 years old male with microscopic hematuria, Proteinuria
less than 100mg/24h. Her 58 years old wife diagnosed ESRD.
He asks about your opinion regarding kidney donation
a. Encourage him as hematuria is microscopic
b. Encourage him as hematuria is not
associated with Proteinuria
c. Encourage him as he is not hematuria is not
associated with HTN
d. Encourage him as hematuria is not
associated with renal injury
e. Discourage him as he has isolated hematuria

55. PD: when


..
..
Rapid transporter
Low transporter

Answer is [hide].a[hide]

Answer is [hide].[hide]

Please Send Your Nephro Exam MCQs

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

Dr. Zahid Hafeez

zamorih@hotmail.com

56. In PD, which thing can be better for patients


a. Low protein diet
b. High sugar diet
c. Overload
d. All of the above
e. None of the above

61. CKD-5 is labeled when GFR is decreased to


a. 50%
b. 35%
c. 25%
d. 15%
e. 5%

Page

a.
b.
c.
d.

a.
b.
c.
d.

ATN
Acute interstitial nephritis
Ac. GN
Cholesterol embolization

70. Plasmapheresis is used in treatment of


a. Antiglomerular basement membrane disease
(Good pastures syndrome)

Answer is [hide]d[hide]
71. Cyclophosphamide used in treatment of
a. cANCA (Wegeners granulomatosis)

63. What is the initial cause of renal osteodystrophy in CKD


a. Hypocalcemia
b. Hyperparathyroidism
c. Hyperphosphatemia
d. 1-25 dihydroxy Vitamin D3 deficiency

Answer is [hide]a[hide]
72. Indomethacin
a.

Type IV Renal tubular acidosis

a.

Normal anion gap metabolic acidosis

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]

75. What is the best immediate treatment to decrease the potassium


levels
a. Ca gluconate
b. Ca resonium
c. Insulin & glucose infusion
d. NaHCO3
Answer is [hide]c[hide]
76. A patient with BP=80/50mmHg, dehydrated having Na=110.
Which solution is best treatment for the patient
a. Half normal saline
b. Colloids
c. Dextrose
d. Normal saline
e. Albumin
Answer is [hide]d[hide]
77. All of the following are present in post streptococcal GN except
a. Low CH50
b. Low C3
c. Properdine
d. High ASO titer
e. Low C4

68. Cyclosporine
Answer is [hide]e[hide]

69. IV immunoglobulin pulse therapy


a. Humoral or Antibody mediated rejection

Please Send Your Nephro Exam MCQs

78. What is the most important in treatment of uremic bleeding


a. Cryoprecipitate
b. FFPs
c. Conjugated estrogen

Dr. Zahid Hafeez

zamorih@hotmail.com

HenochSchnlein purpura

Page

a.

d.

Desmopressin

c.
d.

Captopril uptake test


Peripheral renin measurement

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

85. All of the following can be associated with normal or increased


size kidneys on U/S except
a. Amyloidosis
b. Diabetic nephropathy
c. Scleroderma
d. Nephrocalcinosis
Answer is [hide]d[hide]
86. All of the following can cause hypocalcemia except
a. Renal failure
b. Hypoparathyroidism
c. Pseudohypoparathyroidism
d. Hypomagnesemia
e. Graves disease

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

87. Ultrasound can be diagnostic in all of the following except


a. Stone
b. Wilms tumor
c. Acute tubular necrosis
d. Hydronephrosis
e. Polycystic kidneys
Answer is [hide]c[hide]
88. Obstructive uropathy can be present in U/S in all of the
following except
a. Stones
b. Ectopic ureter
c. Diabetes insipidus
d. Urinary tuberculosis
Answer is [hide]c[hide]
89. Which of the following is most diagnostic of UTI
a. Leukocyte esterase +
b. Dipstick nitrate +
c. Increased WBCs in urine
d. Increased WBCs in blood
e. Dipstick esterase & nitrate +
Answer is [hide]e[hide]

Please Send Your Nephro Exam MCQs

90. A case of upper respiratory tract infection & hematuria within 2


days & normal BP. What is the microscopic finding
a. Mesangial proliferation
b. IgA deposition in mesengium
c. Epithelial cell proliferation
d. All of the above

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

84. What is the most useful diagnostic test to differentiate unilateral


renal artery stenosis from bilateral renal artery stenosis
a. B/L measurement of rennin from renal
artery
b. Differential renin measurement from both
veins

Answer is [hide]b[hide]

Answer is [hide][hide]

Answer is [hide]B[hide]

91. A case of HenochSchnlein purpura. History of acute


gastroenteritis & purpuric rash upper thighs & buttocks,
proteinuria & hematuria. What is the treatment
a. Corticosteroids
b. Plasmapheresis
c. Hemodialysis
d. Supportive

97. What is the most common preceding symptom of Alports


syndrome
a. Microscopic hematuria
b. Microscopic Proteinuria
c. Both microscopic hematuria & Proteinuria
d. Conduction deafness
e. Macroscopic hematuria

Answer is [hide]d[hide]

Answer is [hide]a[hide]

92. All of the following drugs are nephrotoxic except


a. Paracetamol
b. Ibuprofen
c. Cisplatin
d. Cyclophosphamide
e. Cisapride

98. All can cause acute nephritic syndrome except


a. Poststreptococcal GN
b. Mesengiocapillary GN
c. IgA nephropathy
d.
Answer is [hide].[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]

94. Healthy female 41y. Urine dipstick analysis ++ protein. No


other pathology in urine. What is the next valuable test
a. US abdomen
b. 24h urine for proteinuria
c. Urine Protein electrophoresis
d. Urine C/S
e. Urine analysis from first urine voiding
Answer is [hide]b[hide]
95. Most diagnostic test in acute glomerulonephritis
a. RBCs in urine
b. RBC casts
c. WBC casts
d. Dysmorphic RBCs
e. Tubular casts

101. All are present in minimal change glomerulonephritis


a. 90% responding to steroids
b. Age from 2-5 years
c. Low C4
d. Frequent relapse occur in 1st 4 years

Answer is [hide]b[hide]
103. Best solution to give in contrast nephropathy

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

102. All can cause hypercalcemia except


a. Primary hyperparathyroidism
b. 2ndry hyperparathyroidism
c. Tertiary hyperparathyroidism
d. Malignant metastasis
e. Sarcoidosis

Page

is used in which of the high anion gap


Diabetic Ketoacidosis
Alcoholic intoxication
Acute kidney injury
Renal tubular acidosis

Answer is [hide]d[hide]

Answer is [hide]c[hide]

Answer is [hide]b[hide]
96. NaHCO3 infusion
metabolic acidosis
a.
b.
c.
d.

100. All are associated with renal osteodystrophy except


a. Hypocalcemia
b. Hyperphosphatemia
c. 1,25 dihydro cholecalciferol deficiency
d. Calcitonin

a.
b.
c.
d.

Normal saline
D5%
Half normal saline
Crystalloids

c.
d.

Answer is [hide]b[hide]
Answer is [hide]a[hide]

104. Bartter syndrome


a.

Aspirin
Supportive

Increased renin & aldosterone


Answer is [hide]a[hide]

105. In renal failure, hypertension is due to


a. Increased ECF
b. Increased renin & aldosterone

112. A case of Wegeners granulomatosis, hematuria & renal


impairment. What is the treatment
a. Supportive
b. Hemodialysis
c. Corticosteroids & cyclophosphamide
d. Plasmapheresis
Answer is [hide]c[hide]

Answer is [hide][hide]
106. Pheochromocytoma
a. Decreased ECF ???

113. Aspirin can cause all of the following except


a. Hyperglycemia
b. Hypokalemia
c. Hypercalcemia
d. Hemolytic uremic syndrome???
Answer is [hide]..[hide]

Answer is [hide]a[hide]
107. Diabetes mellitus
a.
b.

Increased renin & aldosterone


Decreased renin & aldosterone
Answer is [hide]b[hide]

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

114. A case of repeated upper respiratory tract infection, hemoptysis


with hematuria. O/E bilateral edema & BP=145/95mmHg. CXR
showing bilateral opacities. What is the diagnosis
a. Wegeners granulomatosis
b. Antiglomerular basement membrane disease
c. IgA nephropathy
d. Glomerulonephritis
Answer is [hide]a[hide]
115. A case in ICU with flail chest on ventilator. ABGs --- pH=7.27,
PCO2=30, HCO3=15. What is the abnormality in ABGs
a. Metabolic acidosis
b. Metabolic alkalosis
c. Metabolic acidosis with respiratory acidosis
d. Metabolic alkalosis with respiratory
alkalosis
Answer is [hide].[hide]
116. A case of hyperkalemia with metabolic acidosis. All are true
except
a. Alcoholic toxicity
b. Diabetic ketoacidosis
c. Aspirin toxicity
d. Bartter syndrome
Answer is [hide]d[hide]

DR. RANA ZAHID


Answer is [hide]a[hide]

Please Send Your Nephro Exam MCQs

117. Barter syndrome

Page

111. Diagnosed case of post streptococcal GN. What is the treatment


a. Corticosteroids
b. Penicillin

118. ABGs

Dr. Zahid Hafeez

zamorih@hotmail.com

119. Anion Gap

146. EPO increased in which conditions

120. If plasma osmolality is 330mosm/kg what happens to


intracellualr & extracellualr compartments

147. ADPKD (2-3 MCQs)


148. Screening in ADPKD

121. Salicylate Toxicity


149. Dialysis (4-5 MCQs)
122. Ethanol poisoning
150. How to remove chloramine from dialysis water
123. Hypocalcemia
151. KT/V
124. UTI in infancy & early childhood
152. Treatment of hypertension
125. UTI in Pregnancy
153. Side effects of ACEi/ARBs
126. Calcium Oxalate stones (75%)
154. Hyponatremia
127. Pheochromocytoma
155. Hypokalemia ECG Changes
128. Renal artery stenosis (3-4 MCQs)
156. Hypokalemia Treatment
129. Renal artery stenosis diagnosis
157. Hyperkalemia
130. What happens to the opposite normal unaffected kidney in Renal
artery stenosis

158. Treatment of Ascites in CKD

131. What happens to the remaining kidney after nephrectomy

159. Treatment of Calcium stones is normal calcium intake

132. 2ndy hyperparathyroidism

160. Renal tubular acidosis

133. Pre-Renal & ATN differences

161. Causes of calcium oxalate crystals in urine

134. Interstitial nephritis (Difference between NSAIDs & Antibiotics


induced TIN)

162. Multiple myeloma


163. Amyloidosis

135. Cholesterol Embolization


164. Nephrotic syndrome
136. Waxy casts
165. Analgesic Nephropathy
137. IgA Nephropathy Vs Post-streptococcal
166. Nephritic syndrome
138. Post-Infectious Nephropathy

141. AIDS (Ifosfamide in HIV)

168. Mechanism of kidney injury by sulfamethoxazole

142. CMV (2-3 MCQs)

169. Transplant Rejection

143. Differences between cyclosporine & tacrolimus toxicity

170. Alports Syndrome (Recurrence after Renal Transplant)

144. Best treatment for Anemia in CKD


145. EPO Deficiency in CKD pathogenesis & effects

Please Send Your Nephro Exam MCQs

171. Serum complement levels is not decreased in which conditions


a. Bacterial endocarditis

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

10

140. SLE treatment

167. Which one is nephrotoxic


a. Paracetamol
b. Amphoterecin
c. ..

139. Henoch Schonlein Purpura

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]

186. Lithium is associated with:


a. Nephrogenic DI
b. Cranial DI
c. RTA type 2
d. Glomeulonephritis

177. Sterile pyuria

Answer is [hide]a[hide]

178. Renal Cell carcinoma

187. Patient has lithium toxicity, what is the best treatment:


a. HD
b. PD
c. HDF
d. Plasmapheresis

179. Treatment of bladder carcinoma involving muscle wall


180. Bladder carcinoma risk factors
181. BPH & urinary obstruction

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:

Please Send Your Nephro Exam MCQs

191. Which stone is radiolucent:


a. Calcium oxalate

Dr. Zahid Hafeez

zamorih@hotmail.com

11

DR. NAVEED MIRZA EXAM

188. Patient with salicylate poisoning has which type of abnormality:


a. Respiratory acidosis + metabolic acidosis
b. Respiratory alkalosis + metabolic acidosis
c. Respiratory alkalosis + metabolic alkalosis

Page

ARMED FORCES HOSPITALS IN SOUTHERN REGION


KHAMIS MUSHAIT SCFHS MCQs

b.
c.
d.

Calcium phosphate
Cystine stone
Uric acid stone

thrombocytopenia (usually mild to moderate), and the presence


of thrombosis or other sequelae
Answer is [hide]b[hide]
Answer is [hide]d[hide]
198. SLE on HD is associated with:
a. Recurrent thrombosis
b. Poor quality of HD
c. Anti phospholipid syndrome
d. Graft failure
**SLE patients on HD have high risk for vascular access
thrombosis

192. Ifosfamide is associated with:


a. RTA 1
b. RTA 2
c. RTA 3
d. RTA 4
Answer is [hide]b[hide]

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

199. Recurrent peritonitis is associated with:


a. UF failure
b. Poor quality of dialysis
c. Poor control of blood pressure
d. Peripheral neuropathy
**Recurrent peritonitis may damage the peritoneum causing
sclerosing encapsulating peritonitis (SEP) leading to UF failure.
Answer is [hide]a[hide]

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

200. HDF is associated with:


a. Decrease mortality
b. Increase mortality
c. Increase mortality and morbidity
d. Poor quality of HD
**HDF is associated with decreased mortality and morbidity
Answer is [hide]a[hide]
201. The best treatment for methanol poisoning is:
a. HD
b. HDF
c. PD
d. CVVHDF
Answer is [hide]a[hide]

Please Send Your Nephro Exam MCQs

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

Dr. Zahid Hafeez

zamorih@hotmail.com

12

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

Page

Answer is [hide]a[hide]

202. PD patient developed abdominal hernia, the next step is:


a. HD
b. Continue PD
c. Conservative treatment
d. HD and hernia repair

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

210. Patient has sepsis, multiorgan failure, hypotension, Renal


Failure, the best management is:
a. CVVHD
b. HD
c. PD
d. Conservative treatment
Answer is [hide]a[hide]

Answer is [hide]a[hide]
211. Patient on thiazide diuretics, what is most common:
a. Hyponatremia
b. Hypernatremia
c. Hyperkalemia
d. Hypermagnesemia

205. Hepatitis C is associated with:


a. MPGN 1
b. MPGN 2
c. MNP
d. FSGS

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

213. Patient with transplant has antibody mediated rejection, apart


from steroids, the treatment is:
a. Plasmapheresis
b. HD
c. Plasmapheresis & HD
Answer is [hide]a[hide]
214. The next best step in adult nephrotic syndrome:
a. Renal biopsy
b. Renal biopsy + steroids
c. Conservative treatment
Answer is [hide]b[hide]
215. Diarrhea is associated with:
a. High AG metabolic acidosis
b. Low anion gap metabolic acidosis
c. Normal Anion gap metabolic acidosis
d. Metabolic alkalosis & acidosis

Answer is [hide]a[hide]
Answer is [hide]c[hide]

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

primary

membranous

zamorih@hotmail.com

13

216. The poor prognostic factors in


nephropathy are all except:
a. Female
b. Heavy proteinuria
c. HLA
d. HTN

Page

209. Sickle cell disease is associated:


a. MPGN
b. MNP
c. Secondary FSGS
d. Cryoglobulin
**SCD causes (renal): renal infarction, renal papillary
necrosis, RTA 2, ARF, renal medullary carcinoma, UTI, HTN,
MPGN

** 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]

223. Small kidneys are hallmark of all except:


a. Analgesic nephropathy
b. CRF secondary to GN
c. Amyloidosis
d. Chronic pyelonephritis
Answer is [hide]c[hide]
224. Sterile pyuria is characteristic features of all except:
a. Acute interstitial nephritis
b. Renal Tuberculosis
c. Acute GN

Answer is [hide]a[hide]
Answer is [hide]c[hide]

DR. ASMA EXAM


225. 50 y/o patient with DM 2, BP > 140/95, the anti-hypertensive of
choice is:
a. Calcium channel blockers
b. Beta blockers
c. ACEI
d. Hydralazine
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

227. Regarding glucose solution used in CAPD, the following


statement is most appropriate:
a. Icodextrin use is more favorable the
conventional glucose
b. 2.5% solution is better than 1.5% solution

Answer is [hide]b[hide]

Answer is [hide]a[hide]

221. If ECF osmolality is 320, what would be the change on ICF:


a. Increase ICF & osm 320
b. Decrease ICF & osm < 290
**When ECF osm increases, larger flow from ICF to ECF
occurs, resulting in decrease of ICF and increase ICF osm

228. Change of glucose from 1.5 to 4.25% solution in CAPD


regimen, what you would expect:
a. Decrease UF
b. Increase UF
c. More solute clearance

Answer is [hide]a[hide]

Answer is [hide]b[hide]

222. Analgesic nephropathy is associated with all except: (CWA)


a. Malignant HTN
b. Transitional carcinoma of ureter
c. Small kidneys

Please Send Your Nephro Exam MCQs

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

Dr. Zahid Hafeez

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14

219. What is specific treatment for asymptomatic hematuria: (CWA)


a. Steroid
b. Immunosuppressive treatment
c. Plasmapheresis
d. None

Page

218. What is the best access for HD?


a. AVF
b. AVG
c. Tenchkoff catheter
d. Temporary line

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]

Please Send Your Nephro Exam MCQs

237. FSGS AR type is associated with gene mutation:


a. Nephrin
b. Podocin
c. Alpha actinin 4
**Refer to explanation above
Answer is [hide]a[hide]
238. 34 yrs old female, BP 174/112, Na-139, K-3.4, metabolic
alkalosis, renal US normal for RAS, next investigation is:
a. Cortisol level
b. Aldoterone:renin ratio
Answer is [hide]b[hide]
239. 30 yrs old female, BP 180/110, attacks of nervousness, next
investigation is:
a. Aldoterone:renin ratio
b. Urinary catecholamines
c. CT scan abdomen
Answer is [hide]b[hide]
240. Patient with unilateral RAS, diagnostic method: (CWA)
a. MRA
b. CTA
c. MRI abdomen + gadolinium
d. Diff renin activity in renal vein
e. Diff renin activity in renal artery
Answer is [hide]d[hide]
241. Renal Transplantation patient with pharyngitis, all can be
prescribed except:
a. Augmentin
b. Cefazolin
c. Erythromycin
Answer is [hide]c[hide]
242. Following drugs need to increase the dose of CNI if used:
a. Phenytoin
b. INH
c. Carbamezepine

Dr. Zahid Hafeez

zamorih@hotmail.com

15

230. Ifosfamide is associated with:


a. Renal tubular acidosis-2
b. Renal tubular acidosis-1
c. Renal tubular acidosis-4
d. Hypermagnesemia
e. Hyperkalemia

236. Renal agenesis is associated with:


a. Meckles diverticulum
b. Nephroblastoma
**These abnormalities include a variety of syndromes:
Chromosomal anomalies, Caudal dysgenesis, VATERL, and
isolated anomalies of the cardiovascular, skeletal, and central
nervous systems.
Caudal dysplasia syndrome (CDS), Sirenomelia
Unilateral renal agenesis VUR, UVJO, UPJO, structural
malformations of the heart (eg, septal defects), gastrointestinal
tract (eg, anal atresia), genital, or skeletal systems.
Answer is [hide].[hide]

Page

Answer is [hide]a[hide]

Rifamicin

**INH will decrease CNI level


Answer is [hide]b[hide]
243. 36 yrs old male with family h/o ADPCKD, BP 110/70, no
proteinuria, what investigation to order:
a. CT scan abdomen
b. Genetic study
c. US abdomen
Answer is [hide]c[hide]
244. Patient with calcium oxalate stone, you advise for:
a. Low Ca diet intake
b. High Ca diet
c. High Na diet

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]

251. Bad prognostic factor in MNP:


a. HTN
b. RI
c. Heavy proteinuria for 6 months
**Refer to explanation above
Answer is [hide]c[hide]
252. An alcoholic man with diarrhea & vomiting, came to ER with
hemolysis and rhabdomyolysis, respiratory depression, what
abnormality expected:
a. Hyperphosphatemia
b. Hypophosphatemia
c. Hypomagnesemia
**Hemolysis & rhabdomyolysis will cause hyperPO4
Diarrhea & alcoholism can cause hypoPO4
HypoPO4 can lead to respiratory depression and it can be
caused by resp alkalosis
Severe hypoPO4 will lead to rhabdomyolysis
Answer is [hide]b[hide]
253. 40 yrs old male underwent live related renal transplantation, one
month later presents with gastritis, vomiting, diarrhea, diagnosed
with CMV disease, to confirm:
a. CMV Ab
b. CMV Ag
c. Stool culture
d. US
Answer is [hide]b[hide]
254. Absolute contraindication for living kidney donation is:
a. HTN
b. GFR < 80
c. Age > 60
**Absolute CI: psychiatric disorder, renal disease, abnormal
renal anatomy, stones, DM, HTN, IHD, neoplasm, malignancy,
infection, CLD, neurological disease, anticoagulation use,
pregnancy, thrombotic disease

Dr. Zahid Hafeez

zamorih@hotmail.com

16

Answer is [hide]b[hide]

Please Send Your Nephro Exam MCQs

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

Page

d.

Relative CI: ABO incompatibility, Age <18 or >65, mild HTN,


single episode of stones, smoking
Answer is [hide]b[hide]

270. 40 years old male with nephrotic syndrome, the most common
cause is:
a. Membranous nephropathy

DR. WEAM EXAM


271. Patient with rhabdomyolysis, the treatment is:
a. Fluids

255. Manifestation of hyperkalemia on ECG:


a. Tall peaked T wave
Answer is [hide]a[hide]
256. Hyperkalemic manifestation:
a. Ascending paralysis
257. Patient with Na 160, fluid intake is:
a. Dextrose 5%L
258. Patient with symptomatic hypovolemic Na 116, you should give
him:
a. Hypertonic saline
259. Patient with Na 162 on NGT, the cause:
a. NG suction
**NG suction will cause vomiting, causing hypokalemia and
hyponatremia, maybe if severely dehydrated will cause
hypernatremia
260. Patient with general weakness, low K, low HCO3:
a. Bartter syndrome

272. The most common cause of hypercalcemia, Nephrocalcinosis is:


a. RTA-1
**The most common cause of hypercalcemia and
nephrocalcinosis, is primary hyperparathyroidism, and the
second cause is distal RTA (type 1)
273. Alports syndrome, bad prognosis is:
a. X-linked male
**X-linked is > 80%, females are less affected than males
AR is 15%, females are affected like males
AD is 5%
274. Patient with dialysis with UF failure:
a. Shift to nocturnal APD
275. Patient with peritonitis, diagnosed by:
a. Pain & culture (+)
276. Patient with high PTH on HD, hyperphosphatemia:
a. Secondary hyperparathyroidism

DR. SHAHER EXAM

261. Patient with euvolemic hyponatremia:


a. SIADH
262. Most common cause of post-RTX for delayed graft function is:
a. ATN
263. Most common cause of nephrotic syndrome in children is:
a. MCD

277. Pregnant lady, 3rd trimester, admitted with HTN, proteinuria,


lower limb edema (? Pre-eclampsia) BP 160/110, what is next?
a. Give oral hydralazine then continue on
labetalol to DBP < 90
b. IV enalapril
c. IV nitroprusside

264. Drugs that increase Cyclosporine level:


a. Fluconazole

Answer is [hide]a[hide]
278. Young male with episodic hypertension & nervousness, next
step is:
a. 24 hours urine collection for catecholamines

265. Pregnant woman with hypertension, impaired RFT:


a. Pre-eclampsia

279. In HD, chloramine is removed by:


a. Carbon adsorption
b. Reverse osmosis

267. Patient with SLE, lupus cerebritis, not responding to


cyclophosphamide and steroids:
a. Plasmapheresis
268. Child with nephrotic syndrome not responding to steroids:
a. Cyclosporine

280. Dialysis patient, always HTN, for the last few months has predialysis pressure of 100/50, whats next step:
a. Do echo

269. Patient with IgA NP, biopsy will show:


a. Mesangial proliferation

281. DM, ESRD, has failed AVF on both upper limbs, what is the
next step:

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

17

Answer is [hide]a[hide]

Page

266. Patient on NSAID, impaired RFT:


a. Acute Interstitial Nephritis

Perm catheter
CAPD
Kidney transplant
Observation

b.
c.

Acetazolamide
Diarrhea

**Acetazolamide cause non anion gap metabolic acidosis. RTA


the same but with hyper or hypoK
Answer is [hide]a[hide]

282. CAPD has the following complications:


a. Fluid overload
b. Hyperglycemia
c. Protein loss
d. All of the above
Answer is [hide]d[hide]

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

284. CVVHD is the best modality for the following patients:


a. Uremic pericarditis
b. Hepatic encephalopathy
c. HTN with encephalopathy
d. Hyperkalemia with renal failure
e. Pulmonary edema

Answer is [hide]c[hide]

285. Patient with severe hyperkalemia K = 7.9, next step:


a. Ca gluconate
286. Trimethoprim can cause high serum creatinine by:
a. Block epithelial Na channel
b. Decrease aldosterone secretion
c. Inhibiting tubular ecretion of creatinine
Answer is [hide]a/c[hide]
287. Which of the following ABGs you can fit for patient with RA on
and salicylate toxicity:
a. pH 7.3 HCO3 16 PCO2 22
288. A young man with suspicion of ethyl glycol toxicity, has serum
Osm 330, Na 140, normal renal function, HCO3 22, no crystals
in urine, nausea but no vomiting, whats next:
a. Give fomepizole
b. Follow up because this is mostly ethanol
toxicity
**Fomepizole is given in this case, it is more superior to
ethanol, and HD is the last resort
Fomepizole has replace ethanol (due to CNS manifestation)
If ingestion is since 2 3 hours, then gastric lavage with
charcoal should be performed.l
Answer is [hide]a[hide]
289. Patient with K 4, non anion gap metabolic acidosis, positive
urine anion gap, what is the diagnosis
a. Distal RTA

Please Send Your Nephro Exam MCQs

292. Female on OCP, has polyuria and polydipsia, Urine osmolality


160, Na 133, sugar normal, the most likely diagnosis:
a. NDI
b. CDI
c. DM
d. Psychogenic DI
**From U osm, she has DI, but type is according to WDT and
ADH response
If U osm increase to 750 after ADH --- CDI
If no change --- NDI
If U osm increase to 750 after WDT --- Polydipsia
Answer is [hide]????.[hide]
293. Most common kidney stone:
a. Ca oxalate
294. Patient presents with picture of renal colic, next step:
a. CT scan w/o contrast
295. Main site of reabsorption of Mg+2:
a. Thick loop of Henle
296. Young boy with hematuria, his sister also has hematuria, (?
Suggestive of TBMD), whats next:
a. Renal biopsy , EM for GBM
297. Young patient with hematuria, h/o stone disease, father is
ESRD, most likely diagnosis is:
a. ADPKD
b. Alports syndrome
c. Thin basement membrane disease

Dr. Zahid Hafeez

zamorih@hotmail.com

18

Answer is [hide]e[hide]

Page

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

308. 20 years old patient DM 1, normal RFT, GFR 90,


microalbuminuria, what is the risk of pregnancy on renal
function:
a. No risk
b. RFT will deteriorate during pregnancy the
improve after delivery

Answer is [hide]c[hide]

Answer is [hide]a[hide]

300. ADPKD is mostly associated with cyst in:


a. Liver
b. Ovary
c. Mesenteric
Answer is [hide]a[hide]
301. Which of the following is diagnostic of acute interstitial
nephritis:
a. Renal biopsy
b. Sterile pyuria
c. WBC casts
Answer is [hide]a[hide]

309. One of the following is not characteristic of Henoch Schonlein


purpura:
a. Splenomegaly
b. Palpable non TPP
c. Arthritis
d. GI involvement
Answer is [hide]a[hide]
310. All cause of RPGN except:
a. Lupus nephritis
b. IgA nephropathy
c. Membranous nephropathy
d. Poststreptococcal GN
e. Goodpasture's syndrome

302. HIV patient on ceftazidime and sulfamethaxazole, serum


creatinine is rising, the cause is:
a. Acute interstitial nephritis

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

303. In analgesic nephropathy, all can happen except: (CWA)


a. Papillary necrosis
b. Nephrocalcinosis
c. Malignant HTN

312. High BP, hematuria, AKI, RBC casts:


a. Acute GN

304. All of the following will slow progression of CKD except:


a. High protein diet

314. High Ca, low K, low Na:


a. Thiazide

305. One is characteristic urine findings in ESRD: (CWA)


a. Waxy cast
b. Hyaline cast
c. RBC cast
d. WBC cast

315. Mechanism of amiloride:


a. Block epithelial Na channel in cortical
collecting tubules & ducts
316. Drug affecting Cr without affecting GFR:
a. Cimetidine

Answer is [hide]a[hide]
317. HTN patient, started of ACEI, Cr increased to 115, what is next:
a. Reassure

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

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19

313. Post strep GN is cause by:


a. Group A strep

Page

Answer is [hide]b[hide]

DR. NAVEED EXAM


318. One of the following is not nephrotoxic:
a. Paracetamol
b. Cyclosporine
c. Lithium
d. Cisplatin
Answer is [hide]a[hide]
319. 12 years old, proteiuria 2+, normal Cr, no hematuria, whats
next:
a. Early morning dipstick
320. 60 years male, heavy smoker, alcohol abuser, hematuria, > 90%
normomorphic RBC, whats next:
a. Abdomen CT scan
321. In rhabdomyolysis, all except:
a. Hypercalcemia
322. Elderly patient with atherosclerosis, AAA, underwent repair,
developed AKI, biopsy showed needle shape crystals:
a. Cholesterol emboli
323. Which is true regarding cholesterol emboli:
a. Livido reticularis
b. Skin nodule
c. Eosinophilia
d. All of the above

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]

331. Cisplatin induced nephrotoxicity can be prevented by:


a. Hydration
b. Mg replacement
c. Forced diuresis
Answer is [hide]a[hide]
332. Rhabdomyolysis associated with all except:
a. Hypercalcemia
333. ESRD & DM patient has failure of AVF on both arms, whats
next:
a. Perm catheter
b. AVG
c. Conservative
d. CAPD
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

Dr. Zahid Hafeez

zamorih@hotmail.com

20

327. Potential kidney donor, isolated hematuria, normal creatinine, no


proteinuria, no UTI, no stones, what to do:
a. IVP
b. Cystoscopy and CT abdomen, if normal
proceed for transplant

334. All associated with low compliment except:


a. IgA nephropathy

Page

326. MMF in comparison with AZA:


a. Less episodes of acute rejection

Please Send Your Nephro Exam MCQs

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]

345. 31 years old male, episodic HTN, next step:


a. 24 hrs urine collection for catecholamines
346. Ultrasound will show all the following abnormalities except:
a. Medullary dysplastic kidney
b. Renal stone
c. ATN
d. Acute pyelonephritis

337. All associated with large kidneys except:


a. Analgesic nephropathy

Answer is [hide]c[hide]

338. Mechanism of action for amiloride


a. Blocks epithelial Na channels in collecting
tubules

347. DM on ACEI, metformin, glipizide, HCO3 15, glucose normal,


the likely cause of metabolic acidosis:
a. DKA
b. Alcohol
c. Drug induced

339. Mechanism of action of TMP/SMX, how it increase creatinine


Answer is [hide]c[hide]
340. Patient with DM 15yrs, diabetic nephropathy, diabetic
retinopathy, BP 150/90, what is the best anti hypertensive Rx:
a. ACEI
b. Beta blockers
c. Thiazide diuretics
Answer is [hide]a[hide]
341. 7yr child has Hypertension, proteinuria, hematuria, what is the
diagnosis:
a. Postinfectious glomerulonephritis
b. IgA nephropathy
c. Mesengiopriliferative GN
d. Membranous nephropathy

348. A Cadaveric renal transplantation in 3 months develop fever,


cough, loose motion, Hb < 9, PLT 100, TLC 3.2, next:
a. CMV Ab
b. CMV Ag
c. Stool culture
d. CXR
Answer is [hide]b[hide]
349. The most transmittable donor disease:
a. CMV
b. EBV
c. HBV
d. HCV

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

350. Renal transplantation patient in 2nd month, develop fever, cough,


CXR bilateral infiltration, the diagnosis is:
a. PCP
b. CMV
c. Fungal
d. None of the above
**PCP is usually 6 months post transplant

344. Gold standard to measure GFR


a. Inulin
b. Isothalamate
c. DTPA scan
**DMSA scan is for morphology and structure

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]

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

Answer is [hide]d[hide]

zamorih@hotmail.com

Page

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]

353. The difference between tacrolimus & cyclosporine:


a. Neurotoxicity
b. Less diabetogenic
c. Cause gingival hypertrophy

361. Following water deprivation test, and ADH, Plasma osmolaity


295, Urine osmolaity 760, Urine osmolality after ADH 780
a. Central diabetes inspidus
b. Nephrogenic diabetes inspidus
c. Polydipsia
Answer is [hide]c[hide]
362. 40 yrs, previously healthy, passes urine 20-30 times/day,
glucose normal, Na 143, U Na 20, the diagnosis is:
a. CDI
b. NDI
c. Polydipsia
d. None of the above

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

356. CKD is classified according to:


a. GFR

Answer is [hide]a[hide]

357. 40 y/o age, h/o smoking and analgesia, has hematuria,


cystoscopy normal, RBC isomorphic, the next step is:
a. CT scan + contrast
b. Renal biopsy
Answer is [hide]a[hide]
358. What shows the glomerular origin of hematuria:
a. RBC casts
b. WBC casts

365. Unilateral RAS, the next investigation:


a. Differential renal venous renin level
366. The most common renal stones:
a. Calcium oxalate
367. The most common shiga toxin:
a. E. coli 157
b. Salmonella
c. Shigella
d. None of the above

Answer is [hide]a[hide]

Answer is [hide]a[hide]

359. The characteristic findings in CKD:


a. Hypo Ca
360. ESRD on HD has
except:
a.
b.
c.
d.

DR. NAEEM EXAM

normal size kidneys in all of the following


Analgesic nephropathy
Sarcoidosis
ADCKD
Amyloidosis

Answer is [hide]a[hide]

Answer is [hide]a[hide]

Please Send Your Nephro Exam MCQs

368. MNP is cause by which of the following drug?


a. Penicillamine
b. Vincristine

369. Patient with DM, HTN, Cr 268, K 5.5 5.9, the best
antihypertensive drug is:

Dr. Zahid Hafeez

zamorih@hotmail.com

22

and

Page

352. Antimicrobial
difference is:

a.
b.
c.
d.
e.

ACEI
ARBs
Frusemide
Amiloride
Propranalol
Answer is [hide]c[hide]

370. Patient with head trauma, brain


hypernatremia, polyuria, the diagnosis is:
a. DM
b. DI

hemorrhage,

377. 63 years old male with asymptomatic hematuria wants to donate


his kidney to his wife, KFT normal, urine no proteinuria, what
is your decision:
a. Exclude from donation
b. Proceed with donation
c. Proceed after ruling out any malignancy or
glomerular disease.

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

380. Causes of low compliments except:


a. Shunt nephritis
b. MPGN
c. SBE
d. SLE
e. IgA nephropathy

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

373. What is the percentage of asymptomatic hematuria in children?


374. Most common cause of seizures in hematuria is:
a. Hyperkalemia
b. Hypocalcemia
c. Hyponatremia
d. Increase FDP
Answer is [hide]c[hide]
375. Best method for controlling bleeding diathesis in HD is:
a. Cryoprecipitate
b. DDAVP
c. Platelets
d. Estrogen
Answer is [hide]b[hide]

382. In unilateral RAS, what happens with the other kidney?


a. Increase renin
b. Increase aldosteron
c. Decrease renin
**In the contralateral kidney, the rennin & RBF decrease, I-131
& I-125 decrease, and it all improves after revascularization of
the stenotic kidny
Answer is [hide]c[hide]
383. ESRD & DM patient has failure of AVF on both arms, whats
the most likely option for this patient:
a. Perm catheter
b. AVG
c. Conservative
d. CAPD
e. Transplant

with MI creatinine 80, urea 2.5, what is the


Answer is [hide]e[hide]
Old age
Ischemia
DM
Dehydration
Answer is [hide].[hide]

Please Send Your Nephro Exam MCQs

385. The most common shiga toxin:


a. E coli 157
b. Salmonella
c. Shigella

Dr. Zahid Hafeez

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23

384. The most common renal stones:


a. Ca oxalate

Page

376. 80 years old male


cause of his labs:
a.
b.
c.
d.

Answer is [hide]c[hide]

None of the above


Answer is [hide]a[hide]

386. Patient with renal colic, KUB free, IVP filling defects, the cause
is:
a. Uric acid stone

a. Never found in normal urine


b. Can be found in normal persons
c. Present in acute interstitial nephritis
**Always found in CKD/ESRD, never found in normal urine
analysis
Answer is [hide]a[hide]
396. Patient with abdomen pain, US showed gas around kidney, how
to treat?
a. Emergency nephrectomy
b. Antibiotics
c. Observe
d. Percutaneous drainage

387. Increase of all of the following will cause stones except:


a. Calcium
b. Citrate
c. Oxalate
d. Uric acid
e. Phosphate
Answer is [hide]b[hide]
388. Manifestations of distal RTA?
389. Patient with suprapubic pain, dysuria, KUB free, mild
hematuria, no crystals, expected to find on urine analysis:
a. Calcium oxalate
b. Nitrates + leukocytes

**The diagnosis is emphysematous pyelonephritis


Answer is [hide]a[hide]
397. 7 y/o male with hematuria, the main common cause is:
a. IgAN
b. Mesangioproliferative GN
c. Alports syndrome
d. MCD
e. FSGS

Answer is [hide]b[hide]

Answer is [hide]a[hide]

390. Renal transplantation patient in 4th month, develop fever,


cough, CXR bilateral infiltration, LDH, AST, ALT are high, the
diagnosis is:
a. PCP
b. CMV
c. Fungal
d. None of the above
**PCP is usually 6 months post transplant, but LDH & LFT are
high
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**

391. High Ca, low K, low Na:


a. Thiazides

400. Pneumococcal peritonitis is commonly found in:


a. Minmal change disease

392. Mechanism of amiloride:


a. Block epithelial Na channel in cortical
collecting tubules
393. Drug affecting Cr without affecting GFR:
a. Cimetidine

399. TMP/SMX can cause hyperkalemia in patients with AIDS:


**Reduce renal potassium excretion through the competitive
inhibition of epithelial sodium channels in the distal nephron, in
a manner identical to the potassium-sparing diuretic amiloride

**Common in children, rare in adults, due to cirrhosis,


nephrotic syndrome, CAPD, BMT, RA, SLE, genital tract
infection in women
401. UTI is commonly due to:
a. Enterocoocus
b. Enterobacter
c. E. coli
d. Pseudomonas

394. All cause of RPGN except:


a. Lupus nephritis
b. IgA nephropathy
c. Membranous nephropathy
d. Post infectious glomerulonephritis
e. Goodpastures syndrome
Answer is [hide]d[hide]

402. Patient on CAPD, with bone pain, this is mainly due to:
a. Adynamic bone disease
b. Osteitis fibrosa cystica
c. Osteoporosis

395. Waxy casts are:

Please Send Your Nephro Exam MCQs

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24

Answer is [hide]c[hide]

Page

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

**APD also associated with:


Lower daily sodium removal. (worse volume and BP control )
Rapid loss of residual renal function.
Higher protein losses with multiple night time exchanges.
More expensive
Less peritonitis
Answer is [hide][hide]
404. Patient with shortness of breath, CXR showed infiltrates, normal
sinus X-ray, then developed hemoptysis, rise in creatinine, next
step is:
a. Lung biopsy
b. ANCA
c. Compliments
**The case goes with Goodpasteurs disease, and the diagnosis
is done by anti-GBM levels, or tissue biopsy from renals (linear
stacute interstitial nephritising of the basement membrane
secondary to immunoglobulin G deposition) or lung (extensive
hemorrhage with accumulation of hemosiderin-laden
macrophages within alveolar spaces)
cANCA can be positive in GPS and may precede the anti-GBM.
Answer is [hide].[hide]
405. Pregnancy and bacteruria, all true except:
a. Screen all pregnant women for symptomatic
bacteruria
b. No treatment required if asymptomatic
c. Dysuria can be to non urinary causes

b.
c.
d.

S. aureus
C. albicans
S. typhi
Answer is [hide]b[hide]

408. The benefit of dialyzer re-use is:


**The reuse of dialyzers is associated with
environmental contamination, allergic reactions, residual
chemical infusion (rebound release), inadequate concentration
of disinfectants, and pyrogen reactions
Bleach used during reprocessing causes a progressive increase
in dialyzer permeability to larger molecules, including albumin
No differences in mortality between reusing and those not
reusing dialyzers
The cost savings associated with reuse is substantial, especially
with more expensive, high-flux synthetic membrane dialyzers
Waste disposal is definitely decreased with the reuse of
dialyzers, thematurias environmental
impacts are lessened
409. 12 y/o boy with general weakness and hyperkalemia, all of the
following may be the cause except:
a. Addison disease
b. Bartter syndrome
c. Gordon disease
d. SLE
Answer is [hide]b[hide]
410. All the following causes hyponatremia except:
a. Chloropramide
b. Vincristine
c. Lithium
Answer is [hide]c[hide]
411. 31 y/o male had a car accident and sustained a head trauma, the
urine output is 300cc/hr and Na = 170, the next step is:
a. D5W
b. Aqueous vasopressin
c. NS
d. Water restriction
e. Replace urine output
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

407. Common cause of PD peritonitis:


a. S. epidermidis

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

Answer is [hide]d[hide]

(sorry but no idea about it due to shock )


A partial or complete lack of abdominal muscles. There may be
wrinkly folds of skin covering the abdomen. Undescended
testicles in males. Urinary tract abnormality such as unusually
large ureters, distended bladder, accumulation and backflow of
urine from the bladder to the ureters and the kidneys Frequent
urinary tract infections due to the inability to properly expel

25

412. A question about prune-belly syndrome

urine. Later in life, a common symptom is post-ejaculatory


discomfort. Most likely a bladder spasm, it lasts about two
hours.
413. Patient is scheduled for cisplatin dose, the best preventive
method to avoid nephrotoxicity is:
a. No particular prevention from cisplatin
b. Give Mg supplements pre dose
c. Hydration pre and post CTX dose
Answer is [hide]c[hide]
414. Patient underwent chemotherapy dose, and took hydration
before the dose, but did not take allopurinol before the dose.
Now no urine output, Cr 400, uric acid very high, what to do
next?
a. Continue hydration and monitor KFT
b. Start giving allopurinol
c. Start HD
Answer is [hide]c[hide]
415. Lithium NDI, RTA 1, acute kidney injury, minimal change
disease, FSGS, CIN

improved but lab result creatinine 450, was normal, previously,


urine free what dx:
a. Gentamycin toxicity
b. Interstitial nephritis
c. Volume depletion
d. .
Answer is [hide]a[hide]
421. Pt in ICU sepsis receive nafcillin, vancomycin, creatinine 90,
after 10 days creatinine 185, urine WBC, +protein. FeNa >2%,
the cause of AKI is:
a. ATN
b. Interstitial nephritis
c. Papillary necrosis
Answer is [hide]b[hide]
422. Pt CKD on PD. CAPD 2l 2.5%&4.5% 2l , cr450, p/p0.9, serum
sugar & albumin normal, pt. developed lower limb edema best
Rx:
a. Change to 4.5% 3l X4.
b. Change to nocturnal PD 10-12 cycles
Answer is [hide]..[hide]

416. Isolate hypodipsia Uosm > 700


417. UTI in pregnancy amoxicillin, nutrofurantoin, cephalexin
418. Preeclampsia hospitalization and rest, if HELLP then delivery
Urine Osmolality
After
Dehydration

After
ADH

Vasopressin
Level

Normal

>700

< 10%
increase

>2

CDI

< 300

> 50%
increase

<1

NDI

< 300

< 50%
increase

>5

Diagnosis

423. Pt. ESRD on HD 3/WK develop ascites, not improving with


dialysisLFT normal, serum albumin 3mg, best Rx:
a. Increase freq. of dialysis.
b. TIPPS
c. Leeven shunt.
d. Change to CAPD
Answer is [hide]d[hide]
424. Patient on PD, Develops 1st time peritonitis, fever, abdominal
pain, turbid color fluid aspirate. +culture staph aureus, received
antibiotic treatment, condition improved. Next step:
a. CT abdomen
b. U/S for tunnel
c. No other diagnostic test
Answer is [hide]c[hide]

DR. ASAD EXAM


419. Infusion of normal saline to healthy person results in:
a. ECF increase osmolarity & ICF decrease.
b. ECF decrease osmolarity & ICF increase.
c. No change in osmolarity

425. Pt with chronic hyponatremia, what you suspect:


a. Shift of electrolytes & minerals from brain
out side
b. Brain produces new organic osmolytes with
no shift.
c. Change pH intracellular.
Answer is [hide]a[hide]

Please Send Your Nephro Exam MCQs

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.

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

420. Pt. with severe respiratory infection C&S Pseudomonas.


Sensitive to Gentamycin which was given for 7 days, symptoms

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

437. Obese pt having DM, HTN, complaining abdominal pain,


vomiting & diarrhea. He is on Rx enalapril, metformin, atenolol.
pH low, HCO3 low, Na140, Chloride low.
{high anion gap metabolic acidosis] the cause:
a. Dehydration
b. Drug induced

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]

Please Send Your Nephro Exam MCQs

440. Pt. IHD, CABG, Cr 150, dry skin, urinary spot Na<10. Best to
decrease renal failure:
a. Frusemide
b. Theophylline

Dr. Zahid Hafeez

zamorih@hotmail.com

27

Answer is [hide]d[hide]

Page

433. Children with MCN on cyclosporine what unlikely S/E:


a. Hirsutism
b. Gingival hypertrophy
c. DM

439. Hyponatremia may be present in all conditions except:


a. Increase water & decrease Na.
b. Decrease water & increase water.
c. Increase water & increase Na
d. Increase Frusemide 80-120 mg. increase
hyponatremia

c.

Volume expansion

d.
Answer is [hide]c[hide]

441. Pt normotensive K=3, HCO3=32, urinary K> 30. This is related


to:
a. Barters syndrome
b. GI losses.
Answer is [hide]..[hide]
442. Alcoholic pt came to ER with severe diarrhea & recurrent
vomiting. He is hypotensive, tachycardia. [lab ABGSpH
low, normal anion gap]the acid base is:
a. Non anion gap metabolic acidosis.
443. Pt alcoholic, confused, vomiting, pH7.2, HCO3 16, PCO2 22, his
ABGS:
a. High anion gap metabolic Acidosis +
Respiratory alkalosis

Routine screening is indicated for all


pregnant women with asymptomatic
bacteruria
Answer is [hide]b/d[hide]

449. Pregnancy 28 weeks. Complains of fever, flank pain, dysuria


next step:
a. Renal US
b. Reassure.
c. Treatment
Answer is [hide]c[hide]
450. All can cause decreased serum components except:
a. IgA
451. In GN most found:
a. WBC cast.
b. RBC cast

444. All CKD With small kidney size except:


a. Amyloidosis

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.

452. Pt after CABG without follow up 0 days came complaining of


abdominal pain, big toe blue, livido reticularis, and creatinine
high. Most likely cause:
a. Atheroembolism
453. Patient post catheterization develops high creatinine. Kidney
Biopsy showing needle shaped crystals. The cause:
a. Atheroembolism

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

Please Send Your Nephro Exam MCQs

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:

Dr. Zahid Hafeez

28

Answer is [hide][hide]

454. In minmal change disease, all can be found except:


a. Normal light microscopy
b. Low C3

Page

446. All the following proteins decrease in nephritic syndrome


except:
a. Albumin
b. Fibrinogen
c. Ceruloplasmin
d. Ferritin

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

468. Renal Osteodystrophy comes with:


a. Hypophosphatemia
b. Decrease 1.25 D
c. Secondary hyperparathyroidism
Answer is [hide]c[hide]
469. Patient with tiredness found creatinine 450 mmol it is associated
with:
a. Hypocalcaemia

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

470. All of the following came with CKD except:


a. Retention of PO4
b. Decrease 1-25 D
c. Increase calcitriol

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]

467. Most common stone:

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

Answer is [hide]b[hide]

476. Patient alcoholic, post head trauma 7 days later develops


polyuria Na171, u.osm<160 most common cause:
a. Central diabetes insipidus
b. Nephrgenic diabetes insipidus
c. Cerebral salt wasting

29

475. Pt with CKD follow up lab Ca10.5, PO4 6.2, PTH 351 best Rx:
a. Sevelamer

466. Most common complication of erythropoietin is:


a. Seizure
b. Hypertension

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]

485. In HTN pt the effect of thiazide is:


a. Affect the concentration of distal convoluted
tubules
486. Old pt left hemiparesis on thiazide treatment skin turgor,
diarrhea. Na135 best treatment:
a. Normal saline
487. A patient with bipolar disorder on lithium treatment develops
nephrogenic diabetes insipidus. The cause will be
a. Lithium blocks ADH receptors
b. Lithium cause acute interstitial nephritis
c. Lithium cause marked diuresis
Answer is [hide]a[hide]

DR. FERAS EXAM


488. Alports syndrome inheritance
a. X-linked
489. All of the following can have small kidneys on USG except
a. Amyloidosis
490. Hypertension is found in how many minimal change disease
patients
a. 25%
491. Treatment of choice for DM-1 nephropathy
a. Aspirin
b. Captopril
c. Spironolactone
d. Irbesartan
Answer is [hide]b[hide]

481. In Alport's syndrome all true except:


a. AR most inherited type

492. All of the following are nephrotoxic except


a. Amoxicillin
b. Diclofenac
c. Cisplatin
d. Cyclophosphamide

482. In membranous nephropathy which is most bad prognosis:


a. HTN
b. Male
c. Heavy Proteinuria

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

Dr. Zahid Hafeez

zamorih@hotmail.com

Page

494. A case of congestive heart failure with hyponatremia. What is


the best treatment/cause??
a. Frusemide

30

Answer is [hide]b[hide]

Answer is [hide]c[hide]

Please Send Your Nephro Exam MCQs

493. All of the following are risk factors for renal stone formation
except
a. RTA
b. Gold
c. Cystinosis
d. Dehydration

495. A case of diabetic nephropathy & hyperkalemia. Best treatment


is
a. Salbutamol
b. Calcium gluconate
c. Frusemide
d. Insulin
Answer is [hide]c[hide]
496. A case of recurrent upper respiratory tract infections,
hemoptysis & hematuria. What is the cause
a. Wegeners granulomatosis
b. Henoch Schonlein purpura
c. IgA nephropathy
d. Goodpasture's syndrome
Answer is [hide]a[hide]
497. All of these diseases cause hyperkalemia except
a. Multiple myeloma
498. 26 years old female presents to ER with worsening of fatigue,
nausea, and pruritus. She has HTN. Hb 15, high renal
parameters, K=6.5, Na 128. What is the cause
a. ADPKD
b.
c. .
d. .
Answer is [hide][hide]

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

499. What is the best treatment to get rid of hyperkalemia


a. Calcium resonium

Answer is [hide]a[hide]

500. 9 years old has generalized weakness & diarrhea. Hb 9.3,


platelets 28, urea 114, creatinine 2.3, urine analysis showing
hematuria & proteinuria. What is the best treatment
a. IV cyclophosphamide
b. Ciprofloxacin
c. Oral prednisolone
d. Plasma exchange

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

511. Tuberculosis of urinary tract can present with all except


a. Sterile pyuria
b. Isolation of mycobacteria
c. Ureteral stenosis
d. Painless hematuria
e. Chronic interstitial nephritis

DR. RANA ZAHID EXAM


502. Chronic interstitial nephritis
a. Sarcoidosis
b.
c. .

Answer is [hide]e[hide]

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

man started on HD. What is likely 5 years

31

503. What is the gold standard for acute interstitial nephritis


diagnosis

512. An 82 years old


survival
a.
b.
c.

10-20%
30-40%
50-60%

Page

Answer is [hide][hide]

zamorih@hotmail.com

d.

60-80%

Answer is [hide]d[hide]
Answer is [hide][hide]

513. A PD patient developed abdominal pain & ascetic fluid is turbid.


Analysis revealed Gram + & Gram bacteria. He was put on
antibiotics. What is the next step
a. Do USG of PD catheter
b. CT scan with contrast
c. MRI
d. Do nothing as diagnosis is almost confirmed
Answer is [hide]d[hide]
514. A 35 years old male patient with normal BP & no cysts on USG.
His grandfather & uncle have ADPKD. What is the most
appropriate statement
a. ADPKD is almost excluded
b. Repeat USG
c. Do MRA brain
d. Do genetic testing
Answer is [hide]a[hide]
515. A patient DM-1 for 10 years on insulin treatment, developed
microalbuminuria & started on enalapril 6 months ago. Now her
RFTs are normal & 24 hours proteinuria is 150 mg. What will
be the effect of pregnancy on renal disease
a. No effect
b. Progression to CKD
c. Deterioration of renal function till delivery
then improvement after delivery

519. A patient has bilateral renal cell carcinoma. Previously, he was


operated for brain tumor. Before tumor resection, what should
be done
a. MRI
b. Renal angiography
c. USG
d. Urinary catecholamines
Answer is [hide]d[hide]
520. Target BP in CKD/ nephropathy is
a. <140/90 mmHg
b. <135/85 mmHg
c. <130/80 mmHg
d. < 125/80 mmHg
Answer is [hide]c[hide]
521. A patient of SLE with DPGN, taking steroids &
cyclophosphamide. Patient is refusing later due to sterility. What
is the alternative
a. Azathioprine
b. Mycophenolate
c. Cyclosporine
Answer is [hide][hide]
522. The most common initial presentation of IgA nephropathy is
a. Microscopic hematuria
b. Microscopic hematuria with proteinuria
c. Recurrent macroscopic hematuria

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]

524. Autosomal recessive, steroids resistant nephrotic syndrome is


associated with
a. Nephron
b. Podocin
c. TRCP6
d. Alfa actin 4

525. HIV is associated with


a. Collapsing GN
526. Regarding Minimal change disease all are true except

Please Send Your Nephro Exam MCQs

Dr. Zahid Hafeez

zamorih@hotmail.com

32

Answer is [hide]b[hide]

Page

518. Hypocalcemia is seen in all except


a. Hypoparathyoidism
b. Vitamin D deficiency
c. Pseudohypoparathyroidism
d. Graves disease

523. HSP is associated with all except


a. Abdominal pain
b. Rash
c. Arthralgia
d. Splenomegaly

a.

Low C3

537. A regular patient on HD came with K= 7.8. What will not be in


immediate management plan
a. Calcium gluconate
b. Insulin glucose infusion
c. NaHCO3
d. Emergent dialysis

527. In nephrotic syndrome, all proteins are decreased except


a. Albumin
b. Ferritin
c. Ceruloplasmin
d. Fibrinogen

Answer is [hide]c[hide]
Answer is [hide]d[hide]
538. What will not lower serum K levels
a. Calcium gluconate

528. Decreased complement is not seen in


a. IgA nephropathy

539. How trimethoprim causes hyperkalemia


a. By blocking collecting duct apical Na
channels

529. Hypocomplemtemia seen in all except


a. Post streptococcal GN
b. Shunt nephritis
c. SLE
d. IgA nephropathy

540. ECG findings of hyperkalemia, all are true except


a. Flattening of T wave

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]

532. A patient taking ifosfamide treatment due to breast cancer. What


is side effect
a. Fanconis syndrome

543. An elderly stroke patient, hypertensive on thiazides came with


obtundation. Mucous membranes dry low skin turgor. Pulse 120
bpm, BP 80/50 mmHg. What is most appropriate initial IV fluid
a. 5% DW
b. 5% DW with Normal saline
c. Normal saline
d. Half normal saline

533. Side effects of acetazolamide


a. Normal anion gap metabolic acidosis
534. A patient with hypokalemia, metabolic alkalosis with urinary
K=10, what is the most likely cause
a. GI loss
535. Major site of Mg+2 absorption
a. Thick ascending loop of Henle
536. Rhabdomyolysis is associated with all of the following except
a. Hypocalcemia

Please Send Your Nephro Exam MCQs

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

Dr. Zahid Hafeez

zamorih@hotmail.com

33

530. A patient on mechanical ventilator due to flail chest developed


diarrhea 8-10 times a day. pH=7.2, pCO2=30, HCO3. What is the
abnormality
a. Metabolic acidosis
b. Respiratory acidosis
c. Metabolic acidosis with metabolic alkalosis
d. Metabolic acidosis with respiratory alkalosis

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

553. In PD; which statement is most appropriate


a. Icodextrin is more advantageous
glucose
b. Glucose causes UF failure
c. Glucose increases hyperlipidemia
d. Glucose causes obesity
e. Hyperglycemia

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

554. Renal osteodystrophy includes all except


a. 1,25 dihydroxy Vitamin D3 deficiency
b. Hypocalcemia
c. Hyperphosphatemia
d. 2ndry hyperparathyroidism
e. Decreased Calcitonin
Answer is [hide]e[hide]
555. Patient having IHD underwent CABG, now deteriorating RFTs
& oliguria. What is the most likely treatment
a. Volume expansion
b. Diuretics
c. Mannitol
d. Hemoperfusion
Answer is [hide].[hide]

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]

560. A years old diabetic patient on HD for 1 year developed ascites.


What is the most beneficial initial investigation

Dr. Zahid Hafeez

zamorih@hotmail.com

34

552. Mechanism of action of cyclosporine & tacrolimus


a.
b. .
c. .

559. Clinical features of atheroembolic renal disease are


a. Livido reticularis
b. Subcutaneous nodules
c. Eosinophilia
d. All of the above

Page

Answer is [hide][hide]

Please Send Your Nephro Exam MCQs

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.

Duplex of renal arteries


CT scan of kidneys
Renal angiography
Answer is [hide]d[hide]

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

568. Child with UTI having features of recurrent reflux nephropathy.


What is the investigation of choice
a. IVU
b. USG
c. CT-Scan
d. Micturating cystourethrogram
e. DMSA scan
Answer is [hide]d[hide]

Answer is [hide]b[hide]
569. Best treatment of anemia in CKD-4
a. Oral iron
b. IV iron
c. Folic acid
d. Erythropoietin

562. Which drug will cause hyponatremia


a. Lithium
b. Chlorpropamide
Answer is [hide]..[hide]

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

571. Normal sized kidney in all conditions except


a. Amyloidosis
b. Diabetic nephropathy
c. Analgesic nephropathy
d. ADPKD
Answer is [hide]c[hide]

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

Please Send Your Nephro Exam MCQs

572. What is the most sensitive test for UTI in children


a. WBCs in urine
b. White cell cast in urine
c. Leukocytosis
d. Fever
e. Leukocyte esterase in urine
Answer is [hide]e[hide]

DR. KHALID NASER EXAM


573. In case of hypernatremia Na=170 & plasma osmolality 320, the
most probable condition will be
a. Increased intracellular volume increased
osmolarity >328
b. Decreased ICV and decreased osmolarity <
328
c. Decreased ICV and increased osmolarity
328
d. No change in ICV and osmolarity 420

Dr. Zahid Hafeez

zamorih@hotmail.com

35

Answer is [hide]a[hide]

Page

564. Plasma volume is


a.
b.
c.
d.

570. Granular casts (2 MCQs)

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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Dr. Zahid Hafeez

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