A Peroxidase
5 What is the approximate mortality rate associated with non-ionic contrast media?
6 Which of the following types of diuretic renogram curve refers to a system which is dilated without obstruction?
A 3.5 MHz B 4.5 MHz C 5.5 MHz D 6.5 MHz E 7.5 MHz
A Stents aid stone passage B Stents increase intrarenal pressures C A nephrostomy is better for the relief of an obstructing stone with infection D Stents lower intrarenal pressure E Stents are extremely effective at relieving obstruction from extrinsic compression
11 What stage of chronic kidney disease has a patient with an estimated GFR of 26ml/min/1.73m2?
E Sirolimus
16 Which of the following best describes the thin descending limb of the loop of Henle?
A Impermeable to water B Permeable to water and less permeable to sodium, chloride and urea C Impermeable to water, highly permeable to sodium and chloride and slightly permeable to urea D Permeable to water, sodium, chloride and urea E Impermeable to water and urea with sodium and chloride actively reabsorbed
A Peroxidase B Red azo dye C The production of indoxyl and oxidation of a diazonium salt D Tetrabromophenol blue dye E Double oxidation reaction
A 50-80 mg/day B 80-150 mg/day C 150-200 mg/day D 200-230 mg/day E 230-250 mg/day
Answers
1B 2C The "four R's" which determine radiosensitivity are repair, re-oxygenation, re-assortment and repopulation
3A In SI units, the activity of a radioactive source is measured in becquerels (symbol Bq). The absorbed dose of ionizing radiation is measured in grays (symbol Gy) where one gray is equal to one joule of energy being imparted to one kilogram of matter (the rad is the previously used unit). The dose equivalent, which is a measure of the effects of radiation on living organisms, is measured in sieverts (symbol Sv)
4D 5A 6B Type IV Delayed double peak pattern (Homsey) Type IIIa Dilated without obstruction Type IIIb Equivocal Type II Obstructed Type I Normal
7D 1 in 10,000 or 1mg per 10ml adrenaline solution is often used during cardiace arrest in prepared syringes. A 1 in 1000 or 1mg per ml adrenaline solution is often used IM for anaphylactic reactions.
UrologyUK comment: Although this seems like a fairly non-urological question there are a significant number of everyday clinical MCQ's and EMQ's in the exam.
9E The French guage is equal to the diameter of the tube multiplied by 3 in mm, not as is often thought the circumference in mm. However, remember that the circumference is diameter multiplied by Pi (3.14) so it is nearly correct!!
10B
Stents paralyse peristalsis and therefore do not aid stone passage. They increase intrarenal pressures. Pearle, M; J Urol 1998 demonstrated that there was no difference in recovery between patients treated with nephrostomy vs JJ stent. JJ stents are less effective at relieving obstruction from extrinsic compression.
CKD Stage
Stage 1
Stage 2
Stage 3
eGFR 30-59
Stage 4
eGFR 15 29
Stage 5
eGFR < 15
12B 1 year graft survival for living donor nephrectomy is 95% with HLA-identical siblings, 90% for 1haplotype-identical related donor and 80% for cadaveric kidneys
13D The approximate distribution of new cancers is renal 5%, lung 5%, lymphoproliferative 11%, skin 40% and cervical 4%
15D
16B The thin descending limb is best described by B, the thin ascending limb is best described by C and the thick ascending limb best described by E
Soft tissue (eg muscle) +40 Calculus Bone +100 to +400 +1000
18D Phase IV - Post-launch safety surveillance Phase III - Randomised control trial Phase II - Assesses how well the drug works as well as continued safety Phase I - Assesses safety Phase 0 - First human trial - does it behave in humans as expected
19C Leucocyte esterase catalyses the production of indoxyl which oxidises a diazonium salt leading to a colour change