1. In pre renal azotemia there is

A. Decline in glomerular filtration

B. Intact tubular function

C. Both

D. Neither

 

2. Pre renal azotemia could result from

A. Decrease in circulating blood volume

B. Decrease in renal blood flow

C. Both

D. Neither

 

3. Acute tubular necrosis

A. Deterioration of glomerular function

B. Deterioration of tubular function

C. Both

D. Neither

 

4. Acute tubular necrosis can be the result of

A. Decrease in circulating blood volume

B. Exogenous Toxins

C. Both

D. Neither

 

5. Acute tubular necrosis is a diagnosis of exclusion

A. True

B. False

 

6. Renal functional components are

A. Regulatory

B. Excretory

C. Endocrine

D. All of the above

 

7. Regulatory functions of kidney are

A. Volume of body fluids

B. Composition of body fluids

C. Both

 

8. Loss of renal regulatory function of Volume of body fluids could result in

A. Edema

B. Hypertension

C. Congestive heart failure

D. All of the above

 

9. Loss of renal regulatory function of Composition of body fluids could result in

A. Hyperkalemia

B. Metabolic acidosis

C. Hyperphosphatemia

D. All of the above

 

10. Loss of excretory ability is expressed by

A. Rising BUN

B. Rising Creatinine

C. Both

 

11. Rate of rise in BUN and Creatinine reflects

A. Degree of impairment of excretory renal function

B. Rates of generation of BUN and Creatinine

C. Both

 

12. Rate of rise of creatinine with impaired renal excretory function is high in

A. Acute GI bleed

B. Patient with sleep apnea syndrome

C. Both

D. Neither

 

13. In average patient with acute renal failure the BUN rises about

A. 5-10 mg/dl/day

B. 10-15 mg/dl/day

C. 15-20 mg/dl/day

D. 20-25 mg/dl/day

 

14. A  patient with acute renal failure has BUN rise of 45mg/dl/day . You should then consider

A. Acute GI bleed

B. Catabolic state

C. Both

D. Neither

 

15. Sonogram of kidneys can

A. Evaluate size

B. Assess calyceal system

C. Detect cysts and masses

D. All of the above

E. None of the above

 

16. Best radiological procedure to determine the size of the kidney in a patient with renal failure is

A. Plain x-ray abdomen

B. Sonogram

C. IVP

 

17. Blood flow studies with radio nucleotide method can

A. Determine presence or absence of flow

B. Can evaluate symmetry

C. Both

 

18. Patient with ATN. Renal blood flow evaluated by radio nucleotide method. You are likely to see

A. Decreased renal blood flow

B. Increased renal blood flow

C. Normal renal blood flow

 

19. Presence of red cells in urine should raise suspicion of disease of

A. Glomeruli

B. Tubules

C. Ureters

D. Bladder

E. Non-specific

 

20. Urine sediment contains lymphocytes and eosinophils. Consider

A. Glomerulonephritis

B. Pyelonephritis

C. Acute interstitial nephritis

 

21. Azotemia in the presence of normal urinary sediment is suggestive of

A. Tubular disease

B. Obstructive disease

C. SLE

D. Non diagnostic

 

22. Presence of red cells and white blood cells in urine rules out obstructive disease

A. True

B. False

 

23. In ATN glucose can be detected in the urine in the absence of hyperglycemia

A. True

B. False

 

24. Urine osmolality is close to that of serum in ATN

A. True

B. False

 

25. Patient is being investigated for acute renal failure. Spot check: urine concentration  40 meq/l. It is suggestive of

A. Glomerulonephritis

B. Congestive heart failure

C. ATN

D. Benign prostatic hypertrophy

 

26. Patient with acute renal failure with high urine osmolality, fractional excretion of sodium less than 1 percent. Consider

A. Glomerulonephritis

B. Congestive heart failure

C. ATN

D. Benign prostatic hypertrophy

 

27. Oliguria is considered present when the urine output is

A. < 100 ml/day

B. < 300 ml/day

C. < 500 ml/day

D. None of the above

 

28. Patients with ATN can have

A. Oliguria

B. Polyurea

C. Both

 

29.  All of the following can give rise to total anuria except

A. Dissecting abdominal aortic aneurysm

B. Acute renal vein thrombosis

C. Severe cortical necrosis

D. Urinary tract obstruction

E. Acute interstitial nephritis

 

30. Functions of kidney can be maintained until the kidney has only

A. 50% of function

B. 30% of function

C. 10% of function

 

31. The nephrons that remain functional in the presence of disease act as

A. Partially damaged units

B. Normal units

C. Supernormal units

 

32. "Trade off hypothesis" refers to the adaptive changes mediated by stimuli generated outside and within the kidney

A. True

B. False

 

33. Bleeding complication in chronic renal failure is due to

A. Increased platelets

B. Decreased platelets

C. Functionally abnormal platelets

 

34. Type of anemia encountered in Chronic renal failure is

A. Megaloblastic anemia

B. Iron deficiency anemia

C. Pseudo iron deficiency anemia

D. Aplastic anemia

 

35. Pruritus in Uremia is due to

A. Elevated BUN

B. Micro crystallization of calcium in skin

C. Elevated phosphorous

D. None of the above

 

36. Patient in renal failure. The ratio of BUN to Creatinine is  30:1. Most likely diagnosis is

A. Obstructive disease

B. Glomerular disease

C. Pre renal disease

 

37. A normal kidney in states of dehydration, can generate with maximum concentration, an urine osmolality  in excess of

A. 500 mOsm/kg

A. 900 mOsm/kg

A. 1200 mOsm/kg

 

38. Patient in acute renal failure. Urine osmolality is 600 mOsm/kg. Most likely it is due to

A. ATN

B. Pre renal azotemia

 

39. Patient in acute renal failure. Urinary sodium is 40 mEq/L. Most likely the etiology for renal failure is

A. ATN

B. Pre renal azotemia

 

40. In patients  with chronic renal failure, Hypertension develops in 

A. 95% of patients

B. 50% of patients

C. 10% of patients

 

41. Normal size of kidneys by sonography

A. 10-12 cm's in long axis

B. 7-9 cm's in long axis

C. 14-16 cm's in long axis