Ou Im Absolutes Set 4

Front 1

What is BUN/Cr ratio in prerenal azotemia?

Back 1

20:1

Front 2

What feNa indicates intacts kidney?

Back 2

<1

Front 3

What is urine pH in salicylate or phenobarb OD?

Back 3

alkaline

Front 4

what is dx is eosinophils in the urine?
What is dx if sterile pyuria?

Back 4

-- interstitial nephritis if eos
-- TB or interstitial nephritis if sterile

Front 5

What is dx and next step if pt has RBC casts?

Back 5

glomerulonephritis, Get bx

Front 6

Dx if renal tubular casts?

Back 6

ATN

Front 7

What problems are calcium oxylate crystals seen in?

Back 7

antifreeze ingestions and Crohn's

Front 8

A Urine Na and Urine osmol of what indicates good kidney function?

Back 8

Una <40 and Urine osmol >400

Front 9

What is most common cause of kidney stones? Tx?

Back 9

hypercalciuria -treat with thiazide

Front 10

What size stone will most likely pass?

Back 10

<5mm

Front 11

what is C3 level in post strep GN?

Back 11

low C3 (like lupus)

Front 12

Lupus GN
1. what are C3 levels?
2. what lab is typical?
3. what is treatement?

Back 12

1. C3 low
2. high anti-ds DNA
3. tx with steroids and immune suppressants

Front 13

Pt presents with nephritis and deafness. Dx?

Back 13

alports syndrome

Front 14

young male presents 2 days after URI with hematuria. Dx?

Back 14

IgA or bergers.

Front 15

young male presents after URI with hemoptysis and rapidly progresive renal failure.
1. What is dx?
2. what ab is seen?
3. what is treatment?
4. What will cC3 C4 show?

Back 15

1. Goodpastures
2. anti GBM ab
3. plasmapheresis and steroids
4. normal

Front 16

Nephrotic syndrome
1. how many grams protienuria is seen?
2. What are other common findings for the dx?
3. what is #1 cause in kids? adults?

Back 16

1. 3.5g/24hours
2. hyperlipidemia and hypercoagulable
3. membranous in adults and minimal change in kids

Front 17

African american, IVDU presents with nephrotic syndrome. What is most likely cause

Back 17

Focal segmental - common in HIV, IVDU, transplant pts and more common in african americans

Front 18

what diseases are associated with membranous nephropathy?

Back 18

Hep B, drugs and cancer

Front 19

Chronic GN
1. What acid base disorder is seen?
2. what are Ca and PTH levels like?

Back 19

1. AG metabolic acidosis
2. low CA and very high PTH
also will see low EPO with anemia

Front 20

Pt with chronic renal failure and cr >2 presents with hardened skin and evidence of fibrosis of internal organs. What is the dx and what was the cause?

Back 20

nephrogenic systemic fibrosis
seen after MRI- thought to be due to gadolinium toxicity

Front 21

What are risks of aluminum toxicity and what are sources of aluminum tox?

Back 21

associated with osteomalacia and dementia. Can get from older dialysis machines and Maalox

Front 22

What is McC of ATN?

Back 22

shock post surgery

Front 23

1. What is MC bug in Pyelo?
2. What is mechanism for pyelo?
3. Treatement for pyelo?

Back 23

1. E coli
2. vesicoureteral reflux
3. 10 days of quinolone

Front 24

What is Mc bug in honeymoon cystitis?
What is tx?

Back 24

1. staph saprophyticus
tx with 3 days of nitro

Front 25

Pt presents with eosinophils in blood and urine and elevated Cr. what is most likely cause and what should be done?

Back 25

drug induced from abx or PPI. remove offending agent and cr will improve

Front 26

What are classic causes of renal papillary necrosis?

Back 26

analgesia abuse, DM, acute pyelo and sickle cell

Front 27

What type of RTA does ampho B cause?

Back 27

type 1

Front 28

what electrolyte abnormality is seen with cisplatin?

Back 28

low Mag

Front 29

what drug used for resistant pseudomonas causes AKI?

Back 29

colistin

Front 30

Poly cystic kidney dz
1. how is it acquired?
2. When do cysts present
3. what are classic findings?

Back 30

1. autosomal dominant
2. not at birth, present later in life
3. will ahv HTN and some have berry aneurysms

Front 31

What is # cause of death in HTN?

Back 31

MI not stroke

Front 32

What is drug of choice for HTN in pregnancy?

Back 32

alpha-methyl dopa (aldomet) ??

Front 33

What are common findings in malignant HTN
tx?

Back 33

diastolic BR >140
papilledema
high renin and commonly seen in blacks.
tx with nitro or bb

Front 34

renovascular HTN
1. what is cause in elderly? in young women?
2. best choice to dx it?
3. if fibromuscular what will be seen on imaging?
3. best tx (for boards)?

Back 34

1. atherosclerosis in elderly and fibromuscular hyperplasia in young women.
2. dx with CT angio
3. will see beading effect
4. balloon angioplasty

Front 35

Pt with A fib presents with flank pain and hematuria? what is dx?
what other dz could cause this?

Back 35

renal infacts
can also be seen in polyarteritis nodosa

Front 36

What cancer is associated with hydronephrosis?

Back 36

endometrial or cervical CA
also BPH will cause it

Front 37

What are blood clots rare in the urinary tract?

Back 37

because of urokinase

Front 38

what is risk to bladder with cytoxan?

Back 38

hemorrhagic cystitis

Front 39

shistosomiasis haematobium causes what?

Back 39

squamous bladder cancer

Front 40

What test determines adrenal insuff and how do results of test work?

Back 40

ACTH stimulation test
postive cortisol response= no adrenal insuff
negative cortisol response= adrenal insuff
3 day ACTH stimulation with positive cortisol response= adrenal insuff from steroid withdrawal

Front 41

How to dx cushings?

Back 41

dexamethasone suppression test - should inhibit cortisol. If not suppressed think cushings or false positive from obesity/depression.

Front 42

What two endocrine disorders can be easily suppressed

Back 42

prolactinomas and pituitary cushings

Front 43

postpartum female presents with cessation of lactation. What should you think of?

Back 43

Sheehans postpartum necrosis

Front 44

what is a common cause of nephrogenic DI?

Back 44

lithium

Front 45

pt presents with macroglossia, HTN, DM, CHF, soft tissue swelling and enlarged hands and feet. What is likely dx and tx?
What is the mechanism?

Back 45

acromegaly
tx with octreotide or transphenoidal surgery
--mechanism is pituitary release of GH casues high IGF-1(somatomedin C)

Front 46

What is treatment for prolactinomas?

Back 46

bromocriptine --a dopamine analogue

Front 47

What are causes of hyperprolactinemia

Back 47

antipsychotics
hypothyroid (TRH stimulates TSH and prolactin)
metoclopramide and cimetidine

Front 48

how do estrogens and androgens effect serum T4 levels and free T4 levels? WHy

Back 48

estrogens elevated serum T4 because elevate TBG.
androgens do the opposite
free levels not changed.

Front 49

What is the best test to assess for hyperthyroidism

Back 49

TSH

Front 50

1. What do radiactive iodine scans measure?
2. what is result in Graves and toxic nodular goiter?
3. what is result in hashimotos?
4. what is result in acute tyroiditis?

Back 50

1. measures hormone uptake and production, not amount of release
2. high
3. low
4. low - because its a lot of release but low production

Front 51

what is treatment for de quervians thyroiditis and when does it usually present?

Back 51

tx with bb and NSAIDS

Front 52

What is best hyperthyroid tx in pregnancy?

Back 52

methimazole

Front 53

what is definitive treatment for hyperthryoid?

Back 53

radioactive idodine

Front 54

do thiazides cause increase or decrease Calcium

Back 54

hypercalcemia

Front 55

What is the best marker for endogenous insulin release?

Back 55

c peptide

Front 56

What three things are seen on the autoimmune panel for Type 1 DM?

Back 56

GAD (glutamic acid decarboxylase)
ICA (islet cell antibody)
IAA (islet autoantibodies)

Front 57

what is the most reliable marker for ruling in DKA and type 1 DM?

Back 57

GAD- becausee c peptide may not be low intially

Front 58

what is the common rash in patients with glucagonoma?

Back 58

migratory necrolytic erythema

Front 59

What is the number one cause of death in DM?

Back 59

macrovascular disease from MI

Front 60

how do ACE-I protect the kidney?

Back 60

decrease proteinuria by dilating the EFFERENT arteriole and relaxing pressure in the bowmans capsule

Front 61

What are contraindications for ACE-I?

Back 61

pregnancy, angioedema, bilateral renal artery stenosis

Front 62

how does third nerve palsy neuropathy present in DM?

Back 62

ptosis/mydriasis that SPARES PUPILLARY REFLEX so will respond to light

Front 63

what are treatment options for diabetic neuropathy?

Back 63

tricyclics first then valproate, carbamazapine, gabepentin, and pregabalin

Front 64

Diabetic infections.
what is the common cause of malignant otitis externa in DM?
what common bug should be considered in Diabteic infections?
what fungal infection is seen in diabetics?

Back 64

psuedomonas
candida
-mucormycosis of frontal sinuses

Front 65

lab diagnosis of DM?

Back 65

random >200
fasting >126
A1c>6.5

Front 66

how do sulfonylureas work?

Back 66

stimulate pancreatic release of insulin which is why it can cause hypoglycemia

Front 67

what is a contraindication for metformin and why?
how does metformin work?

Back 67

dont use in creatinine >1.4 becasue can cause lactic acidosis in renal insuff

work by decreasing gluconeogenesis

Front 68

what drugs are good for decreasing post prandial hyperglycemia?

Back 68

acarbose and miglitol

Front 69

how do thiazolinediones/"glitazones workd and what are warnings for these drugs?

Back 69

enhances GLUT4 transport to uptake glucose

caution can cause liver toxicity and shoudl not use in CHF

Front 70

What are side effects of byetta and how does it work?

Back 70

can cause weight loss and rarely pancreatitis

works by mimicking incretin and GLP-1 analog

Front 71

how does sitagliptin work?

Back 71

DPPP4 inhibtior

Front 72

what is somogyi effect?

Back 72

complication of insulin treatment with hypoglycemia at 3 am and hyperglycemia by 7am

Front 73

what is dawn phenomenon?

Back 73

growth hormone in the morning caues am sugars to rise

Front 74

what is the honeymoon period in DM?

Back 74

brief period of no insulin requirements after initial diagnosis of Type 1 DM.

Front 75

what are risks of gestational diabetes in a newborn?

Back 75

macrosomia, RDS, and hypoglycemia

Front 76

why is secondary hyperparathyroid seen in chronic renal failure?

Back 76

becasue of the hypocalcemia causes high levels of PTH

Front 77

how to tell between etopic vs adrenal causes of high cortisol?

Back 77

ACTH is low in adrenal like cushings and high in ectopic like in lung cancer

Front 78

what is waterhouse-friderichsen?

Back 78

adrenal failure from meningococcus infection and can cause shock adn DIC

Front 79

what is the most common cause of congenital adrenal hyperplasia?

Back 79

21-OH deficiency

Front 80

ectopic hormones- what is released by the following?
1. small cell lung CA
2. choriocarcinoma
3. medullary CA of thyroid
4. renal cell carcinoma and hepatic
5. squamous cell of lung, and breast CA
6. carcinoid

Back 80

1. ACTH and ADH
2. hCG
3. calcitonin
4. erythropoeitin
5. PTH-like peptide
6. serotonin

Front 81

what labs should be tested in erectile dysfunction

Back 81

TSH, prolactin, testosterone