Nephrology

🔹 Question:
A 30-year-old man presents to the outpatient clinic with marked peripheral edema. He has no significant past medical history.

🔍 Examination Findings:

• 4+ edema of the lower extremities

🧪 Lab Results:

• Albumin: 18 g/L (normal: 34-56 g/L)
• Dipstick analysis: 4+ proteins
• Urinalysis: Oval fat bodies, hyaline casts, occasional RBCs

Which of the following is the most likely diagnosis?

🔹 Question:
A 45-year-old diabetic woman presents to the Emergency Department with fever, flank pain, and dyspnea.

🔍 Examination Findings:

• Flank tenderness
• Fever: 39°C

🧪 Lab Results:

• WBC: 17 × 10⁹/L (elevated)
• Urine culture: >100,000 CFU/mL E. coli

Which of the following is absolutely contraindicated?

🔹 Question:
A 61-year-old male with end-stage renal disease (ESRD) is found to have anemia on pre-dialysis workup.

🩺 Lab Findings:

• Iron level: Low
• MCV: 71 (Microcytic)
• Ferritin: High

What is the most appropriate treatment?

🔹 Question:
A circumcised male child presents with symptoms suggestive of a UTI or posterior urethral valve. Which factor is most suggestive of the diagnosis?

🔹 Question:
A 58-year-old male presents with hematuria and flank pain. On examination:

• Flank tenderness is noted.
• Digital rectal exam (DRE) reveals an enlarged prostate.
• Urinalysis shows hematuria.

What is the next appropriate step?

🔹 Question:
A 42-year-old female presents with acute oliguric renal failure three days after chemotherapy for non-Hodgkin lymphoma. Urine sediment shows amber crystals.

Which therapy is LEAST likely to be beneficial?

🔹 Question:
What is the most common cause of death in chronic kidney disease (CKD)?

🔹 Question:
A patient with systemic lupus erythematosus (SLE) is diagnosed with grade 1 (minimal) lupus nephritis. Her blood pressure is 150/90 mmHg. What should be done?

🔹 Question:
A 77-year-old man with a history of ischemic heart disease is seen in the Hypertension Clinic. He is taking four antihypertensive drugs, yet his blood pressure remains elevated. His physical examination is unremarkable, but abdominal ultrasound shows asymmetrical kidneys.

• Blood pressure: 169/99 mmHg
• Heart rate: 79/min

What is the most likely diagnosis?

🔹 Question:
A male military trainee develops oliguria and is diagnosed with acute kidney injury (AKI) due to hypovolemia. Which lab finding supports this diagnosis?

🔹 Question:
A patient presents with hyperkalemia and high creatinine, but no ECG changes. What should be done first?

🔹 Question:
A case of hypokalemia was diagnosed via laboratory results, and the patient is experiencing constipation. What should be done next?

🔹 Question:
A 51-year-old patient with chronic kidney disease (CKD) and progressively decreasing GFR is starting dialysis. What is the most likely cause of death within the first year?

🔹 Question:
An elderly patient fell down on his leg 2 weeks ago and has been bedridden since. He presents with shortness of breath, dyspnea, and a high renal profile. Which of the following, if found in the urine, indicates cholesterol embolism?

🔹 Question:
A 55-year-old man with chronic kidney disease and a creatinine clearance of 10 mL/min requires hemodialysis. What is the preferred method to initiate it?