Answer and Explanation 5

5.  D is the correct answer.  Uric acid stones are radiolucent. On CT scan you will just see a widened ureter and associated hydronephrosis on that side.  Ultimately the diagnosis will be confirmed with analysis of the stone.  The index of suspicion should be heightened in a patient with a history or renal failure, renal insufficiency, gout, or known high serum uric acid levels.

Question 5

5.  Which of the following renal calculi are radiolucent?

A.  Cysteine

B.  Magnesium Ammonium Phosphate

C.  Calcium Oxalate

D.  Uric Acid

Answer and Explanation 4

4.  C is the correct answer.  Acute nephritic syndrome is associated with oliguria not polyuria.  These patients with have hematuria with casts.  They have proteinuria (<2 grams in 24 hours) in the non nephrotic range.  They usually have a temporary impairment of renal function that leads to elevated BUN and creatinine as well as retaining sodium and water.

Question 4

4.  Which of the following is not associated with a patient with acute nephritic syndrome?

A.  Hematuria with RBC casts or dysmorphic Red Blood Cells

B.  Proteinuria

C.  Polyuria

D.  Elevated Sodium

Answer and Explanation 3

3.  D is the correct answer.  This patient has SIADH.  There is numerous causes of SIADH identified and SSRI, Porphyria and pneumonia are all identifiable causes.  In addition, trauma infections, TB, being on a mechanical ventilator, cancer, and various medications can cause SIADH.  

Question 3

3.  Your patient is a 56 year old female that presents with a +3 edema BLE and the following lab data:  Na 118, Cl 109 CO2 22 BUN 23 Creatinine 0.9 Glucose 99.  The urine sodium is elevated.  Which of the following is not  a potential cause of this condition?

A.  SSRI's

B.  Porphyria

C.  Pneumonia

D.  Hypothyroidism

Answer and Explanation 2

2.  D is the correct answer.  A renal biopsy is not necessary if a patient with acute renal failure recovers within 6 weeks.  Patients with nephrotic syndrome may need a renal biopsy to determine the type of nephrotic syndrome that they have.  Patients with hematuria that have had cystoscopy may need a renal biopsy to determine the cause.