1. The most important complication of peritoneal dialysis is peritonitis. The organism responsible for most cases of peritonitis in this setting is:
A. Candida
B. Escherichia coli
C. Streptococcus
D. Pseudomonas
E. Staphylococcus
2. Which of the following is NOT associated with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion?
A. Volume depletion on physical examination
B. Normal thyroid and adrenal functions
C. Improvement with fluid restriction
D. Can be seen in patients with tumors
E. Responds to demeclocycline
3. Which of the following is the LEAST important consideration when estimating a creatinine clearance to determine a medication dose for a patient with renal insufficiency?
A. Blood urea nitrogen
B. Serum creatinine
C. Age
D. Weight
E. Sex
4. The most serious consequence of rapid correction of hyponatremia is:
A. Hypokalemia
B. Central pontine myelinolysis
C. Muscle cramps
D. Hypernatremia
E. Fluid overload
5. Which of the following is NOT a feature of hypocalcemia
A. Positive Chovestek's sign
B. Cramps and tingling
C. Tetany
D. Negative Trousseau's sign
E. Seizures
6. Which of the following is the most common pathology in nephrotic syndrome in children?
A. Minimal change disease
B. Membranous nephropathy
C. IgA nephropathy
D. Poststreptococcal glomerulonephritis
E. Henoch-sch?nlein purpura
7. Which of the following statements is NOT true regarding single-dose antibiotic therapy in the setting of acute uncomplicated cystitis?
A. Results in fewer side effects
B. Most fluoroquinolone antibiotics effective
C. Trimethoprim-sulfamethoxazole effective
D. Effective for both men & women
8. A 32-year-old bank executive presents with a 24-hour history of fever, chills, perineal pain, and frequency of urine, urgency, and nocturia. He denies being at risk for sexually transmitted disease and has had no urethral discharge. On physical examination, he is noted to have an acutely inflamed prostate. The treatment of choice for his diagnosis is:
A. Amoxicillin 500 mg qid for 30 days
B. Ciprofloxacin 500 mg bid for 30 days
C. Trimethoprim-sulfamethoxazole (160/800 mg) bid for 10 days
D. Amoxicillin 500 mg qid for 10 days
E. Doxycycline 100 mg bid for 10 days
9. An adolescent female with recurrent urinary tract infections should be evaluated for:
A. Polycystic kidney disease
B. Nephrolithiasis
C. Wilms' tumor
D. Vesicoureteral reflux
E. Minimal change disease
10. What acid-base disorder is seen in chronic kidney disease?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
E. Normal
11. A 41-year-old woman presents for evaluation of renal stones. She is found to have hypercalciuria, hypercalcemia, and hypophosphatemia. What is the most likely cause of hypercalcema in this case?
A. Renal tubular acidosis
B. Gout
C. Idiopathic hypercalciuria
D. Hyperparathyroidism
E. Sarcoidosis
12. The most common cause of chronic kidney disease is:
A. Glomerulonephritis
B. Diabetes mellitus
C. Hypertension
D. Polycystic kidney disease
E. Systemic lupus erythematosus
13. A 50-year-old male presents with abrupt onset of hypertension, headache, palpitations, sweating, weight loss, and anxiety attacks. Which of the following lab tests would be most useful in making the diagnosis?
A. Captopril-induced renal scan
B. 24-hour urine catecholamines and VMA
C. 24-hour urine protein and creatinine clearance
D. Renal vein renin levels
E. Serum creatinine
14. In which of the following cases would renal biopsy be most recommended?
A. Patient with single functioning kidney and creatinine level of 2.0 mg/dl
B. Patient with 30-year history of diabetes, retinopathy, and proteinuria
C. 6-year-old child with sudden-onset edema and 10 g/day proteinuria
D. Patient with bilaterally small kidneys, uncontrolled hypertension, and creatinine level of 5.0 mg/dl
E. Patient with recently diagnosed systemic lupus erythematosus, proteinuria, and creatinine level of 1.7 mg/dl
15. An 8-year-old child presents with onset of periorbital and leg edema following a recent viral upper respiratory tract illness. Urinalysis shows heavy proteinuria and no RBC casts. Which of the following is the most likely diagnosis?
A. Poststreptococcal glomerulonephritis
B. Henoch-sch?nlein purpura
C. Alport's syndrome
D. Minimal change disease
E. Acute leukemia
16. A 20 year old otherwise healthy woman presents with cloudy urine, burning on urination and urinary frequency. She has no allergies. Patient is febrile. She has mild suprapubic pain with palpation but no costo vertebral angle tenderness. Urinalysis is positive for nitrites and leukocyte esterase. Which of the following is the most appropriate treatment in a general practice?
A. Hospitalize the patient and administer intravenous antibiotics
B. Administer macrolide containing antibiotics on an out patient basis
C. Cotrimoxazole on out patient basis
D. Advise the patient to increase fluid intake, especially with cranberry juice.
17. A 31 year old woman presents with high fever, dysuria, flank pain, nausea, and vomiting.On examination she looks ill, (R) renal punch is positive. What is the most appropriate treatment.
A. Hospitalization with administration of intravenous fluids and antibiotics
B. Oral rehydration and oral antibiotics for 10 days
C. Surgical consultation
D. Extracorporeal shock wave lithotripsy
18. Anemia that is seen in patients with chronic renal disease is usually caused by insufficient:
A. Iron stores
B. Vitamin B12
C. Rennin production
D. Erythropoietin production
E. Folate stores
19. 43 years old patient of osteoarthritis (OA) from a remote comes to your clinic for treatment of blood pressure. She is taking NSAIDs for her OA. There is no laboratory in her village so you can not monitor renal function and electrolytes. Which of the following drugs will be safest in her case?
A. ACE inhibitors
B. Calcium channel blockers
C. Diuretics
D. ?-blockers
20. A 65 year old man presents with complaints of back pain and generalized fatigue. Laboratory findings include anemia with rouleau formation, a monoclonal spike seen with serum protein electrophoresis, and hypercalcemia. Radiographs of the unbar spine show lytic lesions. The most likely diagnosis is:
A. Metastatic prostate cance
B. Paget?s disease
C. Osteitis firbosa cystica
D. Multiple myeloma
E. None of the above
21. Which one of the following is the most common cause of pre-renal acute renal failure?
A. Shock
B. Nephrotic syndrome.
C. Nonsteroidal anti-inflammatory drugs.
D. Angiotensin-converting enzyme inhibitors.
E. Congestive heart failure
22. Which one of the following is the preferred initial test for urinary tract obstruction in general practice?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
23. Which one of the following is the preferred initial test for urinary tract stones in general practice?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
24. Which one of the following is the preferred test for urinary stones according to literature?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
25. Which one of the following should prompt evaluation for primary renal disease in a patient with microhematuria?
A. Red cell casts.
B. One red blood cell per high-power field
C. Urinary tract infection
D. Protein excretion of greater than 150 mg per 24 hours
E. White blood cells.
26. A 26 year old woman has had 4 episodes of UTI s in last 1 year. Her investigations for risk factors for recurrent UITs are normal. Which of the following is true about antibiotics for her?
A. Postcoital ciprofloxacin is as effective as continuous daily antibiotic prophylaxis.
B. Antibiotic prophylaxis does not increase the risk of vaginal or oral candidiasis.
C. Because of antibiotic resistance antibiotic prophylaxis is not recommended in her case.
D. Only Fluoroquinolones are recommended for prophylaxis.
27. Which one of the following is the most common cause of chronic kidney disease?
A. Hypertension.
B. Diabetes mellitus.
C. Dyslipidemia.
D. Renal osteodystrophy.
28. Which one of the following causes of edema is most likely to respond to diuretic therapy?
A. Venous insufficiency.
B. Lymphedema.
C. Nephrotic syndrome.
D. Calcium channel blocker-induced edema.
29. A 50 year diabetic patient is on the following medication: Metformin 1g TDS, Gliclazide 80 mg bd, Ramipril 5 mg daily, atenolol 50 mg daily. Her blood results show creatinine 1.9 mg/dl. Which of the following medications should be withdrawn?
A. Gliclazide
B. Metformin
C. Atenolol
D. Ramipril
E. None of the above
30. An 20 year old lady has gross hematuria. She recently had a sore throat. Following this she is found to have persistent microscopic hematuria, Blood pressure is 125/65 and creatinine is 2.3 mg/dl. A renal biopsy shows mesangial deposition of IgA on immunofluorescence with normal tubules and interstitium. Which of the following statements is true about this patient?
A. Complement levels will be low
B. The prognosis is good
C. Family screening should be done
D. An angiotensin-converting enzyme (ACE) inhibitor should be started
E. There is approximately a 50% chance of end stage renal failure
31. A 25 year old woman has recurrent UTIs during childhood. She is now 28 weeks pregnant and has another episode of pyelonephritis. Her renal function is normal. What is the likely predisposing problem?
A. Toxic shock syndrome
B. Renal calculi
C. Reflux nephropathy
D. Pre eclampsia
E. Polycystic kidney
32. A 25 year old woman presents with haematuria and abdominal pains. She has an ultrasound scan which confirms polycystic kidney disease. Which of the following is LEAST likely to occur?
A. Her child may suffer from this disease
B. May suffer from intracranial hemorrhage
C. May have persistant Haematuria
D. May develop renal carcinoma
E. May have Recurrent UTI.
33. 45 year old woman presents with acute pain that radiates from his left loin to his left groin. The pain comes for a few seconds, and then goes. It is sharp in nature. A plain abdominal X Ray is normal while ultrasound shows dilation of pelviccalyceal symptom and presence of stones. Which type of stone is most likely?
A. Calcium stone
B. Cystine renal stones
C. Uric acid renal stones
D. Staghorn stone
34. A 28 years old man rushes into your clinic with 1 hour history of severe right lumber pain. On examination he is moaning with pain. Which analgesic will you give as first line in general practice?
A. Pentazocin
B. Hyosine
C. Diclofenac
D. Nalbufen
E. Tramadol
35. Case same as above. The pain is not improved with the previous analgesic. Which analgesic will you give as second line?
A. Pentazocin
B. Hyosine
C. Nalbufen
D. Any of the above
E. None of the above
36. A 20-year-old man presented to a clinic with a two-day history of pain in his knees and shoulders, low-grade fever and diffuse tenderness in several muscle groups, Skin examination revealed a palpable purpuric rash on both ankles that tapered up to the knees. Investigations showed renal impairment and also hematuria. Which one of the following is the most likely diagnosis?
A. Poststreptococcal Glomerulonephritis
B. Nephrotic syndrome
C. Rhabdomyolysis
D. Diabetic glomerulosclerosis
E. Henoch Schonlein purpura
37. A hemodialysis patient has gout. Which of the following treatments is the least effective?
A. Probenecid
B. Prednisolone
C. Increased dialysis
D. Allopurinol
E. Colchicine
38. A lady with polycystic kidney disease has several family members who are concerned about having the condition themselves. Which one of the following is the appropriate screening test for adult polycystic kidney disease in general practice?
A. Intravenous urogram
B. Renal ultrasound
C. Genetic testing
D. Isotope renography
E. Urine dipstick
39. Which one of the following protein concentrations corresponds to a result of 1+ on a urine dipstick test?
A. 30 mg per dL.
B. 100 mg per dL.
C. 300 mg per dL.
D. 1,000 mg per dL.
40. Which one of the following statements about treating patients with diabetic kidney disease is correct?
A. Angiotensin-converting enzyme (ACE) inhibitors should be used in low doses.
B. ACE inhibitors should be used at a maximally tolerated dose.
C. ACE inhibitors and ARBs should be initiated together.
D. ARBs should be preferred over ACEIs because they do not cause cough.
41. Which one of the following statements about angiotensin-converting enzyme inhibitors in patients with chronic kidney disease is correct?
A. They should never be used in patients with chronic kidney disease.
B. They should be discontinued immediately with any rise in serum creatinine levels.
C. They should be discontinued immediately once the serum potassium level reaches 5 Meq/dl.
D. They should be discontinued if the serum creatinine level rises more than 30 percent from baseline level
42. Among patients with chronic kidney disease, Metformin generally is recommended for which one of the following groups?
A. Patients with chronic heart failure.
B. Men with a serum creatinine level of 1.5 mg per dL or lower.
C. Patients older than 80 years.
D. Patients with severe infection.
43. A 30-year-old woman with a history of Crohn's disease presents with diarrhea and skin lesions. Which one of the following symptoms best supports a diagnosis of erythema nodosum?
A. Ulcerating lesions on the shin.
B. Painless red nodules.
C. Asymmetric lesions on flexor surface of arms.
D. Healing lesions in some areas with bruise-like appearance.
MCQ # Answer MCQ # Answer
1 E 26 A
2 A 27 B
3 A 28 C
4 B 29 B
5 D 30 B
6 A 31 C
7 D 32 D
8 B 33 C
9 D 34 C
10 A 35 D
11 D 36 E
12 B 37 A
13 B 38 B
14 E 39 A
15 D 40 B
16 C 41 D
17 A 42 B
18 D 43 D
19 B
20 D
21 A
22 C
23 D
24 E
25 A
A. Candida
B. Escherichia coli
C. Streptococcus
D. Pseudomonas
E. Staphylococcus
2. Which of the following is NOT associated with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion?
A. Volume depletion on physical examination
B. Normal thyroid and adrenal functions
C. Improvement with fluid restriction
D. Can be seen in patients with tumors
E. Responds to demeclocycline
3. Which of the following is the LEAST important consideration when estimating a creatinine clearance to determine a medication dose for a patient with renal insufficiency?
A. Blood urea nitrogen
B. Serum creatinine
C. Age
D. Weight
E. Sex
4. The most serious consequence of rapid correction of hyponatremia is:
A. Hypokalemia
B. Central pontine myelinolysis
C. Muscle cramps
D. Hypernatremia
E. Fluid overload
5. Which of the following is NOT a feature of hypocalcemia
A. Positive Chovestek's sign
B. Cramps and tingling
C. Tetany
D. Negative Trousseau's sign
E. Seizures
6. Which of the following is the most common pathology in nephrotic syndrome in children?
A. Minimal change disease
B. Membranous nephropathy
C. IgA nephropathy
D. Poststreptococcal glomerulonephritis
E. Henoch-sch?nlein purpura
7. Which of the following statements is NOT true regarding single-dose antibiotic therapy in the setting of acute uncomplicated cystitis?
A. Results in fewer side effects
B. Most fluoroquinolone antibiotics effective
C. Trimethoprim-sulfamethoxazole effective
D. Effective for both men & women
8. A 32-year-old bank executive presents with a 24-hour history of fever, chills, perineal pain, and frequency of urine, urgency, and nocturia. He denies being at risk for sexually transmitted disease and has had no urethral discharge. On physical examination, he is noted to have an acutely inflamed prostate. The treatment of choice for his diagnosis is:
A. Amoxicillin 500 mg qid for 30 days
B. Ciprofloxacin 500 mg bid for 30 days
C. Trimethoprim-sulfamethoxazole (160/800 mg) bid for 10 days
D. Amoxicillin 500 mg qid for 10 days
E. Doxycycline 100 mg bid for 10 days
9. An adolescent female with recurrent urinary tract infections should be evaluated for:
A. Polycystic kidney disease
B. Nephrolithiasis
C. Wilms' tumor
D. Vesicoureteral reflux
E. Minimal change disease
10. What acid-base disorder is seen in chronic kidney disease?
A. Metabolic acidosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Respiratory alkalosis
E. Normal
11. A 41-year-old woman presents for evaluation of renal stones. She is found to have hypercalciuria, hypercalcemia, and hypophosphatemia. What is the most likely cause of hypercalcema in this case?
A. Renal tubular acidosis
B. Gout
C. Idiopathic hypercalciuria
D. Hyperparathyroidism
E. Sarcoidosis
12. The most common cause of chronic kidney disease is:
A. Glomerulonephritis
B. Diabetes mellitus
C. Hypertension
D. Polycystic kidney disease
E. Systemic lupus erythematosus
13. A 50-year-old male presents with abrupt onset of hypertension, headache, palpitations, sweating, weight loss, and anxiety attacks. Which of the following lab tests would be most useful in making the diagnosis?
A. Captopril-induced renal scan
B. 24-hour urine catecholamines and VMA
C. 24-hour urine protein and creatinine clearance
D. Renal vein renin levels
E. Serum creatinine
14. In which of the following cases would renal biopsy be most recommended?
A. Patient with single functioning kidney and creatinine level of 2.0 mg/dl
B. Patient with 30-year history of diabetes, retinopathy, and proteinuria
C. 6-year-old child with sudden-onset edema and 10 g/day proteinuria
D. Patient with bilaterally small kidneys, uncontrolled hypertension, and creatinine level of 5.0 mg/dl
E. Patient with recently diagnosed systemic lupus erythematosus, proteinuria, and creatinine level of 1.7 mg/dl
15. An 8-year-old child presents with onset of periorbital and leg edema following a recent viral upper respiratory tract illness. Urinalysis shows heavy proteinuria and no RBC casts. Which of the following is the most likely diagnosis?
A. Poststreptococcal glomerulonephritis
B. Henoch-sch?nlein purpura
C. Alport's syndrome
D. Minimal change disease
E. Acute leukemia
16. A 20 year old otherwise healthy woman presents with cloudy urine, burning on urination and urinary frequency. She has no allergies. Patient is febrile. She has mild suprapubic pain with palpation but no costo vertebral angle tenderness. Urinalysis is positive for nitrites and leukocyte esterase. Which of the following is the most appropriate treatment in a general practice?
A. Hospitalize the patient and administer intravenous antibiotics
B. Administer macrolide containing antibiotics on an out patient basis
C. Cotrimoxazole on out patient basis
D. Advise the patient to increase fluid intake, especially with cranberry juice.
17. A 31 year old woman presents with high fever, dysuria, flank pain, nausea, and vomiting.On examination she looks ill, (R) renal punch is positive. What is the most appropriate treatment.
A. Hospitalization with administration of intravenous fluids and antibiotics
B. Oral rehydration and oral antibiotics for 10 days
C. Surgical consultation
D. Extracorporeal shock wave lithotripsy
18. Anemia that is seen in patients with chronic renal disease is usually caused by insufficient:
A. Iron stores
B. Vitamin B12
C. Rennin production
D. Erythropoietin production
E. Folate stores
19. 43 years old patient of osteoarthritis (OA) from a remote comes to your clinic for treatment of blood pressure. She is taking NSAIDs for her OA. There is no laboratory in her village so you can not monitor renal function and electrolytes. Which of the following drugs will be safest in her case?
A. ACE inhibitors
B. Calcium channel blockers
C. Diuretics
D. ?-blockers
20. A 65 year old man presents with complaints of back pain and generalized fatigue. Laboratory findings include anemia with rouleau formation, a monoclonal spike seen with serum protein electrophoresis, and hypercalcemia. Radiographs of the unbar spine show lytic lesions. The most likely diagnosis is:
A. Metastatic prostate cance
B. Paget?s disease
C. Osteitis firbosa cystica
D. Multiple myeloma
E. None of the above
21. Which one of the following is the most common cause of pre-renal acute renal failure?
A. Shock
B. Nephrotic syndrome.
C. Nonsteroidal anti-inflammatory drugs.
D. Angiotensin-converting enzyme inhibitors.
E. Congestive heart failure
22. Which one of the following is the preferred initial test for urinary tract obstruction in general practice?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
23. Which one of the following is the preferred initial test for urinary tract stones in general practice?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
24. Which one of the following is the preferred test for urinary stones according to literature?
A. Magnetic resonance imaging (MRI)
B. Intravenous Urography (IVU).
C. Ultrasonography.
D. Plain X-ray.
E. CT scan with stone protocol
25. Which one of the following should prompt evaluation for primary renal disease in a patient with microhematuria?
A. Red cell casts.
B. One red blood cell per high-power field
C. Urinary tract infection
D. Protein excretion of greater than 150 mg per 24 hours
E. White blood cells.
26. A 26 year old woman has had 4 episodes of UTI s in last 1 year. Her investigations for risk factors for recurrent UITs are normal. Which of the following is true about antibiotics for her?
A. Postcoital ciprofloxacin is as effective as continuous daily antibiotic prophylaxis.
B. Antibiotic prophylaxis does not increase the risk of vaginal or oral candidiasis.
C. Because of antibiotic resistance antibiotic prophylaxis is not recommended in her case.
D. Only Fluoroquinolones are recommended for prophylaxis.
27. Which one of the following is the most common cause of chronic kidney disease?
A. Hypertension.
B. Diabetes mellitus.
C. Dyslipidemia.
D. Renal osteodystrophy.
28. Which one of the following causes of edema is most likely to respond to diuretic therapy?
A. Venous insufficiency.
B. Lymphedema.
C. Nephrotic syndrome.
D. Calcium channel blocker-induced edema.
29. A 50 year diabetic patient is on the following medication: Metformin 1g TDS, Gliclazide 80 mg bd, Ramipril 5 mg daily, atenolol 50 mg daily. Her blood results show creatinine 1.9 mg/dl. Which of the following medications should be withdrawn?
A. Gliclazide
B. Metformin
C. Atenolol
D. Ramipril
E. None of the above
30. An 20 year old lady has gross hematuria. She recently had a sore throat. Following this she is found to have persistent microscopic hematuria, Blood pressure is 125/65 and creatinine is 2.3 mg/dl. A renal biopsy shows mesangial deposition of IgA on immunofluorescence with normal tubules and interstitium. Which of the following statements is true about this patient?
A. Complement levels will be low
B. The prognosis is good
C. Family screening should be done
D. An angiotensin-converting enzyme (ACE) inhibitor should be started
E. There is approximately a 50% chance of end stage renal failure
31. A 25 year old woman has recurrent UTIs during childhood. She is now 28 weeks pregnant and has another episode of pyelonephritis. Her renal function is normal. What is the likely predisposing problem?
A. Toxic shock syndrome
B. Renal calculi
C. Reflux nephropathy
D. Pre eclampsia
E. Polycystic kidney
32. A 25 year old woman presents with haematuria and abdominal pains. She has an ultrasound scan which confirms polycystic kidney disease. Which of the following is LEAST likely to occur?
A. Her child may suffer from this disease
B. May suffer from intracranial hemorrhage
C. May have persistant Haematuria
D. May develop renal carcinoma
E. May have Recurrent UTI.
33. 45 year old woman presents with acute pain that radiates from his left loin to his left groin. The pain comes for a few seconds, and then goes. It is sharp in nature. A plain abdominal X Ray is normal while ultrasound shows dilation of pelviccalyceal symptom and presence of stones. Which type of stone is most likely?
A. Calcium stone
B. Cystine renal stones
C. Uric acid renal stones
D. Staghorn stone
34. A 28 years old man rushes into your clinic with 1 hour history of severe right lumber pain. On examination he is moaning with pain. Which analgesic will you give as first line in general practice?
A. Pentazocin
B. Hyosine
C. Diclofenac
D. Nalbufen
E. Tramadol
35. Case same as above. The pain is not improved with the previous analgesic. Which analgesic will you give as second line?
A. Pentazocin
B. Hyosine
C. Nalbufen
D. Any of the above
E. None of the above
36. A 20-year-old man presented to a clinic with a two-day history of pain in his knees and shoulders, low-grade fever and diffuse tenderness in several muscle groups, Skin examination revealed a palpable purpuric rash on both ankles that tapered up to the knees. Investigations showed renal impairment and also hematuria. Which one of the following is the most likely diagnosis?
A. Poststreptococcal Glomerulonephritis
B. Nephrotic syndrome
C. Rhabdomyolysis
D. Diabetic glomerulosclerosis
E. Henoch Schonlein purpura
37. A hemodialysis patient has gout. Which of the following treatments is the least effective?
A. Probenecid
B. Prednisolone
C. Increased dialysis
D. Allopurinol
E. Colchicine
38. A lady with polycystic kidney disease has several family members who are concerned about having the condition themselves. Which one of the following is the appropriate screening test for adult polycystic kidney disease in general practice?
A. Intravenous urogram
B. Renal ultrasound
C. Genetic testing
D. Isotope renography
E. Urine dipstick
39. Which one of the following protein concentrations corresponds to a result of 1+ on a urine dipstick test?
A. 30 mg per dL.
B. 100 mg per dL.
C. 300 mg per dL.
D. 1,000 mg per dL.
40. Which one of the following statements about treating patients with diabetic kidney disease is correct?
A. Angiotensin-converting enzyme (ACE) inhibitors should be used in low doses.
B. ACE inhibitors should be used at a maximally tolerated dose.
C. ACE inhibitors and ARBs should be initiated together.
D. ARBs should be preferred over ACEIs because they do not cause cough.
41. Which one of the following statements about angiotensin-converting enzyme inhibitors in patients with chronic kidney disease is correct?
A. They should never be used in patients with chronic kidney disease.
B. They should be discontinued immediately with any rise in serum creatinine levels.
C. They should be discontinued immediately once the serum potassium level reaches 5 Meq/dl.
D. They should be discontinued if the serum creatinine level rises more than 30 percent from baseline level
42. Among patients with chronic kidney disease, Metformin generally is recommended for which one of the following groups?
A. Patients with chronic heart failure.
B. Men with a serum creatinine level of 1.5 mg per dL or lower.
C. Patients older than 80 years.
D. Patients with severe infection.
43. A 30-year-old woman with a history of Crohn's disease presents with diarrhea and skin lesions. Which one of the following symptoms best supports a diagnosis of erythema nodosum?
A. Ulcerating lesions on the shin.
B. Painless red nodules.
C. Asymmetric lesions on flexor surface of arms.
D. Healing lesions in some areas with bruise-like appearance.
MCQ # Answer MCQ # Answer
1 E 26 A
2 A 27 B
3 A 28 C
4 B 29 B
5 D 30 B
6 A 31 C
7 D 32 D
8 B 33 C
9 D 34 C
10 A 35 D
11 D 36 E
12 B 37 A
13 B 38 B
14 E 39 A
15 D 40 B
16 C 41 D
17 A 42 B
18 D 43 D
19 B
20 D
21 A
22 C
23 D
24 E
25 A
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