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Nephrology Flashcards

6 cards from real ABIM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A 28-year-old man presents with episodic gross hematuria following upper respiratory infections. Renal biopsy shows mesangial IgA deposits. What is the diagnosis?

    Answer: IgA nephropathy (Berger disease)

    IgA nephropathy (Berger disease) presents with episodic gross hematuria coinciding with mucosal infections and is defined by mesangial IgA deposits on immunofluorescence.

  2. A patient on hemodialysis has persistent hypertension despite ultrafiltration. The most common cause is:

    Answer: Volume overload between sessions

    Volume overload from interdialytic fluid and salt intake is the most common cause of hypertension in dialysis patients.

  3. Which medication is the first-line treatment for hypertension in a patient with CKD and proteinuria >300 mg/day?

    Answer: ACE inhibitor or ARB

    ACE inhibitors and ARBs reduce intraglomerular pressure and proteinuria through efferent arteriolar dilation, slowing CKD progression and are first-line in proteinuric CKD.

  4. A patient with CKD stage 3b has a hemoglobin of 9.5 g/dL with low reticulocyte count and low iron stores. What is the correct sequence of treatment?

    Answer: Replete iron first, then reassess for ESA therapy

    Iron deficiency must be corrected before initiating ESA therapy in CKD-related anemia, as functional iron deficiency blunts ESA response.

  5. A patient presents with fever, flank pain, and dysuria. Blood cultures grow E. coli. CT scan shows a gas-forming infection within the renal parenchyma. What is the diagnosis?

    Answer: Emphysematous pyelonephritis

    Emphysematous pyelonephritis is a life-threatening necrotizing infection of the renal parenchyma with gas formation, occurring predominantly in diabetic patients.

  6. A 55-year-old man with gout and recurrent uric acid kidney stones has a 24-hour urine uric acid of 900 mg. What is the most appropriate preventive treatment?

    Answer: Allopurinol

    Allopurinol (xanthine oxidase inhibitor) reduces uric acid production and is the treatment of choice for uric acid nephrolithiasis with hyperuricosuria or hyperuricemia.