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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 60-year-old diabetic patient has proteinuria of 3.5 g/day, hypoalbuminemia, and peripheral edema. Serum creatinine is normal. What is the diagnosis?

    Answer: Nephrotic syndrome

    Nephrotic syndrome is defined by proteinuria >3.5 g/day, hypoalbuminemia, edema, and hyperlipidemia, often with lipiduria.

  2. A patient presents with oliguria after surgery. BUN is 42 mg/dL, creatinine is 1.4 mg/dL (BUN:Cr ratio = 30). Urine sodium is 8 mEq/L and FENa is 0.5%. What is the most likely diagnosis?

    Answer: Prerenal azotemia

    Prerenal azotemia is characterized by elevated BUN:Cr ratio (>20), low urine sodium (<20 mEq/L), and FENa <1%, reflecting intact tubular function with avid sodium reabsorption.

  3. A patient with CKD stage 4 has a serum potassium of 6.2 mEq/L with peaked T waves on ECG. What is the immediate treatment?

    Answer: IV calcium gluconate

    IV calcium gluconate stabilizes the cardiac membrane immediately in hyperkalemia with ECG changes, though it does not lower potassium levels.

  4. Which acid-base disorder is most commonly associated with diarrhea?

    Answer: Non-anion gap metabolic acidosis

    Diarrhea causes loss of bicarbonate-rich intestinal secretions, resulting in non-anion gap (hyperchloremic) metabolic acidosis.

  5. A 35-year-old woman with SLE develops nephrotic-range proteinuria and hematuria. Renal biopsy shows wire-loop lesions on light microscopy. What is the most likely diagnosis?

    Answer: Lupus nephritis class IV (diffuse proliferative)

    Wire-loop lesions on renal biopsy represent subendothelial immune complex deposits and are pathognomonic of diffuse proliferative (class IV) lupus nephritis.

  6. Which medication should be avoided or dose-adjusted in a patient with GFR of 20 mL/min/1.73m²?

    Answer: Metformin

    Metformin is contraindicated when GFR <30 mL/min due to the risk of lactic acidosis from drug accumulation in the setting of reduced renal clearance.