FREE Internal Medicine Nephrology and Kidney Injury Questions and Answers

Question 1

A 72-year-old male with CKD stage 4, diabetes, and hypertension is brought to the emergency department with generalized weakness.
His medications include lisinopril and spironolactone.
An ECG shows peaked T-waves and a widened QRS complex.
His serum potassium is 7.2 mEq/L.
What is the most appropriate initial step in management?

Accepted Answer

Administer intravenous calcium gluconate

Answer

Administer intravenous insulin and glucose

Answer

Initiate emergent hemodialysis

Answer

Administer an oral potassium-binding resin

Question 2

A 65-year-old female with a history of hypertension presents with new-onset peripheral edema, fatigue, and 8 grams of proteinuria on a 24-hour urine collection. Her serum creatinine is 1.4 mg/dL and albumin is 2.5 g/dL. A renal biopsy is performed. Which of the following is the most common cause of primary nephrotic syndrome in non-diabetic White adults?

Accepted Answer

Membranous Nephropathy

Answer

Focal Segmental Glomerulosclerosis (FSGS)

Answer

Minimal Change Disease

Answer

IgA Nephropathy

Question 3

A 58-year-old male with a 15-year history of poorly controlled type 2 diabetes and CKD stage 3 is noted to have a persistent, non-anion gap metabolic acidosis and a serum potassium of 5.8 mEq/L despite dietary counseling. His urine pH is 5.0. Which of the following is the most likely diagnosis?

Accepted Answer

Type 4 (Hyperkalemic) Renal Tubular Acidosis

Answer

Type 1 (Distal) Renal Tubular Acidosis

Answer

Type 2 (Proximal) Renal Tubular Acidosis

Answer

Diabetic Ketoacidosis

Question 4

A 45-year-old man is hospitalized for community-acquired pneumonia and treated with intravenous piperacillin-tazobactam. Ten days later, his serum creatinine rises from a baseline of 1.0 mg/dL to 3.5 mg/dL. Urinalysis reveals white blood cells, red blood cells, and white blood cell casts. A peripheral blood smear shows eosinophilia. Which of the following is the most likely cause of his acute kidney injury?

Accepted Answer

Acute Interstitial Nephritis (AIN)

Answer

Acute Tubular Necrosis (ATN)

Answer

Prerenal Azotemia

Answer

Postrenal Obstruction

Question 5

Which of the following findings is an absolute indication for initiating urgent hemodialysis in a patient with acute kidney injury?

Accepted Answer

Uremic pericarditis with a friction rub

Answer

Serum creatinine of 8.0 mg/dL

Answer

Blood Urea Nitrogen (BUN) of 120 mg/dL

Answer

Urine output of 300 mL in 24 hours

Question 6

A 28-year-old male presents with an episode of gross hematuria that occurred two days after the onset of an upper respiratory tract infection. He has had similar episodes in the past. His blood pressure is 135/85 mmHg, and serum creatinine is 1.1 mg/dL. Urinalysis confirms hematuria and shows 1+ proteinuria. Which of the following is the most likely diagnosis?

Accepted Answer

IgA Nephropathy (Berger's Disease)

Answer

Post-streptococcal glomerulonephritis

Answer

Henoch-Schönlein Purpura (HSP)

Answer

Minimal Change Disease