Tuesday, February 12, 2013

Answer and Explanation 15

15.  D is the correct answer.  It is often associated with NSAIDS or Hodgkins Lymphoma in adults.  It is one the most common nephrotic syndromes in children.  It is often known as nil lesion or lipoid nephrosis.  Key things to remember with the labs are usually normal renal function, bland urinary sediment, and normal complement levels.




Question 15

15.  Which of the following is not a characteristic of Minimal Change Nephrotic Syndrome (MCNS)?

A.  It represents 85-90% of all nephrotic syndromes in children

B.  Laboratory values usually show normal renal function, proteinuria, bland urine sediment,  and normal complement levels

C.  Histologically there is a nil lesion

D.  In adults there is rarely an association with NSAIDS or Hodgkins Lymphoma


Answer and Explanation 14

14.  D is the correct answer.  The CT scan clearly demonstrates multiple cysts in both kidneys.  There is no evidence of calcification or stones.  Renal carcinoma is unilateral.  Polycystic Kidney Disease usually presents during child bearing years.  Hematuria, flank pain, and hypertension are common manifestations.  It is an autosomal dominant trait.


Question 14

14.  Your patient is a 29 year old male that presents with flank pain, hematuria, and a blood pressure of 170/92.  His CT scan is below.  Which of the following is the diagnosis?


A.  Kidney Stones

B.  Renal Carcinoma

C. Good Pasture Syndrome

D.  Polycystic Kidney Disease

Answer and Explanation 13

13.  B is the correct answer.  Electrophoresis for Bence Jones Proteins is the confirmatory test.  Anti GBM antibodies is seen in patients with Rapidly Progressive Glomerulonephritis.  Renal ultrasound and renal biopsy are not usually helpful in confirming multiple myeloma.



Question 13

13.  Your patient is a 54 year old male that presents with hypercalcemia, proteinuria, and lytic lesions seen on his lumbar spine x rays. You suspect he may have Multiple Myeloma.  Which of the following is the confirmatory test for this disorder?

A.  Anti GBM antibodies

B.  Electrophoresis for Bence Jones Proteins

C.  Renal Biopsy

D.  Renal Ultrasound


Answer and Explanation 12

12.  B is the correct answer.  Good Pasteur Syndrome is 6 times more common in men than women.  It is not unusual to have pulmonary hemorrhage. Anti-GBM antibodies are present in the serum.  Treatment does involve high dose steroids, cyclophosphamide, and plasma exchange.  It is a type of rapidly progressive glomerulonephritis.



Question 12

12.  Which of the following is not true regarding Good Pasteur's Syndrome?

A.  About two thirds of Good Pasteur's Syndrome is associated with pulmonary hemorrhage.

B.  It effects women more commonly then men

C.  It is a type of Rapidly Progressive Glomerulonephritis

D.  Treatment involves high dose prednisone, Cyclophosphamide, and plasma exchange


Answer and Explanation 11

11.  The correct answer is D.  The Ureter Vesicular Junction on average is about 3 mm and can dilate to about 5 mm. In general about 90% of kidney stones pass within 2 weeks if they are less than 5 mm.  Agents such as Flomax help relax the ureter and make it more likely for the kidney stone to pass.




Question 11

11.  Which of the following is the most narrowest part of the genitourinary system that a kidney stone must pass through?

A.  Urethra

B.  Renal Pelvis

C.  Ureter Pelvic Junction

D.  Ureter Vesicular Junction