I n t e r n a L medicine questions Bank

30 year old male has IDDM for the past 15 years , now presenting with lower limb edema . Cr 2.0 mg/dl , urea 70 mg/dl . 24 hour urine collection 4.0 gm/24 hrs

All the following have a role in the progression of his renal disease except :

1. 
   Degree of Mesangial expansion on kidney biopsy
   
2. 
   Decrease in intraglomerular pressure
   
3. 
   Duration since onset of DM
   
4. 
   Amount of proteinurea
   
5. 
   Quitting smoking
   

2. 
   All the following are true about Focal Segmental Sclerosis ( FSGS) except :
   

1. 
   Familial type has better prognosis
   
2. 
   Progresses fast in Renal failure
   
3. 
   Collapsing type is associated with HIV
   
4. 
   Recurrence after transplant is high
   
5. 
   Main presentation is Nephrotic syndrome
   

3. 
   25 year old female presented to OPD with Bp 160/100 , she stated that her Bp was the same over the past 2 weeks .
   

All the following are first line investigations for this patient except :

1. 
   Urine analysis
   
2. 
   Serum K, Urea ,Cr
   
3. 
   Lipid profile
   
4. 
   Fasting blood sugar
   
5. 
   MRA for renal arteries
   

4. 
   35 year old female previously healthy presented to ER c/o generalised weakness , Bp 110/80 . Irregular irregular pulse
   

Labs : K 2.5 meq / L , Cl 100 meq /L , Na 135 meq /L ABG : PH 7.48 , HCO3 30 meq/L , PCO2 40 mm Hg
All the following can be in the differential diagnosis of this case except :

1. 
   Bulimia
   
2. 
   Barter syndrome
   
3. 
   Hypercalcemia
   
4.