I n t e r n a L medicine questions Bank

Part7

1 ) 35 year old man presented to ER after an episode of Grand mal seizure and by exam he was afebrile , Bp 130/95 and confused .
Labs showed : Cr 1.0 mg/dl , BUN 12mg/dl , Na 140 meq/L , K 4.8 meq /L , Cl 100 meq/L , HCO3 12 meq/L . ABG : PH 7.25 , PCO2 28 mmHg , HCO3 12 meq/L .
Which of the following is the most appropriate initial treatment for the Metabolic Acidosis : Observation and repeat ABG in 2 hours
NaHCO3 2 ampoules ( 100 meq ) by Iv push

1. 
   L of 5 % dextrose in H2O & HCO3 3 ampoules ( 150 meq ) infused over 3 hours
   

Hemodialysis Fomepizole

2. 
   ) All the following affect short term survival in kidney transplant except :
   

Delayed Allograft function HLA antibodies
Acute rejection
Type of Donor kidney Donor illness

3. 
   ) 25 year old man was found to have microscopic hematuria by chance . Urine analysis showed many RBC
   

/HPF, no RBC casts , no Dysmorphic RBC
IVP showed Medullary Spomge Kidney , but no stones
The most appropriate counseling for this patient includes which of the following :
Advice him that this disorder is likely to progress to CRF over 10-20 years
Advice him that this is a benign finding , there may be a risk for nephrolithiasis but it never progresses to Renal failure
Advice him to have his children undergo genetic testing and get treatment early Advice him that ACE inhibitor can modify course of disease
Advice him that he should be on daily Trimethoprim –Sulfa forever

4. 
   ) All the following are mechanism – drug induced Hyperkalemia except :
   

Trimethoprim inhibits Na channels Cyclosporin and Cl shunting
Heparin decreases Aldosterone level
Digoxin inhibits K-ATP ase
NSAID blocks PG stimulated Renin secretion

5.